Covert marketing of quick-service restaurants via news media in Australia: A content analysis.

OBJECTIVE: To determine the extent and nature of news media coverage generated from press releases made by top-selling quick-service restaurants in Australia. METHODS: We conducted a content analysis of press releases made between July 2021 and June 2022 by the five largest quick-service restaurant brands in Australia by brand share, including coding their main subject. We then conducted a content analysis of news media coverage related to the press releases, including coding its slant towards the brand. RESULTS: Among 52 press releases, new food products (27% of press releases; all unhealthy foods) and corporate social responsibility activities (25%) were the most promoted subjects. For 62% of press releases, at least one news media item was identified. Among the 86 identified news media items, most related to press releases promoting new food products (45% of news media items) or corporate social responsibility activities (21%). News media items overwhelmingly had a slant favourable to the relevant brand (93%). CONCLUSIONS: Press releases by top-selling quick-service restaurant brands in Australia commonly generate news media coverage that promotes such brands and their predominantly unhealthy products. IMPLICATIONS FOR PUBLIC HEALTH: Policies restricting unhealthy food marketing should consider brand-generated news media coverage.

The rise and fall of the Queensland Government policy to restrict unhealthy food and alcohol advertising on publicly owned assets.

OBJECTIVE: To examine the strategies employed by opponents of the Queensland Government's policy to restrict unhealthy food and alcohol advertising on publicly owned assets and identify which of the opposing arguments appeared to influence the policy outcomes. METHODS: Retrospective qualitative policy analysis case study informed by the Policy Dystopia Model of corporate political activity. We used qualitative content analysis to examine data from stakeholder submissions to the 'Advertising content on Queensland Government advertising spaces' policies (v1 and 2), and Minister for Health's diaries. RESULTS: Stakeholders from the food, beverage, alcohol and advertising industries and several not-for-profit health organisations opposed the policy. Industry actors used discursive strategies, coalition management (including co-option of not-for-profit health organisations), information management and direct involvement with policy makers to communicate their arguments against the policy. The second version of the policy was weaker regarding scope and key policy provisions, reflecting the arguments of industry actors. CONCLUSIONS: Influence from industries with a clear conflict of interest should be minimised throughout policy development to ensure public health is prioritised over corporate gain. IMPLICATIONS FOR PUBLIC HEALTH: Our findings can support other jurisdictions to prepare for industry opposition when designing policies to restrict unhealthy food and alcohol marketing.

The impact of primary school nutrition policy on the school food environment: a systematic review.

School nutrition policies that aim to address unhealthy diets have been introduced in many countries. This systematic review aimed to synthesize the international literature to determine the impact (overall and by socioeconomic position [SEP]) of primary school nutrition policies on the availability of foods and beverages in schools. Seven databases were searched using keywords and medical subject headings related to nutrition policies and schools. Studies that reported on the impact of implemented school nutrition policies on food and beverage availability within primary schools were included. Eighteen studies (reported across 20 papers) were included. Fifteen of the included studies reported some positive impacts of policies, including increased availability of healthier foods and decreased availability of less healthy foods. Five studies focused specifically on schools in low-income communities and a further three specifically compared schools by SEP, with mixed findings. Two studies reported on factors influencing policy implementation, reporting a lack of financial resources as a barrier to schools offering a wider selection of healthy foods and additional school resources as increasing the likelihood of offering healthy foods. School nutrition policies appear to be effective at improving the healthiness of foods and beverages available at schools. Furthermore, the results suggest that well-implemented school nutrition policies that improve the healthiness of foods available are unlikely to exacerbate the socioeconomic gradient of poor nutrition. However, the number of studies that reported results by SEP limits drawing strong conclusions regarding equity impacts and we strongly recommend further studies analyze their findings according to SEP.

Turning users into 'unofficial brand ambassadors': marketing of unhealthy food and non-alcoholic beverages on TikTok.

