Where are the alcohol advertising hotspots near schools?

ISSUE ADDRESSED: Physically locating liquor stores near schools can strongly influence the chances of youth accessing and consuming alcohol, and may also increase children's exposure to alcohol advertising. Investigating the association between the presence of a liquor store near a school and the prevalence of outdoor alcohol advertising is crucial from a policy perspective, as it can inform future regulations on the placement of liquor stores and outdoor advertising near educational institutions. METHODS: All outdoor alcohol advertising within a 500 m radius (audit zone) of 64 randomly selected schools from local government areas across metropolitan Perth was identified by direct observation; recording the size, setting, location and content of each advertisement. Results were compared based on whether the school audit zone contained a liquor store or not. RESULTS: Over half (n = 36, 56%) of all school audit zones had at least one alcohol advertisement, with an average number of 5.9 alcohol advertisements per zone (SD = 10.2). The majority (97.9%) of advertisements were in the 38 audit zones containing a liquor store (average = 9.7, SD = 11.9 per zone), compared to zones without a liquor store (average = .3, SD = .7 per zone). CONCLUSIONS: Perth school zones containing a liquor store in their 500 m radius had, on average, 30 times more outdoor alcohol advertising, compared with school zones without a nearby liquor store. SO WHAT?: The siting of liquor stores and the display of alcohol advertisements around educational settings require combined policy, planning and public health approaches to mitigate children's exposure to alcohol marketing, especially during school transit.

'Black Out Rage Gallon' (aka borg): An investigation of a risky drinking trend on TikTok.

ISSUE ADDRESSED: A 'Black Out Rage Gallon' (borg) is a customised, individual alcoholic beverage popularised on TikTok, whereby half the water in a gallon jug is replaced with alcohol (usually spirits), flavourings, electrolytes and caffeine. We investigated the characteristics and portrayal of the emerging alcohol trend associated with the hashtag descriptor #borg on TikTok. METHODS: We identified highly viewed TikTok videos with the #borg hashtag (n = 103) and conducted a content analysis, capturing viewer engagement ('likes', shares, comments), techniques used, characteristics of featured individuals, and the portrayal of alcohol and risky drinking behaviours. RESULTS: Alcohol was visible in three quarters of the videos analysed (n = 78, average amount of alcohol present 865 mL per borg) and consumed in one third of the videos (n = 34). One quarter of videos (n = 25) promoted alleged benefits of borg consumption compared to other alcohol products or approaches to drinking, yet only nine videos included a warning about potential harms. CONCLUSIONS: The borg trend on TikTok may encourage risky drinking, by portraying it in a style that younger viewers are likely to see as fun and entertaining. SO WHAT?: We were able to gain a better understanding of how this potentially health harming activity is represented on a social media platform that is popular with young people. The speedy dissemination of this trend highlights the need to monitor, investigate and counter emerging trends. Concurrently, there is an urgent need for content restrictions to limit the visibility and promotion of risky alcohol consumption on TikTok.

Young people's alcohol use in and around water: A scoping review of the literature.

ISSUES: The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people. APPROACH: We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15-34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. KEY FINDINGS: The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people (n = 13); the epidemiology of alcohol-related unintentional drowning in young people (n = 9); and interventions to reduce alcohol-related harm around water (n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers. IMPLICATIONS: Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water. CONCLUSION: There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice.

Powerful promotions: An investigation of the teen-directed marketing power of outdoor food advertisements located near schools in Australia.

ISSUE ADDRESSED: Adolescents are heavily exposed to unhealthy outdoor food advertisements near schools, however, the marketing power of these advertisements among adolescents has not yet been explored. This study aimed to investigate the teen-directed marketing features present and quantify the overall marketing power of outdoor food advertisements located near schools to explore any differences by content (ie, alcohol, discretionary, core and miscellaneous foods) school type (ie, primary, secondary, K-12) and area-level socio-economic status (SES; ie, low vs high). METHODS: This cross-sectional study audited every outdoor food advertisement (n = 1518) within 500m of 64 randomly selected schools in Perth, Western Australia, using a teen-informed coding tool to score the marketing power of each advertisement. RESULTS: Outdoor alcohol advertisements around schools had the highest average marketing power score and number of advertising features present. Outdoor advertisements for alcohol and discretionary foods scored significantly higher in marketing power than core food advertisements (P < .001). Outdoor alcohol advertisements around secondary schools scored significantly higher in marketing power than around primary and K-12 schools (P < .001); and outdoor advertisements for discretionary foods in low SES areas scored significantly higher in marketing power than those in high SES areas (P < .001). CONCLUSIONS: This study found outdoor advertisements for unhealthy products, such as alcohol and discretionary foods, were more powerful than advertisements for core foods around schools. SO WHAT?: These findings strengthen the need for policies which restrict outdoor advertisements for non-core foods near schools, to reduce adolescents' exposure to powerful alcohol and discretionary food advertisements.

