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Background: Consumption of sugary drinks (SD) among children and adolescents is a prevalent public health issue both within Canada and worldwide. This problem is exacerbated by the powerful marketing of such beverages to youth, which is known to influence a wide range of dietary behaviours. Methods: A cross-sectional, secondary analysis of the International Food Policy Survey Youth Wave 2019 was conducted to assess the relationship between self-reported exposure to SD marketing within the past 30 days or SD brand advertisements and brand preference and brand recall among youth aged 10–17 from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Ordinal, multinomial, and binary logistic regression were used as appropriate to examine these associations. Results: Youth brand preference and recall was positively associated with self-reported exposure to general and brand-specific SD marketing across all countries. No statistical interaction was observed between youth age and SD marketing overall or within countries. Soft drinks, sports drinks, and fruit juice brands were most commonly recalled by all youth. Conclusion: Similar results were observed among children and adolescents within all countries. Global marketing policies should consider older children and adolescents to adequately protect and support child health. [ABSTRACT FROM AUTHOR]

Introduction: Food marketing restrictions often apply nutrient profile models (NPM) to distinguish unhealthy products that should not be advertised, however brand-only marketing remains largely unaddressed. We sought to test a threshold method for classifying packaged food, beverage, or fast-food brands as (non)permitted for marketing, based on the nutrient profile of their product-lines. Methods: We retrieved nutrient information from the Nutritrack databases for all products sold by the top 51 packaged food, beverage and fast-food brands in New Zealand, selected by market share. All products under each brand were classified as permitted (or not) to be marketed to children, using the NPM for WHO Western Pacific. The 25%, 50%, 75% and 90% threshold of brands' products permitted to market were compared. The 50% and 75% thresholds were compared to the WHO CLICK method, which is based on assessment of the brand's leading product. Results: The 90% threshold permitted 13% of the brands to be marketed to children. The 25% threshold permitted the marketing of 62% of brands. The 50% and 75% thresholds remained highly sensitive in identifying brands that should not be marketed to children. Comparison to the WHO CLICK method identified that a threshold method is more comprehensive and less arbitrary. Conclusions: A threshold model based on product-line nutrient profiling provides a robust and option for brand classification. The 50% and 75% thresholds may be the most politically preferred options for use in regulation, while remaining highly effective. Practitioner points: Brand marketing (e.g. sponsorship) remains largely unaddressed in existing restrictions on unhealthy food and beverage marketing to children. An established Nutrient Profile Model can be applied to a brand's entire product line, allowing calculation of the proportion of products that would not be permitted to be advertised to children. Restricting brand marketing for food and beverage brands with less than 50% or 75% of their products classified as 'permitted to be marketed to children' is a robust and evidence-based method that can be applied in regulation, with potential to mitigate industry challenges. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to marketing for foods high in sugar, salt, and fat is considered a key risk factor for childhood obesity. To support efforts to limit such marketing, the World Health Organization Regional Office for Europe has developed a nutrient profile model (WHO NPM). Germany's Federal Ministry of Food and Agriculture plans to use this model in proposed new food marketing legislation, but it has not yet been tested in Germany. The present study therefore assesses the feasibility and implications of implementing the WHO NPM in Germany. Methods: We applied the WHO NPM to a random sample of 660 food and beverage products across 22 product categories on the German market drawn from Open Food Facts, a publicly available product database. We calculated the share of products permitted for marketing to children based on the WHO NPM, both under current market conditions and for several hypothetical reformulation scenarios. We also assessed effects of adaptations to and practical challenges in applying the WHO NPM. Results: The median share of products permitted for marketing to children across the model's 22 product categories was 20% (interquartile range (IQR) 3–59%) and increased to 38% (IQR 11–73%) with model adaptations for fruit juice and milk proposed by the German government. With targeted reformulation (assuming a 30% reduction in fat, sugar, sodium, and/or energy), the share of products permitted for marketing to children increased substantially (defined as a relative increase by at least 50%) in several product categories (including bread, processed meat, yogurt and cream, ready-made and convenience foods, and savoury plant-based foods) but changed less in the remaining categories. Practical challenges included the ascertainment of the trans-fatty acid content of products, among others. Conclusion: The application of the WHO NPM in Germany was found to be feasible. Its use in the proposed legislation on food marketing in Germany seems likely to serve its intended public health objective of limiting marketing in a targeted manner specifically for less healthy products. It seems plausible that it may incentivise reformulation in some product categories. Practical challenges could be addressed with appropriate adaptations and procedural provisions. [ABSTRACT FROM AUTHOR]

