Food advertisements: to ban or not to ban?

Driving in any of our big cities you would hardly miss at least a dozen street food advertisements displaying new menus and the latests inventions of the snack food industry. How many times have you had your little children begging you to go to a fast food restaurant after spotting the magic “Meal Box” on a street ad? Not to enjoy the meal as much but rather to unveil what surprise game is hidden in the box, and perhaps along with some “quality” time in the playground; for me, it has been countless times. But that is not all! Why we are bombarded with “cannot miss” sandwich and pizza deals chasing us to our houses and even while reading the newspaper or watching the television? The answer is quite simple. We are obviously being conditioned to look at food as an entertainment.

This subject should be looked at from the context of the increasing weight problem and associated co-morbidities in the last few decades. Globally, there has been a big change in disease burden as non-communicable diseases have become the main cause of death, where imbalances of nutrition, diet and physical activity play a major role.1 Locally, surveys in a number of different areas and provinces have reported a high prevalence of overweight and obesity in Saudi children in all age groups and in all provinces.2 A recent study indicates that overall country prevalence of overweight and obesity among Saudi children is 23.1% and 9.3%, respectively.3 The picture is gloomier when you look at the children living in urbanized regions where obesity can reach up to 23.3%,4 which coincides with major changes in lifestyle-related factors such as unhealthy eating habits, including the wide availability of high-energy food snacks, and a lack of physical activity. Indeed, a large percentage (i.e. about 50-60%) of children and adolescents do not adequately exercise,5 which adds to the problem of overeating and weight gain. For Saudi adults, it has been estimated that 27.23% of males and 25.20% of females are overweight, while 13.05% and 20.26% males and females, respectively, are obese.6

It is widely accepted that exposure to food advertisements promotes over-consumption in younger children and obese and overweight children are indeed more responsive to food promotion, which specifically stimulates the intake of energy-dense snacks. Halford and co-workers have compared the eating habits of obese to non-obese children and they found that obese children consume significantly more fast foods than the non-obese children.78 These findings among others have led to the development of seven principles known as ‘The Sydney Principles’ by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children.9 The Principles state that actions to reduce marketing to children should support the rights of children, afford substantial protection to children, be statutory in nature, take a wide definition of commercial promotions, guarantee commercial-free childhood settings, include cross-border media, and be evaluated, monitored and enforced.

The National Institute of Health (NIH) conducted a large study to directly tie childhood obesity to fast-food advertising on American television, based on the viewing habits of 13 000 children between 1979 and 1997. The study concluded that a ban on fast-food advertising to children would cut the US obesity rate by as much as 18%.10 This was perceived a long time ago in the Scandinavian countries where Sweden and Norway instituted bans on all ads to children in the early 1990s. Similarly, Quebec has also banned food advertising to children during programs geared toward kids. Also, the Children's Food Act 2004 of United Kingdom makes a provision regarding the marketing and sale of food and drink to children. Unfortunately, studies evaluating the effect of fast-food advertisements on weight gain among Saudis are lacking. Therefore, an exploration of a possible association is highly needed.

Perhaps behavioral modification with respect to food intake will be effective in the treatment of obesity, especially in Saudi Arabia. Controlling exposure to food advertisements should have a positive impact on the way we all perceive food. This, along with reasonable physical activity should be encouraged as a strategy directed towards weight reduction and obesity and related diseases in the Kingdom. And the question “to ban or not to ban the food advertisements in our country” remains to be answered.