Profit Before People: The commercial determinants of health and lessons from the tobacco epidemic (2023)

Ultra processed food and drink

The environment around us influences the choices we make on a day-to-day basis and our environment is 'obesogenic' - one where less healthy choices are the default and encourage excess weight gain and obesity.

In the UK, one in five children aged 10 to 11 years live with obesity. Children and young people are more likely to continue living with obesity into adulthood and to develop obesity-related chronic health conditions at a younger age. Data from the National Child Measurement (NCMP) programme⁴⁹, shows that the prevalence of obesity for children in the most deprived areas continues to be more than double that of those in the least deprived areas. This link to deprivation is further highlighted, in most recent NCMP data (2022-23), with the North-East region having the highest prevalence rates of children living with obesity nationally in Year six and reception. In Gateshead, the picture is not improving, with 12.3% of reception and 27.5% of our year six children living with obesity. For adults, the outlook is similar with 68.4%⁵⁰ reported as living with obesity and similar in terms of deprivation.

We know that tackling the harmful impact of ultra processed food and drink is complex and there are numerous factors that affect and impact our behaviour. There is a need to move beyond individual blame, recognise the tactics at play and seek a more comprehensive approach to the issue that increases opportunities for healthy and sustainable living both now and for current and future generations.

We have seen increasing attention on the role of commercial determinants of health on obesity⁵¹. This includes the marketing of less healthy foods such as those high in fat, salt, and sugar (HFSS). Research has shown that this is particularly influential on children and adolescents, with an impact on awareness, attitudes, and consumption, while driving up calorie consumption^{52 53}. There is now emerging evidence that adults too are influenced by food advertisements in our local areas⁵⁴. Advertising significantly contributes to normalising unhealthy foods in society and we are often unaware of how advertising affect decision-making and the industry's influence on our freedom of choice^{55 56}.

It is interesting to note that a staggering third (33%) of food and soft drink advertising spend goes towards confectionery, snacks, desserts and soft drinks compared to just 1% for fruit and vegetables⁵⁷. Existing regulations meant to protect children from junk food advertising were introduced for TV in 2007 and the non-broadcast environment in 2017. There are however significant loopholes in these regulations. Firstly, they only restrict junk food adverts when a TV show, film or website is designed specifically for children or considered to be 'of particular appeal' to them. They do not cover the times when children are most likely to be watching their favourite shows for example, between 6 and 9pm - often classed as 'family viewing'⁵⁸.

Secondly, the existing rules to do not cover the vast range of channels and outlets through which children consume media in 2019. Children's media time often includes watching TV, going online using a mobile phone and playing games on gaming devices. The Obesity Health Alliance (OHA) wants to see a 9pm watershed on junk food adverts implemented across all 'media devices and channels not just on TV to protect children from the harmful effects of marketing of foods high in fat, sugar and salt'.

From a recent survey, there appears to be clear support among the UK public for these far-reaching restrictions in junk food adverts⁵⁹. The UK does not have any rules for outdoor advertising spaces like billboards, bus shelters and digital displays. These and other outdoor public spaces are thought to be seen by 98% of the UK population at least once a week⁶⁰.

The UK Government acknowledged the harmful influence of advertising on health in their 2020 Obesity Strategy, and then passed legislation to restrict advertising of food (HFSS) and drink online and on TV before 9pm. However, these policies have since been delayed until October 2025.

Areas of good practice include:

The Transport for London (TfL) network showed that advertising restrictions successfully reduced calorie consumption (a 1,000 calorie decrease per week per household from unhealthy foods and drinks)⁶¹. Going forward it is hoped that these measures can potentially be effective through influencing individual choices but also pushing companies to expand to more healthier choices.
Seven local authority areas in England have tried to restrict the advertising of products (HFSS) on council owned spaces, as part of wider strategies to reduce obesity.