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Advertisements promoting energy-dense, nutrient-poor food and drinks influence children's dietary choice and preference and are pervasive in children's environments across Aotearoa, New Zealand. Using a combination of datasets from separate studies, this research seeks to describe the extent of children's unhealthy food/drink advertising exposure in all primary and intermediate school food zones (n = 381) in Tāmaki Makaurau, Auckland, and assess whether this exposure correlates with indicators of neighbourhood deprivation. To achieve this, we developed a simple advertising exposure score using images of advertising collected from Google Street View, and investigated its spatial correlation with indicators of neighbourhood deprivation. Outdoor advertising was present in proximity to 61.9% of the sampled schools (n = 236); of which 83.1% of adverts promoted unhealthy food and/or drinks (n = 2669). Advertising exposure increased statistically significantly with neighbourhood deprivation (p < 0.05). The results show a clear need for policy intervention that regulates and limits unhealthy food/drink advertising around schools in New Zealand. The advertising score proved a useful, easy to understand tool to measure and visualise children's potential exposure to unhealthy food/drink advertising. The score may be used to increase community awareness of the ubiquity of unhealthy advertising in children's neighbourhoods and advocate for policy change. Practitioner points: Advertising present in the vicinity of 62% of Auckland schools; 83% of adverts promoted unhealthy food and/or drinks Novel advertising score assesses the spatial distribution of unhealthy advertising exposure. Advertising exposure score is significantly related to neighbourhood deprivation. Findings show the need for policy action to limit children's advertising exposure around their schools in NZ. [ABSTRACT FROM AUTHOR]

Advertisements promoting energy-dense, nutrient-poor food and drinks influence children’s dietary choice and preference and are pervasive in children’s environments across Aotearoa, New Zealand. Using a combination of datasets from separate studies, this research seeks to describe the extent of children’s unhealthy food/drink advertising exposure in all primary and intermediate school food zones (n = 381) in Tāmaki Makaurau, Auckland, and assess whether this exposure correlates with indicators of neighbourhood deprivation. To achieve this, we developed a simple advertising exposure score using images of advertising collected from Google Street View, and investigated its spatial correlation with indicators of neighbourhood deprivation. Outdoor advertising was present in proximity to 61.9% of the sampled schools (n = 236); of which 83.1% of adverts promoted unhealthy food and/or drinks (n = 2669). Advertising exposure increased statistically significantly with neighbourhood deprivation (p

South Africa has high levels of obesity and overweight, which contribute to non-communicable diseases and are associated with poor diets high in ultra-processed foods. Bundling occurs when two or more products are packaged and sold together, often at a discount and is a marketing strategy for unhealthy foods. Given the paucity of data on bundling of unhealthy foods, this exploratory study sought to document how unhealthy foods are bundled together to be more attractive to consumers in Johannesburg, South Africa. Fifty food outlets were included and compared across two regions. In-store photos were taken of bundles and individual items, and data were captured on the costs of the bundle and of individual components. Descriptive analysis and the contents of the bundles based on the photographs and promotional material were conducted. Almost half of all outlets had more than five bundles and nearly a quarter had bundles targeting children. Most children's meals were burgers, and all had fries as part of the bundle. The average savings per bundle when compared to the combined cost of individual items was R21,39 overall, or 18%. The study demonstrated that unhealthy food bundling is a common practice in food outlets in Johannesburg, often with cost advantages and promotional appeal. Policy options for promoting a favourable food environment include regulating portion sizes of bundles and offering healthy options as part of a bundle. Marketing food to children by bundling unhealthy food with toys is of particular concern and is prohibited in the recently gazetted Regulations Relating to the Labelling and Advertising of Foodstuffs. [ABSTRACT FROM AUTHOR]

