Melaine McLean | Hidden impact of unhealthy food marketing on children’s health

The UN Convention on the Rights of the Child, Article 24, recognises that all children have the right to adequate nutrition as an essential part of guiding and nurturing them to the highest attainable standard of health. This includes local vegetables, fruits, meat, eggs, milk, and many more local products.

However, the marketing of unhealthy foods targeting children represents a present threat to this right. The World Health Organization (WHO) and other leading public health authorities are raising the alarm that widespread advertising of unhealthy foods to children is driving the childhood obesity epidemic globally. This is a public health challenge with potentially devastating and life-altering health consequences.

NUTRITIONAL SHIFT

Daily, millions of children globally consume large amounts of unhealthy calorie-dense, ultra-processed foods (UPFs). UPFs are industrially manufactured by corporations, undergo multiple processes, and are heavily manipulated to be high in saturated fats, trans-fats, sugars and salts. They are then packaged and sold to the consumer. This dietary shift away from unprocessed and minimally processed indigenous staples like meats, grains, legumes, fruits and vegetables has been facilitated by persistent unhealthy food messaging by the food industry. Unfortunately, Jamaican children have not been spared the effects of this global nutritional transition. The 2017 Jamaica Health and Lifestyle Survey (III) revealed that an astounding one in two Jamaicans 15 years and older is overweight or obese, a troubling 76 per cent increase from 2000. Additionally, the 2017 Global School-based Student Health Survey revealed an almost doubling of obesity rates in boys (94 per cent) and a 47 per cent increase in girls, when compared with 2010, with more than 66 per cent of Jamaican adolescents aged 15-19 years consuming fast food most days of the week.

RISK FACTOR FOR CHILDHOOD OBESITY

The marketing of unhealthy foods to children within the Caribbean, especially Jamaica, has grown considerably in recent years. It is practically impossible for children today to escape the ubiquitous and visually enticing advertisements that tempt them to indulge in fast food or other high salt, high sugar, trans-fat-laden food products.

The marketing techniques employed by the food industry to promote sodas, chips, packaged pastries, to name a few, have now extended beyond the confines of the family television screen. This advertising now reaches our children directly, on their school premises, at community and school events, through school sponsorships, on billboards and, unerringly, on their mobile phones and devices, via internet ads and the more effective and continuous digital marketing modes of social media and advergaming (advertising embedded in games).

Largely unmonitored by adults and unchecked by government regulations, this constant messaging is influencing and shaping children’s food desires, dietary preferences and consumption patterns, thereby increasing childhood obesity rates and the resulting health consequences. As a paediatrician, I have seen this increase in diet-related illnesses in my patients.

Children are particularly susceptible to the influence of unhealthy food marketing as most are unable to discern the actual motivation behind these advertisements. The psychology of advertising by the fast-food industry intentionally exploits the developmental vulnerabilities of children and adolescents, particularly younger aged children who are still in the early stages of cognitive development.

Children are ideal targets because once their preferences are shaped by this unhealthy food marketing, they tend to remain loyal customers well into adulthood. The food industry capitalises on this by focusing most of their marketing efforts on promoting foods high in fat, salt and sugar potentially leading to overweight/obesity even when they become adults. In 2016 the WHO Commission on Ending Childhood Obesity concluded that “there is unequivocal evidence that the marketing of unhealthy foods and sugar-sweetened beverages is related to childhood obesity”.

Parents need to be supported in their efforts to choose healthier food options that positively influence their children’s nutritional habits. Many are all too familiar with the dreaded words, “Can I get this? Can I get that?” as they navigate the many unhealthy food and beverage advertisements and fast-food chains encountered in their daily activities. The unrelenting pester power and ‘nag factor” of children tantalised by attractive and colourfully packaged food products as they walk the aisles quickly change parents’ resolute “No” to a capitulating “Yes” as they give in to their child’s request. Unhealthy food marketing targets children, who then act as liaisons who influence their parents and peers to make less healthy purchases.

LONG-TERM HEALTH IMPLICATIONS

Obesity resulting from unhealthy food consumption is a major risk factor for NCDs. Jamaica has experienced an alarming increase in the prevalence of NCDs, and they are deadly. In fact, 80 per cent of preventable deaths in adults are attributable to unhealthy food-derived NCDs. Since obesity in children often persists into adulthood, curbing the growing epidemic of childhood obesity is critical to combating the precipitous rise of NCDs in Jamaica.

Consistent evidence has also shown that children with overweight and obesity may experience psychological and psychosocial effects such as depression, anxiety and low self-esteem. They may also face social stigmatisation and discrimination based solely on their weight, which can lead to a cycle of disordered eating and avoidance of physical activity. Additionally, their self-confidence may be reduced in comparison to their normal-weight peers which can negatively impact school academic performance. Studies have also found that children with obesity also experience a significantly higher likelihood of being teased and bullied in school which can trigger feelings of shame, poor body image, leading to depression, suicidal ideation and even suicide.

CALL TO ACTION

Our parents’ and grandparents’ diseases are fast becoming our children’s diseases. May was National Child Month, where we celebrated the rights and wellbeing of children, rising rates of NCDs are a significant burden on the health of Jamaica’s population and its public health system. NCDs negatively impact quality of life and economic development due to premature mortality, increased disability, and lost productivity. Urgent action is needed to meet this serious public health challenge and must focus on the childhood and adolescent years when eating habits are being shaped.

Extensive evidence has proven that instituting regulations that restrict the marketing of ultra-processed foods high in saturated fats, trans-fats, sugars and salt to children reduces childhood obesity by limiting exposure to harmful ads – effectively blunting their power. Several countries have successfully implemented legislation to limit the deleterious impact of unhealthy food marketing. Chile has been at the forefront of food policy reforms. In 2016, about one of two children in the country was overweight or obese. Their government responded firmly, enacting comprehensive and robust legislation restricting the marketing of foods high in calories, saturated fat, sugar, and sodium to children under 14 years in all media – television programmes, radio, websites and magazines. This 2016 Chilean law also prohibits marketing of these food items in schools and further, forbids the use of cartoons, toys and other child-directed promotional tactics in food advertisements. New York has a renewed push to address the rising levels of childhood obesity with the recent introduction of a Senate bill called the Predatory Marketing Prevention Act (PMPA) that would prohibit targeted advertising of unhealthy foods to children.

With collective advocacy and boldness, Jamaica too can develop and implement robust policies and regulations to ensure that the physical and digital spaces where our children live, learn, play and gather are free from all forms of harmful food marketing. Stakeholders, including government, non-governmental organisations and private sector must commit to working collaboratively to improve childhood eating habits, decrease childhood obesity and eliminate the scourge of NCDs.

Coupled with the proposed National School Nutrition Policy, which was recently approved as a white paper will ensure that Jamaican children and young people will live long, healthy and fulfilling lives. This policy is more than a school matter – it is a public health imperative. The country cannot afford to let this policy sit dormant.

Dr Melaine McLean is New York-based public health practitioner and paediatrician. Send feedback to ghapjm@gmail.com or columns@gleanerjm.com