Children's diets in their first 1000 days influence dietary preferences, eating habits, and long-term health. Yet the diets of most infants and toddlers in the United States do not conform to ...recommendations for optimal child nutrition. This narrative review examines whether marketing for infant formula and other commercial baby/toddler foods plays a role. The World Health Organization's International Code of Marketing Breast-milk Substitutes strongly encourages countries and manufacturers to prohibit marketing practices that discourage initiation of, and continued, breastfeeding. However, in the United States, widespread infant formula marketing negatively impacts breastfeeding. Research has also identified questionable marketing of toddler milks (formula/milk-based drinks for children aged 12-36 mo). The United States has relied exclusively on industry self-regulation, but US federal agencies and state and local governments could regulate problematic marketing of infant formula and toddler milks. Health providers and public health organizations should also provide guidance. However, further research is needed to better understand how marketing influences what and how caregivers feed their young children and inform potential interventions and regulatory solutions.
Food-related promotion of brands via social media represents an increasingly important youth-targeted marketing strategy, but little is known about how adolescents interact with these brands online. ...This study measures adolescents’ social media engagement with food/beverage brands, sociodemographic differences in level of engagement, and relationships between engagement and screen time.
Cross-sectional online survey of US adolescents (ages 13–17, N = 1564), oversampled for non-Hispanic Black and Hispanic (more- and less-acculturated) participants, assessed restaurant, food, and beverage brands ever liked, shared, or followed of on social media. Multivariate logistic regression models examined associations between brand engagement, sociodemographic variables (race/ethnicity, acculturation, age, gender, and parent education), and screen time (TV and other screens).
Seventy percent of adolescents reported engaging with any food/beverage brands on social media (ranging from 1 to 48), and 35% engaged with 5 + brands. Non-Hispanic Black and less-acculturated Hispanic adolescents were more likely than non-Hispanic White adolescents to engage with brands. Approximately one-half reported engaging with brands of fast food (54% of participants), sugary drinks (50%), candy (46%), and snacks (45%), while just 7% reported engaging with all other categories of food/beverage brands. Watching TV more than 2 h-per-day was associated with any brand engagement; while using other screens more than 2 h-per-day was associated with following 5 + brands.
Engagement with unhealthy food brands on social media is common among adolescents. Disproportionate engagement by non-Hispanic Black and less-acculturated Hispanic youth raises additional concerns. Research is needed to understand how such marketing affects adolescents’ food preferences, diets, and health.
To compare children's drink products that contain or purport to contain juice and evaluate labels in light of US Food and Drug Administration (FDA) regulations.
In 2019, we analyzed federal law for ...drinks that contain or purport to contain juice by using LexisNexis and FDA's Web site, identified top-selling children's "juice" drinks in fruit punch flavors, gathered labels in store and online, and extracted data from the principal display and information panels.
FDA regulations permit a wide range of names, claims, and fruit vignettes on drinks that contain or purport to contain juice, reflecting the product's flavor and not necessarily its ingredients. We identified 39 brands of children's drinks, including 100% juice (n = 7), diluted juices (n = 11), juice drinks (n = 8), fruit-flavored drinks (n = 8), and flavored waters (n = 5), with nonuniform statements of identity; vitamin C and low-sugar claims; and fruit vignettes representing 19 fruits. Many products contained added sugar and nonnutritive sweeteners but little to no juice.
Principal display panels rendered it difficult to differentiate among product types, identify those with added sweeteners, and distinguish healthier products. Revised labeling regulations are warranted to support public health.
Many US food companies have identified Black and Hispanic consumers as a significant business growth opportunity.1 In 20 17, these companies spent more than $1 billion to advertise on Spanish ...language-targeted and Black-targeted television, more than 80'⅛ promoting fast food, sugar-sweetened beverages, candy, and unhealthy snack brands. Black children and adolescents saw approximately twice as many television food advertisements compared with their White peers, and these disparities have increased. Unhealthy food marketing and access to unhealthy food are also greater in low-income communities of color.2,3 Furthermore, these same unhealthy food brands often target advertising and sponsorships to "multicultural" youths through celebrity endorsements, music and sporting event sponsorships, scholarships, and other corporate social responsibility initiatives.Targeted marketing is not problematic on its own.3,5 Marketing to racial ethnic minority consumers recognizes the importance of populations previously excluded by most traditional marketers. By signaling that a brand values Black and Hispanic consumers and that its products are for "someone like me," targeted marketing is highly effective. This marketing also often provides much-needed resources to local communities and targeted media properties. However, this onslaught of unhealthy food marketing represents an overwhelming obstacle to successful public health efforts to address the epidemic of diet-related disease, including obesity, diabetes, and heart disease, disproportionately affecting communities of color.As Nguyen et al. (p. 329) clearly show in this issue of' AJPH, targeting food marketing to racial/ethnic minority consumers represents a deliberate strategy designed to foster goodwill in their communities. This strategy borrows heavily from the tobacco marketing playbook and raises ethical and public health concerns.
Reducing food marketing to children has been proposed as one means for addressing the global crisis of childhood obesity, but significant social, legal, financial, and public perception barriers ...stand in the way. The scientific literature documents that food marketing to children is (a) massive; (b) expanding in number of venues (product placements, video games, the Internet, cell phones, etc.); (c) composed almost entirely of messages for nutrient-poor, calorie-dense foods; (d) having harmful effects; and (e) increasingly global and hence difficult to regulate by individual countries. The food industry, governmental bodies, and advocacy groups have proposed a variety of plans for altering the marketing landscape. This article reviews existing knowledge of the impact of marketing and addresses the value of various legal, legislative, regulatory, and industry-based approaches to change.
