How Does the Healthfulness of the US Food Supply Compare to International Guidelines for Marketing to Children and Adolescents?

  • Elizabeth K. DunfordEmail author
  • Shu Wen Ng
  • Lindsey Smith Taillie


Objectives Food marketing to children is pervasive and linked to increased preference and intake of unhealthy foods. The World Health Organization (WHO) developed the only multi-country nutrient criteria, and Chile recently released the world’s most comprehensive regulation to identify foods that should not be marketed to children. Our objective was to examine the proportion of US packaged food and beverage products eligible for marketing to children under the WHO Europe Nutrient Profile Model (NPM) and the 2019 Chilean regulation. Methods Data for this study are from Label Insight’s 2017 Open Access branded food database. Each product was assigned to one of 13 food categories, and nutritional content compared to both the NPM and Chilean criteria. The proportion of US products meeting criteria for marketing to children using both schemes was examined overall and by category. Agreement between the two criteria was examined using Cohen’s Kappa. Results Of 17,740 US products, 21% were eligible to be marketed to children using the WHO criteria and 26% using the Chilean criteria. ‘Egg and egg products’ and ‘Seafood’ had the highest proportion of products eligible for marketing to children under both schemes. ‘Confectionery’ and ‘Snack foods’ had the lowest proportion eligible. Conclusions for practice The WHO NPM and Chilean criteria both restrict less healthy items from being marketed to children. Regulatory agencies in the US developing policies should consider the implementation of nutrient criteria to restrict the marketing of less healthy foods and beverages to children and adolescents.


Food marketing Processed foods Public health nutrition Nutrient profiling 



Robert Wood Johnson Foundation (Grant Nos. 67506, 68793, 70017), Robert Wood Johnson Foundation (US) (Grant No. 71837), National Institutes of Health (Grant Nos. R01DK098072, DK56350), Carolina Population Center (Grant No. P2C HD050924) and National Health and Medical Research Council (AU).

Supplementary material

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Supplementary material 1 (DOCX 53 KB)


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Food Policy DivisionThe George Institute for Global HealthSydneyAustralia
  2. 2.Carolina Population CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Department of NutritionUniversity of North Carolina at Chapel HillChapel HillUSA

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