New research suggests that unhealthy food advertising on television before the 9pm watershed is responsible for 1 in 22 cases of childhood obesity. Removing these adverts before 9pm, the intention of new government regulation announced in July this year, has the potential to reduce the number of children with obesity by 40,000 and those with overweight by a further 80,000, according to a new study published in PLOS Medicine today led by researchers from the Centre for Diet and Activity Research (CEDAR).

The research also suggests that the policy will have a two-fold greater impact in children whose parents earn the least (social grade DE) compared to those whose parents work in the highest paid jobs (social grade AB). This is because children living in the lowest earning households tend to watch more television and are more likely to have obesity than others.

Until now the potential health benefits and consequent savings in healthcare spending in the UK of restricting television advertising of unhealthy food in the UK has not been known. In this study the researchers used computer modelling to estimate the potential health and consequent monetary benefit of banning the advertising of foods high in fat, sugar and salt (HFSS) on television between 5.30am and 9pm in the UK.

Dr Oliver Mytton, from CEDAR and the MRC Epidemiology Unit and lead author on the paper, said:

Television advertising casts unhealthy options in a starring role in children’s minds, whilst healthier food options get lost in the background or are pushed entirely off-stage. Our work shows that television and online advertising for unhealthy food in the UK is having a marked negative impact on children’s health. It is encouraging that the UK Government wants to restrict this advertising on both television and online. Our work suggests it is important to make those restrictions as robust as possible”

Using UK data on children’s exposure to unhealthy food advertising and children’s height and weight, the researchers estimated that if all unhealthy television advertising between 5.30am and 9pm was banned, children in the UK would see, on average, 1.5 fewer HFSS advertisements per day. They calculated that this would reduce the number of children (aged 5-17 years) with obesity by 4.6% and with overweight (including obesity) by 3.6%, equivalent to 40,000 fewer children with obesity and 120,000 fewer children with overweight.

The lifelong health benefits of this decrease in overweight and obesity would results in a healthcare cost saving of £7.4 billion for today’s children across their lifetime. Whilst tackling childhood obesity is important for health in later life, the research also suggests significant health benefits occurs in childhood, reflecting the impact of obesity on children’s physical and mental wellbeing, e.g. through bone and muscle problems and respiratory disease, like asthma.

It is possible that banning unhealthy food advertising before 9pm would result in these ads being moved to the 9-10pm slot – when many children are still watching. This could undermine some of the benefits of a 9pm watershed. The researchers calculated that in a worst-case scenario for health, where all of the HFSS advertising is shifted to after 9pm, around two-thirds of the health benefits from a 9pm watershed may be lost, i.e. there would be 12,000 fewer children with obesity rather than 40,000 fewer. They also argue that this underscores the need to regulate video-based advertising online to prevent displacement of unhealthy food advertising from television to online.

Dr Mytton commented:

Our analysis shows that introducing a 9 PM watershed on unhealthy TV food advertising can make a valuable contribution to protecting the future health of all children in the UK, and help level up the health of children from less affluent backgrounds. However, children now consume media from a range of sources, and increasingly from online and on-demand services, so in order to give all children the opportunity to grow up healthy it is important to ensure that this advertising doesn’t just move to the 9-10pm slot and to online services.”

The researchers caution that they used data from 2015 and since then television viewing in children has reduced. Whilst this may mean that the health benefit attributable to television advertising today has been overestimated, they argue that shifting patterns do underscore the need for broad-based regulation applying to online, television and other forms of advertising.

Background Notes

Research undertaken over the last two decades shows that food and beverage advertising contributes to increasing calorie consumption in children, and in July 2020 the UK Government announced a new obesity strategy that will include a ban on television and online advertising for food and beverages high in fat, sugar and salt (HFSS) before 9pm.

Reference

• Full paper: Mytton OT, Boyland E, Adams J, Collins B, O’Connell M, Russell SJ, et al. The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: A modelling study. PLoS Med (2020) 17(10): e1003212.