Dengue is a spectrum of disease caused by four serotypes of the most prevalent arthropod-borne virus affecting humans today, and its incidence has increased dramatically in the past 50 years. Due in ...part to population growth and uncontrolled urbanization in tropical and subtropical countries, breeding sites for the mosquitoes that transmit dengue virus have proliferated, and successful vector control has proven problematic. Dengue viruses have evolved rapidly as they have spread worldwide, and genotypes associated with increased virulence have expanded from South and Southeast Asia into the Pacific and the Americas. This review explores the human, mosquito, and viral factors that contribute to the global spread and persistence of dengue, as well as the interaction between the three spheres, in the context of ecological and climate changes. What is known, as well as gaps in knowledge, is emphasized in light of future prospects for control and prevention of this pandemic disease.
Summary
Background
Experts recommend against serving sugary drinks and non‐nutritive sweeteners to young children, but misperceptions about drink ingredients may contribute to consumption.
Objectives
...Assess parents' ability to identify added sugar, non‐nutritive sweeteners and juice in children's drinks.
Methods
Researchers recruited U.S. parents of young children (1‐5 years) through an online survey panel (N = 1603). In a randomized experiment, participants indicated whether eight popular children's drink products contained added sugar or non‐nutritive sweeteners and percentage of juice after viewing (a) front‐of‐package alone or (b) front‐of‐package plus nutrition/ingredient information. Participants also viewed common statements of identity on children's drinks to identify product ingredients.
Results
When viewing front‐of‐packages alone, most participants accurately identified products with (83%‐90%) and without (51%‐65%) added sugar. Showing nutrition/ingredient information increased accuracy. However, the majority could not identify drinks with non‐nutritive sweeteners (53%‐58%), and many incorrectly believed that unsweetened juices contained added sugar (38%‐43%), sweetened flavoured waters had no added sugar (24%‐25%), and 100% juice contained less than 100% juice (37%). Furthermore, the majority could not identify product ingredients from statement of identity terms.
Conclusions
Misperceptions about product ingredients under current labelling practices indicate that updated regulations are necessary, including clear disclosures of sweetener and juice content on package fronts.
To evaluate messages about infant feeding on breastmilk substitute (BMS) manufacturer websites directed at US caregivers and compare information and portrayals of breast-feeding/breastmilk with that ...of infant formula (IF) feeding.
We conducted a content analysis of US BMS companies' websites. A codebook was created through an iterative process to identify messages and images about breast-feeding/breastmilk and IF feeding, including benefits or issues associated with each, and direct-to-consumer marketing practices that could discourage breast-feeding.
Data were collected in 2019-2020 and analysed in 2020-2021 for US websites of five IF manufacturers.
The websites of Similac, Enfamil and Gerber, which collectively represent approximately 98 % of the US IF market, and two US organic brands, Earth's Best and Happy Baby.
Websites contained more messages about breast-feeding/breastmilk than IF but were significantly more likely to mention benefits to baby of IF (44 %) than breast-feeding/breastmilk (<26 %), including significantly more statements that IF provides brain, neural and gastrointestinal benefits; 40 % of breast-feeding/breastmilk content was dedicated to breast-feeding problems (e.g. sore nipples). Twice as many screenshots compared IF brands favourably to breastmilk than as superior to other brands. Certain companies displayed images indicating ease of IF feeding and difficulty of breast-feeding.
Substantial messaging on BMS manufacturer websites encouraged IF feeding and discouraged breast-feeding. Health professionals should discourage their patients from visiting these websites and the US government should regulate misleading claims. Companies should refrain from providing breast-feeding advice and align their US marketing with the International Code of Marketing of Breast-milk Substitutes.
Objective:
Health advocates have focused on the prevalence of advertising for calorie-dense low-nutrient foods as a significant contributor to the obesity epidemic. This research tests the hypothesis ...that exposure to food advertising during TV viewing may also contribute to obesity by triggering automatic snacking of available food.
Design:
In Experiments 1a and 1b, elementary-school-age children watched a cartoon that contained either food advertising or advertising for other products and received a snack while watching. In Experiment 2, adults watched a TV program that included food advertising that promoted snacking and/or fun product benefits, food advertising that promoted nutrition benefits, or no food advertising. The adults then tasted and evaluated a range of healthy to unhealthy snack foods in an apparently separate experiment.
Main Outcome Measures:
Amount of snack foods consumed during and after advertising exposure.
Results:
Children consumed 45% more when exposed to food advertising. Adults consumed more of both healthy and unhealthy snack foods following exposure to snack food advertising compared to the other conditions. In both experiments, food advertising increased consumption of products not in the presented advertisements, and these effects were not related to reported hunger or other conscious influences.
Conclusion:
These experiments demonstrate the power of food advertising to prime automatic eating behaviors and thus influence far more than brand preference alone.
Fifteen years ago, public health experts urged industry, governments, and advocates to take action to dramatically improve the unhealthy food-marketing environment surrounding children in order to ...address the global childhood obesity crisis. Since then, research has confirmed that food marketing to children has far-reaching negative effects on their diets and health, takes advantage of adolescent vulnerabilities, and contributes to health disparities. In addition, digital marketing has profoundly changed young people's engagement with brands. Moreover, reliance on industry self-regulation as a solution has proven ineffective. Government-led policies have been more successful, but they remain limited in scope and challenging to adopt and implement. New approaches are necessary to increase public and policy maker awareness that food marketing is more than a nuisance, that it threatens the long-term health of children and adolescents worldwide, and that meaningful governmental action is urgently required to curtail industry's negative impact on young people's well-being. Expected final online publication date for the
, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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