Summary: Food marketing impacts the food behaviors of children and adults, but the underpinning neural mechanisms are poorly understood. This systematic review and meta‐analysis pooled evidence from neuroimaging studies of exposure to food marketing stimuli (vs. control) on brain activations in children and adults to clarify regions associated with responding. Databases were searched for articles published to March 2022. Inclusion criteria included human functional magnetic resonance imaging (fMRI) studies employing a contrast between a food marketing stimulus and a non‐food/non‐exposure control, published in English in a peer‐reviewed journal, reporting whole brain (not Region of Interest [ROI] only) co‐ordinates. Eleven studies met inclusion criteria, of which eight were included in the quantitative synthesis (Activation Likelihood Estimation [ALE] meta‐analysis). Food marketing exposures (vs. controls) produced greater activation in two clusters lying across the middle occipital gyrus, lingual gyrus, and cuneus (cluster 1), and the postcentral gyrus, precentral gyrus, and the inferior parietal lobule/supramarginal gyrus (cluster 2). Brain responses to food marketing are most consistently observed in areas relating to visual processing, attention, sensorimotor activity, and emotional processing. Subgroup analyses (e.g., adults vs. children) were not possible because of the paucity of data, and sensitivity analyses highlighted some instability in the clusters; therefore, conclusions remain tentative pending further research. [ABSTRACT FROM AUTHOR]

Summary: Videogame livestreaming platforms are an emerging form of digital media, popular with young people, where users watch gaming influencers play videogames. Food and non‐alcoholic beverage (hereafter: food) brands have a substantial presence on these platforms, yet no studies have examined the impact of this food marketing on young people. This systematic review and meta‐analysis examined the evidence (quantitative or mixed‐method) for a relationship between exposure to digital game‐based or influencer food marketing, and food‐related (brand awareness, attitudes, preferences, purchase, and consumption), and post‐consumption (weight, body mass index [BMI], and dental caries) outcomes in young people (≤18 years). Twenty‐three databases were searched in March 2021. Twenty‐two studies met the inclusion criteria, of which 20 were included in the quantitative synthesis. Meta‐analyses indicated food marketing was associated with more positive attitudes and greater preferences (OR = 1.74, p < 0.001 [95%CI: 1.355, 2.232]), and increased consumption (SMD = 0.37, p < 0.001 [95%CI: 0.219, 0.529]). Narrative synthesis indicated that food marketing may increase brand awareness but not pester intent, although data were limited. Evidence suggests that there is a relationship between exposure to food marketing via influencers and digital gaming media, and several food‐related outcomes. This is the first quantitative synthesis to demonstrate these relationships; this work has implications for food marketing policy. [ABSTRACT FROM AUTHOR]

Access to informal fresh food markets plays a vital role in household food security and dietary quality in transitioning rural economies. However, it is not well understood if market access also improves child nutrition and if the improvement applies to all socioeconomic groups. In this secondary research study, we combined a national listing of food markets (n = 503) with a national household survey to examine the associations of market access with diet and height across wealth groups in children aged 6 to 23 months in rural Cambodia. All children under two years of age with dietary data (n = 1537) or anthropometry data (n = 989) were selected from the household survey. Food markets were geocoded using Google Maps or villages' geographical coordinates publicly available in the Open Development Mekong data platform. Regression calibration was then used to estimate household distance to the nearest market. Descriptive results indicated a highly uneven distribution of food markets with median household distance to the nearest markets ranging between 4 km (IQR: 3–8 km) in the lowland areas and 9 km (IQR: 4–17 km) in the highland areas. Results from the multivariate linear regressions showed that distance to the nearest market was modestly associated with child dietary diversity score (β: -0.17; 95% CI: -0.29, -0.05) but it was not related to child height-for-age z-score, and that household wealth did not modify the associations between distance to markets and child dietary diversity score. These findings suggest that improving access to food markets alone might not lead to meaningful improvement in child diet. Detailed surveys on household food acquisition are needed to clarify the role of food markets relative to other food sources such as subsistence fisheries, subsistence gardening and mobile food traders. [ABSTRACT FROM AUTHOR]

Introduction: United Nations (UN) agencies are influential global health actors that can introduce legal instruments to call on Member States to act on pressing issues. This paper examines the deployment and strength of global health law instruments used by UN actors to call on Member States to restrict the exposure of children to unhealthy food and beverage marketing. Methods: Global health law instruments were identified from a review of four UN agencies that have a mandate over children's exposure to marketing of unhealthy food and beverage products namely: the World Health Organization (WHO); the Food and Agriculture Organization (FAO); the United Nations General Assembly (UNGA) and the UN Office of the High Commissioner for Human Rights (OHCHR). Data on marketing restrictions were extracted and coded and descriptive qualitative content analysis was used to assess the strength of the instruments. Results: A wide range of instruments have been used by the four agencies: seven by the WHO; two by the FAO; three by the UNGA; and eight by the UN human rights infrastructure. The UN human rights instruments used strong, consistent language and called for government regulations to be enacted in a directive manner. In contrast, the language calling for action by the WHO, FAO and UNGA was weaker, inconsistent, did not get stronger over time and varied according to the type of instrument used. Conclusion: This study suggests that a child rights-based approach to restricting unhealthy food and beverage marketing to children would be supported by strong human rights legal instruments and would allow for more directive recommendations to Member States than is currently provided by WHO, FAO and UNGA. Strengthening the directives in the instruments to clarify Member States' obligations using both WHO and child rights mandates would increase the utility of global health law and UN actors' influence. [ABSTRACT FROM AUTHOR]

