Science and Technology in

childhood Obesity Policy

FOOD
SYSTEMS
FOR

HEALTH

PROTECTING CHILDREN
FROM THE HARMFUL IMPACT
OF FOOD MARKETING: POLICY BRIEF

Policy issue and context

Childhood overweight and obesity are increasing global public health Healthy diets are
problems. In 2020, 38.9 million children aged under 5 years were estimated being undermined by
to be overweight (1), while in 2016 more than 340 million children and
marketing practices, with
adolescents aged between 5 and 19 years were affected by overweight or
a significant amount of
obesity (2). A major driver of the increases in obesity that have been seen
marketing being for foods
in almost all countries – which in turn contribute to the increasing global
burden of disease associated with obesity (3) – is current food environments, that contribute to an
which feature the increasing availability, accessibility, affordability and unhealthy diet1
marketing of foods that are high in saturated fats, trans-fats, sugars and/or
salt and are usually highly processed (4). Evidence is unequivocal
that food marketing
The United Nations (UN) Food System Summit was called to commit to
to which children are
bold new actions and game-changing solutions to transform today’s food
systems, which are failing to support the development of food environments exposed alters their food
that promote healthy diets and improve nutrition. Food environments are preferences, choice,
changing rapidly, especially in low- and middle-income countries, with purchases and intake
the wide availability and heavy marketing of many products; in particular,
those with a high content of fat, sugars or salt/sodium.

1 Foods include both food and non-alcoholic beverages. In the context of food marketing, a food or non-alcoholic
beverage is considered to contribute to an unhealthy diet if it exceeds the thresholds established in WHO region-
specific nutrient profile models or if it belongs to a category for which all marketing is prohibited (and thus no
thresholds are established). Such foods are typically high in fats, sugars and/or salt and are processed. WHO regional
nutrient profiles were developed for all six WHO regions: the African Region, the Region of the Americas, the Eastern
Mediterranean Region, the European Region, the South-East Asia Region and the Western Pacific Region.
 Healthy diets are being undermined by marketing
practices, with a significant amount of marketing
ABOUT WHO’S FOOD SYSTEMS FOR
being for foods that contribute to an unhealthy diet1
HEALTH
(5, 6). Evidence is unequivocal that food marketing
to which children are exposed alters their food
Today’s food systems are simply failing to deliver
preferences, choice, purchases and intake (7-11). Food healthy diets for all. In addition to the suffering
marketing also threatens children’s rights, affecting this causes to individuals and families, the
their physical health as well as their emotional, economic costs to society due to the health and
mental and spiritual well-being (12, 13). Therefore, as environmental impacts of current dietary patterns
noted by the commission set up by the World Health are heavy, and often hidden. If food systems are
Organization (WHO), the United Nations Children’s transformed, they can become a powerful driving
Fund (UNICEF) and the Lancet (the WHO–UNICEF– force towards ending hunger, food insecurity and
Lancet Commission) (12), “commercial governance” is malnutrition in all its forms. There is no single
essential to protect children from harmful marketing solution, instead it is recommended to implement
coherent portfolios of policies, investments and
that encourages unhealthy diets.
legislation that prioritise health. At the same
This policy brief provides policy-makers and programme time, it is also important to ensure a fair price for
managers, health professionals and advocates with the producer and reflect the true environmental,
information and policy options to increase protection health and poverty costs.
of children from the harmful impact of food marketing
by reducing the power of, and exposure to children of, WHO’s Food Systems for Health narrative highlights
such marketing practices. five different ways in which food systems impact
on health and embraces the interconnectedness of
humans, animals, and the planet. The malnutrition
Background pathway comprises the aspects of food systems
that lead to unhealthy diets or food insecurity
The need to protect children from the harmful impact
and therefore contribute to malnutrition in all
of food marketing and to enable children to develop
its forms. Malnutrition and hunger pose the
healthy food values and preferences has long been highest risks to human health in terms of death
recognized. In 2010, the Sixty-third World Health and illness and include obesity, micronutrient
Assembly unanimously endorsed the WHO Set of deficiencies, stunting, wasting, communicable and
recommendations on the marketing of foods and non- noncommunicable diseases and mental illness.
alcoholic beverages to children (14), recognizing that
a significant amount of marketing is for foods high in
fats, sugars or salt and is widespread across the world.
Resolution WHA63.14 on the marketing of food and and the power of each exposure. “Exposure to
non-alcoholic beverages to children (15) urges Member marketing” refers to the quantity, frequency and reach
States to take the necessary measures to implement of marketing communications via a growing number of
the set of recommendations, and to identify the most communication channels, among which digital media
suitable policy approach given national circumstances. platforms have become of particular concern (16, 17).
As noted in the set of recommendations, governments The WHO Regional Office for Europe has spearheaded
are in the best position to set direction and overall the advancement of a focus on digital marketing
strategy to achieve population-wide public health and has developed methods to measure individual
goals, and should therefore set the scope of a country’s children’s exposure to digital marketing across the
marketing restriction. European Region (18). “Power” is the extent to which
The set of recommendations defines marketing as each marketing item convinces its target audience
“any form of commercial communication or message to use the product; it is affected by content design,
that is designed to, or has the effect of, increasing nature and execution of communication of marketing
recognition, appeal and/or consumption of particular messages.
products and services” (14). Marketing includes A policy response that provides the best protection for
advertising, promotion and sponsorship. The impact all children from the harmful impact of food marketing
of marketing is a function of exposure to marketing and is in line with Article 3 of the Convention on the

