title: A hierarchy of unhealthy food promotion effects: identifying methodological approaches and knowledge gaps.
abstract: We assessed the evidence for a conceptual "hierarchy of effects" of marketing, to guide understanding of the relationship between children's exposure to unhealthy food marketing and poor diets and overweight, and drive the research agenda. We reviewed studies assessing the impact of food promotions on children from MEDLINE, Web of Science, ABI Inform, World Health Organization library database, and The Gray Literature Report. We included articles published in English from 2009 to 2013, with earlier articles from a 2009 systematic review. We grouped articles by outcome of exposure and assessed outcomes within a framework depicting a hierarchy of effects of marketing exposures. Evidence supports a logical sequence of effects linking food promotions to individual-level weight outcomes. Future studies should demonstrate the sustained effects of marketing exposure, and exploit variations in exposures to assess differences in outcomes longitudinally.
authors.affiliation: Bridget Kelly is with the Early Start Research Institute, School of Health and Society, University of Wollongong, Wollongong, Australia. Lesley King, Adrian E. Bauman, and Louise A. Baur are with the Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia. Kathy Chapman is with the Cancer Council NSW, Sydney. Emma Boyland is with the Department of Psychological Sciences, University of Liverpool, Liverpool, England.
authors.forename: Bridget
authors.initials: B
authors.lastname: Kelly
authors.forename: Lesley
authors.initials: L
authors.lastname: King MPsy
authors.forename: Kathy
authors.initials: K
authors.lastname: Chapman Mnd
authors.forename: Emma
authors.initials: E
authors.lastname: Boyland
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Bauman
authors.forename: Louise A
authors.initials: LA
authors.lastname: Baur
mesh_terms: D001290:Attitude; D001364:Awareness; D002648:Child; D019649:Food Industry / Q000458:organization & administration*; D005518:Food Preferences; D006801:Humans; D040541:Marketing / Q000458:organization & administration*; D015430:Weight Gain