In effort to address the rising prevalence of obesity, the UK government recently announced plans to implement a total ban on online junk food advertising, restrictions which would amount to the toughest on digital marketing in the world. EASO Colleagues Rebecca Evans and Anna Coates, University of Liverpool, have written a response to the new policy proposal, and ECPO Chair Ken Clare responds below.
Obesity remains one of the greatest long-term health challenges facing the UK and is associated with increased risk of developing diet-related diseases, including cardiovascular disease, type 2 diabetes, various cancers, liver and respiratory disease, as well as poorer mental health. In England, 1 in every 3 children leave primary school with overweight or obesity and there are no signs that the situation is improving 1. Overconsumption of unhealthy food and beverages (hereafter ‘food’) is one of the key factors, therefore it is of great concern that children are continually encouraged to consume these foods, via increased availability, accessibility, affordability, and marketing in the environment in which they grow up. The UK Government was asked by its own Health Select Committee in 2016 to be “brave and bold” in its actions, a total ban on the online marketing of unhealthy foods would certainly be that and should form an important part of a package of measures that could make a meaningful difference to tackling obesity in the UK.
Junk food companies spend millions of pounds each year employing innovative and pervasive marketing techniques to keep their products in the spotlight, and so it should come as no surprise that this strategy works. Indeed, robust evidence demonstrates that exposure to unhealthy food advertising in television and digital media shapes children’s food choices, preferences and intake 2. Children now spend more time online each day than they do watching television and it is no coincidence that between 2011 and 2017 food marketers online spend increased by 450%. Online children are exposed to countless food marketing techniques which are often fun and engaging (e.g. advergames), personalised to the user (e.g. YouTube pop-up adverts), or embedded in non-commercial content (e.g. social media influencers paid to feature products). Such tactics make for powerful campaigns and some robust research on children’s likely exposure to, and impact of, this marketing is beginning to emerge.
Studies conducted at the University of Liverpool have shown that exposure to social media influencer marketing of unhealthy foods increases children’s (9-11 years) food consumption 3 , and preference for the endorsed brand 4, relative to a control group. Given that evidence shows children enjoy engaging with this marketing and do not consume less food at a later eating occasion, in order to compensate for the additional calories consumed in response to food advertising, it is clear that over time this would lead to weight gain 5. Furthermore, influencers’ presentation of foods in social media is found to differ according to nutritional profile. Compared with healthy foods, unhealthy foods were more often featured in appealing contexts (e.g. consumed out of the home, described positively) and as part of explicit influencer marketing campaigns 6. Such contextual details are important to the persuasive power of food marketing and have implications for children’s food-related norms and behaviour 7. This year’s McDonald’s Christmas television advert is a case in point. Via a colourful animation we see a mother struggle to get her young teenage son excited about Christmas traditions and so she takes him to a McDonald’s drive-thru where they consume a meal and acquire a bag of ‘reindeer treats’ (carrot batons). Afterwards we see the teenager’s inner child awakened as he engages in a snowball fight, offers to decorate the Christmas tree, and arranges the reindeer treats by the fireplace. Children’s exposure to such content in which only the positive consequences of visiting a McDonalds are conveyed could subtly guide children’s beliefs that consumption of foods high in fat, salt and sugar is not only normal eating behaviour, but also rewarding, fulfilling and even nostalgic. Whilst there have been some attempts to readdress the balance (e.g. ALDI’s Kevin the Carrot, ITV and Veg Power’s “Eat Them To Defeat Them” campaign), exposure remains heavily in favour of unhealthy foods and emotional manipulation.
A total online ban would also require the Government to take action on areas of digital marketing that are perhaps less well known. For example, that which occurs on videogame live streaming platforms. Live streaming platforms such as Twitch, YouTube Gaming, and Facebook Gaming are popular and growing, with over 10 billion hours watched across the three platforms in the first half of 2020 8. On these platforms, individuals can watch streamers play and talk through videogames (e.g. Fortnite, Minecraft), a pastime that is growing in popularity amongst children 9. Typically, the stream is made up of a game section (where the gameplay is broadcast), a streamer section (where the streamer can be seen on camera), and an interactive chat box for live communication between the streamer and the viewers. Streamers act as influencers, marketing brands and products to viewers using a myriad of techniques that provide a feeling of (genuine or not) authenticity, including product placements, discussions, and endorsements. For example, the most-followed Twitch streamer and two-time Kid’s Choice Award nominee Tyler “Ninja” Blevins is sponsored by Red Bull. He features a fully stocked Red Bull fridge and Red Bull logo banner advertisement and is frequently seen donning a Red Bull bandana whilst streaming, and therefore is constantly promoting the brand to his 16 million plus followers 10. In fact, the largest categories of marketed foods on Twitch are energy drinks (e.g. Red Bull, Monster Energy) and restaurants/food delivery services (e.g. KFC, Uber Eats) 11. Usually, energy drinks and foods from restaurants/delivery services are high in fat, sugar, or salt (HFSS), which are contributing factors in overweight and obesity. Pervasive marketing of HFSS foods is already known (from other media) to impact children’s food preferences, consumption, and ultimately, their health. There is a clear opportunity and need for the Government to understand and address the extent, nature and impact of unhealthy food marketing to children in an increasingly diverse range of digital spaces for the policy to be comprehensive and effective.
