To evaluate food marketing techniques used in Canadian recreation and sport facilities and assess the healthfulness of foods and beverages marketed by the techniques.

Cross-sectional content analysis of photographed food marketing instances coded for marketing techniques according to Health Canada’s Monitoring Protocol, developed for monitoring food marketing techniques across settings, supplemented with new inductively identified codes and sport-related marketing techniques. Healthfulness was classified as ‘of concern’ or ‘not of concern’ according to cut-offs of sodium, sugar and saturated fat established by Health Canada.

Recreation and sport facilities in Canada

134 facilities with 2576 food marketing instances

91·4 % of food marketing instances included at least one general marketing technique. Branded infrastructure, displays and furniture was the most prevalent (87·9 %) and appeared with another technique half of the time. Sport-related marketing appeared in 12·2 % of marketing instances, with most referring to sponsors. Most (86·5 %) marketing instances were ‘of concern’. Food marketing instances with sport-related marketing (97·6 %) were significantly more likely to be ‘of concern’ than without sport-related marketing (84·6 %) (χ2 = 20·54, P < 0·001). Three new indicators – appeals to taste, appeals to emotion, and cross-channel references – captured persuasive elements not addressed by the current monitoring protocol.

This study highlights the presence of food branding and the use of sport-related marketing to promote unhealthy products/brands in recreation and sports facilities. Monitoring protocols may underestimate exposure to persuasive food marketing by overlooking subtle, symbolic and cross-channel techniques. Future research can be improved by including subtle techniques and reinforced messages across marketing channels.

To assess the exposure of Austrian children to TV high in fat, sugar and/or salt (HFSS) food and beverage ads and identify changes in HFSS food advertising after the implementation of self-regulatory measures of marketing restriction.

All ads shown on five popular TV channels for Austrian children/teenagers were coded over 4 d (360 h) using the WHO TV Monitoring Protocol, to identify food/beverage marketing, marketing strategies, target audience and presence in peak viewing times. Nutrient analysis was performed using nutrient profile models (NPM), which classify foods as permitted or not permitted for marketing to children: WHO EURO NPM for international comparability and Austria’s NPM for local regulatory compliance. Results were compared with pre-regulatory Austrian TV monitoring data.

Austria.

None.

Of 9099 ads captured, 17·0 % were for foods and beverages. Most promoted products not permitted for marketing to children according to WHO EURO NPM (81·8 %) and Austria’s NPM (83·8 %). On all channels, the advertising rate for food ads rose throughout the day, culminating during child/teen peak viewing times in the evening. A mix of marketing strategies and persuasive appeals was used; emotional themes (e.g. friendship, holidays and enjoyment) were more common in not permitted ads, compared with permitted ads. Not permitted ads featured elements appealing to children/teenagers significantly more often than permitted ads.

Despite self-regulatory measures of marketing restriction, children and teenagers in Austria are still exposed to a high number of advertisements for HFSS foods using impactful emotional marketing strategies on TV. To protect children from this influence, further regulations are called for.

Newfoundland and Labrador (NL) introduced Canada’s first excise tax on sugar-sweetened beverages (SSB) in 2022. Industry marketing practices in response to SSB taxation may affect public health impacts. We examined changes in posted beverage pricing and marketing of taxable and non-taxable beverages in NL before and after the SSB tax was implemented.

Pre-/post-observational study with in-store audits of beverage prices and marketing. Changes including pricing discounts and promotions were assessed at the individual beverage level for pre/post-tax implementation years.

Eighty food stores (grocery, convenience, drug and dollar) in NL, Canada.

There was no evidence of a change in posted shelf prices between pre/post years. There was a significant increase (+2·5 %, χ2 = 9·693, P = 0·002) in proportion of discounted taxable SSB with no change in non-taxable beverages (P = 0·350). There were no significant differences in change of number of promotions for taxable SSB (+5·2 [−0·1, 10·5], F = 3·789, P = 0·053) nor non-taxable beverages (+3·4 [–1·0, 7·7], F = 2·268, P = 0·134).

The lack of change in posted prices of taxable SSB indicates that the NL SSB tax was not communicated at the point of decision-making. While some marketing changes post-tax were observed, results should be interpreted cautiously as they cannot be attributed definitively to the tax. Existing literature implies that industry may adapt marketing conduct to counteract beverage taxes. Such changes were limited in NL, suggesting retailers may have opted not to display the tax rather than attempt to actively counteract it. Lack of transparency surrounding the tax may neutralise intended behavioural effects.

Explore adolescents’ recall of food and beverage advertisements in digital media, while evaluating associations between socio-demographic characteristics and advertisement recall.

Recruitment took place using a two-stage cluster probability-based sampling approach. Thirty-nine high schools stratified by type (public v. private) were included, with one class within each grade randomly selected, wherein attending students (n 1542; age range: 11–19 years) received a paper-and-pencil questionnaire for completion in their homes. Participants indicated their spontaneous recall of food and beverage advertisements on social media and provided socio-demographic information. Individual responses to an open-ended question were graphically represented using a world cloud, after which the data were analysed through content analysis based on inductive coding.

