On April 16, The Chicago Council launched a new report, Healthy Food for a Healthy World: Leveraging Agriculture and Food to Improve Global Nutrition, at the Global Food Security Symposium 2015. Each week, we will highlight one of the report’s recommendations in a new post on the Global Food for Thought blog. This blog series explores how the strengths and ingenuity of the agriculture and food sector can reduce the reality and risks of malnutrition globally. Watch for a new post each Wednesday, and join the discussion using #GlobalAg. 

Promotional food and beverage marketing designed to influence consumption habits is now ubiquitous throughout the globe, reaching even remote rural areas. Ultraprocessed food products, which are made of processed substances such as hydrogenated oils fats, flours and starches, and sugars, are among the most profitable for food companies and are therefore aggressively marketed. Between 1980 and 2012 global advertising expenditures increased from $216 billion to $497 billion. In the United States food and beverage companies spend more than $2 billion annually to market food and beverages to children in particular. Marketing of these products is commonly targeted to children because it creates brand loyalty from an early age and strongly influences long-term consumer behavior. Studies by the Institute of Medicine of the National Academies and numerous other independent investigations have concluded that food advertising impacts children’s food preferences, diets, and health.

Unfortunately, the overwhelming majorities of food product and beverage advertisements viewed by children are for foods and beverages that are high in fat, sugar, and sodium. Because children do not understand the marketing intent of these advertisements, they are particularly vulnerable to messages that encourage them to eat foods or drink beverages that have limited to no nutritional value and that can displace healthy foods.

In response to concerns about marketing unhealthy foods to children, Congress directed the Federal Trade Commission, the US Department of Agriculture, the Food and Drug Administration, and the Centers for Disease Control and Prevention to form an Interagency Working Group on Food Marketed to Children (IWG) to develop voluntary guidelines limiting the marketing of unhealthy foods to children in the United States. The food and beverage industry found these recommendations to be overly restrictive, but through the Better Business Bureau Children’s Food and Beverage Advertising Initiative (CFBAI), 18 companies signed on to a set of their own voluntary standards for marketing to children.

Self-monitoring by the CFBAI, supported by independent investigations, has shown progress in reducing advertising of unhealthy snacks and beverages to children. Furthermore, products have been increasingly reformulated to meet stricter nutritional standards regarding saturated fat, trans fat, added sugars, and sodium, demonstrating potential for incremental change. In January 2014 CFBAI adopted new standards with stricter limits on overall calories, sugar, and fat in foods marketed to children, so many CFBAI-approved products now meet the IWG standards for specific limits on saturated fats and added sugars.

However, despite such changes to make products healthier, unhealthy foods and beverages continue to be widely marketed to young people. Over time, the CFBAI should work to better align their nutrition standards for marketing of foods and beverages to children with the recommendations set out by the IWG.

Voluntary guidelines, however, do not apply to marketing practices outside the United States. Development and enforcement of child marketing guidelines are particularly needed in low- and middle-income countries, where investments in the marketing and advertising of ultraprocessed foods by transnational food corporations have increased enormously in recent decades. As the nutrition transition continues to unfold in these countries and the prevalence of overweight and obesity continues to climb, especially among youth, it is critically important to limit exposure by children to advertising that could create long-term, unhealthy dietary patterns.

At least 20 countries around the globe already have explicit policies addressing food and beverage marketing to children. In addition, the WHO and Pan American Health Organization (PAHO) have published voluntary guidelines that can be used by countries around the world or specifically in Latin America. For voluntary guidelines like these to have a global impact, restaurants, food and beverage companies, and media companies across the globe must be aligned in their commitment to nutrition-sensitive marketing to children. Using the WHO and PAHO guidelines and the WHO Implementation Framework, the US government should partner with WHO and other international agencies to disseminate and further specify voluntary guidelines that could be adopted by a broad range of restaurants, food and beverage companies, and media companies. 

Establishing an independent monitoring system to track adherence to voluntary commitments is essential to the success of these efforts. When voluntary commitments are adopted by industry based on public health and environmental concerns, there are clear benefits to the private sector’s image and bottom line. However, the success of such efforts hinges on regular, unbiased data to track progress. Progress toward commitments should be published by companies as part of their annual sustainability reports.

