Unhealthy diets high in sugars, saturated fats, sodium and trans fats are one of the main “enemies” of public health, as they contribute to all forms of malnutrition (undernutrition; micronutrient deficiencies; and obesity, associated with chronic noncommunicable diseases). This is especially relevant for children, considering the effects that these conditions have on them. For example, children with obesity are at greater risk of suffering from depression, anxiety, underperformance at school, as well as being more likely to be obese in adulthood. Hence, it is important for the ultra-processed food industry and States to integrate a public health and human rights approach in the development of this economic activity.

Malnutrition, a reality that’s impossible to hide

According to the World Health Organization (WHO), an estimated 38.9 million children under 5 years of age globally were overweight or obese in 2020, 41% of whom lived in low- and lower-middle-income countries. In Latin America, the prevalence of children and adolescents with these conditions increased by at least 25% between 2000 and 2021. Europe has not escaped this reality either. The WHO’s European Childhood Obesity Surveillance initiative found that, in some European countries, almost 50% of eight-year-olds are overweight and more than 25% suffer from obesity.

The causes associated with malnutrition are complex, so we cannot point to a single “evemy”. But there is strong evidence linking repeated consumption of ultra-processed foods (soft drinks, boxed juices, packets, canned foods, etc.) to increased risk of malnutrition. Further, experts agree that advertising is one of the commercial activities that shapes the food environment and has a particularly harmful impact on children’s diets, so its permanent nature in everyday life is not a minor issue.

How is this impact realized? Although children have the cognitive ability to understand sales intent from age 8, it is only after the age of 11 that they understand what advertising is and can therefore protect themselves from its messages. The evidence is clear that advertising directed at children, particularly those under 12 years of age, is by its nature misleading, as it is sending a message to a group that does not have the ability to clearly understand the persuasive sales intent. In the case of ultra-processed products it is especially problematic, because they are being influenced in an invasive way, to increase their desire to consume products that have a negative impact on their health.

What do experts in public health and children’s rights tell us?

Since 2004, the World Health Organization (WHO) has recommended that member states develop strategies to address the marketing of unhealthy foods, due to the relationship between the consumption of these products and malnutrition.  In terms of guaranteeing children’s rights, the Committee on the Rights of the Child has said that the Convention on the Rights of the Child protects the rights to health and to adequate and nutritious food. Therefore, States should regulate the advertising of ultra-processed foods because of the effect they have on the proper fulfillment of children’s rights. It also stated that States should limit the exposure of children and adolescents to ‘fast food’ high in fat, sugar or salt, which is very caloric but lacks sufficient micronutrients. They should also limit exposure to beverages high in caffeine or other substances with possible harmful effects, as a measure that guarantees children’s rights.

New challenges: sponsorships, conventional advertising and digital advertising

Another challenge worthy of our attention is the sponsorship of these companies in major sporting events. More than 160 national and international organizations in the field of health requested the withdrawal of Coca Cola’s sponsorship of the Olympic Games, as it implies the indiscriminate advertising of soft drinks in this event. The presence of this company in one of the most relevant sporting events represents a contradiction since it advertises unhealthy products in a sporting event. It is estimated that more than 4,000 children will attend the Olympics. In principle, the sponsorship of Coca Cola or similar products might seem harmless. But when it comes to promoting to children the consumption of products related to chronic non-communicable diseases, such as diabetes or hypertension, the story changes.

Sports events are environments that have an undeniable influence on children, especially child athletes, so we should be careful about who is at the table and what message they give to our children. Protecting children’s right to health and food through the regulation of ultra-processed food advertising calls on states to take risk factors, such as ultra-processed food consumption, seriously and comprehensively. Governments must respond with robust, evidence-based regulations that allow children to reach their full physical and cognitive potential without the influence of commercial activities. We are late and the more time that passes, the more we will be affecting the health of our children.

Finally, the increasingly frequent interaction of children with the digital environment is undeniable, as is the use of this space for the indiscriminate promotion of ultra-processed products. This brings with it new regulatory and public health challenges. One of them is related to the way in which data is collected, since the design of advertising to users on the Internet is through the identification of characteristics and preferences of each individual user (behavioral advertising). Thus, information about users is collected within the website, application or platform itself.

With this comes the big question: is it compatible with the guarantee of children’s rights to use their digital data to sell products whose consumption has harmful effects on their health? The answer was already given to us in 2021 by the Committee on the Rights of the Child in a General Comment on the rights of the child in relation to the digital environment. The Committee noted that States should prohibit by law the profiling or targeting of children of any age for commercial purposes by means of a digital record of their actual or inferred characteristics, including group or collective data, association-based targeting or affinity profiling.

What has Latin America and Europe done in the face of the challenges of conventional advertising?

In the case of Latin America, Chile pioneered the regulation of ultra-processed food advertising in 2012. The implementation was divided in two phases. First, products with a high content of saturated fats, sugars and/or sodium could not be advertised in children’s media or where children constitute more than 20% of the audience. In a second phase, all advertising “with excess of” is prohibited on television between 6 am and 10 pm, and after 10 pm if the ads are aimed at children. Studies show that, after the implementation of the restriction, the strongest reductions occurred in the proportion of products with excess sugars (80%) and in products with excess sodium (74%).

Mexico, for its part, in 2014 prohibited the advertising of sugary drinks, flavored drinks, confectionery and chocolates during children’s time. This regulatory framework was extended in 2020, additionally prohibiting products bearing one or more seals to include children’s characters, animations, cartoons, celebrities, athletes or mascots, interactive elements aimed at children that promote or encourage the consumption, purchase or choice of unhealthy products.

In Europe, the British were among the first to regulate advertising of ultra-processed products to minors. From 2021, ultra-processed product advertisements can only be shown from 9:00 p.m. to 5:30 a.m. There, studies reveal that the policy was associated with an estimated decrease of 1,001 kcal (6.7%) compared to what would have happened without the policy. Average weekly purchases from chocolate and sweets decreased by 317.9 kcal (19.4%).

What remains to be done?

Despite the growing evidence of the harmful impact of advertising on children’s diets and the increasing recognition that advertising of ultra-processed products is harmful to children’s health, as of May 2022, only 60 countries have adopted policies to restrict advertising of ultra-processed products to which children are exposed. In addition to the regulatory vacuum, there are some challenges in the regulation of advertising in digital environments that have yet to be discussed.

One of the most complex issue is defining jurisdictional rules, since it is necessary to take into account the limited capacity that some States have to enforce the domestic regulatory framework. These activities are usually carried out outside their jurisdiction, but have an impact on the population in their territory. Another important question is the informed consent of adolescents or children over 12 years of age online as a regulatory strategy. Although in principle it seems to be a viable alternative, if we follow a human rights approach in terms of public health, the collection of data from minors when it is intended for activities that are detrimental to their development should not be allowed.

Finally, States must make much more concrete efforts to resolve existing regulatory gaps and protect children from advertising products that have an impact on their health.  Otherwise, we will continue to see the wave of chronic non-communicable diseases continue to grow.