The impact of marketing of 'junk' foods on children's diet and weight

Contemporary Western(ised) society is typified by pervasive and aggressive brand promotion, through all communication platforms. Food promotion in particular is a dominant area of marketing, particularly the marketing by large multinational food companies that manufacturer less healthy foods and beverages (Cairns et al. , 2013). The ubiquitous marketing of these unhealthy foods contributes to creating a negative food culture that undermines international and national nutrition recommendations and guidelines for disease prevention. Specifically, frequent exposure to persuasive promotions for unhealthy foods serves to normalise these food products as part of everyday life, create positive brand images, and ultimately encourage (over) consumption of these foods (Hoek and Gendall, 2006). The Diet, Nutrition and the Prevention of Chronic Diseases report published by the Food and Agriculture Organization and the World Health Organization (WHO) in 2003 concluded that the heavy marketing of fast food outlets and energy dense, micronutrient poor foods and beverages ('junk foods') is a probable causal factor in overweight and obesity, and is a target for future interventions (World Health Organization, 2003). Since this time, limiting children's exposure to unhealthy food marketing has been on the international public health agenda. Over the past decade there have been at least seven major systematic reviews of the scientific evidence relating to the impact of food marketing on children (Dalmeny et al. , 2003; Hastings et al. , 2003, 2006; Escelante de Cruz, 2004; Livingstone, 2006; McGinnis et al. , 2006; Cairns et al. , 2009). The most recent systematic review, commissioned by the World Health Organization in 2008, identified that food marketing has a modest impact on nutrition knowledge, food preferences and consumption patterns, and that these effects operate at both the brand and food category level (Cairns et al. , 2009). In other words, not only does food marketing contribute to brand switching within a food category, but also leads to switching between less marketed foods to more highly marketed food types. These findings are concerning as the most commonly promoted foods have been identified as sugarsweetened breakfast cereals, savoury snacks, fast food restaurants, confectionery and soft drinks (Cairns et al. , 2009). This chapter provides a detailed overview of the scope and impact of food marketing on children, including: 1. the extent of children's exposure to unhealthy food promotions, as evidenced by studies measuring the prevalence of promotions through a range of media; 2. policy responses to unhealthy food promotion, including at the international level and exemplars of good practice by national and provincial governments, and policy actions by the food and advertising industries; and 3. evidence linking food promotions to food consumption and nutrition and weight outcomes. In the latter section, we provide a conceptual framework of cause and effect to indicate how immediate impacts of exposure to promotions (e.g. brand awareness and recall) can be linked to subsequent, downstream behavioural and health-related outcomes.