WIREDGOV

Rapid evidence review on the current restrictions on out of home advertising of products high in fat, sugar and salt across local governments in England.

Introduction

Obesity is defined by the World Health Organisation (WHO) as a multifaceted, non-communicable disease associated with excess adiposity and subsequent poor health outcomes, including mortality, cardiovascular disease, diabetes, and some cancers. There is no one cause of obesity; rather, it can occur due to complex interactions between biological, commercial, social, and political factors .

Scotland has the highest levels of overweight and obesity in the UK, with around two thirds of Scottish adults (66%) currently living with overweight or obesity . Overweight and obesity levels amongst children remain a concern, with 17% of Scottish children at risk of living with obesity in 2023, increasing from 14% since records began in 1998. In 2022, the annual cost of obesity in Scotland was estimated to be £5.3 billion, which is predicted to rise further.

One factor influencing the high prevalence of overweight and obesity is diet. Scottish Health Survey (2022) data  confirms that Scotland has a poor diet and with too many calories being consumed. Scottish Dietary Goals have been missed since they were introduced in 1996. For example, children should consume five portions of fruit and vegetables per day, but only 21% of children aged 2 – 15 met this target in 2022. Therefore, finding new methods to improve diet and subsequently overweight and obesity is a significant public health priority in Scotland.

In 2018, the Scottish Government published a policy highlighting their vision to halve childhood obesity by 2030 through fostering healthy diet and regular physical activity. A Healthier Future: Scotland’s Diet and Healthy Weight Delivery Plan includes five key outcomes:

• “Children have the best start in life – they eat well and have a healthy weight”
• “The food environment supports healthier choices”
• “People have access to effective weight management services”
• “Leaders across all sectors promote healthy weight and diet”
• “Diet-related health inequalities are reduced”

However, it is increasingly difficult for many people to eat well and maintain a healthy diet and weight due to sedentary lifestyles and factors in the environment, such as exposure to advertising of food and/or drinks high in fat, sugar, and salt (HFSS), often referred to in the media as “junk food”. HFSS products are marketed using a range of media including broadcast television, promotions within stores and online, and via outdoor advertising such as billboards, posters, bus stops, kiosks, and phone boxes. Research shows that there is an association between exposure to HFSS advertising and consumption, with children particularly vulnerable to the effects of advertising. Advertising of HFSS products therefore has a clear influence on children’s dietary intake and could be contributing to the high prevalence of overweight and obesity.

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