INTRODUCTION: TikTok has over one billion monthly users and is particularly popular among children. We examined the (1) use of owned media by major unhealthy food and non-alcoholic beverage brands on TikTok and (2) nature of branded hashtag challenges instigated by such brands and the user-generated content created in response. METHODS: We assessed the (1) content of all videos posted on the accounts of 16 top food and non-alcoholic beverage brands (based on global brand share) as at 30 June 2021, and (2) content and sentiment of a sample of brand-relevant user-generated content created in response to branded hashtag challenges instigated by these brands. RESULTS: Of 539 videos posted by brands, 60% were posted in the first half of 2021. The most common marketing strategies were branding (87% of videos), product images (85%), engagement (31%) and celebrities/influencers (25%). Engagement included instigation of branded hashtag challenges that encouraged creation of user-generated content featuring brands' products, brands' videos and/or branded effects. The total collective views of user-generated content from single challenges ranged from 12.7 million to 107.9 billion. Of a sample of 626 brand-relevant videos generated in response to these challenges, 96% featured branding, 68% product images and 41% branded effects. Most portrayed a positive (73%) or neutral/unclear (25%) sentiment, with few negative (3%). CONCLUSION: Unhealthy food and non-alcoholic beverage brands are using TikTok to market brands and products via their own accounts and to encourage users to create and share their own content that features branding and product images. Given TikTok's popularity among children, this study supports the need for policies that protect children from the harmful impact of food marketing on social networking platforms.

Use of artificial intelligence to enable dark nudges by transnational food and beverage companies: analysis of company documents.

OBJECTIVE: To describe the use of artificial intelligence (AI)-enabled dark nudges by leading global food and beverage companies to influence consumer behaviour. DESIGN: The five most recent annual reports (ranging from 2014-2018 or 2015-2019, depending on the company) and websites from 12 of the leading companies in the global food and beverage industry were reviewed to identify uses of AI and emerging technologies to influence consumer behaviour. Uses of AI and emerging technologies were categorised according to the Typology of Interventions in Proximal Physical Micro-Environments (TIPPME) framework, a tool for categorising and describing nudge-type behaviour change interventions (which has also previously been used to describe dark nudge-type approaches used by the alcohol industry). SETTING: Not applicable. PARTICIPANTS: 12 leading companies in the global food and beverage industry. RESULTS: Text was extracted from 56 documents from 11 companies. AI-enabled dark nudges used by food and beverage companies included those that altered products and objects' availability (e.g., social listening to inform product development), position (e.g., decision technology and facial recognition to manipulate the position of products on menu boards), functionality (e.g., decision technology to prompt further purchases based on current selections) and presentation (e.g., augmented or virtual reality to deliver engaging and immersive marketing). CONCLUSIONS: Public health practitioners and policymakers must understand and engage with these technologies and tactics if they are to counter industry promotion of products harmful to health, particularly as investment by the industry in AI and other emerging technologies suggests their use will continue to grow.

Costing recommended (healthy) and current (unhealthy) diets in urban and inner regional areas of Australia using remote price collection methods.

OBJECTIVE: To compare the cost and affordability of two fortnightly diets (representing the national guidelines and current consumption) across areas containing Australia's major supermarkets. DESIGN: The Healthy Diets Australian Standardised Affordability and Pricing protocol was used. SETTING: Price data were collected online and via phone calls in fifty-one urban and inner regional locations across Australia. PARTICIPANTS: Not applicable. RESULTS: Healthy diets were consistently less expensive than current (unhealthy) diets. Nonetheless, healthy diets would cost 25-26 % of the disposable income for low-income households and 30-31 % of the poverty line. Differences in gross incomes (the most available income metric which overrepresents disposable income) drove national variations in diet affordability (from 14 % of the median gross household incomes in the Australian Capital Territory and Northern Territory to 25 % of the median gross household income in Tasmania). CONCLUSIONS: In Australian cities and regional areas with major supermarkets, access to affordable diets remains problematic for families receiving low incomes. These findings are likely to be exacerbated in outer regional and remote areas (not included in this study). To make healthy diets economically appealing, policies that reduce the (absolute and relative) costs of healthy diets and increase the incomes of Australians living in poverty are required.

The Nature and Extent of Online Marketing by Big Food and Big Alcohol During the COVID-19 Pandemic in Australia: Content Analysis Study.