Objective: Children are frequently exposed to unhealthy food marketing on digital media. This marketing contains features that often appeal to children, such as cartoons or bold colours. Additional factors can also shape whether marketing appeals to children. In this study, in order to assess the most important predictors of child appeal in digital food marketing, we used machine learning to examine how marketing techniques and children's socio-demographic characteristics, weight, height, BMI, frequency of screen use and dietary intake influence whether marketing instances appeal to children. Design: We conducted a pilot study with thirty-nine children. Children were divided into thirteen groups, in which they evaluated whether food marketing instances appealed to them. Children's agreement was measured using Fleiss' kappa and the S score. Text, labels, objects and logos extracted from the ads were combined with children's variables to build four machine-learning models to identify the most important predictors of child appeal. Setting: Households in Calgary, Alberta, Canada. Participants: 39 children aged 6–12 years. Results: Agreement between children was low. The models indicated that the most important predictors of child appeal were the text and logos embedded in the food marketing instances. Other important predictors included children's consumption of vegetables and soda, sex and weekly hours of television. Conclusions: Text and logos embedded in the food marketing instances were the most important predictors of child appeal. The low agreement among children shows that the extent to which different marketing strategies appeal to children varies. [ABSTRACT FROM AUTHOR]

Food and beverage marketing influences children’s food preferences and dietary intake. Children’s diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent’s self-reported exposure to unhealthy food marketing and a range of outcomes related to children’s desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children’s requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children’s consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children’s weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children’s exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods [ABSTRACT FROM AUTHOR]

Background: Children's exposure to unhealthy food and beverage marketing has a direct impact on their dietary preference for, and consumption of, unhealthy food and drinks. Most children spend time online, yet marketing restrictions for this medium have had slow uptake globally. A voluntary Children's and Young People's Advertising (CYPA) Code was implemented in Aotearoa, New Zealand (NZ) in 2017. This study explores the Code's limitations in protecting children from harmful food and beverage marketing practices on digital platforms accessible to children. Methods: A cross-sectional content analysis of company websites (n = 64), Facebook pages (n = 32), and YouTube channels (n = 15) of the most popular food and beverage brands was conducted between 2019 and 2021 in NZ. Brands were selected based on market share, web traffic analysis and consumer engagement (Facebook page 'Likes' and YouTube page views). Analysis focused on volume and type of food posts/videos, level of consumer interaction, nutritional quality of foods pictured (based on two different nutrient profile models), and use of specific persuasive marketing techniques. Results: Eighty-one percent of websites (n = 52) featured marketing of unhealthy food and beverages. Thirty-five percent of websites featuring unhealthy food and beverages used promotional strategies positioning their products as 'for kids'; a further 13% used 'family-oriented' messaging. Several websites featuring unhealthy products also had designated sections for children, 'advergaming,' or direct messaging to children. Eighty-five percent of all food and drink company Facebook posts and YouTube videos were classified as unhealthy. Twenty-eight percent of Facebook posts for unhealthy products featured persuasive promotional strategies, and 39% premium offers. Nearly 30% of YouTube videos for unhealthy food and beverages featured promotional strategies, and 13% premium offers. Ten percent of Facebook posts and 13% of YouTube videos of unhealthy food and beverages used marketing techniques specifically targeting children and young people. Conclusions: The voluntary CYPA Code has been in effect since 2017, but the inherent limitations and loopholes in the Code mean companies continue to market unhealthy food and beverages in ways that appeal to children even if they have committed to the Code. Comprehensive and mandatory regulation would help protect children from exposure to harmful marketing. [ABSTRACT FROM AUTHOR]

Summary: This systematic review examined the effectiveness of policies restricting the marketing of foods and/or non‐alcoholic beverages to children to inform updated World Health Organization (WHO) guidelines. Databases were searched to March 2020. Inclusion criteria were primary studies of any design assessing implemented policies to restrict food marketing to children (0–19 years). Critical outcomes were exposure to and power of marketing, dietary intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, diet‐related noncommunicable diseases, product change, and unintended consequences. Forty‐four observational studies met inclusion criteria; most were moderate quality. Pooling was conducted using vote counting by direction of effect, and GRADE was used to judge evidence certainty. Evidence suggests food marketing policies may result in reduced purchases of unhealthy foods and in unintended consequences favorable for public health. Desirable or potentially desirable (for public health) effects of policies on food marketing exposure and power were also found. Evidence on diet and product change was very limited. The certainty of evidence was very low for four outcomes (exposure, power, dietary intake, and product change) and low for two (purchasing and unintended consequences). Policies can effectively limit food marketing to children; policymakers should prioritize mandatory approaches aligned with WHO recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Unhealthy food and beverage marketing in various media and settings contributes to children's poor dietary intake. In 2019, the Canadian federal government recommended the introduction of new restrictions on food marketing to children. This scoping review aimed to provide an up-to-date assessment of the frequency of food marketing to children and youth in Canada as well as children's exposure to this marketing in various media and settings in order to determine where gaps exist in the research. Methods: For this scoping review, detailed search strategies were used to identify relevant peer-reviewed and grey literature published between October 2016 and November 2021. Two reviewers screened all results. Results: A total of 32 relevant and unique articles were identified; 28 were peer reviewed and 4 were from the grey literature. The majority of the studies (n = 26) examined the frequency of food marketing while 6 examined actual exposure to food marketing. Most research focussed on children from Ontario and Quebec and television and digital media. There was little research exploring food marketing to children by age, geographical location, sex/gender, race/ethnicity and/or socioeconomic status. Conclusion: Our synthesis suggests that unhealthy food marketing to children and adolescents is extensive and that current self-regulatory policies are insufficient at reducing the presence of such marketing. Research assessing the frequency of food marketing and preschooler, child and adolescent exposure to this marketing is needed across a variety of media and settings to inform future government policies. [ABSTRACT FROM AUTHOR]

