Junk Food Injunction- Latest Edition
With childhood overweight and obesity rates at around 25% it is pleasing to hear New South Wales has recognised the importance of tackling this issue with the NSW Premier announcing that reducing childhood obesity rates will be a priority for his government. In this issue, we look at studies into the prevalence of unhealthy outlets in neighbourhoods and we showcase two studies from UK, one, an experimental study on the impact of 'healthy' fast food advertising on children's food selection, and the other a review of 18 studies that looked at the link between food intake and food advertising.
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Addressing childhood obesity is one of the 12 personal priorities announced by the NSW Premier in September 2015. The target is to reduce the rates of overweight or obesity, from the 2014 level where more than one in five children were overweight or obese, by 5% over the next 10 years.
An evidence review commissioned by the NSW Ministry of Health and conducted by the Physical Activity Nutrition Obesity Research Group (PANORG) at the University of Sydney looked at the latest research on the effectiveness of different obesity prevention interventions in a range of settings. While the review is not yet published, PANORG has presented some of its findings at a recent Healthy Eating and Active Living Strategy Network meeting. In particular they highlighted policy to reduce children's exposure to the marketing of unhealthy foods as one of the most cost-effective obesity prevention initiatives. This is in line with recent international recommendations, including the World Health Organisation Ending Childhood Obesity report on tackling childhood and adolescent obesity around the world.
It is not clear what commitments the NSW government will make to address junk food marketing to children as it is largely a federally regulated area although the NSW Healthy Eating and Active Living Strategy 2013-2018 includes an action to contribute to national efforts to reduce children's exposure to unhealthy foods. We would welcome the NSW Premier championing a push to improve existing Commonwealth regulation, and take action in areas that are within NSW Government responsibilities such as placement of outdoor advertising, advertising in or around public transport and at state government owned venues such as sporting grounds.
One area where state governments have jurisdiction is planning and the healthy built environment. A study in New Zealand has found that 68% urban schools had a convenience store and 62% had a fast food or takeaway outlet within 800 metres. Schools in areas of lower socio-economic status were closer to convenience stores. As expected, rural schools were further away from unhealthy food outlets with the median distance from a rural school to an unhealthy food outlet being 10km. One urban school had 85 unhealthy outlets located within a square kilometre of the school.
Similar to Australia, the Local Government Act in New Zealand does not include provisions for local councils to make zoning decisions based on a food outlet's proximity to schools. The authors highlight one initiative where some schools have made arrangements with local convenience stores not to sell to students in school uniforms.
A 2015 study looking at the number of greengrocers, supermarkets, takeaway shops and alcohol outlets within 1.6 km from a person's home compared North Sydney to Western Sydney. The researchers used these two areas to compare as rates of type 2 diabetes are almost 7% in Western Sydney and just over 2% in North Sydney. They found 8% neighbourhoods in the west did not have a greengrocer or supermarket within 1.6 km compared to 4% neighbourhoods in the north. About 28% of neighbourhoods in the west had at least three takeaway shops to every greengrocer and supermarket, in comparison with 20% in the north.
Vandevijvere S, Sushil Z, Exeter DJ, et al. Obesogenic Retail Food Environments Around New Zealand Schools. Am J Prev Med
Astell-Burt T, Feng X. Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap? Med J Aust 2015 Sep 21; 203, 246-8
In Australia, McDonald's advertisements for children's meals now show the 'healthier choice' but a study in UK of 7-10 year olds has shown being exposed to fast food ads may influence children's liking of fast food, but not necessarily the products promoted. The children watched a cartoon show interspersed with ads for toys. Some of the children saw a fast food kid's meal ad amongst the toy ads. The meal was the 'healthier choice', of fish fingers, fruit bag and water. The children then answered a number of questions including what food items they would choose if they were constructing a McDonald's Happy Meal at the moment. While there was no difference between the groups in the meals they then chose, those children who saw the fast food ad indicated they liked fast food more than the other group.
The study shows exposure to the healthier fast food ad did not influence children to choose the healthier fast food meal. Yet exposure to the healthier fast food advertisement influenced how they feel about fast food generally. Given children's actual intake is likely to be affected by their liking for fast foods and that the majority of fast food options are unhealthy choices, measures are needed to protect children from fast food advertising more broadly regardless of the healthiness of the products advertised.
Boyland EJ, Kavanagh-Safran M, Halford JC. Exposure to 'healthy' fast food meal bundles in television advertisements promotes liking for fast food but not healthier choices in children. Br J Nutr 2015 Mar 28; 113, 1012-8.
UK researchers have carried out a review of 18 experimental studies designed to assess whether food advertising influences children's diet and food choices. They found that exposure to food advertising increased food intake in children but not adults. The effect was found from both food advertising on television and internet advergaming where food branding is incorporated into online games. This is strong evidence to support the need for tighter regulation to protect children from exposure to marketing of unhealthy foods. At present, self-regulatory initiatives in Australia only restrict unhealthy food advertising on television when children make up over 35% of the audience. Higher numbers of children actually watch shows in the early evening although they don't make up more than 35% of the total viewing audience because there is also a large proportion of adult viewers at this time. This research lends weight to calls for extending food advertising restrictions to cover the programs and periods when the greatest number of children are watching, not just the children's programs and periods where food advertising restrictions currently apply.
Boyland EJ, Nolan S, Kelly B, et al. Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. Am J Clin Nutr 2016 Jan 20; doi: 10.3945/ajcn.115.120022.