Children's self-regulation of eating provides no defense against television and online food marketing

Ultra-processed food consumption and quality of life: a cross-sectional study in Iranian women

Background

Ultra-processed foods (UPFs) have been associated with a higher intake of added sugars, sodium, and unhealthy fats; however, the relationship between UPFs and quality of life (QoL) is not well understood.

Methods

The present cross-sectional study included 193 Iranian women aged 18-48 years with a body mass index (BMI) of ≥25 kg/m2. UPFs were identified using the NOVA classification. QoL was evaluated using the SF-36 questionnaire. Anthropometric measurements and body composition were assessed using an appropriate method.

Results

The mean BMI and fat-free mass (FFM) of the subjects were 30.90 kg/m2 and 46.69 kg, respectively. At first, a significant difference was observed in the height of women across tertiles of UPF consumption. The mean score of the total QoL scale was 66.90. Women who were in the tertile 3 of UPFs intake had 23.59 units lower the scale of limitation in physical capabilities and activity (score of role-physical) (β = -23.59, 95% CI: -37.77-9.40, p = 0.001). Among those with the highest adherence to UPF intake, there was an 8.76 unit reduction in addressing feelings of energy and fatigue (vitality domain) in model 2 (β = -8.76, 95% CI: -16.42-1.11, p = 0.02). Finally, a reduction of 15.78 units was observed in the mental health scale, specifically in the mental states of anxiety and depression, among participants in the third tertile of UPF intake (β = -15.78, 95% CI: -24.11-7.45, p < 0.001).

Conclusion

Increased UPF consumption was associated with lower QoL in Iranian women. Further studies are needed to confirm these findings and develop effective strategies to promote healthy food choices.

The food and beverage cues in digital marketing model: special considerations of social media, gaming, and livestreaming environments for food marketing and eating behavior research

Digital marketing to children, teens, and adults contributes to substantial exposure to cues and persuasive messages that drive the overconsumption of energy dense foods and sugary beverages. Previous food marketing research has focused on traditional media, but less is known about how marketing techniques translate within digital platforms, such as social media, livestreaming, and gaming. Building upon previous theories and models, we propose a new model entitled food and beverage cues in digital marketing (FBCDM). The FBCDM model specifies key marking elements and marketing integration strategies that are common on digital platforms and are hypothesized to enhance the effects of advertising and incentive sensitization process. FBCDM also categorizes measurable outcomes into three domains that include brand, food, and social outcomes. Additionally, repeated marketing exposure and the resulting outcomes are hypothesized to have long term consequences related to consumer markets, consumption behavior, culture, and health. We include a discussion of what is currently known about digital marketing exposure within the outcome domains, and we highlight gaps in research including the long-term consequences of digital marketing exposure. The FBCDM model provides a conceptual framework to guide future research to examine the digital marketing of food and beverages to children and adolescents in order to inform government and industry policies that restrict the aggressive marketing of products associated with obesity and adverse diet related outcomes.

Revisiting 42 Years of literature on food marketing to children: A morphological analysis

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.

The influence of unhealthy food and beverage marketing through social media and advergaming on diet-related outcomes in children-A systematic review

Children are increasingly exposed to food and beverage marketing, but little is known about the specific effects of marketing through media most used by children. This study aims to systematically review the influence of unhealthy food and beverage marketing through social media and advergaming on diet-related outcomes in children. Seven databases were systematically searched for English peer-reviewed quantitative and qualitative scientific studies on the effects of marketing of unhealthy products through social media or advergaming on a range of diet-related outcomes in children. Risk of bias was assessed with tools specific for the different study designs. Twenty-six studies were included, of which 20 examined the effect of food and beverage marketing through advergaming and six through social media. Most studies had a high risk of bias. The results suggested that unhealthy food and beverage marketing through social media and advergaming has a significant effect on pester behaviors, food choice, and food intake of children. The studies demonstrate that unhealthy food and beverage marketing through media popular with children significantly impacts different diet-related outcomes. Combined with existing evidence on this effect in other settings, this review provides clear evidence of the need for policies targeting screen-based marketing.

Screen use during food consumption: Does it cause increased food intake? A systematic review

Nowadays people use screens, such as mobile phones, television, or tablets, more often during mealtimes, which may have an effect on intake. This review aims to analyze the effect of screen use, during food consumption, on intake. A systematic review was carried out, based on those protocols established by PRISMA. The Cochrane Library, PubMed, Web of Science and Scopus databases were consulted. Experimental studies, published between 2010 and 2021, that recorded individual intake while using screens such as television, cell phones, or tablets, were selected. A total of 7181 relevant articles were obtained, which were then assessed in accordance with predetermined inclusion and exclusion criteria. Finally, 35 studies were included in the complete review: 22 compared different kinds of television content (e.g., adverts), five which compared television versus the absence of screens, four which compared television versus video games, two which compared the use of simultaneous screens, and two studies which included cell phones. A total of 27 studies reported consumption increases related to the presence of advertisements and food signals on screens. No significant differences in intake were reported in the eight studies that reported design or sample size limitations, or lack of control of certain variables. It is thus concluded that screen use during food consumption may increase intake. Education is necessary to regulate the habit of consuming food in the presence of screens. Also, the creation of policies that regulate advertising and food cues on screens are justified and must be accompanied by strategies to monitor compliance. As a limitation, further evidence is necessary in order to determine the effect of mobile phone and tablet use while eating. This protocol was registered via PROSPERO, ID: CRD42020211797.