Background: Governance processes play an important role in shaping the formulation and implementation of policy measures such as restrictions on marketing of ultra-processed foods. However, there is limited analysis of the factors that affect governance for nutrition, especially in low- and middle-income countries such as Thailand and the Southeast Asia region. This study aimed to examine governance factors that create opportunities and challenges for the introduction of policy to restrict food marketing in Thailand, in line with the WHO recommendations to restrict food marketing to children.Methods: A qualitative study design was used. Interviews were conducted with 20 actors with experience and in depth knowledge of food marketing in Thailand, including government, civil society, industry and international organisations. Open questions were asked about experiences and perceptions of the governance processes related to policies for restricting food marketing in Thailand. Themes were derived from the 3-i Framework which relates to interests, ideas and institutions influencing the introduction of food marketing policy were identified and analysed using abductive methods.Results: Actors viewed institutional challenges as a significant barrier to advancing effective regulation of food marketing. Three major clusters emerged from the data: interests (priorities, relationships), institutions (formal structures, informal structures, broader institutional strategies), and ideas (norms). The study has three major findings in relation to these factors, highlighting the influence of formal structures, institutional interests in food marketing issues, and ideas in promoting multisectoralism. The siloed nature of policymaking was reflected in the government failing to stimulate engagement among key actors, posing challenges for implementation of effective policy change. Contested interests led to disagreements between actors over food marketing agenda and thus competing policy priorities. Consistent with these findings, the lack of effective mechanisms to promote multisectoral coordination across diverse actors reinforced barriers to policy change.Conclusion: The findings highlight ongoing challenges to the government's aim to strengthen policy to restrict food marketing which, without greater coordination in governance mechanisms, will hinder effective regulation and the achievement of public health goals. This analysis suggests that the Government should prioritise the development of a holistic, multisectoral approach to improve governance for better nutrition outcomes by overcoming policy silos. [ABSTRACT FROM AUTHOR]

During the last two decades, childhood obesity has become a global pandemic, creating harmful impacts on children, tutors, and society. If the obesity/overweight trend continues upwards, especially in developing countries, it may significantly alter millions of children's professional, social, and psychological well-being. Furthermore, it is conceivable that when obesity/overweight issues appear at a young age, they may persist during adulthood and disrupt individual development and community well-being. By targeting children at a very young age and with a broad array of strategies, junk food marketers have often been accused of inducing children to (over)consume junk food from an early age and throughout adolescence until adulthood. This paper reviews the literature about childhood obesity/overweight and junk food marketing strategies to develop a conceptual framework delineating the forces and counter-forces to the childhood obesity phenomenon and identify avenues for future research and managers. [ABSTRACT FROM AUTHOR]

Summary: Unhealthy marketing has been unequivocally linked to children's food preferences, requests, purchases and eating behaviors and hence to childhood obesity. Regulating children's exposure to such marketing has been identified as a key challenge to which States must rise. Regulation mandates the need for monitoring and hence for credible data that are comparable between countries, regions and across time. However, there are major challenges presented by the complexity of the digital marketing ecosystem including the personalized targeting with persuasive, exploitative advertising to which children are subject. This narrative review identifies challenges faced by researchers in the digital ecosystem; reviews recent papers attempting to address these and specifies benefits and limitations; and introduces a set of WHO protocols with templates and guidance for studies of food marketing to children. [ABSTRACT FROM AUTHOR]

Objective: To describe US adults' levels of support, neutrality and opposition to restricting junk food advertising to children on social media and explore associations with socio-demographic and health-related characteristics. Design: In 2020–2021, we used cross-sectional data from the National Cancer Institute's 2020 Health Information National Trends Survey to estimate the prevalence of opinions towards advertising restrictions and correlates of neutrality and opposition using weighted multivariable logistic regression. Setting: United States. Participants: Adults aged 18+ years. Results: Among the analytic sample (n 2852), 54 % of adults were neutral or opposed to junk food advertising restrictions on social media. The odds of being neutral or opposed were higher among Non-Hispanic Black adults (v. non-Hispanic White; OR: 2·03 (95 % CI 1·26, 3·26)); those completing some college (OR: 1·68 (95 % CI 1·20, 2·34)) or high school or less (OR: 2·62 (95 % CI 1·74, 3·96)) (v. those with a college degree); those who were overweight (v. normal weight; OR: 1·42 (95 % CI: 1·05, 1·93)) and those reporting a moderate (OR: 1·45 (95 % CI 1·13, 1·88)) or conservative (OR: 1·71 (95 % CI 1·24, 2·35)) political viewpoint (v. liberal). Having strong (v. weaker) weight and diet-related cancer beliefs was associated with 53 % lower odds of being neutral or opposed to advertising restrictions (OR: 0·47 (95 % CI 0·36, 0·61)). Conclusions: The current study identified subgroups of US adults for whom targeted communication strategies may increase support for policies to improve children's food environment. [ABSTRACT FROM AUTHOR]