Yet investments for independent data collection such as the Access to Nutrition Index are also needed. The Access to Nutrition Index (ATNI) assesses and ranks the world’s largest food and beverage manufacturers on their nutrition-related commitments, practices, and performance globally. By serving as a means for companies to benchmark their approaches to nutrition and identify areas for improvement, ATNI seeks to stimulate dialogue about the ways in which companies might improve their nutrition practices. The ATNI Global Index 2013 ranked 25 companies, with Danone, Unilever, Nestlé, PepsiCo, and Kraft Foods Inc. identified as the top five performing companies across all categories. The second ATNI Global Index will be released in late 2015. In addition to the Global Index ranking, Access to Nutrition also intends to develop and publish “Spotlight Indexes” that rate the largest manufacturers for each of its spotlight countries—India, South Africa, and Mexico. These indexes underscore the importance of food and beverage manufacturers in addressing obesity and undernourishment.

References:

• Access to Nutrition Foundation. “Objectives.” Accessed June 12, 2015.
• Children's Food & Beverage Advertising Initiative (CFBAI). Category-Specific Uniform Nutrition Criteria. Arlington, VA: Council of Better Business Bureaus, Inc., 2011.
• –––. The Children's Food & Beverage Advertising Initiative in Action: A Report on Compliance and Progress During 2013. Arlington, VA: Council of Better Business Bureaus, Inc., 2014.
• Hastings, G., et al. Does Food Promotion Influence Children? A Systematic Review of the Evidence. London: Food Standards Agency, 2003.
• Hawkes, Corinna. “Uneven Dietary Development: Linking the Policies and Processes of Globalization with the Nutrition Transition, Obesity and Diet-Related Chronic Diseases.” Globalization and Health 2, no. 4 (2006).
• Hawkes, Corinna, and Tim Lobstein. “Regulating the Commercial Promotion of Food to Children: A Survey of Actions Worldwide.” International Journal of Pediatric Obesity 6, no. 2 (2011).
• Kunkel, Dale. “Children and Television Advertising.” In Handbook of Children and the Media, edited by Dorothy G. Singer and Jerome L. Singer, 375-93. Thousand Oaks, CA: Sage, 2001.
• Makhijani, Shakuntala. “Advertising Spending Continues Gradual Rebound Driven by Growth in Internet Media.” WorldWatch Institute Vital Signs, March 26, 2013.
• McGinnis, J. Michael, Jennifer Appleton Gootman, and Vivica I. Kraak, eds. Food Marketing to Children and Youth: Threat or Opportunity? Washington, DC: National Academies Press, 2006.
• Moodie, Rob, et al. “Profits and Pandemics: Prevention of Harmful Effects of Tobacco, Alcohol, and Ultraprocessed Food and Drink Industries.” Lancet 381, no. 9867 (2013): 670-79.
• Pan American Health Organization (PAHO). Recommendations from a Pan American Health Organization Expert Consultation on the Marketing of Food and Non-alcoholic Beverages to Children in the Americas. Washington, DC: PAHO/WHO, 2011.
• Powell, Lisa M., Glen Szczypka, and Frank J. Chaloupka. “Trends in Exposure to Television Food Advertisements Among Children and Adolescents in the US.” Archives of Pediatric and Adolescent Medicine 164, no. 9 (2010): 794-802.
• Powell, Lisa M., Glen Szczypka, Frank J. Chaloupka, and Carol L. Braunschweig. “Nutritional Content of Television Food Advertisements Seen by Children and Adolescents in the United States,” Pediatrics 120, no. 3 (2007): 576-83.
• World Health Organization (WHO). A Framework for Implementing the Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children. Geneva: WHO, 2012.
• –––. Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children. Geneva: WHO, 2010.
• Worldwatch Institute. Worldwatch Global Trends Database—World and US Advertising Expenditure 1950-2004. Washington, DC: Worldwatch Institute, 2004.