High In Fat, Sugar And Salt Research Articles

Trends of high fat, salt and sugar food consumption and its impact on nutritional status of school children

Background: India is currently in a phase of nutrition transition. Increased consumption of food high in fat, sugar and salt (HFSS) is contributing significantly to prevalence of triple burden of malnutrition among children. Methods: In this study, the nutritional status and frequency of HFSS food consumption were assessed in 360 school children (boys n=171, girls n=189) aged between 6-16 years using standard tools and techniques. Results: From the results, it was evident that the frequency of consumption of HFSS food among children of both the age group 6-10 years and 11-16 years was significantly high (p≤0.05). Children aged between 6-10 years were more prone to under nutrition (38%) and they were consuming more snacks such as chips, biscuits, packaged fruit juices high in sodium, saturated fat and sugar. On the other hand, adolescents aged between 11-16 years show a higher prevalence of both under nutrition and overweight (10%), potentially linked to their consumption of bakery products, street foods, sugary drinks and carbonated beverages. Conclusions: The nutrition transition shift is towards consumption of refined, ultra processed, high sodium and fat foods. The age-based trend is a nutritional challenge among children and adolescents. The findings of this study emphasized the urgent need for early screening of nutrient deficiencies, comprehensive interventions to address the triple burden of malnutrition among school children. Efforts should focus on promoting healthy dietary behaviours, enhancing nutritional literacy among children, parents and care givers, improving access to nutritious foods, and regulating the marketing and availability of HFSS foods.

What works in advocating for food advertising policy change across an english region – a realist evaluation

BackgroundWith increasing recognition of the role of commercial determinants of health, local areas in England have sought to restrict the advertising of products high in fat, salt and sugar (HFSS) on council-owned spaces, as part of wider strategies to reduce obesity. While there is some evidence of the impact of such policy change on behaviour, little is known about what works in the process of implementing this policy change.MethodsGuided by a realist evaluation framework that explores the interaction between context, mechanism and outcomes, this study aims to investigate the factors that influence the restriction of outdoor advertising of HFSS products in one region in England. It refines a programme theory co-produced with stakeholders from 14 local authorities within a region and uses multiple data sources from each area with an in-depth examination of four case study sites. Data sources include longitudinal realist interviews, focus groups and surveys with policy advocates and policy stakeholders. Data were analysed retroductively to understand the causal link between context, mechanism and outcomes.ResultsOutcomes were driven by five dominant mechanisms: a strategic and staggered approach to stakeholder engagement, gathering intelligence, identifying policy champions, building relationships, reframing the issue; and two secondary mechanisms of amplifying the issue and increasing public will. These led to varied outcomes with no changes in formal policy position within the evaluation period but draft policy guidance in place and changes in political will demonstrated. Dominant context factors influencing change included having a named and resourced policy advocate in place supported by an external Community of Improvement and having existing aligned local objectives. Organisational complexity and change, financial concerns, lack of local examples, ideological positions and the pandemic were also influencing contextual factors.ConclusionEffecting policy change in this area requires the commitment of an extended period and the valuing of short-term policy outcomes, such as increasing political will. The importance of a resourced and well-supported policy advocate to lead this work is fundamental and the commercially sensitive nature of this policy change means that a complex interplay of mechanisms is required which may be dominated by a strategically staggered approach to stakeholder engagement.

Nutritional Quality of Diets of Adults (20-40 Years) in Delhi, India

Rise in prevalence of diet related non communicable diseases can be prevented by following balanced and healthy diets. The study aimed to assess adequacy of nutrient and food group intakes along with frequency of consumption of foods High in Fat, Sugar and Salt (HFSS). The study was a cross-sectional study with non-probability purposive sampling method. A total of 589 adults (20-40 years) were selected from housing colonies from four geographical zones of city. Dietary intake was assessed using 24-hour dietary recall method. Frequency and amount of foods consumed was recorded using a semi quantitative Food Frequency Questionnaire (FFQ). The differences in food groups and nutrient intakes across socio-demographic groups were assessed using Independent sample t-test and Mann-Whitney U test. Statistical significance was assumed at 5% level (p<0.05). Most participants had nutrient intakes lower than the EAR for calcium (97%), zinc (98%), riboflavin (100%), niacin (68%), vitamin B6 (96%) and vitamin A (60%). All participants had lower intakes of pulses, green leafy vegetables, other vegetables, fruits, milk and milk products, oilseed and nuts when compared to the recommended intakes. HFSS foods-sweet plain biscuits (46%), fried namkeen (37%), roasted namkeen (30%), non-carbonated drinks (29%) and deep-fried foods (25%) were eaten regularly by more than one fourth of participants. Participants occasionally consumed pizzas (60%), chat (54%), dosa (50%) and burgers (48%). Therefore, reducing the share of foods high in fat, sugar and salt and enabling healthier selection of food groups through behaviour change communication strategies will ensure adequate nutrient intakes.