The built environment and child obesity: A review of Australian policies.

Child obesity is a serious public health challenge affected by both individual choice and societal and environmental factors. The main modifiable risk factors for child obesity are unhealthy eating and low levels of physical activity, both influenced by aspects of the built environment. Coordinated government policy across jurisdictions, developed using strong research evidence, can enable built environments that better support healthy lifestyles. This study reviewed current Australian and Western Australian government policies to understand if and how they address the impact of the built environment on child obesity, physical activity, sedentary behavior, and diet. Current government policy documents related to the built environment and child health were analyzed using the Comprehensive Analysis of Policy on Physical Activity framework. Ten Australian and 31 Western Australian government policy documents were identified. Most referred to the role of the built environment in supporting physical activity. Very few policies mentioned the built environment's role in reducing sedentary behaviors, supporting healthy eating, and addressing obesity. Few recognized the needs of children, and none mentioned children in policy development. Future government policy development should include the voices of children and child-specific built environment features. Inter-organizational policies with transparent implementation and evaluation plans are recommended.

A massive hit that targets kids quite a bit: Where and how Australian school children see energy drinks.

ISSUES ADDRESSED: Energy drinks (EDs) are not recommended for children due to their high caffeine content and adverse health risks. Their popularity among children may be due to children's exposure to ED marketing. This study aimed to identify where children have seen ED marketing and whether they believe ED marketing targets them. METHODS: Participant data were drawn from 'AMPED UP: An Energy Drink Study', where 3688 students in grades 7-12 (age 12-17 years) from 25 randomly selected secondary schools in Western Australia were asked if they had ever seen ED advertising on television, posters/signs in shops, online/internet, movies, cars/vehicles, social media, magazines/newspapers, music videos, video games, merchandise and free samples. Participants were also shown three ED advertisements and asked, 'Which age group/s do you think this ad targets?' (12 years or less, 13-17 years, 18-23 years, 24 years or older) and could select multiple age groups for each advertisement. RESULTS: On average, participants saw ED advertising on 6.5 (SD = 2.5) of 11 possible marketing channels, including television (seen by 91% of participants), posters/signs in shops (88%), online/internet (82%) and movies (71%). Participants also perceived ED advertisements targeted children (< 18 years). CONCLUSIONS: ED marketing has a high reach among Western Australian children. The voluntary ED advertising pledge to not market EDs to children in Australia does not prevent children from seeing or being targeted by ED marketing. SO WHAT?: Stronger regulatory control of ED marketing is needed to better protect children from the appeal and adverse health risks of ED use.

Nutritional quality of children's menus in restaurants: does cuisine type matter?

OBJECTIVE: It is unknown whether the nutritional quality of children's menus varies depending on the cuisine type. This study aimed to investigate differences in the nutritional quality of children's menus by cuisine type in restaurants located in Perth, Western Australia (WA). DESIGN: Cross-sectional study. SETTING: Perth, WA. PARTICIPANTS: Children's menus (n 139) from the five most prevalent restaurant cuisine types in Perth (i.e. Chinese, Modern Australian, Italian, Indian and Japanese) were assessed using the Children's Menu Assessment Tool (CMAT; range -5-21 with lower scores denoting lower nutritional quality) and the Food Traffic Light system, evaluated against Healthy Options WA Food and Nutrition Policy recommendations. Non-parametric ANOVA was used to test for a significant difference in total CMAT scores among cuisine types. RESULTS: Total CMAT scores were low for all cuisine types (range -2-5), with a significant difference between cuisine types (Kruskal-Wallis H = 58·8, P < 0·001). The highest total CMAT score by cuisine type was Modern Australian (mean = 2·27, sd = 1·41) followed by Italian (mean = 2·02, sd = 1·02), Japanese (mean = 1·80, sd = 2·39), Indian (mean = 0·30, sd = 0·97) and Chinese (mean = 0·07, sd = 0·83). When using the Food Traffic Light for assessment, Japanese cuisine had the highest percentage of green food items (44 %), followed by Italian (42 %), Modern Australian (38 %), Indian (17 %) and Chinese (14 %). CONCLUSIONS: Overall, the nutritional quality of children's menus was poor regardless of cuisine type. However, children's menus from Japanese, Italian and Modern Australian restaurants scored better in terms of nutritional quality than children's menus from Chinese and Indian restaurants.