Objective: The food and beverage industry, which have expanded rapidly in recent years, create market potential by influencing children and young adults with the use of high sugar drinks. Therefore, children and young consumers will be the adult consumers and target audience of the future. In this study, the objective was to determine the current order and strategy of the effects of advertising on children and adolescents in the food and beverage industiy. Material and Method: This study was conducted as a scope review, and the methodology was derived from published articles in PubMed directed at food marketing in children and adolescences. The study was conducted between 2008 and 2018 and focused on special cases in Turkey, Europe, and USA. Results: Food preferences develop at a very young age. Awareness levels of parents play a major role in determining the child's eating style. In recent years, the food and beverage industry has chosen young people and children as their target market. The purpose of marketing in this industry has been to create long-term brand loyalty. Conclusion: The role of advertising in the food and beverage industry may play a significant factor in influencing eating preferences and body weight of young people, which is controversial in terms of the growing epidemic of childhood obesity. Government policies are important in this regard. However, more research are still needed and may draw attention to the prevalence of food marketing on children's healthy eating. [ABSTRACT FROM AUTHOR]

Child dietary diversity is poor in much of rural Africa and developing Asia, prompting significant efforts to leverage agriculture to improve diets. However, growing recognition that even very poor rural households rely on markets to satisfy their demand for nutrient-rich non-staple foods warrants a much better understanding of how rural markets vary in their diversity, competitiveness, frequency and food affordability, and how such characteristics are associated with diets. This article addresses these questions using data from rural Ethiopia. Deploying a novel market survey in conjunction with an information-rich household survey, we find that children in proximity to markets that sell more non-staple food groups have more diverse diets. However, the association is small in absolute terms; moving from three non-staple food groups in the market to six is associated with an increase in the number of non-staple food groups consumed by ∼0.27 and the likelihood of consumption of any non-staple food group by 10 percentage points. These associations are similar in magnitude to those describing the relationship between dietary diversity and household production diversity; moreover, for some food groups, notably dairy, we find that household and community production of that food is especially important. These modest associations may reflect several specific features of our sample which is situated in very poor, food-insecure localities where even the relatively better off are poor in absolute terms and where, by international standards, relative prices for non-staple foods are very high. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the nutritional quality of foods marketed to children in the UK and to explore the use of health and nutrition claims.Design: This cross-sectional study was carried out in a wide range of UK food retailers. Products marketed to children above the age of 1 year containing any of a range of child friendly themes (i.e. cartoons, toys and promotions), and terms suggesting a nutritious or healthy attribute such as 'one of 5-a-day', on product packaging were identified both in stores and online. Information on sugar, salt and fat content, as well as health and nutrition claims, was recorded. The Ofcom nutrient profiling model (NPM) was used to assess if products were healthy.Results: Three hundred and thirty-two products, including breakfast cereals, fruit snacks, fruit-based drinks, dairy products and ready meals, were sampled. The use of cartoon characters (91.6%), nutrition claims (41.6%) and health claims (19.6%) was a common marketing technique. The one of 5-a-day claim was also common (41.6%), but 75.4% (103) of products which made this claim were made up of less than 80 g of fruit and vegetables. Sugar content (mean±SD per 100 g) was high in fruit snacks (48.4±16.2 g), cereal bars (28.9±7.5 g) and cereals (22.9±8.0 g). Overall, 41.0% of the products were classified as less healthy according to the Ofcom NPM.Conclusion: A large proportion of products marketed to children through product packaging are less healthy, and claims used on product packaging are confusing. Uniform guidance would avoid confusion on nutritional quality of many popular foods. [ABSTRACT FROM AUTHOR]

