Marketing of food and its impact on child and adolescent health
A complex combination of dietary practices, environmental, social and economic factors in countries of the Eastern Mediterranean Region have resulted in the persistence of what is described as the double-burden of malnutrition, where under-nutrition among young children and women in the child-bearing age group co-exist with nutrition of excess demonstrated by increasing rates of overweight, obesity and chronic diseases.
Evidence from the WHO StepWise surveillance system and the Global School-based Student Health Survey (GSHS) indicates an increasing prevalence of noncommunicable diseases and the risk factors related to overweight and obesity. In the EM countries, the prevalence of overweight among adult population ranges from 37% to 74% for male and 39% to 77% for female with a Regional average of 56.4%1.
The GSHS data confirm the overweight and obesity trend among adolescents with a percentage of students aged between 13-15 years old who are at risk of becoming overweight or are currently overweight or obese. This rate can reach 39% in some countries of the Region2. Obviously, these will have detrimental health consequences as about 60% of obese children before puberty will stay obese during adulthood with high risk of developing noncommunicable disease.
While the World health report 2002 highlights the role of behavioural factors, including unhealthy eating habits, the environment in which children live in is a great source of danger. Aggressive marketing campaigns and quasi-inexistent legislations protecting consumers and weak presence of consumers associations are factors facilitating unhealthy behaviors. It is widely known that many fast food commercials are targeting children and offer meals featuring characters for kid with prizes that are highly advantages with low nutrition benefits and high on sugar and carbohydrate. The techniques used to promote food high in fat, salt and sugar are very creative, and many of them hold appeal for children. Modern media and mass communication are key influencing tools in contemporary life determining our way of life. In the EMR, children are spending long hours watching TV or using the Internet with a percentage of children aged 13-15 years spending 3 or more hours per typical or usual day sitting and watching TV2. Clearly this increases exposure to marketing of snacks or other unhealthy drinks. According to a study by Mindshare’s Communications Channels Survey 79% of Arab females in the UAE said they were affected by soft drink ads and 82% by chocolate ads, 77% of Arab males in the UAE said they are impacted by car ads; 71.5% of them perceive TV to be the most effective medium for soft drinks. The same study found that 68% of Arab consumers in the UAE are influenced by ads on TV, 29% by outdoor advertising, 30% by newspapers, 18% by radio and 22.5% by indoor ads3.
In response, several global and regional instruments were developed to tackle issues of the endemic of NCDs and related risks behaviors such as the WHA resolutions on Prevention and control of noncommunicable diseases4 and implementation of the global strategy on diet, physical activity and health. Regionally, at the fifty fourth session, the EM Regional Committee, was the first Region to pass a resolution on Food marketing to children and adolescents. The resolution urged member states to:
- Develop appropriate multisectoral approaches and regulations to deal with the marketing of food and beverages directed at children and adolescents, including such issues as sponsorship, promotion, and advertising to involve celebrities in promoting healthy food habits;
- Require the food industry to provide clear, correct and consistent consumer nutrition information and media messages and to comply with the dietary guidelines regarding the nutritional quality and portion sizes;
- Formulate or further strengthen school health policies that support healthy diets and eliminate the availability in schools of products high in salt, sugar and fats, including sweetened carbonated drinks, and require daily physical activity in schools;
- Further strengthen nutrition and food safety education, including the introduction of media literacy education in schools, particularly in the health-promoting schools and the nutrition friendly schools initiatives;
- Establish a multisectoral mechanism to monitor the implementation of regulations regarding the marketing of food and beverages directed at children and adolescents;
- Provide consumers with accurate and clear information to enable them make healthier food choices, including supporting the efforts of consumer associations and groups.
Member States of the EMR realized the need for protecting children from aggressive marketing actions through the promotion of healthy public policies including legislation on food marketing, tax system to control ads of unhealthy food during sports events and policies related to food display in shops have become an area of concerns. In addition, several countries are attempting to limit street vendors around schools and reviewing the canteen dietary guidelines to encourage the consumption of fruits and vegetables. In 2009, Dubai Health Authority, in collaboration with UNICEF and WHO, launched the Childhood Obesity Awareness Campaign, “the FAT truth”, to bring the issue of child obesity at the forefront of social concern by making it a top political priority. In Tunisia, the local project of Hammam Sousse Health Study, which is a partnership project involving the municipality, hospital Sahloul and the Community concerned about the rise of NCDs, conducted several health education activities to educate mothers and children about the need to consume sufficient vegetables and fruits daily. In 2010, the Saudi Ministry of health in collaboration with the Ministry of Education launched an obesitycontrol campaign as part of its national health awareness programme. All these initiatives based on behavioural change are quite encouraging.
However, in order to obtain sustainable health results, they should be supported by legislation and healthy public policies. It is crucial that member states of the EMR strengthen national legislations particularly in the area of marketing of soft drinks and saturated food to control the rise of overweight and obesity among children and put in place a consumerwatch body to ensure that children are not mislead by aggressive marketing strategies.
- WHO StepWise surveillance system
- GSHS WHO- CDC. GSHS Fact Sheets in the Eastern Mediterranean Region
- Oman Economic Review. April 2006 “Following the western TV channels, the reality TV bug has hit the Arab TV channels in the GCC in a big way”.
- Resolution WHA60.23. Prevention and control of noncommunicable diseases: implementation of the global strategy. Excerpt: Sixtieth World Health Assembly, Geneva 14-23 May 2007. Volume 1. Resolutions and decisions, annexes. Geneva, World Health Organization, 2000 (WHA60/2007/REC/1)