Calls for restricting the marketing of unhealthy foods to children ignored by policy makers: what can we do?

Unhealthy diet is the leading risk factor for death, life-years lost, and disability in Canada according to the latest Global Burden of Disease Study, which estimated that 65 722 Canadians died and 864 032 lifeyears were lost in 2010 as a result of unhealthy diet.1 Unhealthy diet, broadly defined by the World Health Organization as being high in saturated fats, trans fatty acids, free sugars, or sodium,2,3 is a substantial contributor to much of the global and national disease burden through obesity, dyslipidemia, diabetes, and hypertension. Dietary habits start early in life, and the effect of Canadians’ suboptimal diets is cause for concern.4 In Canada, it is estimated that 1 in 4 adults and 1 in 3 children are obese, largely the result of excess caloric intake and physical inactivity.4,5 Evidence further demonstrates that childhood obesity is closely linked to increasing pediatric hypertension and type 2 diabetes, diseases that have traditionally been restricted to adult populations.6,7 If current trends continue, it is expected that the current generation of Canadian children will live shorter lives than their parents.8 Family physicians face the medical consequences of diet-related diseases daily and play a key role in both the prevention and the management of these diseases. While the basis for unhealthy eating and its associated diseases is multifactorial, dietary choices and behaviour are directly attributable to an environment that promotes and facilitates access to unhealthy foods and beverages. This includes the pervasive marketing practices used to promote unhealthy foods and beverages. Research has shown an association between obesity in children and the strong and negative influence the marketing of unhealthy foods and beverages has on children’s dietary behaviour.9 Not only have such marketing practices normalized the eating of unhealthy foods, but they are also disproportionately directed at children.10 Indeed, Canadian children have higher rates of exposure to marketing of unhealthy foods than children in many other countries do.11 While countries worldwide prioritize the prevention of chronic disease and enhance efforts to improve diet as a key strategy,12 the food industry continues to direct millions of marketing dollars at increasing sales and consumption of the very foods contributing to our diet-related disease burden.10