Abstract Objective: To examine the proportion of products offered by leading food brands in Canada that are ‘unhealthy’ according to Health Canada’s (HC) nutrient profile model for proposed restrictions on food marketing to children (M2K-NPM). Design: Nutritional information for products offered by top brands was sourced from the University of Toronto FLIP and Menu-FLIP 2020 databases, respectively. HC’s M2K-NPM, which includes thresholds for Na, total sugars and saturated fat, was applied to products. Setting: Canada. Participants: Overall, 1385 products from top breakfast cereal (n 15 brands, n 222 products), beverage (n 21 brands, n 769 products) and yogurt (n 10 brands, n 394 products) brands, and 3153 menu items from seventeen chain restaurants in Canada were assessed (n 60 unique brands overall). Results: For 42 % of brands (n 21), 100 % of their products exceeded ≥1 nutrient threshold(s), with ≥50 % of the products offered by twenty-three brands (46 %) exceeding two thresholds. Specifically, one or more nutrient thresholds were exceeded by ≥50 % of the products offered by 14/15 breakfast cereal brands, 18/21 beverage brands, all ten yogurt brands and all seventeen restaurant brands. Notably, 100·0 % of the products offered by ten breakfast cereal, six beverage, two yogurt and three restaurant brands exceeded ≥1 threshold(s). Conclusions: Most products offered by top food brands in Canada exceeded HC’s M2K-NPM thresholds. Nonetheless, these brands could still be marketed under the proposed regulations, which exclude brand marketing (i.e. promotions without an identifiable product) despite its contribution to marketing power. These findings reinforce the need for Canada and other countries to include brand marketing in M2K policies.

There are growing concerns about the commercialisation of childhood and the consequences of marketing to children, including marketing's negative effects and increasingly sophisticated and potentially deceptive online tactics that permeate the contemporary media environment. Children and young people are prolific users of video-sharing platforms (VSP) such as TikTok and YouTube, yet little is known about children's advertising literacy within these contexts. Therefore, this paper answers recent calls for a deeper understanding of children's advertising literacy in light of their increasingly digital lifestyles. A combination of qualitative, participatory creative methods were used with children aged 9–11 from the UK. Findings show that despite their negative perceptions of online advertising, children place a level of trust in video-sharing platforms, based on a misconception that the commercialisation of content is always disclosed. This is concerning because children may prefer and pay more attention to content that they believe to be genuine. [ABSTRACT FROM AUTHOR]

Abstract Objective: To describe the development and testing of two assessment tools designed to assess exterior (including drive-thru) and interior food and beverage marketing in restaurants with a focus on marketing to children and teens. Design: A scoping review on restaurant marketing to children was undertaken, followed by expert and government consultations to produce a draft assessment tool. The draft tool was mounted online and further refined into two separate tools: the Canadian Marketing Assessment Tool for Restaurants (CMAT-R) and the CMAT-Photo Coding Tool (CMAT-PCT). The tools were tested to assess inter-rater reliability using Cohen’s Kappa and per cent agreement for dichotomous variables, and intra-class correlation coefficients (ICCs) for continuous or rank-order variables. Setting: Waterloo, Ontario, Canada. Participants: Restaurants of all types were assessed using the CMAT-R (n 57), and thirty randomly selected photos were coded using the CMAT-PCT. Results: The CMAT-R collected data on general promotions and restaurant features, drive-thru features, the children’s menu and the dollar/value menu. The CMAT-PCT collected data on advertisement features, features considered appealing to children and teens, and characters. The inter-rater reliability of the CMAT-R tool was strong (mean per cent agreement was 92·4 %, mean Cohen’s κ = 0·82 for all dichotomous variables and mean ICC = 0·961 for continuous/count variables). The mean per cent agreement for the CMAT-PCT across items was 97·3 %, and mean Cohen’s κ across items was 0·91, indicating very strong inter-rater reliability. Conclusions: The tools assess restaurant food and beverage marketing. Both showed high inter-rater reliability and can be adapted to better suit other contexts.

