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ScienceOctober 1, 2019

When treat foods become the norm: A doctor on our childhood obesity epidemic

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Just a glance at our child obesity stats shows how severely inadequate our current advertising codes really are, argues public health medicine specialist Dr Michael Hale. 

There’s no such thing as a free lunch, or so the saying goes. So when a well-known fast food restaurant offered 50,000 ‘free’ burgers to consumers last month, there had to be an ulterior motive right? You bet.

It was ‘all about sharing the love’, ‘giving back to loyal customers’ and creating ‘surprise and delight’. Oh wait, and getting you to download their app. You know, so they can continue targeting you with daily and weekly offers of cheap, high fat, high salt, high sugar ‘foods’.

Would you like a side of obesity, diabetes or heart attack with that? Too melodramatic, you might think; the odd burger never hurt anyone.

Well, actually…

The problem is, it’s not just the odd burger, and it’s not just fast food outlets. There’s virtually no escape from the daily onslaught of cheap, unhealthy foods and drinks, or their associated marketing.

Stop for petrol and there’s the counter-top lure of three chocolate bars for the price of one. Swing by the dairy for milk; grab a pie and fizzy drink for a mere $2.50. Take the kids to Saturday sport and celebrate their win, or not, with a round of lollipops for the team and hot chips after the game. Even the weekly supermarket shop involves running the gauntlet of specials, savings and cleverly positioned displays promoting foods the human body doesn’t even need.

According to Associate Professor Adrian Cameron of Australia’s Global Obesity Centre in Melbourne, Australian supermarkets put junk food on special twice as often as healthy food. “Despite their claims to be healthy places to shop, supermarkets are major culprits in pushing junk food upon us,” he says.

And sadly, but unsurprisingly, the University of Auckland’s recently-released New Zealand State of the Food Supply report has revealed a similar state of affairs here.

After analysing 13,000 items, the researchers found that almost 70% of the foods on our supermarket shelves are ultra-processed, often with added sugar, salt, fat and other additives.

And here’s the rub. Some of us have been around long enough to remember when treat foods were just that: treats we consumed every now and then on special occasions. Despite the prevailing tide, some of us are still managing to cling desperately to that philosophy.

But our kids aren’t so lucky. They’re growing up in an environment where ‘treat food’ is ubiquitous, inescapable and, most frightening of all, the norm.

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Why haven’t we fixed what’s broken?

We’ve been hearing about New Zealand’s obesity epidemic for years now. We’ve long held the bronze medal on the OECD dais of world obesity, and we’re rapidly closing in on the silver.

You could be forgiven for thinking it’s old news. But the fact that we’ve known about this for so long, combined with our dire health statistics, should be making us all ask why we haven’t already fixed what’s broken.

One in three New Zealanders is obese, almost 250,000 of us have diabetes (not including the 100,000 who probably have it but are undiagnosed), and obesity is costing us around $800 million a year in healthcare and lost productivity. What we’re eating is causing almost 10% of our illnesses and early deaths.

But most concerning is that the obesity baton has already been handed to our kids. They’re being served up more of the same, if not worse.

In 2006/7, 8% of New Zealand kids were obese. In 2017/18 it was 12%, and for our Māori and Pacific kids, the figures were 17% and 33% respectively. Globally, 124 million children and adolescents are obese – a figure that has increased tenfold in the last four decades.

They’re terrifying numbers that have been fuelled by some other, equally alarming figures.

Twenty seven, for example. That’s the estimated number of unhealthy food and drink ads our children are exposed to in New Zealand every, single, day.

Or eight. That’s how many unhealthy food and drink ads they see on TV every hour during peak viewing times.
That’s before we even consider what they see on social and digital media platforms.

Earlier this year the findings of a University of Otago study into junk food marketing were published in the New Zealand Medical Journal.

The 11-13 year-olds interviewed reported seeing food marketing in some or all of the places they were asked about, including at home, at school, at sports venues, while in the car, outdoors in public places, in shops and supermarkets, on billboards and signs, and on the internet.

