What is the evidence for marketing restrictions on unhealthy foods and beverages? What is the evidence for marketing restrictions on unhealthy foods and beverages?

People—especially children and underserved communities—are exposed to pervasive, unhealthy food and beverage marketing where they live, learn and play. The food and beverage industry that produces ultra-processed products spends billions on marketing to shape food preferences and build brand loyalty from an early age.

Marketing is extensive and persuasive

• Children across 22 countries were exposed to 1.7 to 13.4 unhealthy food ads per hour during peak television (television) viewing times (average: 3.1 ads).
• Adults across five mostly higher-income countries encountered at least one marketing strategy in the prior month, with brand characters being most prevalent (32%).
• A review of 71 studies found that food marketing techniques—from television ads to product packaging—broadly shifted children’s attitudes, preferences and consumption toward unhealthy foods.
• television remains the most prominent channel for marketing exposure, but industry spending is rapidly shifting to digital platforms—social media (Facebook, Instagram, TikTok, Twitch) and video games—following where people spend their time.    

Marketing disproportionately targets underserved communities

• In lower-middle-income countries, the industry targets children more aggressively than in high-income countries and more prominently showcases its charitable activities.
  • Approximately 12% of posts from McDonalds Instagram accounts in high-income countries included child-targeted themes vs. 22% in lower-middle-income countries.
• Research from Australia, Canada, Sweden, the United Kingdom and the United States shows that unhealthy food and beverage marketing disproportionately targets people from marginalized racial and ethnic groups and lower socioeconomic backgrounds—including through outdoor advertising in less affluent neighborhoods—potentially worsening diet-related health disparities.[/madeo_footnote]Adams J, Tyrrell R, Adamson AJ, White M. Socio-economic differences in exposure to television food advertisements in the UK: a cross-sectional study of advertisements broadcast in one television region. Public Health Nutr. 2012;15(3):487-94.Sainsbury E, Colagiuri S, Magnusson R. An audit of food and beverage advertising on the Sydney metropolitan train network: regulation and policy implications. BMC Public Health. 2017;17(1):490.'>
  • In the U.S., Black youth and adults viewed 9% to 21% more food and beverage television ads than white counterparts in 2021 (accounting for viewing time differences). Most television ad spending on Spanish-language channels and those targeting Black consumers promoted unhealthy foods like sugary drinks and snacks.

Pervasive, unhealthy food and beverage marketing contributes to poorer diets and health outcomes. Research demonstrates that this marketing changes social norms and shapes food preferences and consumption across populations. For children, the evidence is especially strong: marketing shapes attitudes toward unhealthy foods, increases dietary intake and contributes to obesity.

The scale of the problem

• 88% of food policy stakeholders across 24 countries identified unhealthy food marketing as a problem. The respondents that did not were from countries that have already taken or are in the process of taking regulatory action.
• A WHO systematic review of 118 studies found that 50% to more than 90% of food marketing promoted unhealthy foods, with sweetened beverages being the most marketed category.
• Across 22 countries, television had four times more ads for unhealthy foods than healthy ones, with more than one-third of unhealthy ads airing during peak children’s viewing times.

Impact on children’s food choices, consumption and health outcomes

• A meta-analysis and review of 17 randomized controlled trials found that children exposed to marketing were 10 percent more likely to select the advertised foods and beverages and that exposure to marketing led to an immediate increase of approximately 30 calories consumed.
• A meta-analysis of 16 studies found that children exposed to 4.4 minutes of television advertising increased short-term food consumption by 60 calories compared to those who did not view advertising. Playing an advergame with food cues for five minutes increased consumption by approximately 53 calories.
• A systematic review of 26 studies found that exposure to marketing via advergames or social media significantly affected children’s diet‐related outcomes, including higher intake of unhealthy food and beverages.
• A review of 12 studies found that marketing encourages children to request advertised foods—which are consistently high in fat, salt or sugar—and parents often purchase these less healthy foods.
• A two-year study across eight European countries found that children who often requested items seen on television had 1.3 times the odds of becoming overweight.