Could taxes on foods high in fat, sugar and salt (HFSS) improve climate health and nutrition in Scotland?

Foods high in fats, sugar and salt (HFSS) have a significant impact on public health, the climate and the economy. As such, it is critical to ascertain how pricing policies could help reduce their consumption in Scotland. This study analysed secondary data of 3260 households from Kantar Worldpanel, which comprised 18 food categories consumed in Scotland. The primary objective was to simulate the implications of an excise tax imposed on HFSS food purchases on climate health and consumer welfare using uncompensated own- and cross-price elasticities estimated from the Exact Affine Stone Index demand model. Two policy scenarios were considered: taxing all HFSS while the prices of the remaining foods remain unchanged; and taxing HFSS while subsidising fruit and vegetables with the revenue generated. The results from the study indicate that imposing taxes on HFSS would reduce their consumption due to price effects. A 10% tax on HFSS food groups while subsidising fruit and vegetables with the tax revenues simultaneously brought about a 5–9% decline in the consumption of HFFS and an 11% and 7% rise in vegetable and fruit consumption respectively. Weekly per capita greenhouse gas emissions could increase by 2% if fruit and vegetables were subsidised with the tax revenues, while decreasing by 3% when only HFSS food groups were taxed. Taxing HFSS without a subsidy policy in place was more regressive on consumers than when fruit and vegetables were subsidised. In conclusion, imposing a revenue-neutral HFSS tax policy would result in a trade-off between dietary, welfare and environmental goals. The policy scenario adopted by the government would depend on the national goal being pursued.

Snacking practices from infancy to adolescence: parental perspectives from longitudinal lived experience research in England.

Consumption of snacks and ultra-processed foods (UPF) high in fat, salt and sugar (HFSS) is associated with rising rates of obesity and growing socioeconomic disparities in nutrition. While infancy, childhood and adolescence are critical periods for development of dietary preferences, there remains a dearth of research exploring factors that underpin snacking behaviour over this time. This review aims to address this gap by drawing from qualitative lived experience research, with 122 families of different socioeconomic position (SEP), to explore how the (i) home food environment, (ii) food environment and (iii) social value and meanings of food shape parental provision of snacks. This review shows that snacking holds important meanings in everyday family life, with infants integrated into existing snacking practices from an early age. Price promotions, low-cost and long shelf-lives all make UPF and HFSS snacks an appealing option for many low-SEP parents; while children's requests and preferences for HFSS snacks present a challenge across SEP. However, higher-SEP parents can ensure fresh fruits are always available as an alternative snack, while fruit is described as a financially risky expenditure for low-SEP families. The present findings also indicate that retailers and producers are increasingly promoting 'healthier' snacks through product packaging and marketing, such as 'meets one of your five a day', despite these products displaying similar nutritional profiles to traditional UPF and HFSS snacks. We outline a series of policy recommendations, including extending Healthy Start Vouchers and the Fruit and Vegetable Scheme in schools and action to address misleading product marketing and packaging.

Assessing exposure to outdoor advertisement for products high in fat, salt and sugar (HFSS); is self-reported exposure a useful exposure metric?