1 Foods include both food and non-alcoholic beverages. In the context of food marketing, a food or non-alcoholic beverage is considered to contribute to an unhealthy diet if it exceeds
the thresholds established in WHO region-specific nutrient profile models or if it belongs to a category for which all marketing is prohibited (and thus no thresholds are established).
Such foods are typically high in fats, sugars and/or salt and are processed. WHO regional nutrient profiles were developed for all six WHO regions: the African Region, the Region of the
Americas, the Eastern Mediterranean Region, the European Region, the South-East Asia Region and the Western Pacific Region.

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Rights of the Child (CRC) to include children aged under digital marketing. Countries within the European
18 years (19), needs to be as comprehensive as possible, Union can capitalize on efforts by the European Union,
to reduce both the exposure of children to marketing which – in line with the various provisions of the EU
and the power of that marketing. The WHO Commission Treaties and the EU Charter on Fundamental Rights
on Ending Childhood Obesity underlines in its final and Freedoms has significant powers to regulate cross-
report: border marketing within its borders.
As noted in the implementation framework, the
“Government and society have a moral
responsibility to act on behalf of the child to
government’s ultimate aim should therefore be a
comprehensive policy approach. In 2016, the WHO
reduce the risk of obesity. Tackling childhood
Commission on Ending Childhood Obesity noted with
obesity resonates with the universal acceptance concern in its final report “the failure of Member States
of the rights of the child to a healthy life as well as to give significant attention to Resolution WHA 63.14
the obligations assumed by State Parties to the endorsed by the World Health Assembly in 2010 and
Convention of the Rights of the Child (20).
” requests that they address this issue” (20). Furthermore,
in 2018, the WHO Independent High-Level Commission
This new perspective offers some potential to increase on Noncommunicable Diseases called for an increase
the pressure on States to effectively address the various in effective regulation; in particular, that “governments
harms associated with the marketing of unhealthy, should give priority to restricting the marketing of unhealthy
ultra-processed food to children. products (those containing excessive amounts of sugars,
sodium, saturated fats and trans fats) to children” (27).
The framework for implementing the set of To date, no country has implemented a comprehensive
recommendations (21) proposes the following policy (28), despite evolving evidence on the harmful
three comprehensive policy approaches that are impact that food marketing can have on children of all
considered to have the highest potential to achieve ages, including those aged over 12 years (8, 9, 29), and
the desired policy impact: despite the lack of evidence that stepwise approaches can
▶ eliminating all forms of food marketing that reduce both exposure to and the power of food marketing,
is “high in saturated fats, trans-fatty acids, and have a positive impact on children’s health.
free sugars, or salt” to which a broad range of As of May 2022, a total of 60 countries have adopted
children are exposed; policies that restrict marketing of food and nonalcoholic
▶ eliminating all forms of food marketing to which a beverages to children, especially in the Region of the
broad range of children are exposed; and Americas and the European Region. Twenty of these
countries have mandatory marketing restriction policies
▶ eliminating all forms of marketing to which a and another 18 mandatory policies in the school setting.
broad range of children are exposed. Several countries have multiple approaches, mandatory
and voluntary and there is great variation in scope, such
The framework for implementation acknowledged as channels or settings covered. Some policies cover all
that some Member States may choose to start with a food and beverage products, others restrict marketing
narrower, stepwise policy approach, and to restrict of products based on their nutrient content, and some
marketing of only certain foods and of some forms of focus on a specific product such as energy drinks or SSB.
marketing through some channels. However, experience Furthermore, many countries have policies that do not
since endorsement of Resolution WHA63.14 shows cover children up to 18 years of age.
that such approaches leave children inadequately
protected because exposure to food marketing that
encourage unhealthy diets continues (22, 23). Narrow
policy criteria allow for gaps that companies may use
to shift their marketing investment from regulated to
© UNICEF/UNI210978/Sujan

unregulated areas (24-26). Food marketing originating

from sources outside a country’s jurisdiction may be
beyond the scope of a current national policy. This
issue of cross-border marketing already recognized in
Recommendation 8 of the WHO set of recommendations,
is gaining importance, especially also with increased