• We developed the Food and Beverage Marketing Monitoring Framework for Canada. • The Framework details how to monitor youth's exposure to food marketing in Canada. • This approach has been implemented in Canada and can be adapted for global use. As many countries are considering the restriction of marketing to children for unhealthy foods and beverages to improve population health, systematic monitoring of this marketing to inform and evaluate policies is critical. The objective of this research was to develop and describe the Food and Beverage Marketing Monitoring Framework for Canada, a framework commissioned by Health Canada to help guide their monitoring efforts. Following a literature review and expert consultation, the questions to be answered by the framework, the frequency and scope of monitoring activities, the short-/long- term outcome indicators and the methodologies to be employed were determined. The resulting Framework aims to assess the frequency and power of food marketing in various media and settings and monitor children and adolescents' exposure to food marketing, food company practices, and changes in children's attitudes, behaviours, and health. It proposes that monitoring occur annually in six regions across Canada. Considering probable budget constraints and research capacity, television, digital media, schools, convenience stores, packaging and children's sport/event sponsorship were identified as priority media/settings. Short- and long-term outcomes include: food marketing (e.g., advertising rate, marketing technique use), company-level (e.g., ad expenditures, product reformulation) and behavioral/health indicators (e.g., children's marketing awareness and recall, food requests and consumption). While significant efforts have been made in monitoring food marketing in Canada via the implementation of the Framework into the Health Canada M2K Monitoring Strategy, gaps remain (e.g., within diverse sociodemographic groups). The Framework can be leveraged to inform policy in Canada and the development process and content of the Framework could be adapted and implemented for global use. [ABSTRACT FROM AUTHOR]

Despite the preventive measures taken by the WHO, childhood obesity is still on the rise and is expected to increase by 100% between 2020 and 2035. Food marketing continues to permeate children's environments in numerous ways and influence the food behaviour of children, thus significantly contributing to the rise of obesity. Studies suggest that the literature on the effects of food marketing on children is complex and multidimensional. To fully understand these effects, a comprehensive and systematic approach is required. Nonetheless, existing reviews have focused only on specific aspects and have not comprehensively covered the literature on food marketing to children. Therefore, this review aims to navigate potential research gaps in the existing literature through a comprehensive examination of the literature by using morphological analysis (MA) methodology, the first time in this domain. Using PRISMA, 202 papers were considered eligible for inclusion and further analysed using MA. The articles were categorised into three dimensions to develop the MA framework: Stimuli (Food well-being), Organism, and Response, and 34 variants. The review has presented future research prospects by identifying at least 218 research gaps. With these findings, researchers can further explore the gaps and develop new research questions that could foster an understanding of the multifarious literature. Moreover, these findings can also provide marketers and practitioners with a better comprehension of the current state of the literature and develop more effective strategies for responsible marketing practices and policies. [ABSTRACT FROM AUTHOR]

Since 2006, many U.S. food and beverage companies have pledged to market healthier foods to children to help combat the childhood obesity epidemic. Despite this, companies’ expenditures on online advertising have increased of late. To explore this seemingly contradictory situation, the authors conducted a content analysis of approximately 100 food and beverage brand websites, examining a multitude of online marketing practices across a variety of different products, as well as the relationship between marketing techniques and the nutritional profile of promoted foods. This is the first study to examine if nutrition varied by marketing technique. Few brands maintained child-oriented websites, but the brands that did have child-oriented websites included a large number of games promoting particularly obesogenic food products. Somewhat surprisingly, games with many brand identifiers were paired with slightly less obesogenic foods. These findings present a mixed picture of the threat posed by online child-oriented food marketing. [ABSTRACT FROM PUBLISHER]

This study compares messages displayed on children's and adults' cereal boxes. In total, 127 cereal boxes were collected and content analysed. On the front panel, we found an interesting contradiction between health-related textual and graphical messages. The nutrient claim appeared on more than half of cereals for children, which is significantly higher coverage compared with that of adult cereals. On the other hand, the representation of a bowl of cereal was far more likely to appear artificially coloured or sweetened on child-targeted cereal boxes and contain less fruits and nuts compared with adult-targeted cereals. Results on the back and side panels showed that messages targeting adults are mostly health related (e.g. well-being, purity) while messaging to children focuses less on health-related messages and more on games, toys and other entertaining topics. Nutritionally, child-targeted cereals overall are less nutritious than adult-targeted cereals and have higher rankings of sugar sources in the ingredients. This study calls for a critical consideration about not only on what is in the cereal box but also what is on the box. [ABSTRACT FROM AUTHOR]

The article examines the influence of a child on the buying behavior of parents in the Czech Republic. Previous studies claim that Czech consumers are only slightly influenced by the marketing tool of the product package when purchasing food. Whereas children are increasingly becoming influencers of consumption, the question arises, whether or not the parent succumbs to their requesting through their pester power. The main goal of this article is to evaluate the influence of children during deciding and purchasing the food in a supermarket. A secondary goal is to identify the techniques of pester power used by children and to identify the reaction of parents to children's food product requesting; to identify children's packaging preferences for food products. The primary data have been collected through an electronic questionnaire for parents. Complex factors are identified using exploratory factor analysis. Factor analysis explored 4 factors: (1) "The effort of the child to influence shopping", (2) "Children's preferences in package design", (3) "Preference of unhealthy foods", (4) "Buying healthy foods with children". Results of hypotheses testing revealed a strong dependence relating to techniques of pester power, accommodating their requests and transact the purchase. [ABSTRACT FROM AUTHOR]

