Regulating marketing of foods to children in South Africa: which nutrient profiling model should be used?

Introduction: Childhood obesity is increasing at an alarming rate and in Africa childhood obesity has nearly doubled in the last 25 years. The World Health Organisation has called for governments to improve children’s food environment by implementing policies, such as regulating the marketing of unhealthy foods to children. Numerous nutrient profiling (NP) models are available supporting such regulation by defining unhealthy foods The aim of this study was to compare five NP models proposed for child-directed food marketing regulations by determining (a) how many and (b) what kind of foods the models would allow to market to children. Method: A representative food list of 197 foods was compiled by including all foods advertised on South African free-to-air television channels in 2014 and foods commonly consumed by South African children. The nutritional information of the foods was sourced from food packaging, company websites and a food composition table. Each individual food was classified by each of the five NP models. Results: The percentage of foods that would be allowed to be marketed to children according to the different NP models ranged from 6% to 45 %. The majority of the pairwise comparisons between the NP models yielded kappa statistics greater than 0.4, indicating that there was moderate agreement between the models. Conclusion: The NP models varied considerably with regards to the amount and type of foods allowed to be marketed to children, emphasising the importance of thorough testing and evaluation of a proposed NP model before implementing it into policy