Promoting Fruit and Vegetable Consumption for Childhood Obesity Prevention

Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable.

Rising to the challenge: Introducing protocols to monitor food marketing to children from the World Health Organization Regional Office for Europe

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.

Overabundance of unhealthy food advertising targeted to children on Guatemalan television

To assess, for the first time, the extent (by hour channel) and nature (e.g. persuasive marketing techniques (PMT) and health-related claims) of unhealthy food advertisements (ads) targeted at children (3–11 years) on the six most-watched television (TV) channels in Guatemala. We recorded 864 h of video on the six most popular channels featuring children’s programmes. We classified food and beverage ads as permitted or non-permitted for marketing to children, according to the 2015 World Health Organisation (WHO) nutrient profile. Furthermore, we also analysed PMT (i.e. premium offers, promotional characters, brand benefit claims) and health-related claims. Most food ads (85%) were non-permitted to be marketed to children. Non-permitted food ads were six times more likely, either on weekdays or weekends, for all programme and channel categories compared with permitted food ads. There was no difference in the frequency of non-permitted food ads between peak and non-peak hours, weekend and weekdays or children and non-children programmes. PMT and health-related claims were present in all food ads (5.3 ± 1.9 techniques/claims per ad). There is a need to regulate food ads on TV channels featuring children’s programmes in Guatemala as a result of a high frequency of non-permitted food ads and extensive use of PMT together with health-related claims.

The Devil is in the Detail: Challenging the UK Department of Health's 2019 Impact Assessment of the Extent of Online Marketing of Unhealthy Foods to Children

Background: How much unhealthy marketing do children see on digital devices? Marketing of unhealthy food and beverages has long been identified as a factor in children’s preferences, purchase requests and consumption. Rising global obesity mandates States to craft environments that protect children and young people’s health, as recommended by the World Health Organization, among others. However, assessing the impact of marketing restrictions is particularly challenging: the complexity of digital advertising markets means that measurement challenges are profound. In 2019, the UK Department of Health published an Impact Assessment that applied a novel method aiming to calculate costs and benefits of restricting unhealthy food and beverage advertising on digital devices (planned for implementation by 2022). It estimated UK digital unhealthy marketing to children at 0.73 billion advertising impressions annually, compared to television impacts of 3.6 billion. Aim and Method: We assessed this conclusion by reviewing the UK Department of Health/Kantar Consulting’s Online Baseline Methodology (the “Government Model”). We examined the model’s underlying premise and specified the seven analytic steps undertaken. For each step, we reviewed industry and academic evidence to test its assumptions and the validity of data applied. Results: We found that, in each step, the Government Model’s assumptions, and the data sources selected, result in underestimates of the scale of digital advertising of unhealthy foods—at least tenfold, if not substantially more. The model’s underlying premise is also problematic, as digital advertising spend data relate poorly to digital advertising exposure, leading to further underestimation of market scale. Conclusion: We conclude that the Government Model very substantially underestimates the impact of digital unhealthy food advertising restrictions on health. This analysis has relevance for global policy and for the impact of regulation on children’s health and well-being.

The effect of screen advertising on children's dietary intake: A systematic review and meta-analysis

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. Meta-analyses were conducted for measured and nonmeasured outcomes. Food advertising was found to increase dietary intake among children (age range 2-14, mean 8.8 years) in experimental conditions for television (TV) advertising and advergames. Meta-analysis revealed that children exposed to food advertising on TV (11 studies) and advergames (five studies) respectively consumed an average 60.0 kcal (95% confidence interval [CI], 3.1-116.9) and 53.2 kcal (95% CI, 31.5-74.9) more than children exposed to nonfood advertising. There was also an effect by body mass index (BMI). Findings from nonexperimental studies revealed that exposure to TV food advertising was positively associated with and predictive of dietary intake in children. Short-term exposure to unhealthy food advertising on TV and advergames increases immediate calorie consumption in children.

Maternal attitudes, beliefs and practices related to the feeding and nutritional status of schoolchildren

ABSTRACT Objective To analyze the relationship between the maternal attitudes, beliefs and practices and the children’s food consumption and nutritional status. Methods A cross-sectional study of 563 mother-child pairs. Mothers answered an online questionnaire that collected the following information: sociodemographic data, maternal nutritional status, the child’s food consumption (evaluated through the Food Frequency Questionnaire and the School Child Diet Index), and maternal attitudes, beliefs and practices about the schoolchildren’s eating (assessed through the Child Feeding Questionnaire). Children had their anthropometric measurements evaluated for the interpretation of the nutritional status. Results Mothers who considered their children to be bigger (ORaj=6.60) and who worried more about their children’s weight (ORaj=3.47) presented greater chances of having overweight children. Mothers with a greater perception of responsibility (ORaj=0.57) and who put more pressure in their children to eat (ORaj=0.38) presented lower chances of having overweight children. The majority of children consumed high-quality food (77.4%). Mothers who more closely monitored their children’s food consumption were 2.79 times more likely to have their children eating high-quality food. Conclusion Nutritional interventions should focus on stimulating the parents’ sense of responsibility for the child’s nutrition, as well as on promoting the frequent monitoring of the child’s food intake.