In launching this consultation, the UK Government have shown that it is serious about improving children’s health by announcing that it would introduce a 9pm watershed, both on television and online, to restrict the amount of unhealthy food advertising children are exposed to. A watershed on television alone is predicted to reduce child obesity by ~5% and lead to a health-related net monetary benefit of £7.4 billion to society 12. Given children’s increased presence online, evidence of the detrimental impact of food marketing exposure on children’s food choices and intake, and the scale of the childhood obesity crisis, such world-leading protective measures have been long awaited 13. Implementation of a total ban of unhealthy food marketing online is a bold move that would signal to Industry that the Government is determined to tackling childhood obesity.
Rebecca Evans and Anna Coates, University of Liverpool
1. Public Health England. National child measurement programme (NCMP): trends in child BMI. (2017). Available at: https://www.gov.uk/government/publications/national-child-measurement-programme-ncmp-trends-in-child-bmi. (Accessed: 27th July 2018)
2. Boyland, E. J. 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 103, 519–533 (2016).
3. Coates, A. E., Hardman, C. A., Halford, J. C. G., Christiansen, P. & Boyland, E. J. Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial. Pediatrics 143, e20182554 (2019).
4. Coates, A. E., Hardman, C. A., Halford, J. C. G., Christiansen, P. & Boyland, E. J. The effect of influencer marketing of food and a “protective” advertising disclosure on children’s food intake. Pediatr Obes e12540 (2019). doi:10.1111/ijpo.12540
5. Norman, J. et al. Sustained impact of energy-dense TV and online food advertising on children’s dietary intake: A within-subject, randomised, crossover, counter-balanced trial. Int J Behav Nutr Phys Act 15, (2018).
6. Coates, A. E., Hardman, C. A., Halford, J. C. G., Christiansen, P. & Boyland, E. J. Food and Beverage Cues Featured in YouTube Videos of Social Media Influencers Popular With Children: An Exploratory Study. Front Psychol 10, 2142 (2019).
7. Cairns, G. A critical review of evidence on the sociocultural impacts of food marketing and policy implications. Appetite 136, 193–207 (2019).
8. Streamlabs Blog. Streamlabs & Stream Hatchet Q2 2020 Live Streaming Industry Report. (2020). Available at: https://blog.streamlabs.com/streamlabs-stream-hatchet-q2-2020-live-streaming-industry-report-44298e0d15bc. (Accessed: 6th August 2020)
9. Ofcom. Children and parents: media use and attitudes report 2019. (2020). Available at: https://www.ofcom.org.uk/research-and-data/media-literacy-research/childrens/children-and-parents-media-use-and-attitudes-report-2019. (Accessed 18th November 2020)
10. Social Blade. Top 50 most followed twitch accounts (sorted by followers count). (2020). Available at: https://socialblade.com/twitch/top/50/most-followers. (Accessed 18th November 2020)
11. Pollack, C. C., Kim, J., Emond, J. A., Brand, J., Gilbert-Diamond, D., & Masterson, T. D. Prevalence and strategies of energy drink, soda, processed snack, candy and restaurant product marketing on the online streaming platform Twitch. Public Health Nutrition 23, 2793-2803 (2020).
12. Mytton, O. et al. The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: a modelling study. PLOS Med (2020). doi:10.1371/journal.pmed.1003212
13. WHO. Report of the commission on ending childhood obesity. (2016). doi:10.1017/CBO9781107415324.004
In response to this commentary, Ken Clare, chairman of ECPO, a trustee of the U.K. Association for the Study of Obesity and a Director of Obesity UK said:
“We couldn’t agree more. There are potentially opportunities to improve public health in this effort to ban junk food advertising, but it is important to acknowledge the complexity of obesity. Advertising bans may improve healthy eating particularly for children and young people, but they certainly will not ‘solve’ the obesity problem in the UK.“