Playing with children’s health: an integrative review of marketing strategies on labels, regulatory measures and nutritional quality of child-targeted foods

Child-directed marketing frequently promotes foods high in sugar, sodium, and saturated fats, contributing to unhealthy diets and long-term health risks. This integrative review examines self-regulation and legislation in child-directed food marketing and the nutritional quality of packaged foods marketed to children. Literature was sourced from PubMed, Scopus, and Web of Science, including articles in English, Portuguese, Spanish, and French. Eighty-seven studies were included. Chile, Mexico, and Argentina stand out for implementing World Health Organization-recommended policies to limit unhealthy food and beverage marketing to children and extending restrictions on food labels. The review highlights the ineffectiveness of self-regulation as a single strategy for promoting healthy food choices among children. Furthermore, the exclusion of food labeling as a marketing channel represents a concerning shortcoming of the studied initiatives. We discussed key gaps in current practices, including the lack of a clear and global definition for "child" and "child-targeted food," inconsistencies between labeling practices and recommended nutrition intake for children, and the exclusion of seasonal products from analyses. The poor nutritional quality of foods marketed toward children represents a significant public health issue, threatening their long-term health. Recommendations for future action to address these challenges are pointed out.