Television Feeds Unhealthy Food Advertising To Children In Asia: Evidence From Nine Countries Using A Harmonized Approach (Preprint)

BACKGROUND Prevailing childhood obesity in Asia adds risk for future adult burden of obesity and non-communicable diseases. Weak policies across most Asian countries enables unrestricted marketing of obesogenic foods and beverages directly to children. Television is the common medium for food marketing to reach this audience. OBJECTIVE This study aimed to assess the extent and nature of television food and non-alcoholic beverage marketing in nine Asian countries (Bangladesh, China, India, Malaysia, Mongolia, Nepal, Philippines, Sri Lanka and Vietnam) with capacity building from the International Network for Food and Obesity/NCD Research, Monitoring and Action Support who enabled harmonization of data collection method and content analyses. METHODS Advertised foods were categorized as permitted (P) or not permitted (NP) based on the nutrient profile models (NPM) established by the WHO regional offices for South-East Asia (SEARO) and the Western Pacific (WPRO). Data were reported as rate of food advertisements (ads/h/channel) overall and persuasive strategy usage during children’s peak (PVT) and non-peak (non-PVT) viewing times. RESULTS Cross-country comparisons, irrespective of country income level, indicated NP food advertising dominated children’s popular television channels especially during PVT with rates as per WPRO/ SEARO criteria ranging from 2.40/ 2.29 ads/h/channel (Malaysia) to 9.70/ 9.41 ads/h/channel (Philippines). Persuasive strategy rates were also higher during PVT compared to non-PVT. Sugar-sweetened beverages, sugar-containing solid foods, and high salt and fat-containing snacks and fast foods were frequently advertised. Evaluation of the application of WPRO and SEARO NPMs identified inconsistencies due to regional taste and cuisine variations across Asia. CONCLUSIONS Our study clearly showed unhealthy food marketing through popular children’s television channels is widely occurring in Asia and is a clear breach of child rights. Evidence outcomes will be used to advocate for stronger policy regulations to control unhealthy food marketing and strengthen strategies to promote a healthier food environment for the Asian people. CLINICALTRIAL Not relevant to this study as this is not a clinical trial.