Reducing the volume, exposure and negative impacts of advertising for foods high in fat, sugar and salt to children: A systematic review of the evidence from statutory and self-regulatory actions and educational measures.
OBJECTIVE
To identify and review evidence on 1) the effectiveness of statutory and self-regulatory actions to reduce the volume, exposure or wider impact of advertising for foods high in fat, sugar and salt (HFSS) to children, and 2) the role of educational measures.


METHODS
A systematic review of three databases (Medline, CINAHL and PsycINFO) and grey literature was carried out. Relevant evidence included studies evaluating advertising bans and restrictions, advertising literacy programmes and parental communication styles. Relevant media included TV, internet, radio, magazines and newspaper advertising. No studies were excluded based on language or publication date.


RESULTS
Forty-seven publications were included: 19 provided evidence for the results of statutory regulation, 25 for self-regulation, and six for educational approaches. Outcome measures varied in approach, quality and results. Findings suggested statutory regulation could reduce the volume of and children's exposure to advertising for foods HFSS, and had potential to impact more widely. Self-regulatory approaches showed varied results in reducing children's exposure. There was some limited support for educational measures.


CONCLUSIONS
Consistency in measures from evaluations over time would assist the development and interpretation of the evidence base on successful actions and measures to reduce the volume, exposure and impact of advertising for foods HFSS to children.
Oral Health and Health Research Group, Dental Health Services Research Unit, University of Dundee, Dundee Dental School, Park Place, Dundee DD1 4HN, United Kingdom; Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. Electronic address: stephanie.chambers@glasgow.ac.uk.
Stephanie A
SA
Chambers
Oral Health and Health Research Group, Dental Health Services Research Unit, University of Dundee, Dundee Dental School, Park Place, Dundee DD1 4HN, United Kingdom. Electronic address: r.e.freeman@dundee.ac.uk.
Ruth
R
Freeman
Centre for Public Health Nutrition Research, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. Electronic address: a.s.anderson@dundee.ac.uk.
Annie S
AS
Anderson
Social Dimensions of Health Institute, University of Dundee, Airlie Place, Dundee DD1 4HJ, United Kingdom. Electronic address: s.a.macgillivray@dundee.ac.uk.
Steve
S
MacGillivray
D000329:Advertising; D002648:Child; D002675:Child, Preschool; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D057140:Fast Foods; D019649:Food Industry / Q000331:legislation & jurisprudence / Q000592:standards; D033161:Government Regulation; D006801:Humans; D008402:Mass Media; D018673:Nutrition Policy; D012927:Social Control, Informal; D017673:Sodium Chloride, Dietary
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D017673:Sodium Chloride, Dietary
Advertising; Children; Marketing; Mass media; Regulation