3
Elements to consider when implementing a comprehensive policy to protect
children from the harmful impact of food marketing

Given that the impact of food marketing is a function of Determining marketing types, techniques and
exposure and power, all policies should reduce both the channels to reduce power and exposure
exposure of children to marketing and the power of that
marketing. From the outset, it is crucial to clearly define Marketing types include advertising, promotion or cross-
the objectives of the marketing restrictions, to increase promotion, and sponsorship. Techniques include the use
transparency and support for the policy. Governments of licensed or brand-equity characters, celebrity endorsers
are in the best position to define the scope of the policy and incentives (e.g. toys), whereas channels include
and its components (14). Parliamentarians also play print, outdoor, broadcast and the Internet. Combining
marketing types, techniques and channels can powerfully
a unique role in advancing policies, including those
reinforce commercial messages, which makes it
to protect children from the harmful impact of food
important to ensure the broadest possible policy scope.
marketing through their mandates of representation,
For example, “advergames” use engaging video games to
legislation, budget and oversight (30).
advertise brand-name products by featuring them as part
of an online game; direct advertising uses targeted emails
The policy should consider the following elements or app notifications to children; influencers advertise
(21), in the best interests of all children, aged under and promote brand-name products by featuring them
18 years (19): in online videos; and brand-name products are shown
prominently during sponsored events.
▶ What foods are to be restricted
from marketing?
▶ What marketing types, techniques and
channels are to be restricted?

Determining foods to be restricted

A critical step is to clearly define nutrient criteria or

thresholds for foods to be restricted from marketing. To
support countries in determining foods to be restricted
from marketing, WHO has developed regional nutrient
profile models (31-36) in line with international dietary
guidelines, which governments can adopt and adapt,
depending on their respective country contexts. The
stricter the criteria and thresholds, the more foods
are restricted from marketing. Models developed by
the food industry as part of self-regulation tend to be
less strict than those developed by WHO or national
governments (37), and therefore provide less protection
to children from the harmful impact of food marketing.
Policies that have an underlying nutrient profile models
@ Victoria Shes on Unsplash

may be more effective (38). Food marketing restrictions

may be part of a wider package of policies to promote
healthy diets; hence, although every policy will have
its own distinct regulatory objectives, it is important
to ensure alignment between policies – in particular in
relation to the set nutrition criteria and thresholds.

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 Country experiences
To date, no country is implementing any of the three the audience. Stepwise, or voluntary industry pledges
comprehensive policy approaches proposed in the that typically only restrict marketing directed to
framework for implementation. Therefore, there children aged under 12 years and are likely to have less
is no available evidence on the effectiveness of a strict nutrient criteria and thresholds. Such stepwise
comprehensive approach. approaches only partially protect children (26), and are
less likely to be effective (38).
Stepwise policy approaches are the most commonly
implemented; they include both mandatory regulation Some countries are now broadening the scope of their
and voluntary approaches, such as industry pledges. policies and are implementing stronger policy elements
Examples of stepwise mandatory approaches include that help to better protect children from the harmful
regulations of TV advertising for defined foods, impact of food marketing. These country examples
marketing restrictions on children’s channels during which are provided in Table 1, can serve as an inspiration
children’s programmes or during a short, defined to other countries.
time-period where children make up the majority of

Table 1. Country examples of policy elements to achieve stronger protection of children from the harmful
impact of food marketing2

Policy elements to consider

when implementing a
comprehensive policy Country examples

Protecting all children aged Restrictions for unhealthy food marketing in Ireland and Turkey
under 18 years apply to children aged under 18 years.
In Ireland, commercial communications for unhealthy food products
and/or services are not permitted in children’s programmes, and
shall not include licensed characters. Children’s programmes are
defined as those where more than 50% of the audience is aged
under 18 years.

In Turkey, the Regulations on Principles and Procedures of

Broadcasting Services protect children aged under 18 years, and
restrict advertising of unhealthy food and beverages before, during
or after children’s television programmes. If such food is advertised
during non-children’s programmes, health promotion messages
must be displayed.