ObjectivesThis study aimed to examine and compare the extent to which different nutrient profile models (NPMs) from Latin America (LA) identify packaged foods and beverages with child-directed marketing sold in Brazil as being high in nutrients associated to the risk of non-communicable diseases (NCDs).Materials and methodsIn this cross-sectional study, we evaluated 3,464 foods found in the five largest Brazilian supermarkets. Child-directed marketing was coded using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) protocol. Differences in medians of sugar, saturated fats, and sodium per 100 kcal in foods, with the presence and absence of child-directed marketing, were tested using the Mann–Whitney test. We compared six NPMs in LA and examined to what extent they targeted these products using prevalence ratios. Analyses were performed overall and by the degree of food processing according to the Nova food classification.ResultsWe found 1,054 packages with child-directed marketing. Among these, candies, cakes and pies, sauces and creams, and sugar-sweetened beverages were significantly higher in sugar, saturated fat, and sodium per 100 kcal than products that are not targeted at children (p < 0.05). Compared with PAHO and the Mexico models, the Brazilian NPMs would allow three times more ultra-processed foods to omit warnings for sodium (p < 0.05). The Uruguayan NPM also flagged fewer ultra-processed foods high in sodium (p < 0.05). The Brazilian model also allows four times more sugar-sweetened beverages and six times more dairy drinks to omit warnings for sugar than the Mexico and PAHO models. In comparison to all other NPMs, the Brazilian model showed the worst performance in identifying baked goods as high in sodium. Chile, Uruguay, and Peru models would also target significantly less sugar-sweetened beverages and high in at least one critical nutrient than PAHO and Mexico models.ConclusionCompared with other NPMs in LA, the NPM criteria adopted in Brazil are more permissive and less likely to inform consumers of the poor nutritional quality of ultra-processed foods and beverages with child-directed marketing.

Objective: To assess the frequency with which soft drinks and premiums are available with children's meals marketed on the top restaurant chains' websites worldwide.Design: Cross-sectional structured observational assessment of secondary information about top international restaurant chain children's meals.Setting: Websites of top restaurant chains for 193 countries and five regions of the United Nations.Participants: Top restaurant chains (including McDonald's, Subway, Burger King and KFC) across 193 countries. Children's meal images and descriptions were reviewed to determine if the meal was marketed with a soft drink as a beverage option and whether the meal offered a premium.Results: Children's meals were marketed online on restaurant websites by at least one of the four chains in a total of seventy eight of the 193 countries (40·4 %). Overall, 56·3 % of countries with any online children's meal marketing by the four chains included at least one chain that marketed soft drinks and 92·3 % marketed premiums with the meal.Conclusions: Every region in the world includes marketing of children's meals on the websites of the top restaurant chains. The high prevalence of premiums marketed online with children's meals is of concern. Similarly, with over 50 % of countries with online children's meal marketing having at least one chain that offers soft drinks as part of the meals, additional regulation and education may be warranted. [ABSTRACT FROM AUTHOR]

This research examines effects of on-package licensed characters on children's and caregivers' choices of healthy and indulgent food and children's consumption amount. The authors propose that food liking exerts the greatest influence on children's choices and consumption, such that the impact of on-package characters will be limited to choices between equally liked options. Caregivers' choices are primarily influenced by their food goals for their children; thus, the impact of characters will likewise be limited to caregivers' within-category choices. Two experiments show that a character influences children's choices between two same-category options but not between indulgent and healthier options. A third experiment reveals that food liking influences amount consumed, while the presence of a character influences neither amount consumed nor food liking. Two additional experiments show that characters influence caregivers' choice between the same foods, but not between different food types or intention to purchase a food. The expanded framework for the effects of licensed characters—taking into account choice versus consumption, children versus caregivers, and healthy versus unhealthy foods—enhances understanding for consumers, practitioners, and policy makers. [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]

Research demonstrates that brands can influence children's food preferences and potentially contribute to unhealthy consumption patterns. This article extends this line of research by investigating the complex and interacting effects of food brand marketing on experienced taste. The empirical field in a remote Russian town enabled the assessment of branding effects when entering a newly established market. Examining the combination of various advertisement features with emotional brand elicitation, we derive hypotheses about the interplay of brands and advertisement components linked to the perceived taste of a fast food meal. In Novosibirsk, Russia, 778 children and adolescents aged 10–18 years were exposed to fast food advertisements with real and imaginary brand logos and varying advertising claims. The advertisements consisted of a warning, an exaggerated credence claim, or both. A subsequently offered fast food meal—a portion of French fries—was experimentally varied and prepared to be either healthier but less tasty and unsalted, or less healthy but tastier and salted. The findings verify strong and positive brand effects on children's taste satisfaction. Warnings in advertisements "worked" only for novel fast food brands by negatively affecting taste satisfaction, but increased taste satisfaction when applied in advertisements for established brands. Single credence claims did not improve the taste experience, but counteracted the negative effects of warnings for novel brands. Finally, the established brand influenced taste satisfaction positively when the fries were saltier. The findings reveal various opportunities for fast food marketing to artificially create taste satisfaction for potentially unhealthy food. Public health strategies that focus on advertising claim restrictions should be reconsidered in the context of possible evasion strategies of the food industry and counter‐effects of warnings among strong fast food brands. [ABSTRACT FROM AUTHOR]

