New research has found that the US government and schools have made mixed progress to comprehensively address food and beverage marketing practices that put young people's health at risk. A comprehensive review published in the March issue of the American Journal of Preventive Medicine finds that public sector stakeholders have failed to fully implement recommendations from the Institute of Medicine (IOM) to support a healthful diet to children and adolescents.
"Evidence links the marketing of high-calorie, nutrient-poor branded food and beverage products to obesity rates. Our evaluation found that the prevailing marketing environment continues to threaten children's health and the public sector has missed important opportunities to promote a healthful diet and create healthy eating environments," says lead author Vivica Kraak, MS, RD, Research Fellow at Deakin University's Population Health Strategic Research Center in Melbourne, Victoria, Australia.
In a study requested by Congress in 2004, the IOM determined that food marketing influences children and adolescents to prefer, request, and consume high-calorie and nutrient poor foods and beverages. In December 2005, an expert IOM committee issued a report with 10 recommendations to guide public- and private-sector stakeholders to promote healthy eating in children and adolescents. Kraak and colleagues Mary Story, PhD, RD, University of Minnesota School of Public Health, and Ellen A. Wartella, PhD, Northwestern University School of Communication, conducted a comprehensive literature review of the evidence to determine what progress had been made toward 5 of the report's recommendations for the public sector. The other 5 recommendations directed at industry stakeholders, were examined in a separate publication released in September 2011. They evaluated 80 data sources, including published articles, enacted legislation, and media stories over 5 years (from late 2005 to early 2011). Their work was funded by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation.
The evaluation showed that extensive progress was not made by any public-sector group. For example, the report recommended that government partner with the private sector to create a long-term, multifaceted, and financially sustained social marketing program to support parents, caregivers, and families to promote a healthful diet. No progress was found. In a commentary accompanying the article, Lori E. Dorfman, DrPH, of the Berkeley Media Studies Group in Berkeley, CA, notes, "Our government is ceding education about nutrition to the food and beverage industry, which spends $2 billion annually – more than $5 million every day – inundating children with enticements to eat and drink high-fat, sugary and salty foods, and sugar-sweetened beverages."
The best news came from the US Department of Agriculture (USDA), educational leaders, and state and local schools. They collectively made moderate progress toward developing nutritional standards for foods and beverages sold in school, and adopting model school wellness policies and practices to expand the availability of healthy foods and beverages, as called for in the IOM food marketing report. Many states implemented competitive food guidelines and stricter nutrition standards than called for by USDA and 23 states supported farm-to-school programs in 2010 compared to just 1 state in 2005. Despite these efforts, widespread availability of unhealthy competitive foods, especially for older students, and in-school marketing of high-calorie, nutrient-poor foods for celebrations and school fundraisers, continued through early 2011.
"It is notable that USDA made some progress to promote healthier meals during the period reviewed. USDA has accelerated progress immensely with the new school meal nutrition standards released in January 2012," remarked Dr. Story. Additionally, the Food, Conservation, and Energy Act of 2008 and the American Recovery Act of 2009 made grants available to states and local communities to increase fruit and vegetable availability to children. Still, federal, state, and local governments have not done their best job to implement the IOM food marketing report recommendations. The researchers found that the government failed to use all available policy tools to fund initiatives promoting healthy eating in proportion to its spending on diet-related chronic diseases, including subsidies for healthy foods and taxes for unhealthy foods and beverages.
The IOM report emphasized the need to conduct studies about new promotional techniques and venues (i.e., digital interactive marketing to children through the Internet), healthier foods, smaller portion sizes, product viability, and the impact of TV advertising on young people's diet quality and diet-related health. Kraak and colleagues found that federal research institutions such as the National Institutes of Health and the USDA were inadequately funded by Congress to comprehensively research how marketing practices influence young people's diets.
Actions suggested by the researchers include:
Congress could support the federal Interagency Working Group for Food Marketed to Children to complete and release robust voluntary nutrition standards for industry marketing to children and adolescents, despite industry lobbying to stall efforts.
Congress could empower the Federal Trade Commission (FTC) to regulate misleading or deceptive industry practices that promote high-calorie, nutrient poor food and beverage products directed to young people.
Congress could support the Food and Drug Administration (FDA) to cover all food and beverage products marketed to children through the 2010 Menu-Labeling Law (as candy companies and movie theaters are exempt).
"Congress could also empower the Federal Communications Commission (FCC) to develop new rules for advertising and commercial promotion during children's programming," Kraak suggests. "If industry's voluntary efforts continue to show unabated unhealthy food and beverage marketing, FCC could pursue measures such as limiting interactive marketing of unhealthy products, prohibiting unhealthy product placement in programs with a substantial child audience, and reducing the minutes per hour of advertising allowed for TV programs with a high proportion of child viewers."
"Food companies have railed against even voluntary guidelines for what foods should be marketed to kids, spending $37 million to lobby Congress to weaken science-based recommendations from the Interagency Working Group for Food Marketed to Children. Yet the companies continue to aggressively market the sugary, salty foods kids should avoid. It seems that the companies need the very advice that the recommendations will provide. Now more than ever we need the Interagency Working Group guidelines to strengthen our national commitment to address how food is marketed to children," notes Dr. Dorfman.
The article is "Government and School Progress to Promote a Healthful Diet to American Children and Adolescents: A Comprehensive Review of the Available Evidence," by V.I. Kraak, M. Story, E.A. Wartella (DOI: 10.1016/j.amepre.2011.10.025). It appears in the American Journal of Preventive Medicine, Volume 42, Issue 3 (March 2012), published by Elsevier.
The commentary is "The Nation Needs to Do More to Address Food Marketing to Children," by L.E. Dorfman, M.G. Wootan (DOI: 10.1016/j.amepre.2011.12.005). It appears in the American Journal of Preventive Medicine, Volume 42, Issue 3 (March 2012), published by Elsevier.
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