Introduction

The prevalence of obesity in European countries is on the rise and currently ranges between 10% and 40% in adults. The prevalence of obesity and the overweight in children skyrockets dramatically. Being overweight negatively impacts on the health and quality of life of the individuals, who suffer from increased risks of, e.g., diabetes, cardiovascular disease, and cancer, as well as from social stigmata. In addition, the obesity epidemic affects society and the economy: health care costs are increasing and productivity is decreasing significantly.

The issues of food advertisements, especially aimed at children, and food labeling are factors behind the obesity epidemic which need to be tackled. Commercial communication increases consumer information. However, the promotion of unhealthy foods negatively impacts the health of the population. Actions need to be taken to protect children from commercial activity in this field. Appropriate food labeling may help citizens make healthy choices regarding nutrition (Erginel and Kyprianou 2006).

Consumers’ freedom of choice is a fundamental aspect of the common European internal market model. European citizens must have the freedom to decide how much advertising they wish to view. In order to achieve this freedom, advertising messages and program content need to be clearly distinguishable from one another (BEUC 2006).

Nutrition campaign in 2005

The Bureau Européen des Unions de Consommateurs (BEUC, the European Consumers Organisation) launched a nutrition campaign in March 2005 in which seven demands were addressed. The BEUC encouraged the consideration of nutrition in other EU policies and access to healthy, affordable products for all consumers. Nutritional information on food products should be clearer, unhealthy food should no longer be promoted as healthy, and manufacturers and caterers should reduce fat, sugar, and salt content in food. According to the BEUC, it is essential to provide consumers with good information on the characteristics of healthy diets and restrict the marketing of unhealthy foodstuff for children (Gallani 2006).

The current legislation on food labeling is 16 years old and is no longer working appropriately. Questions which need to be addressed include the extent and presentation of required information, as well as the legal binding of regulations (Erginel and Kyprianou 2006).

Advertising aimed at children

The dietary and health-related patterns of children are influenced by the interplay of many factors, including genetics and biology, culture and norms, economic status, physical and social, as well as commercial and media environments. Among these factors, the media plays a central socializing role for young people and is an important channel for food and beverage promotion (IOM 2005).

Advertisements reach children through the means of television, radio, magazines, music, mobile phones, and the Internet. Children are exposed to marketing messages at a whole variety of venues, including at home, schools, childcare settings, shopping malls, sporting events, and cinemas. In the UK, 75% of children aged 9–19 years old have access to the Internet at home and more than 90% of children have access at school (IOM 2005; WHICH? 2006).

The depiction of nutrition and obesity in television—telecasts and advertisements—negatively impacts food habits in children. The fact that watching television often replaces less sedentary activities may explain the positive correlation between the time spent watching television and being overweight or obese across different age groups. While watching TV, children are exposed to important unhealthy stimulations in terms of food consumption. Television food commercials, particularly of junk food, targeted at children have increased over the last few years. The consumption of unhealthy foodstuff in movies and cartoons may lead to children’s misconception of the consequences of unhealthy diets and stimulate the excessive intake of poor nutritional food. On the other hand, broadcasting campaigns on healthy diets and obesity prevention may be a successful tool in the promotion of healthy lifestyles (Caroli et al. 2004).

The different national regulations related to TV programs and advertising directed at children may partly explain the variations in the prevalence of childhood obesity across Europe (Caroli et al. 2004).

Internet marketing techniques and advertising strategies targeting children and adolescents include “advergaming” (games in which the advertised product is part of the game) and the usage of cartoons and spokescharacters. Some food and beverage brand websites even have specially designated children’s areas (Food Commission 2005; Weber et al. 2006).

Food advertising aimed at children and the obesity epidemic

There seems to be a direct relationship between food advertising aimed at children and their food choice. Hastings et al. even conclude in their review on the effects of food promotion aimed at children that there is sufficient evidence to indicate a causal association between promotional activity and children’s food knowledge, selection, preferences, and behaviors. Most existing studies, however, lack the appropriate design to prove causality (Hastings et al. 2003; IOM 2005)

Children remember products seen in advertisements and are more easily influenced compared to adults. In addition, young children are not necessarily able to distinguish between TV programs and advertisements. Another reason why food marketing aimed at children is attractive to the industry is the strong influence of children on household purchases. Although parents often decide on the meals and socialize children, the children themselves are able to actively change their parents’ attitudes (Young 2003). The purchase influence of children and adolescents increases with age (Young 2003; IOM 2005; Gallani 2006).