Food and beverage marketing has been identified as a major driver of obesity yet sports sponsorship remains common practice and represents millions of dollars in advertising expenditures. Research shows that food and beverage products associated with sports (e.g., M&M's with National Association for Stock Car Auto Racing logo) generate positive feelings, excitement, and a positive self-image among adults and children. Despite this, self-regulatory pledges made by food companies to limit exposure of unhealthy products to children have not improved the nutritional quality of foods marketed to children. We reviewed the literature about sports-related food marketing, including food and beverage companies' use of sports sponsorships, athlete endorsements, and sports video games. This review demonstrates that sports sponsorships with food and beverage companies often promote energy-dense, nutrient-poor products and while many of these promotions do not explicitly target youth, sports-related marketing affects food perceptions and preferences among youth. Furthermore, endorsement of unhealthy products by professional athletes sends mixed messages; although athletes may promote physical activity, they simultaneously encourage consumption of unhealthy products that can lead to negative health outcomes. We argue that more athletes and sports organizations should stop promoting unhealthy foods and beverages and work with health experts to encourage healthy eating habits among youth. [ABSTRACT FROM AUTHOR]

Artificial food colors (AFCs) in foods and beverages may be harmful to children. This study assesses the percentage of grocery store products marketed to children that contain AFCs, by category and company. The research team collected product and food-color information about 810 products in one grocery store in North Carolina in 2014. Overall, 350 products (43.2%) contained AFCs. The most common AFCs were Red 40 (29.8% of products), Blue 1 (24.2%), Yellow 5 (20.5%), and Yellow 6 (19.5%). Produce was the only category that did not have any AFCs. The highest percentage of products with AFCs was found in candies (96.3%), fruit-flavored snacks (94%), and drink mixes/powders (89.7%). Forty-one of the 66 companies marketed products containing AFCs. Given concerns about health effects of AFCs and high proportions of high-AFC categories, clinicians, parents, food companies, and the government can take steps to support children’s healthy eating and development by reducing AFCs in children’s diets. [ABSTRACT FROM AUTHOR]

Exposure to unhealthy food and beverage marketing is an important environmental determinant of dietary intake. The current study examined self-reported exposure to marketing of unhealthy foods and beverages across various media channels and settings among parents of children younger than 18 years in five high and upper-middle income countries. Data from 4827 parents living with their children were analyzed from the International Food Policy Study (2017), a web-based survey of adults aged 18-64 years from Canada, the United States (US), the United Kingdom (UK), Australia, and Mexico. Respondents reported their exposure to marketing of fast food and of sugary drinks across media channels/settings overall and how often they see fast food and sugary drink marketing while viewing media with their children. Regression models examined differences across countries and correlates of marketing exposure. Parents in Mexico and the US reported greater exposure to marketing for fast food and sugary drinks compared to parents in Australia, Canada, and the UK. Patterns of exposure among parents were generally consistent across countries, with TV, digital media, and radio being the most commonly reported media channels for both fast food and sugary drinks. Exposure to marketing of fast food and sugary drinks was associated with a variety of sociodemographic factors, most strongly with ethnicity and education, and sociodemographic trends differed somewhat between countries. The findings demonstrate differences in self-reported parental exposure to marketing of fast food and sugary drinks between countries, and may help to evaluate the impact of marketing restrictions implemented over time. [ABSTRACT FROM AUTHOR]