The Institute of Medicine has warned of the harm of food marketing to children from television to new media channels such as the Internet. The authors identified and analyzed the techniques used to engage children on websites from cereal companies—the third largest food marketer to children. The authors found that top breakfast cereal manufacturers maintain child-oriented websites, using strategies unique to the Internet to capture and maintain children's attention. These include branded engagement techniques such as advergames, videos, site registration, and viral marketing, including inviting friends to join the site. The authors found 3 progressive levels of telepresence on child-targeted cereal websites: sites with more than 1 engaging feature, multiple techniques present on individual pages, and the construction of a virtual world. Using Internet traffic data, the authors confirm that these techniques work: cereal marketers reach children online with lengthier and more sophisticated engagements than are possible with traditional, passive media such as television advertisements or product packaging. Despite the cereal manufacturer's self-regulatory pledge to improve their marketing to children, their marketing practices exploit children's susceptibility to advertising by almost exclusively promoting high-sugar cereals using deeply engaging techniques. [ABSTRACT FROM PUBLISHER]

Abstract: This paper gives a definition of ‘nutrient profiling’ and outlines the scope ‘marketing of foods to children’ and it’s ‘regulation’ for the purposes of the paper. It then points out that nutrient profiling has many other purposes besides the regulation of marketing of foods to children. It briefly outlines the ideal process for developing a nutrient profile model and summarises how nutrient profiling models have been validated to date. It discusses how existing nutrient profiling models for the purpose of regulating the marketing of foods to children can be compared and it concludes that nutrient profiling has much potential but that there are several obstacles to overcome before an ideal model for regulating the marketing of foods can be agreed. [Copyright &y& Elsevier]

Abstract: A 2009 systematic review of the international evidence on food and beverage marketing to children is the most recent internationally comprehensive review of the evidence base. Its findings are consistent with other independent, rigorous reviews conducted during the period 2003–2012. Food promotions have a direct effect on children’s nutrition knowledge, preferences, purchase behaviour, consumption patterns and diet-related health. Current marketing practice predominantly promotes low nutrition foods and beverages. Rebalancing the food marketing landscape’ is a recurring policy aim of interventions aimed at constraining food and beverage promotions to children. The collective review evidence on marketing practice indicates little progress towards policy aims has been achieved during the period 2003–2012. There is a gap in the evidence base on how substantive policy implementation can be achieved. We recommend a priority for future policy relevant research is a greater emphasis on translational research. A global framework for co-ordinated intervention to constrain unhealthy food marketing which has received high level support provides valuable insight on some aspects of immediate implementation research priorities. [Copyright &y& Elsevier]

Childhood obesity is associated with children's exposure to food/beverage marketing. Policy options in this area are being sought in order to reduce childhood obesity rates on a population-level. We examined the nutritional quality of foods advertised to children during their preferred television viewing in Ontario (Canada), where advertising is self-regulated by industry, and in Quebec (Canada), where a child-directed advertising ban exists. A total of 428 children aged 10-12 years completed television viewing diaries for 7 days. Thirty-two television stations were recorded simultaneously between 6 am and midnight. A content analysis of 90 h of English Ontario, French Quebec, and English Quebec children's preferred viewing was then undertaken. A total of 429 food and beverage advertisements were analyzed and their nutritional quality was assessed. Food advertisements in the Quebec French sample were statistically significantly higher in total fat, saturated fat and protein, and lower in carbohydrates and sugar per 100 g, and as a percentage of energy than food ads in the two English samples. A statistically significantly lower percentage of the Quebec French food advertisements were classified as either high fat, sugar or sodium and a smaller proportion of food ads were classified as 'less healthy' compared to the Ontario and Quebec English samples. These results suggest that the Quebec advertising ban is influencing the macronutrient profile of advertised foods viewed by French Quebec children during their preferred viewing and that their promotions are marginally healthier than that viewed by the English samples. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to understand, from a theoretical standpoint and from an empirical perspective, why food products can be designed and perceived as ''playful'' and ''funny''. Drawing on the experiential framework developed in marketing research and recent advances in theories of play, it seeks to clarify the conceptual articulation of ''play'' with ''fun'' and it seeks to highlight the need to reconsider the contribution of the product in framing situations that children experience as ''playful'' and ''fun''. Design/methodology/approach - The paper focuses on qualitative data gathered through a combination of observations and in-depth interviews of 14 dyads ''child-mother'' confronted by four product innovations at a prototype stage, and a series of eight focus groups involving children from three to eight years old as well as their mothers. Findings - Children were very able to categorize food products by appreciating their different degrees of fun. The study led to the identification and coding of 13 key dimensions associated with ''playfulness'' and ''fun'' in a food product. Practical implications - The paper offers a heuristic operational tool to guide marketing managers and R&D teams in their exploration and testing of the possibilities/impossibilities in the association of ''playfulness'' and ''fun'' with food products aimed at children. Originality/value - The research demonstrates that some dimensions which characterize play cannot be directly applied to food products, and differentiates ''playful'' from ''fun'' by considering the intensity of the social interaction being developed through the food product or food consumption situation. [ABSTRACT FROM AUTHOR]