Restricting a broad range The Turkish broadcasting regulations apply restrictions on the
of foods by applying strict marketing of unhealthy foods to children based on the WHO Regional
nutrient profile models Office for Europe nutrient profile model (31). Specific food categories
– including chocolate and candies, energy bars, sweet biscuits
and waffles, potato chips and sugar-sweetened beverages – are
prohibited from being advertised during children’s programming.

2 Adapted from a forthcoming WHO/UNICEF publication titled Implementing policies to protect children from the harmful impact of food marketing:
a child rights-based approach.

5
5
 Policy elements to consider
when implementing a
comprehensive policy cont. Country examples cont.

Restricting the power of Chile’s Food Labelling and Advertising Law includes a ban on
marketing advertising for unhealthy foods where advertising appeals to
children by including characters, toys or other strategies considered
to be “directed to children”.
The Law Promoting Healthy Eating for Children and Adolescents in
Peru includes restrictions for advertising through any medium.
Companies are prohibited from using real or fictional characters, gifts
or prizes or other incentives to market unhealthy foods and beverages.

Including a broad set of In Quebec, Canada, the Quebec Consumer Protection Act bans any
marketing communication commercial advertising (directed at children aged under 13 years),
channels including of foods and nonalcoholic beverages on television, radio,
print, Internet, mobile phones and signage, as well as the use of
promotional items.

Adopting an effective In Quebec, Canada, the Office for Consumer Protection enforces the
enforcement mechanism Consumer Protection Act in three principal ways: notifying the actors
concerned of the rules that apply to their activities; negotiating with
said actors to voluntarily change their practices; or filing criminal
proceedings against the actors for violating the Act. Fines can be levied
on any actor in the advertising process (from the conception phase to
its distribution), ranging from 600 to 100 000 Canadian dollars.

A review of contextual factors relevant for the policies to restrict food marketing to children (40-43, 49,
implementation of policies to restrict food marketing 51-53). Obtaining buy-in to implement a comprehensive
(39) identified studies that described elements affecting policy that best protects children from the harmful
the overall feasibility of such policies. Facilitators impact of food marketing is likely to be challenging.
included strong political leadership, supporting evidence, To identify possible opposition, submissions received
intersectoral collaboration and community support during transparent public consultations provide valuable
(40-44). Challenges or barriers included complexity of insights (54-57). Acceptability of stakeholders on a
the regulatory processes, conflicting interests, lack of comprehensive, mandatory policy approach to marketing
financial and human resources, industry interference, a restrictions varies greatly (39). The food industry opposes
weak evidence base, and ambiguous categorization of, or mandatory measures and offers voluntary measures that
lack of criteria for, foods to be restricted or banned (40-50). would only partially protect children from the harmful
The review of contextual factors also showed a wide impact of food marketing (54-57). Table 2 provides
range of literature reports on industry opposition to possible arguments against food marketing regulation,
government action on developing or implementing as well as counterarguments.

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 Table 2. Examples of common arguments from opponents and counterarguments3

Common arguments from

opponent Counterargument

Parents and caregivers are The majority of food marketing undermines dietary recommendations
responsible for what their and encourages unhealthy diets. Marketing negatively influences food
children eat. This should values and preferences, and undermines efforts of parents and other
not be decided either by the caregivers to encourage healthy eating. The overabundance of such
government or by businesses. marketing also distorts the information landscape, impacting children
directly and making it more difficult for parents to navigate.

Restricting food marketing is an important policy action to improve

the food environment to support children in making it easier to make
healthier decisions, and to support parents in providing better care for
their children (13, 58).

There is no proof that the This argument is no longer sustainable. A large body of consistent
marketing of unhealthy food and independent evidence has determined that marketing
and beverages is linked to influences children’s food preferences, purchase requests and
children’s health outcomes, dietary intake (7-9), and ultimately impacts their health.
such as overweight and
obesity.

The ministry of health is not the Governments have a legal obligation to protect child rights, including
appropriate actor to determine those that are threatened by harmful marketing. All relevant
how food marketing to children governmental sectors should be involved in drafting, adopting and
should be regulated. enforcing regulations on food marketing.
Whether or not the ministry of health has the legal authority to
regulate food marketing varies between jurisdictions and is a matter
for each government to determine based on its domestic legislation.
In some countries, marketing restrictions were passed under a food
law (as in Chile), or under a broadcast regulation (as in Ireland and the
United Kingdom of Great Britain and Northern Ireland). The ministry
of health will typically take the lead on the process, given the health
objective of food marketing restrictions, but needs to be supported
by the appropriate governmental bodies and agencies, to ensure that
legislation or regulations are issued by the appropriate government
body, following required procedures. In the United Kingdom, the
Department of Health and the Department for Digital Culture, Media
and Sport have worked closely on the development of marketing
restrictions.