Awake and Alert: Examining the Portrayal of Energy Drinks on TikTok.

PURPOSE: Energy drinks (EDs) are not recommended for minors' consumption due to a myriad of health risks, but marketing initiatives persist. This study explored the promotion of EDs on TikTok, a platform frequented by children and adolescents. METHODS: 197 highly viewed videos from the four top ED-related hashtags on TikTok were coded for engagement variables, user information, sponsorship status, video content, and sentiment toward EDs. RESULTS: Of the 197 videos analyzed (combined 70 + million views), 29% disclosed sponsorship and 22% featured a child/adolescent. ED consumption appeared in 46% of videos, with 15% depicting hazardous consumption. Most videos (67%) had a positive sentiment toward EDs. DISCUSSION: ED-related TikTok videos are positively framed, have high engagement, and are not restricted for viewing by minors. As the platform's underage user-base grows, such videos may encourage heightened consumption. Given the known health risks, effective age-gated content restrictions are needed to reduce minors' exposure.

The community food environment and its association with diet, health or weight status in Australia: A systematic review with recommendations for future research.

ISSUE ADDRESSED: This study systematically reviewed Australian literature to determine if an association exists between geospatial exposure to food outlets and diet, health or weight status. Recommendations for future research are provided. METHODS: A systematic literature search was conducted in December 2021 using CINAHL Plus, PubMed and Web of Science databases. Data were extracted, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using an eight-item checklist. A descriptive synthesis of study characteristics and findings was carried out, stratified via study outcomes. RESULTS: Of the 36 included articles, the majority were from Victoria (n = 19), involving adult participants (n = 30) and cross-sectional in design (n = 27). Overall, associations were mainly null (nonsignificant) for diet (80%), weight status (75%) and health outcomes (90%). Significant findings were mixed with no positive trend with study quality. CONCLUSIONS: Six recommendations are suggested to address current knowledge gaps and limitations in the Australian evidence base: (1) Conduct research on different populations; (2) Employ robust study designs that can test the impact of change over time; (3) Improve the accuracy of food outlet data sources; (4) Improve food outlet geospatial exposure measures; (5) Improve measurement of outcome variables; and (6) Incorporate theoretical models into study design and data analysis. SO WHAT?: Improving the quality and consistency of research will be critical to informing locally relevant policy. Despite the present limitations in the evidence base, it is reasonable to assume that decisions to purchase and consume food are driven by availability and access. Thus, policy and planning aimed at improving the overall "healthiness" of the community food environment by increasing access to healthy food outlets is warranted to ensure that healthy options are easier choice for all.

Would you like fries with that? Investigating fast-food outlet availability near schools in Perth, Western Australia.

ISSUE ADDRESSED: Locating fast-food outlets near schools is a potential public health risk to schoolchildren, given the easy access and repeated exposure to energy-dense, nutrient-poor foods they provide. Fast-food outlet availability near schools has not been previously investigated in Perth, Western Australia. This study aimed to quantify fast-food outlet availability near Perth schools and determine whether differences in area-level disadvantage and school type exist. METHODS: Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth Primary (n = 454), Secondary (n = 107) and K-12 (n = 94) schools were assigned an area-level disadvantage decile ranking based on the Australian Bureau of Statistics Socio-Economic Index for Areas (SEIFA). Regression models assessed whether fast-food outlet availability within 400 m, 800 m and 1 km of schools differed by school type (ie, Primary/Secondary/K-12) or SEIFA. RESULTS: Secondary schools were significantly more likely than Primary and K-12 schools to have a higher presence and density of fast-food outlets and the "Top 4" fast-food outlet chains (McDonalds, Hungry Jacks, KFC and Red Rooster) nearby. Schools located in low socio-economic status (SES) areas had a significantly higher density of fast-food outlets within 400 m, and "Top 4" fast-food outlet chains within 400 m and 1 km, than schools located in high SES area. CONCLUSIONS: Perth schools are surrounded by fast-food outlets with densities significantly higher around secondary schools and schools located in lower SES areas. SO WHAT?: Policies and regulations aimed at reducing fast-food outlets near schools is an essential strategy to improve dietary intakes and reduce obesity in schoolchildren.

School Built Environments and Bullying Behaviour: A Conceptual Model Based on Qualitative Interviews.