So far, there is no data to prove the causal relationship between advertising unhealthy foodstuff to children and the obesity epidemic in children and adolescents. Appropriate studies must be longitudinal and experimental in design, as well as sufficient in duration. Adjustment for confounding factors such as socioeconomic status, family lifestyle, and sedentary habits is critical in the evaluation of the influence of advertising.

A multifaceted approach in the promotion of healthy food

In order to improve the diet-related health of children, a multifaceted approach is indispensable. Different marketing strategies should promote healthy food, beverages, and meal options. Researchers have to evaluate changes and track improvements in food advertising aimed at children.

So far, food and beverage industries, restaurants, and retailers have highly underutilized the potential to devote resources in promoting food and beverages which support healthy diets for children. Marketing practices geared towards children and adolescents are unbalanced with recommended healthy diets and contribute to an unfavorable environment for children (IOM 2005). The food, beverage, and restaurant industries should shift their product range towards child-oriented foods which are lower in total calories, fat, salt, and added sugars, as well as higher in nutrient content. These healthier products must be actively promoted, especially to children and adolescents. Calorie content and key nutritional information should be prominently visible at the point of choice and use of menus and packaging.

The media and entertainment industries may include storylines on healthy nutrition and accurately interpret and report to the public research findings related to the health effects of different diets on children.

In addition, community-based educational efforts to help parents and children building skills for selecting healthy foods have to be enforced. Governments may act through the whole variety of policy approaches, including subsidies, taxes, legislation, and federal nutrition programs. If the industries’ voluntary efforts on shifting the emphasis away from high-calorie, low-nutrient foods during children’s television programming remain unsuccessful, legislators should enact laws to ensure adherence to the industries’ agreement. Moreover, governments may increase funds for research on factors influencing children’s diets, as well as monitor and report on activities and interventions in relation to the promotion of healthy food.

Lastly, schools have to provide visible leadership in the promotion of healthy diets. Nutrition standards for food and beverages available in the school environment should be developed and implemented. The integration and extension of education about healthy diets for children and adolescents in school curricula may be critical in the prevention of ill-health (IOM 2005; Wagner et al. 2005a,b).

BEUC studies on advertising aimed at children

There have been several studies on the analysis and consequences of advertising. AltroConsumo conducted a survey in Italy and DECO, conducted in Portugal, are surveys on television advertisements aimed at children. The quality and quantity of broadcasted advertisements aimed at children have also been investigated in studies done by TESTACHATS in Belgium. The Swedish Consumers’ Association (Sveriges Konsumentråd) contributed additional data on advertisements on the Internet and in the press. WHICH?, conducted in the UK in 2000 and 2003, mainly covers parents’ concerns in relation to the advertising of food to children.

In Italy, almost 20% of advertisements on public TV channels, in which 7% to 11% of broadcasting time is dedicated to advertisements, target children. Some private channels, especially those targeted at children, almost only promote products to children. In general, about 25% of TV advertisements cover foodstuff. Fruits and vegetables, fish, and other healthy choices are, by far, less promoted on Italian television compared to, e.g., cookies, crackers, chocolate, and fast food (AltroConsumo 2005).

The Swedish survey revealed that about 50% of Internet food advertisements that could be seen as aimed towards children promote unhealthy foods, including candy, crisps, soda drinks, ice cream, and cookies. Seventy percent (70%) of webpages further contained hidden and subtle promotion in terms of animated figures, games, contests, children’s clubs, and material for download (fun stories, birthday party tips, etc.). The authors of the study conclude that ethical Internet policies, including legal scrutiny, to promote clear practice concerning food advertising aimed at children should be developed. As it is particularly difficult for children to realize the impact of commercial influence, children need to be protected from the promotion of unhealthy foods which endanger their physical health (SCA 2006).

