The proposition for restricting marketing of unhealthy foods to children is currently being debated in many countries around the world. As the prevalence of childhood overweight and obesity increases globally(Reference Wang and Lobstein1), food marketing, which predominantly promotes unhealthy products, has come under increasing scrutiny for its contribution to an obesogenic environment for children(2). Consequently, public health groups are increasingly calling on governments to restrict the marketing of unhealthy foods to children in order to reduce children’s exposure and the food industry’s influence on their dietary choices(Reference Swinburn3).
To reduce the prevalence of childhood obesity at the population level, public health approaches, such as policy, fiscal and legislative measures, offer more powerful and effective tools than behavioural and clinical strategies(Reference Maziak, Ward and Stockton4). Tobacco control provides a good example of a public health strategy being more effective than individual approaches at reducing smoking rates. While obesity is not identical to smoking, it does share similarities, by way of big business promoting unhealthy products to consumers(Reference Chopra and Darnton-Hill5).
Calls for statutory restrictions to the marketing of unhealthy foods to children represent a structuralist discourse on health, whereby interventions target the markets that promote unhealthy products. This contrasts with the dominant individualist discourse, which places responsibility for change on the consumer – to exercise self-restraint and make the ‘right’ food choices in an environment that promotes consumption of energy-dense foods(Reference Rawlins6). The individualist discourse is consistent with neoliberal ideologies that nurture the operations of markets and favour individual responsibility for choices over government interventions to create supportive environments for healthy choices(Reference Hindess7).
Predominance of industry self-regulation
Thus, while we currently see robust debate about restrictions on unhealthy food marketing to children, in many countries around the world there has in fact been very little action. In her review of changes to global regulatory environments for the marketing of food and beverages to children between 2004 and 2006, Hawkes found that more governments had supported industry self-regulatory codes than had implemented statutory restrictions(Reference Hawkes8). The UK was notable in implementing statutory restrictions on the advertising of foods high in fat, salt or sugar during television programmes when children (up to 16 years) comprise 20 % or more of the viewing audience(9). Yet while this strategy has resulted in reduced advertising in programmes captured by the regulations(9), it has nevertheless failed to capture many other programmes that children actually watch in large numbers, such as Beat the Star, Emmerdale and Coronation Street (10).
Among the plethora of industry self-regulatory codes that have been promulgated, some worth mentioning because of their wide publicity are the Children’s Food and Beverage Advertising Initiative in the USA(11), The Responsible Children’s Marketing Initiative in Australia(12), and the Australian Quick Service Restaurant Industry Initiative for Responsible Advertising and Marketing to Children(13). All share the same shortcomings: they apply to advertising to children only up to 12 years of age; the definitions of principles and standards are ambiguous and open to interpretation; and the criteria for healthy foods are inconsistent(Reference Handsley, Mehta and Coveney14). On the plus side, they restrict the use of licensed characters and popular personalities, as well as product placement in programme content and interactive games. They also extend to marketing beyond traditional broadcast media. The food and beverage industry claims to have significantly reduced its advertising during children’s programmes(Reference Dunn15), but kids actually watch programmes outside ‘children’s’ classification in far greater numbers. In fact, Hawkes found food and beverage marketing to children on traditional (broadcast) and non-traditional media (Internet, video games, supermarkets, magazines, sports, etc.) to have increased between the period 2004 and 2006(Reference Hawkes8), contradicting industry claims about reductions in marketing to children.
Research papers
Two papers on food advertising to children in this issue of the journal speak directly to the problem of regulatory reform. The paper by Romero-Fernandez et al.(Reference Romero-Fernández, Royo-Bordonada and Rodríguez-Artalejo16) addresses the weaknesses of self-regulation. Their study found that almost 50 % of companies that signed up for Spain’s self-regulatory Code were non-compliant. Furthermore, there was no difference between companies that agreed or did not agree with the Code. The paper by Goris et al.(Reference Goris, Petersen and Stamatakis17) sought to attribute effects of food advertising to childhood obesity, across six countries, using mathematical modelling. Their results suggest that limiting food advertisements may lead to significant decrease in the prevalence of childhood overweight and obesity. Together, the two papers suggest that children will benefit from restrictions on food marketing, but that these restrictions must be statutory rather than self-regulatory in order to make a difference.
International health sector response
In recognition of the transnational nature of marketing food and beverages to children, public health and consumer groups have proposed an International Code to restrict children’s exposure to unhealthy marketing(18). The WHO, in its latest report on the prevention of non-communicable diseases, acknowledged the problem of cross-border and integrated marketing of predominantly unhealthy food and beverages to children, and recommended that member states tackle this problem(19). Clearly, we have achieved recognition that this is a problem. Now it is time for concrete statutory reform.