Interest in how the school built environment impacts bullying behaviour has gained momentum in recent years. While numerous studies have identified locations within schools where bullying frequently occurs, few studies have investigated the potential conceptual pathways linking school locations to bullying behaviour. This study aimed to (i) identify school built environment factors that may prevent or facilitate bullying behaviour in primary and secondary schools; and (ii) develop a conceptual model of potential pathways between the school built environment and bullying behaviour for future anti-bullying intervention research. Seventy individual semi-structured interviews were conducted between May and December 2020, with policymakers (n = 22), school staff (n = 12), parents (n = 18), and students (n = 18). School staff, parents and students, were recruited from six metropolitan primary and secondary schools in Perth, Western Australia. Interviews were conducted online and face-to-face using semi-structured interview guides. A thematic analysis was undertaken. Participants identified school bullying locations (e.g., locker areas, bathrooms, corridors) and built environment factors linked to bullying behaviour via (i) visibility and supervision; (ii) physical and psychological comfort and safety; and (iii) social-emotional competencies. The findings have policy and practice implications regarding the design of school built environments to prevent bullying behaviour.

How does the school built environment impact students' bullying behaviour? A scoping review.

RATIONALE: School bullying is a public health concern affecting the physical and mental health of children and young people. While school-based interventions to prevent bullying have been developed internationally, the effectiveness of many interventions has been mixed and modest. Despite a growing recognition that the school built environment may impact bullying behaviour, few anti-bullying interventions have addressed the built environment. OBJECTIVE: This systematic scoping review explored existing literature for evidence that the school built environment influences bullying behaviour in school students. METHODS: The review was guided by Arksey and O'Malley's methodological framework for scoping reviews. A search of six databases (Medline, PsycINFO, ERIC, EMBASE, CINAHL Plus and The Cochrane Library) identified studies addressing primary, middle and secondary school students, bullying, school bullying locations, and school built environments. Peer-reviewed journal articles published in English prior to July 19, 2021, were included. RESULTS: In total, 7568 documents were screened by title and abstract. Following a full-text review, 61 studies (63 articles) were selected; 43 studies identified school bullying locations, and 19 studies linked features of the school built environment to bullying behaviour. Classrooms, playgrounds, and corridors were identified as common bullying locations. Features of the school built environment linked to bullying behaviour included security cameras, architectural design, aesthetics, seating, and vandalism. CONCLUSIONS: This review identified key school settings for anti-bullying interventions and identified gaps in existing built environment and bullying literature. Further analyses of published studies will inform anti-bullying policy and practice.

Gender-Neutral Toilets: A Qualitative Exploration of Inclusive School Environments for Sexuality and Gender Diverse Youth in Western Australia.

School toilets have been identified by sexuality and gender diverse (SGD) students as the least safe spaces in educational institutions. They are sites of verbal, physical and sexual victimisation. Providing gender-neutral toilets in primary and secondary schools may reduce the bullying and victimisation of SGD students, particularly those who are transgender or gender-diverse. This study explored factors influencing the inclusion of gender-neutral toilets in primary and secondary schools in Western Australia. Thirty-four interviews were conducted from May to December 2020 with policy makers or practitioners (n = 22) and school staff (n = 12) in Perth, Western Australia. Interviews were conducted online and face-to-face using semi-structured interview guides. A thematic analysis of the cross-sectional qualitative data was undertaken. School staff, policy makers, and practitioners identified school toilets as sites of bullying and victimisation of SGD youth and expressed support for gender-neutral toilets as an anti-bullying strategy. Perceived barriers to introducing gender-neutral toilets in schools included financial and spatial costs, building code compliance constraints, resistance from parents and students, privacy and confidentiality concerns, and cultural appropriateness. Including gender-neutral toilets in schools may reduce school-based bullying and victimisation, and improve the mental and physical health of SGD youth.

The Nutritional Quality of Kids' Menus from Cafés and Restaurants: An Australian Cross-Sectional Study.

