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Background
Through the Children's Food and Beverage Advertising Initiative (CFBAI), major food companies in the US pledge to only advertise products that meet CFBAI nutrition criteria in child-directed media. In 2020, the CFBAI implemented revised nutrition criteria to align with US dietary guidelines and federal Nutrition Facts label changes. The CFBAI periodically updates their list of products that may be advertised directly to children (i.e., the Product List).
Objective
Evaluate the nutrition quality of products on the 2020 CFBAI Product List following implementation of revised nutrition criteria.
Study Design, Setting, Participants
Repeated cross-sectional design, assessing differences in products between 2017 (n = 307) and 2020 (n = 245).
Measurable Outcome/Analysis
We assessed changes between 2017 and 2020 CFBAI Product Lists in energy and nutrients to limit (saturated fats, sodium and total sugars) for products overall and food and drink categories. Applying the OFCOM nutrient profile model yielded a nutrition quality score (Nutrition Profile Index, NPI) for each product. Wilcoxon rank-sum test evaluated differences in NPI score, nutrients, and energy density between years. Chi-square test assessed differences in drinks containing sweeteners between years.
Results
The nutrition quality of foods on the CFBAI Product List improved slightly from 2017 to 2020 (median NPI = 66 vs. 68), with median NPI increases found only in two categories: sweet snacks (+28) and yogurts (+2). However, the overall percent of foods with healthy NPI scores remained unchanged (62% vs. 63%, P = 0.8), and healthy products included primarily yogurts not advertised to children. Fewer drinks contained sweeteners in 2020 than in 2017 (23% vs. 78%, P < 0.05). Median energy, saturated fat, sodium, and total sugar content across all products were lower in 2020 compared with 2017, although the magnitude and direction of change varied between categories.
Conclusions
Continued advertising of unhealthy foods contradicts nutrition education efforts to promote healthy eating in children. Additional improvements to CFBAI nutrition criteria and exclusion of unhealthy product categories are necessary.
Funding
Robert Wood Johnson Foundation
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Copyright
© 2022 Published by Elsevier Inc.