Common conclusions

Conclusions common to all of the cited studies are that the industry exerts a whole variety of methods in order to promote foods high in fat, sugar, and salt to children. Foodstuff is claimed to be healthy, e.g., because of fortification with minerals and vitamins, although outweighed by unhealthy food contents. Free gifts and collectible toys are offered to children to make them stay with the product. The promotion of unhealthy foods by cartoon characters and celebrities is also a common practice, which puts parents under pressure. In addition, industry sponsor events targeted at children and families (e.g., pop concerts, sports events) creates “happy family” environments (e.g., playground facilities) and promotes their products via the Internet or SMS text messages, which are both modern ways of communication that are attractive to youngsters. In-store promotions (e.g., the promotion and display of children’s snacks at the supermarket checkout) and in- or on-pack promotions (e.g., the usage of packaging which is fun to play with, games on the packet, etc.) are methods effective in the promotion of unhealthy foodstuff. Effective marketing tricks increasingly exploit new media, which allow advertisers to reach children in new ways. Products are placed in computer and Internet games, promotional websites offer games and free downloads, and food companies use chatterbots as well as Hypertag technology in order to make promotion more successful (Food Commission 2005; Gallani 2006).

Parents’ concerns

Marketing strategies targeting children put pressure on parents, as parents have to counteract increasingly to children’s food desires of unhealthy food choices. About three quarters of parents believe that advertisements aimed at children (including the existence of cartoon characters on food packages) makes it difficult for them to insist on healthy nutrition for their children and deny the promoted product to their children. According to parents’ opinion, the family is far less influential on children’s consumption of unhealthy food compared to television advertisements, friends, and promotion via free gifts or popular characters. Manufacturers even seek to actively undermine parental control. Parents largely miss advertisements of healthy foods and encourage celebrities and sports personalities to support the promotion of healthy foods to children. Most parents are in favor of advertising restrictions concerning the promotion of junk food during children’s viewing times (Gallani 2006, WHICH? 2006).

Why self-regulation is not the solution

In order to fight the obesity epidemic, efforts must include issues related to food production, food promotion, as well as education, awareness raising, and promotion concerning healthy lifestyle. Public education has to start in pre-school institutions and has to be continued throughout the whole lifespan in order to be effective. All stakeholders have to take part in these continued, multi-sectoral efforts. Stakeholders related to food labeling include governments, NGOs (BEUC, etc.), food and beverage industries, retailers and trade associations, restaurants, the entertainment industry, the media, medical and public health professionals, society/community, the family (parents, caregivers, etc.), and individuals (Wagner et al. 2005c; Wagner and Kirch 2006).

Self-regulation instruments which are accepted by the main stakeholders may play a role in delivering a high level of consumer protection. However, such codes of conduct cannot replace a legal framework of governance, including corresponding reporting and enforcement instruments (BEUC 2006).

Effective marketing strategies of unhealthy food are undermining efforts to improve children’s diet and to tackle the obesity epidemic and the increasing prevalence of diet-related diseases. If the industry does not voluntarily stop the promotion of foods high in fat, sugar, and salt to children, European governments have to introduce uniform restrictions covering the whole variety of marketing tactics. Children need to be protected from encouragement to consuming unhealthy food. Consumer-friendly nutrient profiling models, a ban on unhealthy foods in vending machines in schools, as well as restrictions on television advertisements of foods high in fat, salt, and sugar during children’s viewing times are examples of potential strategies which should be introduced. Direct commercial activity of unhealthy foodstuff in pre-schools and schools needs to be strictly prohibited. In order to have maximum effect, interventions need to focus on all forms of food advertising and promotions. The success and effectiveness of introduced measures have to be monitored and evaluated (WHICH? 2006).

Television without frontiers—a European directive for food advertising

In December 2005, the European Commission (EC) adopted a proposal to amend the “Television without Frontiers” directive launched in 1989. The revised directive proposes to liberalize new forms of advertising, ease advertising restrictions, and to extend the scope to non-linear services. The EC wants to shift a lot of decisions concerning the authorization of product placement, e.g., in movies, shows, and news programs, to EU member states. However, product placement must not take place in children programs and some products (e.g., tobacco) must not be placed at all (EC 2005).