Australian families increasingly rely on eating foods from outside the home, which increases intake of energy-dense nutrient-poor foods. 'Kids' Menus' are designed to appeal to families and typically lack healthy options. However, the nutritional quality of Kids' Menus from cafes and full-service restaurants (as opposed to fast-food outlets) has not been investigated in Australia. The aim of this study was to evaluate the nutritional quality of Kids' Menus in restaurants and cafés in metropolitan Perth, Western Australia. All 787 cafes and restaurants located within the East Metropolitan Health Service area were contacted and 33% had a separate Kids' Menu. The validated Kids' Menu Healthy Score (KIMEHS) was used to assess the nutritional quality of the Kids' Menus. Almost all Kids' Menus (99%) were rated 'unhealthy' using KIMEHS. The mean KIMEHS score for all restaurants and cafés was -8.5 (range -14.5 to +3.5) which was lower (i.e., more unhealthy) than the mean KIMEHS score for the top 10 most frequented chain fast-food outlets (mean -3.5, range -6.5 to +3). The findings highlight the need for additional supports to make improvements in the nutritional quality of Kids' Menus. Local Government Public Health Plans provide an opportunity for policy interventions, using locally relevant tools to guide decision making.

Individual, Social, and Environmental Correlates of Energy Drink Use Among Adolescents.

OBJECTIVE: To investigate the correlates of adolescent energy drink (ED) use using a socioecological approach to inform future interventions. METHODS: In 2017-2018, 3,688 students attending 25 randomly selected Western Australian secondary schools completed a self-report survey. A backward stepwise logistic regression analysis was used to construct a model of the most significant individual (n = 12), social (n = 3), and environmental (n = 4) factors associated with being an ED user (ie, past month ED use). RESULTS: Overall, 18% of participants were ED users. The factors significantly associated with being an ED user included being male (P < 0.001), having a higher disposable income (P < 0.001), perceiving EDs as good for health (P = 0.009), perceiving EDs as safe for someone their age to drink (P < 0.001), having a sensation-seeking personality (P = 0.011), having friends who drink EDs (P < 0.001), having parents who would give them an ED if asked (P < 0.001), and having EDs available at home (P < 0.001). CONCLUSIONS AND IMPLICATIONS: Initiatives to reduce ED intake among adolescents need to be multifaceted, addressing individual, social, and environmental factors. It is also important that educational interventions target both parents and adolescents.

Does fast-food outlet density differ by area-level disadvantage in metropolitan Perth, Western Australia?

ISSUE ADDRESSED: Socio-economic spatial patterning of fast-food outlets can result in disparities in the availability and access of food across geographic areas, contributing to health inequalities. This study investigated whether area-level socio-economic disparities exist in fast-food availability across the Perth metropolitan region of Western Australia. METHODS: Fast-food outlet locations were sourced from Perth Local Governments in 2018/2019. All Perth suburbs (n = 328) were allocated a decile ranking based on the Australian Bureau of Statistics Socio-Economic Index for Areas with decile 1 indicating relatively greater disadvantage and decile 10 indicating a relative lack of disadvantage. Zero-inflated negative binomial regression models, adjusted for suburb area and population density, were used to investigate the association between area-level disadvantage decile and availability of fast-food outlets. RESULTS: A socio-economic gradient was identified; for every unit increase in disadvantage decile (ie a reduction in relative disadvantage), the count of fast-food outlets decreased by 6% (P < .01), and the count of the "top ranking" fast-food chains (ie McDonalds, KFC, Hungry Jacks and Red Rooster) decreased by 10% (P < .001). CONCLUSIONS: Consistent with evidence internationally and from within Australia, socio-economic spatial patterning of fast-food outlet availability was shown to exist in Perth, with greater fast-food availability in areas with more relative socio-economic disadvantage. SO WHAT?: To address health inequities associated with fast-food consumption, policy and practice changes are needed that manage fast-food outlet proliferation in areas of greater socio-economic disadvantage.

Children's exposure to outdoor food advertising near primary and secondary schools in Australia.

ISSUE ADDRESSED: Previous research has highlighted children's frequent exposure to advertisements of unhealthy food and beverages on television. However, the food industry is increasingly utilising non-broadcast channels such as outdoor advertising (eg billboards, bus shelters, shop fronts) for product marketing. Few studies have investigated children's exposure to outdoor food advertising around primary and secondary schools. This study aimed to quantify the presence and content of outdoor food advertisements within a 500 m radius of primary and secondary schools in Perth, Western Australia. METHODS: A cross-sectional design was used to capture outdoor advertisements within a 500 m radial buffer around the school boundary. The INFORMAS protocol for monitoring outdoor advertising around child-serving institutions was used. Sixty-four primary and secondary schools in Perth, Australia, were selected using random sampling within socio-economic and population density strata. RESULTS: In total, 5636 outdoor advertisements were identified within a 500 m radius of all 64 schools combined and 30% were for food. Of the 1708 food advertisements, 74% were for unhealthy (non-core) food. The most frequently advertised food products were alcohol, fast food and sugar-sweetened beverages. Only 8% of food advertisements featured a healthy product. The majority of schools (75%) had at least one food advertisement within 500 m (mean 36, range 3-190). Schools in lower socio-economic areas had more food advertisements and a significantly higher proportion of unhealthy food advertisements within 250 m. CONCLUSION: Outdoor advertising around schools constitutes a potential frequent source of children's exposure to unhealthy food and alcohol advertising. SO WHAT?: Policy interventions restricting the content of outdoor food advertising near schools are needed.