BACKGROUND: Emerging evidence demonstrates that obesity is associated with a higher risk of COVID-19 morbidity and mortality. Excessive alcohol consumption and "comfort eating" as coping mechanisms during times of high stress have been shown to further exacerbate mental and physical ill-health. Global examples suggest that unhealthy food and alcohol brands and companies are using the COVID-19 pandemic to further market their products. However, there has been no systematic, in-depth analysis of how "Big Food" and "Big Alcohol" are capitalizing on the COVID-19 pandemic to market their products and brands. OBJECTIVE: We aimed to quantify the extent and nature of online marketing by alcohol and unhealthy food and beverage companies during the COVID-19 pandemic in Australia. METHODS: We conducted a content analysis of all COVID-19-related social media posts made by leading alcohol and unhealthy food and beverage brands (n=42) and their parent companies (n=12) over a 4-month period (February to May 2020) during the COVID-19 pandemic in Australia. RESULTS: Nearly 80% of included brands and all parent companies posted content related to COVID-19 during the 4-month period. Quick service restaurants (QSRs), food and alcohol delivery companies, alcohol brands, and bottle shops were the most active in posting COVID-19-related content. The most common themes for COVID-19-related marketing were isolation activities and community support. Promotion of hygiene and home delivery was also common, particularly for QSRs and alcohol and food delivery companies. Parent companies were more likely to post about corporate social responsibility (CSR) initiatives, such as donations of money and products, and to offer health advice. CONCLUSIONS: This is the first study to show that Big Food and Big Alcohol are incessantly marketing their products and brands on social media platforms using themes related to COVID-19, such as isolation activities and community support. Parent companies are frequently posting about CSR initiatives, such as donations of money and products, thereby creating a fertile environment to loosen current regulation or resist further industry regulation. "COVID-washing" by large alcohol brands, food and beverage brands, and their parent companies is both common and concerning. The need for comprehensive regulations to restrict unhealthy food and alcohol marketing, as recommended by the World Health Organization, is particularly acute in the COVID-19 context and is urgently required to "build back better" in a post-COVID-19 world.

Uptake of the Victorian Government school and early childhood service health promotion framework in the City of Greater Geelong according to area-level socioeconomic position.

ISSUE ADDRESSED: Whole-of-setting initiatives have been recommended as an equitable approach to health promotion. However, there has been little analysis of differences in uptake of such approaches according to indicators of socioeconomic position. In Victoria, Australia, the Achievement Program is a state government health promotion initiative that uses a whole-of-setting approach in early childhood services, schools and workplaces. We conducted an exploratory comparison of uptake of and progression through the programme by schools and early childhood services in one local area, according to area-level socioeconomic position. METHODS: Approximately 3 years after programme initiation, we linked data on the progress of 89 early childhood services and 67 primary schools to an area-level index of relative socioeconomic disadvantage. We compared uptake of and progression through the programme by setting (service or school) and quartiles of socioeconomic position. RESULTS: About 89% of early childhood services and 70% of primary schools had registered for the programme, with 18% and 15%, respectively, attaining the goal of completing the final stage. A greater proportion of settings in areas in the most disadvantaged quartile had registered for the programme and completed the final stage of the programme, compared with settings in areas in the least disadvantaged quartile. However, variation by socioeconomic position was not linear across quartiles. CONCLUSION: The Achievement Program did not appear to be inequitable in its uptake. Research into uptake in other local areas and outcomes achieved would be beneficial. SO WHAT?: This demonstrates that whole-of-setting approaches can potentially be an equity-enhancing approach to health promotion.

The effect on drink sales of removal of unhealthy drinks from display in a self-service café.

OBJECTIVE: The present study assessed the impact of the retailer-led removal of unhealthy beverages from display at a self-service café within a major health service. While unhealthy beverages remained available from behind the counter upon request, this was not communicated directly to customers. DESIGN: Drinks were categorised based on the state government nutrient profiling system, classifying drinks as 'green' (best choices), 'amber' (choose carefully) and 'red' (limit). Total drink sales (as number of items sold per week) in the café were measured for five weeks. All unhealthy 'red' beverages were removed from display (but were still available for purchase) and the sales of all beverages were measured for another six weeks. RESULTS: We found that, in response to this strategy, the proportion of 'red' drinks sold decreased from 33 % to 10 % of total drink sales. As 'amber' and 'green' drink sales increased in response to this strategy, total retailer sales remained steady. Most consumers appeared to switch to purchasing 'amber' drinks rather than the healthiest option, 'green' drinks. CONCLUSIONS: The removal of unhealthy beverages from display can result in consumers making healthier purchases, while not significantly affecting retailers' sales.