Food advertising is a hot political topic

With rising interest worldwide on the role of poor diets and obesity on causing non-communicable diseases, including cancers, diabetes and heart disease, the commercial promotion of food and beverage products is now the policy agenda in most countries. In 2004 the World Health Assembly called on the private sector to promote healthy diets in accordance with national dietary guidelines and to practice responsible marketing and in 2010 urged member states to restrict advertising to children¹.

National responses have varied. Some countries have new regulations backed by statutory law to restrict advertising on TV, and others have maintained legislation banning all advertising to children, but most countries are relying on the food and beverage industry to take voluntary measures to cut the promotion of unhealthy foods.

Are voluntary controls the answer?

The voluntary approach is attractive, as it may offer the same results quickly and without the need for legislation or the bureaucracy to monitor compliance. But it is risky: voluntary measures may not be supported by all companies, the measures can be rolled back or weakened at a later date, and above all they can be full of small loopholes which make them unfit for their purpose.

In 2008, several large companies agreed to a world-wide voluntary ban on marketing of unhealthy products to children, which in Europe took the form of the EU Pledge (see www.eu-pledge.eu). These companies set self-defined targets for restricting what and how they market, and to whom. The different company pledges show a degree of inconsistency in terms of the media formats, the age of children, and especially the types of foods which would and would not be restricted, which makes evaluation of the impact of the pledges hard to assess².

The pledge-coordinating bodies have published annual reports showing levels of compliance above 90% year after year, indicating a remarkable reduction in the exposure of children to the marketing of unhealthy foods.

Independent surveys find only weak effects of voluntary controls

Our organisation, the International Association for the Study of Obesity, is currently undertaking a systematic review of the peerreviewed scientific literature and reports from government agencies and academic institutions, to assess the independent evidence on the effectiveness of self-regulation.

Our findings will be published later this year, but for IFAVA Newsletter readers we can summarise as follows:

• The scientific papers showed only weak or no improvement in reducing children’s exposure.
• Government and academic reports also showed only low levels of improvement over the period, although there is stronger evidence for an improvement in the UK, which has introduced statutory regulations.
• In countries where no pre-Pledge data are reported, surveys have shown that children are continuing to experience a high level of exposure to advertising for unhealthy foods.
• Overall, self-regulation has had only a small impact or no impact, as children’s exposure levels are not significantly below the levels found in pre-Pledge years.

Why do Pledge reports differ from independent surveys?

These results contrast strongly with the results reported by the Pledge coordinating bodies. One cause of discrepancy may lie in the lack of complete coverage of the pledges across all food companies, and it is possible that advertising from non-pledge members has continued and even increased, but this will not be reported in the Pledgesponsored reports.

Further potential causes of discrepancy between industry-sponsored reports and other reports may lie in the definitions used for assessing the advertising. These include different audience definitions: most of the scientific papers used times of day when children are likely to be watching television, whereas the pledges have specified ‘children’s TV’ to be only those TV programmes watched by an audience of which over 35% (or in some cases over 50%) are children under the age of 12 years. Different nutrient profiling definitions: scientific papers used a single set of definitions of unhealthy foods whereas each company has used its own, favouring its products. Thus a breakfast cereal company allows up to 35g sugar per 100g as advertisable, while more than 20g sugar per 100g makes the cereal an unhealthy product in the scientific papers.

Is it now time for governments to set the standards?

In conclusion, we recognise the remarkable efforts that have been made by many food and beverage companies to reduce the marketing of some of their products to children, and that new nutrient profiling schemes and new definitions of children’s programming are being offered by the Pledge members for implementing in 2013.

However, the narrow range of media, the weak definitions of marketing, the absence of many large food companies, and the lack of enforceability or penalties for failure suggest that self-regulatory pledges are unlikely to be sufficiently comprehensive to have the desired effect of reducing children’s exposure to the promotion of unhealthy food products.

Stronger measures are recommended, preferably based on government-led definitions of the media and the products to be controlled and the audience to be protected.