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Br Dent J 2017;222: 171–176 http://dx.doi.org/10.1038/sj.bdj.2017.120

Childhood obesity is considered a serious global public health issue. In the UK it is estimated that in the first year of primary school just under 10% of students are obese. Twice as many are obese by the time they are finishing primary education. It is expected that by 2050, 35% of boys and 20% of girls will be obese. This is not only a current concern, but if this trend continues it could have a devastating effect on the future of the nation's health. As a society, how can we counter this?

Over the next two years we are due to see the implementation of the 'sugar tax' which the government hopes will combat obesity, but could a decrease in advertisements of sugary foods also help avert an obesity and caries epidemic?

With the knowledge that children significantly increase their food consumption after viewing food advertising, and that children who spend more time watching television are at greater risk of developing caries, Boyland et al. aim to quantify how many adverts for potentially harmful foods are shown during the peak hours that children are watching television. They have done so by analysing 352 hours of ITV programming, shown between the hours of 6 am and 10 pm. Food and drink adverts made up 16.7% of all the adverts recorded, however, 61% of these were considered potentially harmful to dental health (cariogenic and/or acidogenic) and this increased during peak children's viewing hours. Only 1% of adverts for potentially harmful foods were screened around children's programmes. Most were screened during other types of shows (entertainment and game shows). This could be due to the fact that Ofcom introduced regulations regarding advertising food and drink products to children in 2007 and it also may be because advertising harmful foods during children's programmes would not be beneficial for a company's reputation and image. However, the authors state that this is of particular concern because most children spend their television viewing time watching programmes that are not aimed for children. Worryingly, this also indicates that by not necessarily screening adverts for harmful foods during children's programmes, the marketers still aim to advertise directly to children.

The authors propose that stricter restrictions are applied to Ofcom's regulations in order to reduce children's exposure and that the government takes dental health into account alongside obesity when considering food marketing policies.

By Jonathan Coe

Author Q&A Emma Boyland University of Liverpool

Why do you think TV advertising is still so powerful?

Despite increasing access to and engagement with the Internet, young people still watch a great deal of television. The advertising they see on television can be very sophisticated and engaging, featuring promotional characters and celebrities, vivid colour and action, themes of fun and fantasy, memorable music and appealing food imagery. This grabs their attention, holds it for the duration of the ad, and increases the likelihood that they will remember the ad and the brand at the point of sale and buy it themselves (or pester their Mum and Dad to buy it for them). These TV adverts are also increasingly linked with further marketing activity online, including in social media, so this is one aspect of a much bigger problem.

What was the biggest challenge in carrying out your study?

For this study, we coded over 9,000 adverts, and coded in detail over 1,500 food adverts across 352 hours of television. Recording such large volumes of television and conducting extensive coding of the advertising shown is a really time consuming task! It requires patience and a lot of attention to detail.

What do you feel should be done to help people make better food choices?

I think the emphasis needs to be on creating a healthier food environment so that healthier choices become easier. It is questionable how much of a 'choice' we actually have at the moment, when so much of the food we are exposed to, whether in advertising, marketing, or food outlets, contains unhealthy amounts of sugars and fats. Our bodies are hardwired to find these foods appealing and palatable, and yet some simple changes (eg making the healthier choices more prominent and cheaper) can make a big impact on the foods we select.