BackgroundExposure to advertising of unhealthy commodities such as fast-food and gambling is recognised as a risk factor for developing non-communicable diseases. Assessment of the impact of such advertisement and the evaluation of the impact of any policies to restrict such advertisements on public health are reliant on the quality of the exposure assessment. A straightforward method for assessing exposure is to ask people whether they noticed any such advertisements in their neighbourhoods. However, the validity of this method is unclear. We assessed the associations between measured exposure to outdoor advertising, self-reported exposure, and self-reported consumption.MethodsWe collected exposure information in January-March 2022 using two methods: (i) through a resident survey investigating advertising and consumption of unhealthy products, distributed across Bristol and neighbouring South Gloucestershire, and (ii) through in-person auditing. Self-reported exposure was obtained from the resident survey (N = 2,560) and measured exposure from photos obtained for all Council owned advertisement sites (N = 973 bus stops). Both data sources were geographically linked at lower-super-output-area level. Reporting ratios (RRs), 95% confidence intervals (CIs), and Cohen’s kappas, are presented.Results24% of advertisements displayed food and/or drink advertising. Bristol respondents in neighbourhoods displaying food/drink adverts were more likely to also report seeing these adverts compared to those in neighbourhoods without food/drink adverts (59% vs. 51%, RR = 1.15, 95%CI 1.01–1.31). There was no such association in South Gloucestershire (26% vs. 32%, RR = 0.82, 95%CI 0.58–1.14). Respondents in both Bristol and South Gloucestershire who recalled seeing advertising for unhealthy food and drink products were more likely to consume them (e.g. for fast-food: 22% vs. 11%, RR = 2.01, 95%CI 1.68–2.42). There was no such association between measured food and drink adverts in respondents’ local areas and self-reported consumption of HFSS product (90.1% vs. 90.7%, RR = 0.99, 95%CI 0.96–1.03).ConclusionsSelf-reported outdoor advertisement exposure is correlated with measured exposure, making this a useful methodology for population studies. It has the added advantage that it correlates with consumption. However, given that measurement error can be significant and self-reported exposure is known to be susceptible to various biases, inferences from studies using this exposure metric should be made with caution.

UK government’s new placement legislation is a ‘good first step’: a rapid qualitative analysis of consumer, business, enforcement and health stakeholder perspectives

BackgroundThe current food system in England promotes a population diet that is high in fat, sugar and salt (HFSS). To address this, the UK government has implemented legislation to restrict the promotion of HFSS products in prominent locations (e.g. store entrances, checkouts) in qualifying retailers since October 2022. This study investigated the perceived impact of the legislation for affected stakeholders.MethodsA pre-implementation rapid qualitative evaluation of stakeholder interviews. One hundred eight UK stakeholders participated in the study including 34 consumers, 24 manufacturers and retailers, 22 local authority enforcement officers and 28 academic and charitable health representatives. A participatory conference was used to enable policy recommendations to be confirmed by stakeholders.ResultsStakeholders perceived the legislation to be a ‘good first step’ towards improving population diet but recognised this needed to be considered amongst a range of long-term obesity policies. Areas of further support were identified and these are presented as six recommendations for government to support the successful implementation of the legislation: (1) provide a free central HFSS calculator, (2) refine legislation to enhance intent and clarity, (3) conduct a robust evaluation to assess intended and unintended outcomes, (4) provide greater support for smaller businesses, (5) provide ring-fenced resources to local authorities and (6) create and communicate a long-term roadmap for food and health.ConclusionsThis legislation has the potential to reduce impulse HFSS purchases and makes a solid start towards creating healthier retail outlets for consumers. Immediate government actions to create a freely accessible HFSS calculator, support smaller businesses and provide additional resources to local authorities would support successful implementation and enforcement. Independent evaluation of the implementation of the legislation will enable monitoring of potential unintended consequences identified in this study and support refinement of the legislation. A long-term roadmap is necessary to outline strategies to support equal access to healthier and sustainable food across the whole food system within the next 20–30 years.

Newspaper framing of food and beverage corporations’ sponsorship of sport: a content analysis

BackgroundUnhealthy diets are a leading contributor to obesity, disability and death worldwide. One factor cited as contributing to rises in obesity rates is the pervasive and ubiquitous marketing of unhealthy foods and beverages (F&Bs) across a variety of mediums, such as sport sponsorship at both professional and amateur levels. Despite increased academic attention on the detrimental impacts of sport sponsorship within the obesogenic environment, this has not been matched by legislative action. One explanation may be the way that F&B corporations’ sport sponsorship is framed within policy debates. Framing is the deliberate ways in which (often contested) issues are presented in communication. This paper examines how sport sponsorship by F&B corporations is framed through media reports.MethodsThis study employed a mixed methods content and framing analysis. First, we conducted a quantitative newsprint content analysis (n = 234). This then informed and directed a thematic framing analysis of a sub-set of articles (n = 54) that specifically associated sport sponsorship by F&B corporations with obesity and childhood obesity.ResultsThe findings suggest that two competing frames are evident within newspaper coverage: 1) public health and 2) industry. The public health frame rejects the sponsorship of sport by High in Fat Sugar and Salt (HFSS) product corporations in particular, calling for such sponsorship to be restricted or banned. The industry frame characterises sponsorship of sport as a form of corporate social responsibility, positioning industry as good moral actors and part of the solution to childhood and adult obesity. These frames are evident across other Unhealthy Commodity Industries (UCIs) policy debates. However, the prominence of industry actors within the sample is potentially indicative of their discursive power within this space, particularly with their emphasis on the financial maintenance of sport as well as encouraging physical activity, contributing to the lack of regulatory development of sport sponsorship by F&B corporations.ConclusionsThe findings of this study are particularly useful for public health organisations who seek regulatory change, as it may provide further insight into countering industry framing practices, raising the salience of regulation of sport sponsorship and thus increasing the likelihood of regulatory development that seeks to improve population health.

