Abstract
BackgroundThe first phase of a comprehensive marketing policy was implemented in Chile in 2016. The policy restricted child-directed marketing of foods and beverages considered high in energy, total sugars, sodium or saturated fat (“high-in”). The objective of this study was to examine the role of high-in TV food advertising as a mediator in the association between policy implementation and consumption of high-in foods and beverages between 2016 and 2017.MethodsDietary data were from 24-hour diet recalls collected in 2016 and 2017 in a cohort of 12–14 y children (n = 721). Television use was assessed concurrently and linked to analyses of food advertisements on broadcast and paid television to derive individual-level estimates of exposure to high-in food advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure.ResultsFollowing the policy implementation, high-in advertising exposure was significantly reduced (p < 0.01). High-in food intake decreased in adolescents with lower levels, but not higher levels, of high-in advertising at baseline. We did not find evidence of mediation by changes in high-in ad exposure.ConclusionsAdolescents’ exposure to high-in TV advertising decreased after the 2016 implementation of the Chilean Food Labeling and Marketing Law. However, evidence that changes in advertisement mediated dietary changes was not found. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.
Highlights
The first phase of a comprehensive marketing policy was implemented in Chile in 2016
Baseline associations of food consumption and TV advertising Compared to adolescents with low high-in ad exposure, those with high exposure at baseline had higher absolute intake of high-in foods and beverages; this difference did not reach statistical significance (Table 2), and the relationship was not step-wise
Total energy intake was highest among high exposure adolescents, when compared to low advertising exposure (p < 0.05), and no appreciable differences were observed in nutrient intake
Summary
The first phase of a comprehensive marketing policy was implemented in Chile in 2016. Marketing of unhealthy food and beverages influences food preferences, attitudes and consumption among youth [1,2,3,4,5], and it is a global health concern, because most of the promoted products are high in energy, saturated fat, sugars, or sodium, and are of little nutritional recognize the persuasive intent of marketing until close to age 12 [9]. There were several major policy changes that were enacted along with the marketing restriction component of the regulation: foods that exceeded energy and saturated fat, sugars or sodium thresholds (hereafter high-in) are prohibited from being sold in schools, and they are subject to a front-of-package warning label [12] Given that these changes occurred simultaneously, the evaluation of changes in food intake that are due to the marketing restriction is complex. Because global recommendations often include adopting a package of policy actions to create healthier food environments [18], mediation can help evaluate single components of such policies, when the policies target the same longer-term outcomes (dietary intake, food purchases, health status, among others)
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