This matters because we know the food marketing our children see directly influences what they choose to eat. Most of the children from that same Otago study reported buying unhealthy food and snacks like chocolate, fizzy drinks and chips – the foods they see advertised most often – despite knowing they’re unhealthy.

In London, junk food advertising has been banned across their entire public transport network – we could do well to replicate that here.

It also matters because the power is being taken out of parents’ hands. Any parent who has approached a confectionery-lined checkout dreads the onset of their child’s begging as the eye-level lollies loom into view. Or the scathing after-school critique of their untouched lunchbox which, while lovingly packed with nutritious offerings, couldn’t compete with classmates’ chips, giant cookie and juice.

In Parents vs The Food Industry, the food industry is winning our children’s taste buds, hearts and minds, and locking in their future customer base. It’s what the University of Auckland’s Dr Milind Mandlik calls the ‘pervasiveness of institutionally-driven food marketing campaigns’.

“‘Individual choice’ is a false premise,” he says. “Food marketers have created desires and steered our choices toward their products.”

So what hope for our kids? Is it even possible to wrest back control from the food industry?

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Creating a new norm means holding the food industry to account

Right now, there’s no law in New Zealand to prevent junk food marketing to children. Food marketing is self-regulated by the industry via the Advertising Standards Authority (ASA), and there are gaping loopholes in the frameworks – the Advertising Standards Code and the Children and Young People’s Advertising Code – guiding what and how companies advertise.

We don’t just need to close those loopholes; we need to completely overhaul the ASA.

All over the world, industry self-regulation has failed to reduce the exposure of children and adolescents to unhealthy food marketing. The status quo is simply too lucrative.

In New Zealand, government-developed guidelines jointly enforced with industry would provide better control and monitoring of what’s being advertised to our kids. Restrictions on junk food advertising between 5pm and 9pm (when most 6-14 year olds are actually watching), rather than just during children’s programming, would also have an impact, and we need to call time on the unhealthy food and drink sponsorships of children’s sports. Currently teams and clubs are exempt from the advertising code, despite food and drink companies targeting young people in these settings and using high-profile sports stars to endorse unhealthy products.

Enticing future consumers doesn’t stop at the age of 14 either, yet that’s the age up to which the code defines someone as a child. The World Health Organization defines a child as being up to 18 years, and so should we.

There are other anomalies too. For an ad to breach the Young People’s Advertising Code children must make up a ‘significant proportion’ (usually around 25%) of an expected audience. Ironically, companies get around this by advertising during family viewing times. Why? Because the large overall audience numbers mean the child audience doesn’t reach the 25% threshold.

The codes don’t consider that modern marketing campaigns can reach children across multiple channels, nor do they cover brand advertising, front-of-pack labelling, promotions or giveaways. The result is that a large amount of in-store packaging and marketing is untouchable.

The sale of a popular corn chip in a ‘Limited Edition’, Spiderman-emblazoned bag for just $2 at an iconic Kiwi retailer and the use of cartoon character Homer Simpson to market a US brand of doughnut in petrol stations are just two of the recent ‘child-magnets’ I’ve seen – but there are hundreds more.

Even when a complaint against an ad is upheld, the only consequence is that the advertiser must modify or remove the ad; little more than a slap on the wrist with a wet bus ticket when what’s actually needed is a meaningful financial penalty or other robust sanction.

Tackling the way we advertise and market food products to children in New Zealand by itself won’t cure our obesity epidemic – it’s a far more complex beast than that. But in their Report of the Commission on Ending Childhood Obesity WHO lists responsible marketing, especially to children and teenagers, as one of the three crucial things industry could do to play a significant role in reducing childhood obesity globally.

Obesity has now surpassed smoking as the greatest risk driving death and disability in New Zealand. So we need to follow WHO’s lead, hold industry to account, and demand better for our children.

Keep going!