The study was conducted in Montevideo, the capital city of Uruguay, which is a high-income South American country with a high prevalence of overweight and obesity among adolescents.

A total of 1542 adolescents attending public and private high schools participated.

Almost nine of ten adolescents (87·6 %) reported having seen a food or beverage advertisement on digital media and more than three of four (76·1 %) could spontaneously recall at least one such advertisement. The three most frequently used words for spontaneous recall were ‘McDonalds’, ‘Coke’ and ‘burgers’, whereas the three most frequently mentioned product categories were ‘Fast-food and fast-food restaurants’, ‘soft drinks’ and ‘savoury snacks’. Some socio-demographic differences emerged.

The findings stress the need to implement mandatory regulatory approaches to reduce adolescent exposure to digital marketing of unhealthy foods and beverages.

Food environments can influence dietary behaviours. Promotion of foods high in fats, salt and sugars is a barrier to healthy eating. We explore advertising by deprivation in an English city.

Using a cross-sectional design, we describe the prevalence of outdoor advertising, the types of products advertised and the UK Nutrient Profile Modelling scores for advertised foods and non-alcoholic beverages. Differences in outdoor advertising prevalence by area deprivation were assessed using χ2 tests.

Six areas in each of five deprivation strata were randomly selected from all 482 Leeds neighbourhoods (England) (n 30 neighbourhoods).

Eligible outdoor advertisement assets (intentionally placed permanent/semi-permanent advertisements visible from the street) were photographed in May–June 2023.

A total of 295 outdoor advertising assets were recorded. The most deprived quintile had the highest number of advertising assets (n 74). Bus shelters were the most prevalent asset (n 68). The number of food adverts differed significantly by deprivation level. The two most deprived areas had higher than expected exposure, while the two least deprived areas had lower than expected exposure (P < 0·01). Data were insufficient to compare compliance against a hypothetical Healthier Food Advertising Policy; however, bus shelters were most likely to display high in fats, salt and sugars food adverts.

Food advertising in Leeds is unequally distributed, with more food adverts in more deprived areas. Similar inequalities may exist in other cities, but data are scarce. Unhealthy adverts are most prevalent on bus shelters, highlighting an important asset for policy focus.

To assess the nutritional quality of foods and beverages (F&B) advertised to adolescents and analyse marketing techniques and persuasive appeals used by celebrities and influencers on Instagram.

A content analysis study was conducted using the WHO’s CLICK Monitoring Framework and Nutrient Profile Model.

Instagram, a popular social media platform among adolescents with frequent F&B advertisements by celebrities and influencers.

The top forty-eight Instagram accounts of celebrities and influencers posting F&B advertisements were selected based on follower count and engagement metrics. Nutrient profiling of advertised F&B (n 344) and content analysis of posts featuring F&B (n 326) between January 2021 and May 2023 were performed. Data collected included characteristics of celebrities and influencers, marketing techniques, online engagement and persuasive appeals in the posts.

Carbonated beverages and flavored waters (28·5 %), energy drinks (20·6 %) and ready-made foods (15·4 %) were most frequently advertised, with the majority (89·2 %) of products not permitted for advertisement to adolescents, according to WHO. Common marketing techniques included tagging brand (96·9 %) and using brand logo (94·2 %). The most frequently used persuasive appeals were taste (20·9 %), energy (10·7 %), link to sports events (10·7 %), new product (9·5 %) and fun (7·4 %).

Most F&B advertised on Instagram by celebrities and influencers are prohibited from being advertised to adolescents by the WHO. This highlights the need for stricter regulation of user-generated content and for users and parents to be better educated about persuasive techniques used on social media to make them less vulnerable to the influence of marketing.

To describe menu item prices and promotions on a meal delivery app in the UK and explore their socio-economic patterns.

Cross-sectional descriptive analysis

We analysed over 21 million menu items from 71 532 food outlets listed on JustEat across the UK. We assessed median prices and types of promotions, examining variations by cuisine (e.g. chicken dishes, pizza) and outlet type (i.e. grocery, chain takeaways). Promotions were categorised into six types: percentage off, stamp cards, free items, meal deal notifications, buy one get one free and low delivery fees.

The median number of food outlets accessible via JustEat was sixty-nine per postcode district with delivery access (IQR = 14–225). The median menu item price was £6·25, with small/independent takeaways showing the highest prices. Menu item prices were generally lower in more deprived areas. Promotions were prevalent, with 65·96 % of outlets offering at least one. Outlets delivering to more deprived areas tended to offer more promotions, with the most common being low delivery fees, stamp cards and percentage off. Price and promotion strategies differed across cuisines and outlet types.

Online menu item prices are relatively high, and promotions are widespread in the UK. Food outlets serving deprived areas often offer lower prices and more promotions. These targeted pricing and promotional strategies may influence purchasing behaviour and contribute to diet and health inequalities. Further research is needed to assess their impact on dietary behaviours and population health and guide policy interventions in the digital food environment.