In: Biology
SUMMARY
Over the past year political momentum has grown for strong action to tackle childhood obesity and there is an emerging consensus that regulation of food advertising to children is both necessary and achievable.
Evidence indicates that screen advertising for unhealthy food results in significant increases in dietary intake among children. This review was undertaken with the main aim of estimating the quantitative effect of screen advertising in experimental and nonexperimental conditions on children's dietary intake.
Systematic searches were undertaken of interdisciplinary databases. Studies from 1980 to April 2018, all geography and languages, were included; participants were children and adolescents aged between 2 and 18 years; the intervention was screen advertising; and the outcome was dietary intake.
Short‐term exposure to unhealthy food advertising on TV and advergames increases immediate calorie consumption in children.
1 INTRODUCTION
is a serious public health problem that increases morbidity, mortality, and has substantial long term economic and social costs. The rates of obesity in America’s children and youth have almost tripled in the last quarter century. Approximately 20% of our youth are now overweight with obesity rates in preschool age children increasing at alarming speed. According to the Centers for Disease Control and Prevention, the prevalence of obesity has more than doubled among children ages 2 to 5 (5.0% to 12.4%) and ages 6 to 11 (6.5% to 17.0%). In teens ages 12 to 19, prevalence rates have tripled (5.0% to 17.6%). Obesity in childhood places children and youth at risk for becoming obese as adults and associated poor health such as diabetes, cardiovascular disease, and some forms of cancer. Prevention efforts must focus on reducing excess weight gain as children grow up.
There is a substantial burden of illness and disease resulting from poor diet, which is estimated to account for 40.0% of noncommunicable diseases across Europe
.1 Rates of childhood obesity have been rapidly increasing, and in 2016, there were an estimated 340 million children aged 5 to 19 in the world living with overweight or obesity.
2 Food and drink marketing is a vast global industry, and evidence indicates disproportionate marketing of products with high sugar, fat, and salt content
.3 Children are exposed to a high volume of marketing and advertising, a substantial proportion of which is for unhealthy foods
.4Television (TV) viewing among children has been found to predict obesity even when levels of physical activity are controlled for,5 which suggests it is not just the effect of a sedentary lifestyle that increases the risk factors for weight gain. Research has shown that exposure to unhealthy food advertising, at least under experimental conditions, results in significant increases in food consumption, particularly energy‐dense, low‐nutrient foods, and that increases are greatest among children with obesity.
6-9. This review sought to establish the effect size of screen advertising on children and adolescents' dietary intake, body mass index (BMI), or body composition by systemically reviewing the evidence in the available literature. We aimed to extend previous work by including data sources from business and economics databases and including nonexperimental studies. Meta‐analyses were conducted, primarily on experimental studies between exposure to unhealthy food and nonfood advertising, where outcomes for dietary intake were provided in kcals or a convertible alternative.
DEVELOPMENTS
WHO recommendations
WHO has developed a set of 12 recommendations, endorsed by the World Health Assembly, aimed at reducing the impact of marketing foods high in saturated fats, trans-fatty acids, free sugars or salt.
Rationale
1. The policy aim should be to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
Policy development
3. To achieve the policy aim and objective, Member States should consider different approaches, i.e. stepwise or comprehensive, to reduce marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt, to children.
TIPS FOR PARENTS
Discussion and Conclusions
This analysis, based on a subsample from the IDEFICS study, examines the effects of advertising on children's food knowledge and preferences, as well as on dietary choices and weight status. For the sake of focusing on the role of commercial communication, we do neglect possible impacts of genetic as well as lifestyle factors—which may indeed modify appetite, food intake, and preferences—in our analysis. Both types of factors and their influence have been studied within the IDEFICS study and will be published elsewhere. The key findings of our study are that better food knowledge is not seemingly linked to healthier food preferences and diet apparently has no significant effect on weight status. Although we acknowledge that the study is limited in sample size and operationalisation of the variables is based on our own reasoning and hence could be debated, these key findings do stand on robust empirical ground based on the analysis presented in this paper.
We interpret our results in light of the frequent claims that effectively countering harmful food marketing practices requires child awareness and understanding, paired with the ability and motivation to resist [31]. Many empirical studies, as well as evaluations of health intervention programmes, have indeed shown that providing information and education alone—the major policy strategy of recent decades—fails to successfully decrease advertising's effects on children.
nce, the old WHO motto “making the healthy choice the easy choice” should be reassessed and taken more seriously by everyone responsible for children's diet. Above all, food choices are strongly affected by the “triple A” of food items—availability, affordability, and accessibility—particularly if paired with and supported by social norms.