Gabriela Fretes

Front-of-pack labels and young consumers: An experimental investigation of nutrition and sustainability claims in Chile

Digital marketing of unhealthy foods and non-alcoholic beverages to children and adolescents: A narrative review

With growing access to electronic devices and time spent online, the food and beverage industry increasingly uses digital media to market unhealthy foods and non-alcoholic beverages (high in unhealthy fats, sugars, and/or salt and often highly processed) to children and adolescents. We conducted a narrative review of the global evidence on digital marketing of these foods and drinks and studied policies and regulations in Latin American and Caribbean (LAC) countries. Evidence was limited to a few high, upper-middle and lower-middle income countries where children and adolescents were found to be extensively exposed to the digital marketing of unhealthy foods and non-alcoholic beverages and this exposure increased with age. A wide range of purposefully designed marketing techniques were used. Exposure to the digital marketing of unhealthy foods appears to be followed by increased consumption, but the quality of the evidence was limited. Accurate assessment of exposure was a shortcoming in most studies. Stronger evidence will require studies with more rigorous designs that minimize confounding and objectively quantify individual exposure. Mandatory comprehensive policies are needed that limit exposure of children and adolescents to the marketing of unhealthy foods and non-alcoholic beverages irrespective of the medium or platform they use. The experience of LAC countries may provide insights for the development of effective policies in other countries. Novel technologies that can be used by governments to monitor digital marketing regulations are needed.

Low Global Diet Quality Score (GDQS) among adolescents in Vietnam is due to inadequate consumption of fruits and vegetables rather than high consumption of unhealthy foods

Objectives: Rapid urbanization coupled with a nutrition transition has catalyzed significant shifts in lifestyle and diets in mega-cities around the world, but the impacts on adolescent diets are poorly understood. This study aims to fill this gap, comparing diet quality (measured by the Global Diet Quality Score, GDQS) and adequacy of micronutrient intakes among adolescents in urban, peri-urban, and rural areas of Vietnam. Methods: We collected data on adolescents (11-19 y) from low-income neighborhoods in urban (n=868), peri-urban (n=937), and rural (n=1056) areas and assessed dietary intake using multi-pass 24-hour recalls (15% repeated measures). We classified foods consumed into 25 GDQS food groups (score 0-49; GDQS healthy (+): 0-32; unhealthy (-): 0-17), with a higher score reflecting a lower risk of poor diet quality. Nutrient intakes were derived using food composition tables; and micronutrient probability of adequacy (PA) was calculated using the National Cancer Institute (NCI) method. Differences in diet quality and adequacy by residence were compared using ANOVA with Bonferroni post-hoc tests. Results: GDQS+ was low (6.6-7.1 over 32 points) while GDQS- was ∼11 over 17 points across the three areas. The risk of poor diet quality was slightly higher in rural (23.4%) than peri-urban (18.5%) and urban areas (17.1%), and was driven by low consumption of healthy foods (fruits, vegetables, legumes, and eggs) rather than excessive consumption of unhealthy foods. Refined grains and baked goods were universally consumed, but sweets, ice cream, and sugar-sweetened beverages were consumed by 20% or less of our sample. Consumption of high-fat dairy (32.9%) and red meat (74%) was higher in urban compared to rural areas. The PA of micronutrient intakes was low (< 0.5) for most micronutrients except iron, zinc and vitamin C and mean PA was very low (0.32-0.35). Conclusions: Diet quality among Vietnamese adolescents is generally poor across residential areas, mostly due to inadequate consumption of healthy foods. The very low PA for micronutrients across all three areas is concerning. Efforts are needed to stimulate increased consumption of healthy foods, to reduce consumption of red meat and replace high-fat dairy with low-fat options, and to maintain a low consumption of other unhealthy foods. Please note that it is not a full journal article; it is only published as an abstract in the journal.