In this regard, national measures are not satisfactory, as there is a need for strict, EU-wide legislation on the advertisements and the promotion of unhealthy food. In times of an increasingly globalized economy in which national and European legislations have to respect international trade agreements, consumer protection and information becomes more and more important.

At the European level, actions and interventions concerning the definition of children’s programs and products for children, restrictions on advertisements, sponsorships, and product placement, as well as bans on advertising of foods high in fat, sugar, and salt to children are needed (Gallani 2006).

Principle of separation and editorial product placement

Product placement may be editorial or of an advertising nature. In contrast to the latter, editorial product placement should not be denied, as it serves objectively justifiable editorial purposes. However, there are various reasons for opposing the product placement of an advertising nature. The product placement of an advertising nature disrespects the principle of separation—a vital precondition of independent reporting—between advertising and editorial content. Product placement has an impact on the content of programs and, consequently, on culture as a whole. The editorial independency is a critical structural element which needs to be defended. Moreover, product placement jeopardizes the consumers’ freedom of choice, as the consumer can retreat from advertising only by not viewing the whole program in question. The EC’s proposal to identify product placement before and/or after a broadcast is unsatisfying. The announcements may be missed by the majority of consumers who do not watch programs from the very beginning to the very end and including preliminary and additional remarks. Another reason why the identification during the program is unrealistic is the fact that “distinctive designs” may vary across countries, and even across programs.

In order to protect consumers from aggressive and unidentifiable advertising, the proposal of the EC to legalize product placement of an advertising nature should be rejected (BEUC 2006).

Food labeling

According to a survey conducted by the Swedish Consumers’ Association, only about one third of consumers read the nutrition facts printed on food packages. Additionally, only two thirds out of these actually understand what the information means (SCA 2005). A simplified and understandable labeling scheme helps consumers choose a healthy diet. Individuals are in favor of improvements in the labeling of foods: consumers expect food labeling on contents and calories to be simple, clear, and legible, well-structured, as well as to offer sources of additional information and help. Labeling should be easily understandable, prominent (e.g., on the front of the pack), EU-wide, up-to-date, provide at-a-glance information, and enable easy comparison between different products. In order to achieve these goals, food information should include only the most important information—a limited number of nutrients in relation to health priorities and consumer research—and be consistent and uniform across products. The Discussion Group on Simplified Labelling headed by the BEUC concluded that an energy logo does not provide sufficient information, but a combination of the information per serving and per 100 g helps consumers make healthy choices (Gallani 2006; Smillie 2006).

A framework on healthy consumer decision-making should consider that claims which the industry makes on food packages regarding alleged nutritional and health benefits are evidence-based and valid (Erginel and Kyprianou 2006).

The evidence base on food labeling would benefit from large, representative studies eliciting information on the label-reading habits and interpretation abilities of special subpopulations, such as children, immigrants, or the elderly. Further gaps in the research include the association between label-reading and diet quality, the investigation of measures encouraging label-reading, and the development of objective methods of assessing nutrition label use and understanding in real-life situations (Cowburn and Stockley 2003).

Related links

BEUC, Bureau Européen des Unions de Consommateurs, The European Consumers’ Organisation

Home page at http://www.beuc.org.

The European Consumers’ Organisation (BEUC) is a Brussels-based federation of 40 national European consumer organizations. The BEUC was founded in 1962.

EUFIC, The European Food Information Council

Home page at http://www.eufic.org.

The EUFIC is a non-profit organization which provides science-based, but understandable, information on food safety and quality, as well as on health and nutrition. The EUFIC is co-financed by the European Commission and the European food and drink industry.

European Platform for Action on Diet, Physical Activity and Health

Home page at http://ec.europa.eu/health/ph_determinants/life_style/nutrition/platform/platform_en.htm.

This is a publicly available database designed as a means of effectively collecting actions and presenting them in a way that allows members and external parties to view, analyze, sort, and compare actions related to diet, physical activity, and health.

TACD, The Trans Atlantic Consumer Dialogue

Home page at http://www.tacd.org.

The TACD is a forum of US and EU consumer organizations which develops and agrees joint consumer policy recommendations to the US government and European Union to promote consumer interest in policy making. The TACD was launched in 1998.