Food Marketing to Children in Iran: Regulation that Needs Further Regulation

Increased exposure to advertising of unhealthy food products is one of the main risk factors for the increased prevalence of childhood obesity and non-communicable diseases. This scoping review aimed to investigate the characteristics and effects of food advertisements targeted at children in Iran and review the existing regulations on food marketing targeted at children in the country. In this study, we searched Web of Science, Scopus, PubMed, Google, and Google scholar, in addition to Iranian scientific search engines, including Iranian Research Institute for Information Science and Technology (Iran.doc), Scientific Information Database (SID), Iranmedex, Magiran, and Civilica up to December 2020 to find any literature about food marketing to children in Iran and current related regulations and policies in the country. A total of 23 eligible studies were selected for this review. Most of the studies had focused on television as the media to assess. The main food products advertised with reference to children included: Salty snacks, including cheese puffs, chips, cheese fish snacks, puffed corn, and sweet snacks such as ice creams, cakes/biscuits/cookies and candies, beverages/drinks/soft drinks/fruit juices, dried fruits and fruit rolls, and chocolates. Strategies that most commonly used in marketing foods to children in Iran were emotional appeals, misleading messages/claims, use of music and known characters to children, as well as conveying happiness and/or security. The main reported violation of food regulations included using obese children, either as consumers or presenters of the product. In Iran the advertising of unhealthy food products for the general population is banned; however, it is weakly implemented. There are a limited number of regulations that have addressed children explicitly in this regard. The main barriers identified in partial implementation of regulations included weakness in scientific criteria, legal enforcement guarantee, poor intersectoral collaboration, inadequate infrastructures, and poor monitoring. Policies and regulations in food marketing need to clearly address children as an important audience. It is suggested future policies focused on children cover all forms of food marketing and consider all types of persuasive food marketing strategies targeted at children.

Longitudinal geo-referenced field evidence for the heightened BMI responsiveness of obese women to price discounts on carbonated soft drinks

There is increasing interest in the effect that food environments may have on obesity, particularly through mechanisms related to the marketing and consumption of calorie-dense, nutrient-poor foods and sugary beverages. Price promotions, such as temporary price discounts, have been particularly effective in the marketing of carbonated soft drinks (CSDs) among consumers. Research has also suggested that the purchasing behavior of consumer groups may be differentially sensitive to price discounts on CSDs, with obese women particularly sensitive. In addition, the intensity of price discount in a person’s food environment may also vary across geography and over time. This study examines whether the weight change of obese women, compared to overweight or normal BMI women, is more sensitive to the intensity of price discounts on CSDs in the food environment. This study used longitudinal survey data from 1622 women in the Montreal Neighborhood Networks and Health Aging (MoNNET-HA) Panel. Women were asked to report their height and weight in 2008, 2010 and 2013 in order to calculate women’s BMI in 2008 and their change of weight between 2008 and 2013. Women’s exposure to an unhealthy food environment was based on the frequency in which their neighborhood food stores placed price discounts on CSDs in 2008. The price discount frequency on CSDs within women’s neighborhoods was calculated from Nielsen point-of sales transaction data in 2008 and geocoded to participant’s forward sortation area. The prevalence of obesity and overweight among MoNNET-HA female participants was 18.3% in 2008, 19.9% in 2010 and 20.7% in 2013 respectively. Results showed that among obese women, exposure to unhealthy food environments was associated with a 3.25 kilogram (SE = 1.35, p-value = 0.02) weight gain over the five-year study period. Exposure to price discounts on CSDs may disproportionately affect and reinforce weight gain in women who are already obese.

Nutrition and Cardiovascular Diseases

Unhealthy food intake and insufficient physical activities are related with obesity or life-style diseases, which can cause cardiovascular diseases, finally leading to death [...]

Gene-Environment Interactions in Attention-Deficit/Hyperactivity Disorder Symptom Dimensions: The Role of Unhealthy Food Habits

Background: Dietary habits were investigated as environmental risk factors for Attention-Deficit/Hyperactivity Disorder (ADHD). However, no previous studies explored the effects of dietary factors on modifying the role of genetic factors on ADHD. Methods: Based on a Swedish population-based twin study with 1518 twin pairs aged 20–47 years, we tested whether the importance of genetic and environmental effects on ADHD varied as a function of dietary habits. Self-reported dietary habits and ADHD symptoms were collected. Twin methods were used to test the degree to which high-sugar and unhealthy food intake moderated the genetic and environmental influences on ADHD symptoms. Results: In middle-aged adults, genetic influences on inattention symptoms were statistically significantly higher among individuals with higher levels of high-sugar (45%, 95%CI: 25–54%) and unhealthy food intake (51%, 95%CI: 31–60%), compared with those with lower levels of consumption of high-sugar (36%, 95%CI: 25–47%) and unhealthy foods (30%, 95%CI: 20–41%). Similar patterns were also found for the associations between hyperactivity/impulsivity and high-sugar/unhealthy food intake, even though the moderation effects were not statistically significant. Conclusion The present study suggests that genetic factors play a more prominent role in individual differences of ADHD symptoms in the presence of the high consumption of sugar and unhealthy foods. Future longitudinal studies with multiple assessments of ADHD and dietary habits are needed to replicate our findings.