Children's, parents' and professional stakeholders' views on power concerning the regulation of online advertising of unhealthy food to young people in the UK: A qualitative study.

Examinations of corporate power have demonstrated the practices and activities Unhealthy Commodity Industries (UCIs) employ to exert their power and influence on the public and health policy. The High in Fat Sugar and Salt (HFSS) product industry have exploited the online environment to market their products to young people. Regulating UCIs’ marketing can limit the power of those industries and is argued to be one of the most appropriate policy responses to such marketing. However, there is minimal consideration of how stakeholders view regulation of online advertising of HFSS products to young people. This UK-focused study addressed this through a secondary analysis of focus groups with young people (n = 15), the primary analysis of focus groups with parents (n = 8), and interviews with professional stakeholders (n = 11). The findings indicated that participants’ views on the regulation of online advertising of HFSS products were informed by how professional stakeholders exerted instrumental, structural and discursive power. Participants cited regulation as a means to re-negotiate problematic power dynamics to increase young people’s and parents’ autonomy over young people’s diets, yet concern remained as to the impact regulation may have on individual autonomy. To garner increased public support for such regulatory policies, it may be beneficial for advocates to emphasise the empowering elements of those regulatory policies. Advocacy actors may wish to shift their framing of regulation from one that focuses on restricting industry practices, to one that centres on empowering individuals.

Changes to local area public sector spending and food purchasing in England: a longitudinal ecological study

ObjectivesChanges in public sector service spending may influence food consumption. We make use of changing local authority (LA) expenditure in England to assess impacts on food purchasing. We examine total...

Exposure of French Children and Adolescents to Advertising for Foods High in Fat, Sugar or Salt.

Food marketing of products high in fat, sugar and salt (HFSS), including television advertising, is one of the environmental factors considered as a contributor to the obesity epidemic. The main objective of this study was to quantify the exposure of French children and adolescents to television advertisements for HFSS products. TV food advertisements broadcast in 2018 were categorized according to the Nutri-Score of the advertised products. These advertisements, identified according to the days and times of broadcast, were cross-referenced with audience data for 4- to 12-year-olds and 13- to 17-year-olds. More than 50% of food advertisements seen on television by children and adolescents concerned HFSS products, identified as classified as Nutri-Score D and E. In addition, half of advertisements for D and E Nutri-Score products were seen by children and adolescents in the evening during peak viewing hours, when more than 20% of both age groups watched television. On the other hand, during the same viewing hours, the percentage of children and adolescents who watched youth programs, the only programs subject to an advertising ban, was very low (<2%). These results show that the relevance of regulating advertising at times when the television audience of children and adolescents is the highest and not targeted at youth programs, in order to reduce their exposure to advertising for products of low nutritional quality.

Instrumental, structural &amp; discursive power &amp; the regulation of online advertising of unhealthy food

Abstract Background Examinations of corporate power demonstrate how Unhealthy Commodity Industries (UCIs) exert influence on the public and policymakers. For example, the High in Fat Sugar and Salt (HFSS) product industry exploit online environments to market their products to young people as a form of discursive power, and regulating this marketing can limit the power of those industries and is recognised as an important policy response. Here we address the gap in consideration of stakeholders' views of regulation of online advertising of HFSS products to young people to limit industry power. Methods We undertook primary analysis of 8 focus groups of parents, 11 stakeholder interviews and secondary analysis of 15 focus groups of young people (aged 12 and 15 years-of-age) in various community settings, with 5 individual interviews over the telephone. Focus group participants were recruited from a range of socioeconomic areas following the Scottish Index of Multiple Deprivation quintiles. Stakeholders were recruited from civil society organisations, government bodies and industry. Analysis employed Fuchs and Lederer's (2007) framework on instrumental, structural and discursive power. Results Stakeholders' views on the power of HFSS product industry appeared to predicate their views on regulation as an appropriate policy response. The majority of participants viewed regulation as a means to increase young people's and parents' autonomy over young people's diets by addressing the problematic power dynamic with industry at a policy level, yet concern remained about the adverse impact of regulation on individual autonomy. Conclusions Power is an important consideration when examining acceptability of To increase public support for regulation, it may be beneficial to emphasise the empowering effects of policy proposals. Advocates should shift their framing of regulation from focusing on restricting industry, to focusing on empowering the public. Key messages Views on power appear important when considering public acceptability of regulatory policy. Understanding views on power may improve public health messaging on policy interventions.

