Health policy analyst Jennifer Doggett’s recent post critiquing calls for a ban on junk food advertising to children has drawn a strong response from Jane Martin, Senior Policy Advisor at the Obesity Policy Coalition.
Jane Martin writes:
After accusing the Obesity Policy Coalition and other health groups of ‘over-simplifying the issues around junk food advertising to kids’, health policy consultant Jennifer Doggett misrepresents the outcomes of reviews of the evidence and makes a series of unsupported and rather bizarre statements about the ‘potential side effects’ of junk food advertising restrictions.
Doggett states that “three comprehensive reviews of the impact of junk food advertising on children (World Health Organisation 2009, Ofcom 2006 and the US Institute of Medicine 2006) … have failed to find evidence that an advertising ban has any positive impact on children’s overall health and well-being.”
Since these reviews didn’t examine the impact of ad bans on children’s health and well-being, they could hardly be expected to find such evidence.
In fact the reviews looked at the influence of advertising on children’s food consumption, preferences, behaviour and diet-related health outcomes, and key conclusions were as follows.
“Nearly all research published in the past few years supports the hypothesis that food promotion, especially television advertising, contributes to the unhealthy food preferences, poor diet and consequently, growing obesity among children in Western societies.
Systematic and substantial reviews of the best quality empirical investigations concur that these effects exist and that, since the vast majority of advertising is for high-calorie, low-nutrient foods and beverages, the result is harmful to children’s health.”
What’s more, while Doggett correctly cites Ofcom’s findings that some estimates suggest exposure to junk food marketing accounts for some 2% of the variation in food choice/obesity, she fails to provide is the following qualification of the impact this actually has on childhood obesity:
“Cumulatively, this may make an appreciable difference to the number of children who fall into the ‘obese category’. Further, this effect may be larger than the measurable effects of exercise and some other factors.
Following this review, Ofcom, the UK communications regulator, introduced restrictions on advertising of high fat, sugar and salt foods during TV programs appealing to under 16 year-olds.
US Institute of Medicine 2006:
“Along with many other intersecting factors, food and beverage marketing influences the diets and health prospects of children and youth.”
This conclusion led the US Institute of Medicine to recommend that, in the absence of successful voluntary efforts, congress enact legislation to shift advertising during children’s TV programming from high calorie and low-nutrient foods to healthful foods.
World Health Organization 2009:
“Research that has examined associations between food promotion and food behaviours, determinants of behaviour and diet-related health outcomes, finds modest but consistent evidence that the link is causal.”
On the basis of this evidence, the World Health Organization has just called on member states to take steps to reduce children’s exposure to unhealthy food advertising.
Does Doggett suggest that these organisations have misrepresented the evidence too?
And what evidence can Doggett produce to support her dubious assertion that junk food advertising restrictions would result in children watching more TV?
The OPC does not suggest that junk food advertising to children is a single cause of childhood obesity Australia, just as it does not suggest restrictions are the sole solution. It is widely recognised that Australia needs a multi-faceted approach of which junk food marketing restrictions is, according to numerous reviews, an essential component.
Until then, attempts by industry and others to discredit the evidence supporting regulation of junk food marketing is just one of the many challenges facing those who are genuinely committed to ensuring the future health of Australian children.
Jane,
As a parent of three kids, with statistical training, and with no other vested interest, I approach this subject wanting to understand whether there is any scientific basis for banning advertising of so called junk food to children.
It seems to me that at the heart of implementing any such bans there must, amongst other things, be some evidence that such foods, consumed in moderation, are bad for kids. It is here that I find that the public health activist emperor has no clothes. Simply put, the evidence base for the system you advocate for choosing which foods to ban advertising about, has little scientific foundation.
Elsewhere on this blog, you have advocated as the basis for deciding what to ban, the indirect use of the UK calculator, as modified for Australia, as seen at:
http://www.foodstandards.gov.au/consumerinformation/nutritionhealthandrelatedclaims/nutrientprofilingcal3499.cfm
A careful examination of this calculator suggests it is a very complex machine built upon a number of very simple assumptions, as to what is good and bad for us to eat, at what dosage levels. If these assumptions are incorrect, the calculator collapses.
