Marketing mortality? Healthy vs. unhealthy food in television advertising

ABSTRACT

Background: Cardiovascular disease has been the leading killer of Americans since the Spanish flu pandemic of 1918, despite recent COVID-19 mortality. During this global pandemic, the social distancing and stay-athome requests, there was increased television (TV) engagement, and media marketing has become more impactful in modifying consumer behaviors. Purpose: We evaluated the healthfulness of food marketing in the United States (US), based on TV commercials most frequently aired on American primetime networks during the COVID-19 pandemic. Methods:We reviewed a total of 104 TV commercials between 2020-2021 on network and cable programs dividing them into 4 categories 1) fastfood chains, 2) brand-recognized individual items, 3) grocery chains, and 4) home-delivery meals. The food items displayed in each commercial were recorded and scored based on the previously validated healthful versus unhealthful nutrition scoring system (Sajita, et al., JACC 2017), assigning either positive or negative values for each food item in the commercial. Results: We found that 58% of the commercials advertised food from fastfood chains (mean score = -2.82, indicating an average of nearly 3 more unhealthy items than healthy items per commercial), 27% were brandrecognized individual items (-0.86), 9% were grocery chains (-0.90), and 6% were for home-delivery meals (-0.33), with significant differences noted between fast-food and individual items, home deliveries and grocery chains (each p<0.0001). Conclusions: This study demonstrated that commercial TV in the US routinely promotes the consumption of foods that are known in published medical literature to be unhealthy, particularly those underpinning cardiovascular disease and its risk factors. In order to prevent an increase in cardiovascular mortality during and after this global pandemic, we suggest regulation and or legislation to curtail the frequency and/or content of these commercials, and consider a ban on such advertising to children, similar to that previously employed in Canada and the European Union.