3 Adapted from a forthcoming WHO/UNICEF publication titled Implementing policies to protect children from the harmful impact of food marketing:
a child rights-based approach.

7
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Table 2 cont. Examples of common arguments from opponents and counterarguments

Common arguments from

opponent Counterargument

The food industry is better Research has established that voluntary actions by industry, such as
placed than the government to pledges to promote food “responsibly” to children, contain significant
reduce the harmful impact of gaps that prevent them from reducing the exposure of children to
food marketing: the adoption food marketing. These gaps relate to limitations in the age ranges of
of industry-led, self-regulatory children protected; exemptions in the marketing techniques, media
pledges is more efficient and and programmes used; and weaknesses in the categorization of foods
less costly than the imposition that contribute to an unhealthy diet. Industry-led initiatives are also not
of mandatory restrictions of effectively enforced, monitored and evaluated; as such, they cannot be
business practices. substituted for a mandatory, child-rights compliant implementation of
the WHO set of recommendations (14).

Sweeping restrictions are The WHO set of recommendations recognizes that a comprehensive
excessive: they limit business approach is most effective in ensuring the broadest possible coverage
activity too much and infringe and a high level of public health protection against food marketing
on the ability to market food to (14). Stepwise approaches may be perceived as representing small
adults. A stepwise approach, and cumulative gains over time, but research has shown that they can
starting with more narrowly have counterproductive effects and can lead to an increase (rather
defined approaches, would be than a decrease) in children’s exposure to such marketing. Gaps in
better. restrictions encourage companies to shift their marketing investment
to unregulated programmes, media, marketing techniques and
settings (24, 59). As a result, a stepwise approach does not sufficiently
protect children from exposure to commercial practices that
negatively impact their rights, as enshrined in the CRC (19).

Marketing restrictions are Business actors have invoked different legal arguments challenging
unlawful. the validity of food marketing restrictions. These arguments can
be rebutted, particularly where a government has considered the
likelihood of legal challenges in the development of the regulations.
Governments that have ratified the CRC have an obligation to ensure
the enjoyment of the highest attainable standard of health for all
children in their territories. In upholding this right, they have a broad
margin of discretion in determining how to do this most effectively,
including through the use of regulations.

CRC: Convention on the Rights of the Child

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8 ©WORLD HEALTH ORGANIZATION (WHO), SEP 2021
Call to action
To mitigate the harmful impact of food marketing on broad to restrict all forms of food marketing to which
children, governments are called upon to implement children are exposed, including cross border marketing.
comprehensive policy approaches to restrict
In view of the increasing concern of digital marketing, and
marketing of foods that contribute to an unhealthy
in line with the general comment on children’s rights in
diet, to reduce children’s exposure to such marketing
relation to the digital environment (60), policies to protect
and to reduce the power of such marketing, offering the
children from the harmful impact of food marketing
best possible protection to all children. Comprehensive
should also include digital marketing restrictions.
policy approaches have the potential to be sufficiently

Acknowledgements
This policy brief was prepared by Dr Katrin Engelhardt, María M. Morales Suárez-Varela, Dr Susanna Raulio,
Ms Kaia Engesveen, Dr Chizuru Nishida, Ms Camilla Prof Franco Sassi and Dr Josep A. Tur. The STOP project
Haugstveit Warren, and Dr Rain Yamamoto, Department (http://www.stopchildobesity.eu/) received funding
of Nutrition and Food Safety, World Health Organization from the European Union’s Horizon 2020 research and
(WHO), and Mr Jo Jewell, Nutrition Section, Programme innovation programme under Grant Agreement No.
Group, UNICEF. Sections are adapted in part from the 774548. The STOP Consortium is coordinated by Imperial
forthcoming joint WHO/UNICEF publication: “Taking College London and includes 24 organisations across
action to protect children from the harmful impact of Europe, the United States and New Zealand. The content
food marketing: a child rights-based approach”. We also of this publication reflects only the views of the authors,
acknowledge Ms Kristiana Bruneau for her inputs to this and the European Commission is not liable for any use
document. that may be made of the information it contains.

Valuable inputs and critical review were also provided WHO gratefully acknowledges the financial support
by the following experts who contribute to the Science provided by the Government of Japan and the
& Technology in Childhood Obesity Policy (STOP) Government of Sweden, for the production of this
project: Dr Anu Aaspõllu, Prof Amandine Garde, Prof policy brief.
Tiina Laatikainen, Dr Tim Lobstein, Ms Päivi Mäki, Dr

@ epha.org

@ Chris Futcher

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Protecting children from the harmful impact of food marketing: policy brief

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