Point-of-Purchase Food Marketing and Policy Solutions

Background: Food marketing has been implicated as a driver of obesity. However, few studies have examined point-of-purchase marketing in supermarkets and restaurants, or marketing in lower-income countries. Furthermore, policy solutions to counteract marketing and provide consumers with objective nutritional information require evidence of efficacy. Paper 1. We documented child-oriented marketing practices, product claims, and health-evoking images on 106 cereals sold in Guatemala City, Guatemala. Linear regression was used to evaluate the association between various marketing strategies and nutritional quality. We found that child-oriented cereals had worse overall nutritional quality and higher sugar content compared to non-child oriented cereals. Cereals with health claims were not significantly healthier than those without claims. Paper 2. Menu items marketed on general and kids’ menu boards and signage were recorded at McDonald’s, Burger King, Wendy’s, and Taco Bell throughout the United States in 2010 and 2013. Linear regression was used to model changes over time in nutritional quality of marketed foods and beverages. On general menu boards, marketed items became healthier, improving in overall nutritional quality and decreasing in calories. This pattern was evident in all chains except Taco Bell, where marketed items increased in calories. On general menu boards and signage, while marketed foods improved in nutritional quality, marketed beverages remained the same or became worse. However, on kids’ menu boards, both foods and beverages became healthier. Paper 3. 1,958 adults completed an online survey. Participants were randomized to one of six labeling groups: No label; Calories per bottle; Traffic light; Warning label; Calories+Warning; Traffic Light+Warning. Differences in purchase intentions and perceptions for SSBs across groups were assessed with ANCOVAs. Single health warning labels on SSBs appeared as effective as single traffic lights or combined calories plus warning labels. Warning labels were most effective when combined with traffic light labels in conveying health-related risks associated with SSB overconsumption. Conclusions: Although marketed products in fast food restaurants in the United States appear to be showing modest improvements in nutritional quality, the increase in child-oriented marketing on nutritionally-poor items in other countries is concerning. Continued research on nutrition-minded policy solutions is essential