Does the prevalence of promotions on foods and beverages vary by product healthiness? A population-based study of household food and drink purchases in New Zealand

Objective: To assess the prevalence of promotions on foods and non-alcoholic drinks purchased by New Zealand households and to determine if they vary according to healthiness of products. Design: We undertook a cross-sectional analysis of Nielsen New Zealand Homescan® 2018/19 panel data. We conducted multivariate analyses to examine the variability in quantities of healthy vs. unhealthy food and beverage products purchased on promotion. Promotion was self-reported by the panelist. Healthiness of products was measured by the Health Star Rating system (HSR). We also carried out a subgroup analysis for beverages according to the threshold of < 5 g vs. ≥ 5 g sugar per 100 ml content of products. Setting: The Nielsen New Zealand Homescan® data were linked with two New Zealand food composition databases (Nutritrack and the FOODfiles). Participants: Food and beverage purchases data by 1,800 panel households were used. Results: Overall, 46% (1,803,601/3,940,458) of all purchases made were on promotion. Compared with purchases of food and beverage products with HSR < 3.5 (unhealthy), food and beverage products with HSR ≥ 3.5 (healthy) were significantly less likely to be on promotion (OR=0.78, 95% CI 0.77 - 0.79). The subgroup analysis for beverages shows that products with < 5 g per 100ml were significantly less likely to be on promotion than those with > 5 g sugar per 100ml (OR=0.76, 95% CI 0.75 - 0.78). Conclusions: Policies to improve healthy food retailing should focus on increasing the promotion of healthier food and drink options in stores and supermarkets.

Taxation of unhealthy food consumption and the intensive versus extensive margin of obesity

If an individual’s health costs are U-shaped in weight with a minimum at some healthy level and if the individual has both self-control problems and rational motives for over- or underweight, the optimal paternalistic tax on calorie intake mitigates the individual’s weight problem (intensive margin), but does not induce the individual to choose healthy weight (extensive margin). Implementing healthy weight by a calorie tax is not only inferior to paternalistic taxation, but may even be worse than not taxing the individual at all. With heterogeneous individuals, the optimal uniform paternalistic tax may have the negative side effect of reducing calorie intake of the under- and normal weights. We confirm these theoretical insights by an empirical calibration to US adults.

Rural Food Environment, Caregiver Influence and School-Aged Children’s Unhealthy Food Choice: New Evidence From Rural China

Background A large number of unhealthy foods with low nutrition content and safety issues exist in the rural food consumption environment of China. Guiding rural children to avoid eating unhealthy foods through family intervention has become much more critical. However, when current rural caregivers are once left behind by their parents and lack of family education in their childhood, how would they affect their children’s unhealthy food choices? The purpose of this study is to highlight the new evidence of current rural caregivers’ influences on children’s unhealthy food choices in China. Methods Based on a survey of 5611 pairs of rural school-aged children and their caregivers in seven provinces, the significant effects of caregivers’ types, parenting attitudes, and socio-demographic characteristics on children’s unhealthy food choices were evaluated through an ordered probit model. Results This study found that rural parents did not perform positive influence than rural grandparents as conventionally believed. When the caregiver type changing from parents to grandparents, the percentage of children who mildly accept unhealthy foods increased 6.94%, while the percentage of children who moderately and severely accept unhealthy foods decreased 6.48% and 0.46%, respectively. In addition, this study underscored the significance of caregivers’ neglectful parenting attitudes on the impact of children’s unhealthy eating behavior. When caregivers’ parenting attitudes changing from doting attitude to neglectful attitude, the percentage of children who mildly accept unhealthy foods decreased 9.75%, while the percentage of children who moderately and severely accept unhealthy foods increased 8.77% and 0.99%, respectively. Conclusions Our study proposes new evidence that the current rural parents’ inherent intention and preference for those unhealthy foods formed in their childhood would be much higher than rural grandparents and might have performed a significantly negative influence on their children. Our findings also have policy implications for health promotion professionals who look for intervention targets of caregivers to improve their health education effectiveness for children. For the health education toward rural caregivers, instead of focusing on the caregiver types, segmenting those rural caregivers with neglectful parenting attitude would be the key step to identify the intervention targets.