Association between food-outlet availability near secondary schools and junk-food purchasing among Australian adolescents.

OBJECTIVES: We sought to investigate the association between food-outlet availability near Australian secondary schools and frequency of Australian students' discretionary food purchases. METHODS: Secondary-school students in Perth (Western Australia) reported the frequency of their discretionary food purchases from food outlets near their school (17 schools, n = 2389 students grades 7-12, ages 12-17 y). Food-outlet availability was sourced from local governments, then geocoded. A mixed-effects model was used in analyses. RESULTS: Almost half of students (45%) purchased discretionary foods from food outlets near their secondary school at least weekly. Only the density of top-ranking fast-food chain outlets near secondary schools was associated with a significant increase in the frequency of discretionary food purchases. CONCLUSIONS: Availability of major fast-food chains near Australian secondary schools appears to be a key driver of Australian students' discretionary food purchasing. Restricting these outlets near schools may help reduce adolescents' discretionary food intake.

Exposure to unhealthy food and beverage advertising during the school commute in Australia.

BACKGROUND: Food marketing exposure has the potential to influence children's dietary behaviours and health status, however, few studies have identified how 'obesogenic' the outdoor food marketing environment is along public transport (bus and/or train) or walking routes that children take to school. METHODS: Audits of all outdoor advertisements present along likely train, bus and walking routes to 24 secondary schools (ie, 3 routes per school, 72 routes total) were conducted in Perth, Western Australia (WA). The size, content, type and setting of each advertisement were recorded in accordance with the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support protocol for monitoring outdoor advertising. RESULTS: Of the 4016 total advertisements observed, almost half were for food (n=1754, 44%) and of these, 80% (n=1397) advertised discretionary (non-core) foods, and 8% (n=138) advertised healthy (core) foods. On average, commuting to school by train, bus and walking exposed Perth schoolchildren to 37.1, 22 and 4.5 discretionary (non-core) food ads per one-way trip to school, respectively. CONCLUSIONS: Children living in Perth, WA experience a high level of exposure to unhealthy outdoor food advertisements during the school commute. Policies which restrict the placement and content of outdoor advertising, could be a useful strategy in the fight against childhood obesity.

Dietary pattern trajectories across adolescence and early adulthood and their associations with childhood and parental factors.

BACKGROUND: Although adolescent dietary patterns tend to be of poor quality, it is unclear whether dietary patterns established in adolescence persist into adulthood. OBJECTIVES: We examined trajectories across adolescence and early adulthood for 2 major dietary patterns and their associations with childhood and parental factors. METHODS: Using data from the Western Australian Pregnancy Cohort (Raine Study), intakes of 38 food groups were estimated at ages 14, 17, 20 and 22 y in 1414 participants using evaluated FFQs. Using factor analysis, 2 major dietary patterns (healthy and Western) were consistently identified across follow-ups. Sex-specific group-based modeling assessed the variation in individual dietary pattern z scores to identify group trajectories for each pattern between ages 14 and 22 y and to assess their associations with childhood and parental factors. RESULTS: Two major trajectory groups were identified for each pattern. Between ages 14 and 22 y, a majority of the cohort (70% males, 73% females) formed a trajectory group with consistently low z scores for the healthy dietary pattern. The remainder had trajectories showing either declining (27% females) or reasonably consistent healthy dietary pattern z scores (30% males). For the Western dietary pattern, the majority formed trajectories with reasonably consistent average scores (79% males, 81% females) or low scores that declined over time. However, 21% of males had a trajectory of steady, marked increases in Western dietary pattern scores over time. A lower maternal education and higher BMI (in kg/m2) were positively associated with consistently lower scores of the healthy dietary pattern. Lower family income, family functioning score, maternal age, and being in a single-parent family were positively related to higher scores of the Western dietary pattern. CONCLUSIONS: Poor dietary patterns established in adolescence are likely to track into early adulthood, particularly in males. This study highlights the transition between adolescence and early adulthood as a critical period and the populations that could benefit from dietary interventions.