So, for instance, the calculator has, as one of it’s key inputs, the assumption that eating saturated fat is not good for us, with the degree of harm linearly related to dosage.
As far as I can work out, this assumption has no basis in medical science. I have extensively read the literature and can find no Level 1 evidence linking consumption of saturated fat in the human diet and hard end points such as all cause mortality, or softer end points such as incidence, for particular major diseases such as cancer or CVD. Recent pooled meta analysis by prominent lipids research support my view. For instance see:
http://www.ajcn.org/content/early/2010/01/13/ajcn.2009.27725.abstract
If I am wrong, please provide me with the Level 1 evidence that would be required to include saturated fat in the above mentioned calculator as a health risk. I am wiling to bet you cannot. If you cannot, your house of cards collapses.
hptns – you say that “It seems to me that at the heart of implementing any such bans there must, amongst other things, be some evidence that such foods, consumed in moderation, are bad for kids.” Huh? Seriously??? Have you actually read the information on the back of a packet of any salty fatty kids snacks recently?
I’m a parent of 3 as well, and a scientist, and I endorse a restriction on advertising, along with a range of other complementary strategies. Unhealthy diets early in life build up throughout life, and there is consensus by those who have actually read the literature (I encourage you to do so if you haven’t already), that junk food advertising influences children’s food preferences, purchase requests and consumption patterns. I see it my own children whenever I got to the supermarket with them – my insistence on healthy foods borders on child abuse (I’m told by them)
Will restrictions work? Well – there is no randomised controlled trial to prove it – but advertisers spend increasing $$millions trying to embed purchasing habits as young as possible, helped along by some delightfully addictive ingredients in their fatty, salty kiddy snacks. Do you think advertisers would be paying all that money if the ads didn’t work?
How about we ban the ads and run an experiment then. Worst case scenario we miss out on a bunch of annoying ads.
JANE MARTIN asked me to post this comment for her:
@hptn The nutrient profile model was developed by a team of researchers at Oxford University over a number of years (see http://www.publichealth.ox.ac.uk/bhfhprg/projects/CompletedProjects/nutrientprofiles) prior to its adoption by the UK Food Standards Agency as the basis for restrictions on food advertising to children, and by Food Standards Australia New Zealand as the criteria for eligibility of foods to carry health claims.
The validity of the model for discriminating between healthy and unhealthy foods has been extensively tested. http://www.publichealth.ox.ac.uk/bhfhprg/projects/OngoingProjects/npmodelsvalidation For example, the model was found to be in broad agreement with a consensus of over 700 UK nutrition professionals. http://www.ncbi.nlm.nih.gov/pubmed/17362529
Yes, this model takes into account the saturated fat content of foods. It also takes into account the energy, sugar, sodium, dietary fibre, protein, fruit, vegetable, nut and legume content.
We do not propose entering into a long debate about the scientific literature on saturated fat and disease risk, which is somewhat removed from the broader issue of whether food companies should be allowed to advertise unhealthy foods to children at a time when around a quarter of Australian children are overweight or obese.
Suffice to say, we are aware there is some controversy in the literature, but the broad consensus among health bodies, the medical community and governments internationally, is that saturated fat intake is a risk factor for CVD, and this 2010 review of the evidence concluded that ‘the evidence from epidemiologic, clinical, and mechanistic studies is consistent in finding that the risk of CHD is reduced when saturated fatty acids are replaced with polyunsaturated fatty acids’. http://www.ajcn.org/content/93/4/684.full
Government dietary guidelines in countries including Australia, New Zealand, the UK, US and Canada consistently recommend reduction or limitation of saturated fat intake. So too does the World Health Organization and Heart Foundations/Associations in Australia, New Zealand, the UK and the US.
While your interpretation of the scientific literature may differ, the OPC will continue to follow the recommendations of the experts on this issue.
Jane Martin