Restricting unhealthy food and beverage marketing refers to government-led policies that limit or ban the advertising, promotion and sponsorship of products high in nutrients or ingredients of concern (fat, salt, sugar, nonsugar sweeteners) that are often ultra-processed.

The need for such restrictions is clear: food and beverage marketing is pervasive, with the majority promoting unhealthy products to which children are exposed, contributing to poorer diets and health outcomes across generations.

-> See best practice recommendations for food and beverage marketing restrictions.

Policies that limit food and beverage marketing have been found to reduce the volume and persuasiveness of marketing and contribute to reduced purchases, but their impact has been constrained by limited scope, with industry often migrating to unregulated channels.

• After the U.K. banned television advertising of foods high in fat, salt and sugar during programming for children aged 4–15, children viewed 37% fewer such ads. Yet, these gains were offset by reallocation of advertising spend toward non-television media, and children’s overall relative exposure to unhealthy food advertising did not change, while exposure among all viewers increased.
• After South Korea introduced regulations banning television advertising of unhealthy foods during the 5–7 p.m. children’s prime time slot and during commercial breaks of children’s programs outside those hours, the number of television ads for unhealthy foods and beverages during regulated hours decreased by 81%.
  • However, following implementation, unhealthy food companies were more likely than non-unhealthy food companies to increase their use of online, mobile and social marketing—suggesting that restrictions on one channel can prompt industry to migrate to unregulated ones.
• A systematic review of 44 studies found food and beverage marketing restrictions were more likely to reduce children’s exposure and marketing power when they were: mandatory, designed to protect children of all ages, applied to television advertising and based on a government-led nutrient profile model.

Restricting food and beverage marketing is cost-effective in the long term. Health benefits—such as improved life expectancy and reduced health care costs—outweigh the resources needed to implement these restrictions.

• All nine modeling studies in a WHO review found that policies to protect children from unhealthy food marketing would be cost-effective or cost-saving in the long term.
  • A study from Australia found that eliminating unhealthy food marketing from television during daytime hours would save approximately AUD $784 million (~US$520 million in 2018 dollars) in health care expenditures. Children from lower socioeconomic backgrounds would experience 1.5 times higher health benefits and 1.4 times higher total cost savings over a lifetime.
• An OECD analysis of obesity prevention policies in 36 countries found that regulating food and beverage advertising to children costs only about 20% of what it returns in economic benefits—or for every purchasing power parity (PPP) $1 invested, approximately PPP $4-5 is returned.

WHO guidelines emphasize that effective policies must address both exposure to and power (influence) of unhealthy food and beverage marketing. Policies should restrict all forms of unhealthy food marketing across all age groups, platforms and marketing techniques.

-> See Food Policy Hub’s best practice recommendations to learn what makes a policy comprehensive

The gap between best practice and current implementation:

As of May 2022, 60 countries have adopted food and beverage marketing policies, but most use either industry-led voluntary approaches or government-led stepwise (partial) approaches with gaps:

• Only 20 have mandatory marketing restrictions
• Another 18 have mandatory policies limited to school settings

Common loopholes include:

• Covering only younger children (aged 12 years or younger)
• Using weak nutrient criteria to determine which food and beverages are subject to marketing restrictions
• Regulating only certain media platforms
• Restricting only in narrowly defined child-directed media

Evidence of ineffectiveness of voluntary approaches:

• A study across 22 countries found that unhealthy food marketing during children’s peak viewing times was higher in countries with industry self-regulation than in countries with no policies at all (3.8 ads per hour vs. 2.6).

Evidence of marketing migration with stepwise policy:

• Studies have demonstrated the migration of food and beverage marketing to nonregulated age groups or platforms following stepwise (partial) policy.

Mandatory stepwise policies can still work:

• Well-designed and implemented, mandatory, stepwise policies have been shown to reduce exposure to and power of marketing and contribute to reduced purchases. (See section: How do marketing restrictions work?) However, comprehensive policies that close loopholes could deliver even greater public health benefits.