Unhealthy Foods Marketed to Children Prevalent in Canada

Packaged foods marketed specifically to appeal to children are significantly higher in sugar and lower in other nutrients than foods not targeted to children, data suggest.

In a Canadian study of close to 6000 packaged foods, more products with child-appealing packaging than with non-child-appealing packaging exceeded Health Canada's nutrient thresholds (98% vs 94%; P < .001).

"Our goal...has always been to try to provide robust evidence that will support the implementation of marketing restrictions in Canada," study author Christine Mulligan, a PhD candidate at the University of Toronto, told Medscape Medical News.

"Our findings align directly with the body of literature in Canada and around the world that speaks to the enormous volume of marketing of unhealthy products that children are exposed to on packaging, and in many other media and settings," she added. "Together, all this evidence tells us how urgently action needs to be taken to help protect children."

The study was published online May 3 in PLOS ONE.

High in Sugar

In this cross-sectional study, the investigators analyzed child-appealing marketing on product packaging using a newly developed tool called Child-Appealing Packaging (CAP) and compared the nutritional quality of child-appealing products with that of non-child-appealing products.

The CAP tool identifies core techniques that could independently make a package appealing to children. It also identifies broad marketing techniques that would not on their own cause a package to appeal to children but that increase the overall persuasiveness of the marketing message.

The researchers sampled 5850 child-relevant packaged foods from the University of Toronto's Food Label Information Program (FLIP) 2017 database, which contains data from a product's Nutrition Facts table and ingredients list, as well as photos of all sides of the product packaging. FLIP 2017 categorizes products according to Health Canada's Table of Reference Amounts (RAs) for Foods' major food categories (such as bakery products) and subcategories (such as cookies).

Almost 13% of child-relevant products had child-appealing packaging. The categories with the highest proportion of such products were toaster pastries (100%), cereals (53.4%), and crackers (42.4%). Several categories had a high absolute number of child-appealing packages, including candy, ice cream, cookies, meals, and juice.

Categories with the lowest proportion of products with child-appealing packaging were cheese, hot cocoa, and meats.

The techniques used and the power of the marketing varied. The most frequent techniques were "child-appealing visual/graphical design" (10% of products), "appeals to fun or cool" (3.3%), and "presence of branded characters or spokespersons" (3.2%).

On the basis of the nutrient profile model that Health Canada has proposed to underpin marketing restrictions, almost all child-relevant products would be restricted from being advertised to children, but significantly more with child-appealing packaging would be restricted, compared with products with non-child-appealing packaging (97.9% vs 94.2%). More than 82% of products with child-appealing packaging in all food categories would be restricted from being advertised directly to children.

As noted, products with child-appealing packaging were higher in total sugars (median of 14.7 g/RA vs 9 g/RA for non-child-appealing packaging) and free sugars (11.5 g/RA vs 6.2 g/RA) but were lower in all other nutrients, compared with Health Canada's reference amounts.

Parents Face Pressures

"Product packaging has been identified as a top source of children's exposure to marketing for unhealthy foods and is a platform often neglected by restrictions and regulations, presenting a dangerous loophole for food and beverage manufacturers to exploit," write the researchers.

"Unhealthy products with powerful child-appealing marketing displayed on [the] package are prevalent in the food supply," they write. "Implementing marketing restrictions that protect children should be a priority."

Although parents play a role in children's diets, Mulligan said, "parents already face a number of pressures when making food decisions for their families.... They shouldn't also be held responsible for fighting against the impact food marketing is having on their children. This is where governments need to step in and take charge."

Governmental efforts are in development now. Mulligan noted that a Private Member's Bill (C-252) that would restrict food and beverage marketing directed at children currently is undergoing parliamentary review. Also, Health Canada has recently released a proposed marketing policy that is currently under public consultation.

Meanwhile, "clinicians can point parents toward nutrition resources like Canada's Food Guide to help support them in making the most healthful choices they can," said Mulligan. They can also "advocate for the implementation of robust marketing policies that will help take the pressure off parents.... Health Canada's marketing policy consultation is open to everyone and is a great way to get involved in real-time policy action."

Commenting on this topic for Medscape, the Canadian Paediatric Society said, "Dietary habits are formed in childhood, and poor-quality diet is associated with many chronic health conditions, including overweight and obesity, type 2 diabetes, and cardiovascular disease. Current trends in childhood nutrition demand a multipronged response; the [society] therefore supports efforts to regulate and limit the marketing of foods high in sodium, added sugar, and saturated fats to children."

The study was funded by the Canadian Institutes of Health Research Frederick Banting and Charles Best Doctoral Award. Mulligan has disclosed no relevant financial relationships.

PloS One. Published online May 3, 2023. Full text

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Image 1: Katherine Fogler Photography

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Cite this: Unhealthy Foods Marketed to Children Prevalent in Canada - Medscape - May 17, 2023.