Food environment in and around schools and colleges of Delhi and National Capital Region (NCR) in India

BackgroundFood policies and environment (availability, accessibility, affordability, marketing) in and around educational institutes can influence food choices and behaviours of children and adolescents.MethodsCross-sectional, mixed-methods study was implemented in schools (n = 9; Private = 6, Public = 3) and colleges (n = 4) from Delhi and National Capital Region (India). The data was collected from students of schools (n = 253) and colleges (n = 57), parents of school students (n = 190), teachers (n = 12, schools = 9, colleges = 3) and canteen operators of Private schools and colleges (n = 10; schools = 6, and colleges = 4). The primary and secondary data was collected to: 1) identify the strengths and weaknesses of the existing guidelines and directives (desk review); 2) examine food environment, existing policies and its implementation (structured observations, in-depth interviews, surveys, focus group discussions), and; 3) assess food choices, behaviours of students (focus group discussions). The thematic analysis was used for qualitative data and descriptive analysis for quantitative data.ResultsThe available food and beverage options, in and around the participating educational institutes were either high in fat, salt and sugar (HFSS), despite government and educational institute guidelines on restricting the availability and accessibility of HFSS foods. The healthy food and beverage options were expensive compared to HFSS foods both inside and outside educational institutes. In total, 37 vendors (Private = 27; Public:10) were observed outside schools at dispersal and twelve at lunchtime. Around colleges, vendors (n = 14) were seen throughout the day. Students from all Private schools (n = 6) and colleges (n = 2) were exposed to food and beverage advertisements either HFSS (Private schools = 1–3 and colleges = 0–2 advertisements), whereas no advertisements were observed around Public schools.ConclusionIt is imperative to implement food policies to improve the food environment in and around educational institutes to ensure the availability of healthy foods to establish and sustain healthy eating behaviours among students. Thus, the study findings emphasise stringent implementation, regular monitoring and surveillance of recently introduced Food Safety and Standards (Safe food and balanced diets for children in school) Regulation 2020, ensuring its compliance through effective enforcement strategies.

An Assessment of Government Capacity Building to Restrict the Marketing of Unhealthy Food and Non-Alcoholic Beverage Products to Children in the Region of the Americas.

The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the capacity-building needs in PAHO’s Member States to restrict the marketing of HFSS food and beverages to children. We asked Ministries of Health officials or national institutes/departmental representatives (n = 35) to complete a 28-item web-based survey (January to July 2020). Capacity-building needs were assessed using an adapted version of the World Health Organization’s government capacity-building framework with three modules: public health infrastructure, policies and information systems. Notable achievements for the PAHO’s Plan of Action were identified. State representatives reported strong infrastructure and information systems; however, policy improvements are needed to increase comprehensive national responses. These include using a constitutional health and human rights approach within the policies, policies that document conflict of interest from non-state actors, and strengthening regulatory oversight for digital media platforms. These findings provide baseline data and we suggest priorities for further action to strengthen national governments’ capacity-building and to accelerate the development, implementation, and monitoring systems to restrict the marketing of HFSS food and non-alcoholic beverages to children in the region of the Americas.