Purpose - This study seeks to show that children are not passive consumers, rather that they have a reflexive attitude towards their eating practice and the ability to override food-use rules invented by the manufacturers. Design/methodology/approach - Drawing on an ethnographic survey conducted among families with children aged from six to 12, the paper will seek to show, from the child's point of view, why fun products, which at first sight are so beguiling, are not in fact much fun when used. From the observations made of the children's eating practices with regard to specific fun foods, and from interviews with the children on these, it emerges that these foods give the child little scope for deciding how to eat them. Findings - Over the years, there has appeared on the market a range of fun food products for which clear instructions are given on how children should eat and play with them. Despite copy, produced with the young consumer in mind, and carefully defined product affordance, consumer practice is far removed from what the product designers expect. For children, however, deviating from prescribed use and re-appropriating products with their own ''art of doing'' or food-use techniques are key elements of their eating practice. Originality/value - Most of the studies on that topic are centred on fun food manufacturers and industry. The most original aspect of this study is to focus on the children's representations, discourses and practices. Thus it provides a new aspect on fun food consumption. [ABSTRACT FROM AUTHOR]

The fast food industry has been increasingly criticized for creating brand loyalty in young consumers. Food marketers are well versed in reaching children and youth given the importance of brand loyalty on future food purchasing behavior. In addition, food marketers are increasingly targeting the Hispanic population given their growing spending power. The fast food industry is among the leaders in reaching youth and ethnic minorities through their marketing efforts. The primary objective of this study was to determine if young children recognized fast food restaurant logos at a higher rate than other food brands. Methods Children ( n = 155; 53% male; 87% Hispanic) ages 4–8 years were recruited from elementary schools and asked to match 10 logo cards to products depicted on a game board. Parents completed a survey assessing demographic and psychosocial characteristics associated with a healthy lifestyle in the home. Results Older children and children who were overweight were significantly more likely to recognize fast food restaurant logos than other food logos. Moreover, parents’ psychosocial and socio-demographic characteristics were associated with the type of food logo recognized by the children. Conclusions Children’s high recognition of fast food restaurant logos may reflect greater exposure to fast food advertisements. Families’ socio-demographic characteristics play a role in children’s recognition of food logos. [ABSTRACT FROM AUTHOR]

Budgets for marketing to children have spiked well into the billions, an escalation that mirrors the rise in childhood obesity rates. Children are targets for a maelstrom of marketing for all sorts of products enabled by sophisticated technology and minimal government regulation. Despite the fact that recent studies document links between food advertising and childhood obesity, a significant proportion of marketing that targets children is for energy-dense, low-nutrient food. Moreover, advances in digital technology allow marketers to find more direct, personalized gateways to reach young audiences that sidestep parental authority and bank as much on the unknowing parent as the gullible child. Cataloguing the depth and breadth of child-centered food marketing while discussing grassroots strategies for instituting change, the authors argue that parents can no longer keep pace either with innovations in advertising or increased spending, suggesting the need for more stringent government regulations on food marketing to children. [ABSTRACT FROM AUTHOR]

A large body of research suggests that food marketing affects children's food preferences, short- and long- term dietary consumption, and purchase requests directed to parents. It is frequently argued that younger children are more susceptible to marketers' messages than older children because they do not understand the persuasive nature of advertising; however, little direct evidence supports this claim. Employing an experimental design, this study examined the influence of food marketing on children's preferences and tested whether age (and gender) moderated the effects of ad exposure. The sample consisted of 133 children between the ages of five and eleven. Results indicated that exposure to food commercials increased children's preferences for the advertised products. Age did not moderate this effect; younger and older children were equally persuaded by the commercials. Boys were more influenced by the commercials than girls. Implications for the study of food marketing to children are discussed. [ABSTRACT FROM AUTHOR]

Background: Food is one of the most frequently promoted commodities, and promoted foods are overwhelmingly unhealthy. Marketing normalizes unhealthy foods, creates a positive brand image, and encourages overconsumption. Limited research is available to describe the extent of food marketing to children on web-based media, and measuring actual exposure is challenging.Objective: This study aims to monitor the extent of children's exposure to web-based media food marketing as an essential step in increasing the accountability of industry and governments to protect children.Methods: Children aged 13-17 years were recruited from October 2018 to March 2019. Children recorded their mobile device screen for 2 weekdays and 1 weekend day any time they visited relevant web-based platforms. After each day, the participants uploaded the video files to a secure server. Promoted products were defined using the World Health Organization European Region nutrient profile model.Results: The sample of 95 children uploaded 267.8 hours of video data. Children saw a median of 17.4 food promotions each hour on the internet. Considering the usual time spent on the internet on mobile devices, children would be exposed to a median of 168.4 food promotions on the web on mobile devices per week, 99.5 of which would not be permitted to be marketed based on nutrient profiling criteria. Most promotions (2613/4446, 58.77%) were peer endorsed and derived from third-party sources.Conclusions: Exposure to brand content that is seemingly endorsed by peers or web-based communities likely heightens the effects of marketing on children. Regulations to protect children from this marketing must extend beyond paid advertising to paid content in posts generated through web-based communities and influencers. [ABSTRACT FROM AUTHOR]