Whose rights deserve protection? Framing analysis of responses to the 2016 Committee of Advertising Practice consultation on the non-broadcast advertising of foods and soft drinks to children

Exposure to advertising of food and beverages high in fat sugar and salt (HFSS) is considered a factor in the development of childhood obesity. This paper uses framing analysis to examine the strategic discursive practices employed by non-industry and industry responders to the Committee of Advertising Practice’s consultation responses (n = 86) on UK regulation of non-broadcast advertising of foods and soft drinks to children. Our analysis demonstrates non-industry and industry responders engaged in a moral framing battle centred on whose rights were deemed as being of greatest importance to protect: children or industry. Both industry and non-industry responders acknowledged that childhood obesity and non-broadcast advertising were complex issues but diverged on how they morally framed their arguments. Non-industry responders employed a moral framework that aligned with the values represented in social justice approaches to public health policy, where children were identified as vulnerable, in need of protection from harmful HFSS product advertising and childhood obesity was a societal problem to solve. In contrast, industry responders emphasised industry rights, portraying themselves as a responsible industry that is victim to perceived disproportionate policymaking, and values more closely aligned with a market justice approach to public health policy. Our analysis provides detailed insights into the framing strategies used in the policy debate surrounding the non-broadcast advertising of HFSS foods to children. This has relevance as to how advocacy organisations can develop counter-framing to industry frames which seek to limit effective regulation.

Sociodemographic differences in self-reported exposure to high fat, salt and sugar food and drink advertising: a cross-sectional analysis of 2019 UK panel data

ObjectivesTo explore sociodemographic differences in exposure to advertising for foods and drinks high in fat, salt and sugar (HFSS) and whether exposure is associated with body mass index (BMI).DesignCross-sectional survey.SettingUK.Participants1552...

The food advertising preying on our children

British Journal of Child HealthVol. 2, No. 1 EditorialThe food advertising preying on our childrenCaroline VoogdCaroline VoogdEditorSearch for more papers by this authorCaroline VoogdPublished Online:16 Feb 2021https://doi.org/10.12968/chhe.2021.2.1.5AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Büttner OB, Florack A, Serfas BG. A Dual-step and dual-process model of advertising effects: Implications for reducing the negative impact of advertising on children's consumption behaviour. J Consum Policy 2014; 37:161–182. https://doi.org/10.1007/s10603-013-9250-0 Google ScholarDepartment for Digital, Culture, Media and Sport, Department of Health and Social Care. Introducing a total online advertising restriction for products high in fat, sugar and salt (HFSS). 2020. https://bit.ly/2YJB84o (accessed 3 February 2020) Google ScholarIAB UK. Ad industry unites with joint letter to PM on HFSS. 2020. https://www.iabuk.com/news-article/ad-industry-unites-joint-letter-pm-hfss. (accessed 3 February 2020) Google Scholar FiguresReferencesRelatedDetails 2 February 2021Volume 2Issue 1ISSN (print): 2633-5417ISSN (online): 2633-5425 Metrics History Published online 16 February 2021 Published in print 2 February 2021 Information© MA Healthcare LimitedPDF download

Development of a Responsible Policy Index to Improve Statutory and Self-Regulatory Policies that Protect Children's Diet and Health in the America's Region.

In 2010, 193 Member States of the World Health Organization (WHO) endorsed World Health Assembly Resolution WHA63.14 to restrict the marketing of food and beverage products high in fat, sugar and salt (HFSS) to children to prevent obesity and non-communicable diseases (NCDs). No study has examined HFSS marketing policies across the WHO regional office countries in the Americas. Between 2018 and 2019, a transdisciplinary team examined policies to restrict HFSS food and beverage product marketing to children to develop a responsible policy index (RESPI) that provides a quality score based on policy characteristics and marketing techniques. After designing the RESPI, we conducted a comprehensive literature review through October 2019 to examine policies in 14 countries in the WHO Americans Region. We categorized policies (n = 38) as either self-regulatory or statutory and calculated the RESPI scores, ranked from 0 (lowest) to 10 (highest). Results showed Brazil, Canada, Chile, and Uruguay had the highest RESPI scores associated with statutory policies that restricted point of sale, cartoon, licensed media characters and celebrities; and HFSS products in schools and child care settings, and broadcast and print media. Policymakers can use the RESPI tool to evaluate marketing policies within and across geopolitical boundaries to protect children’s diet and health.

Area deprivation, screen time and consumption of food and drink high in fat salt and sugar (HFSS) in young people: results from a cross-sectional study in the UK

ObjectivesTo investigate associations between deprivation in young people and consumption of foods high in fat, salt and sugar (HFSS), screen time exposure and health knowledge.DesignAn online cross-sectional survey with people...

The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M–AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m2). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372–25,155); total cost-savings AUD126.3M (95% UI AUD58.7M–196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812–15,679); total cost-savings AUD90.9M (95% UI AUD44.3M–136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.