Early childhood is a critical period for promoting healthy eating and reducing intake of high sugar foods to reduce lifelong risk of non-communicable diseases such as dental caries, type 2 diabetes and cancer. This study tested the effectiveness of three front-of-pack added sugar warning label (WL) designs in helping parents identify commercial infant and toddler foods (CITFs) with added sugars and make healthier choices. In an online experiment (August-December 2023), 1368 Australian parents of infants and toddlers were randomly assigned to one of four WL conditions: control (no WL), text only WL, text plus teaspoon of sugar icon WL, or text plus tooth decay icon WL. Participants viewed three pairs of mock CITF products (low versus high sugar, labelled according to condition) and indicated which they would prefer to buy, and which contained added sugar. They then rated the high sugar product from each pair on purchasing intentions, perceptions of total and added sugar content, suitability, and naturalness. All WLs significantly improved identification of products with added sugar and perceptions of added sugar levels. WL designs with icons (text plus sugar or decay icon) significantly increased perceptions of total sugar levels and reduced intentions to purchase high sugar CITFs relative to control condition. None of the WLs influenced preference for low sugar CITFs over high sugar CITFs. In conclusion, WLs help parents identify and evaluate high sugar CITFs and reduce intentions to purchase these products. All WLs showed beneficial effects compared to no label, and those incorporating a graphic were particularly effective across multiple measures.

AIMS:Nutrition content claims and health claims are commonly displayed on food packaging and are known to influence consumer preferences and purchasing of labelled foods. This study aimed to assess the prevalence of content and health claims found on ready meals in the Australian food supply and examine their alignment with the Nutrient Profiling Scoring Criterion and Standard 1.2.7 of the Food Standards Code. METHODS:In a cross-sectional analysis, ready meal products were identified from the Australian FoodSwitch 2023 database to record serving size, nutrition information, Health Star Rating and claims for each product. The Nutrient Profiling Score was calculated for each product and claim compliance was assessed against Standard 1.2.7. Descriptive statistics were conducted to explore the data for prevalence of content and health claims, and alignment with the relevant standard. RESULTS:A total of n = 777 ready meals were identified in the database. Eighty-eight percent of products met threshold criteria for eligibility to carry a health claim. In total, 2051 claims were identified, with nutrition content claims the most common (93% of all claims). In total, 92% of nutrition content claims and 39% of general-level health claims complied with all provisions of Standard 1.2.7. CONCLUSIONS:This study highlights the widespread use of claims, particularly nutrition content claims, on ready meal products sold in Australia. Strengthened guidelines and stricter enforcement of claim compliance are essential to prevent misleading claims in the Australian food supply.

BACKGROUND/OBJECTIVES:Diet quality is relevant to athlete health and recovery, yet practical methods for assessing dietary patterns in elite sporting environments remain limited. This exploratory study aimed to examine the relationship between skin carotenoid status and diet quality in male professional National Rugby League players. METHODS:Skin carotenoids were assessed at three time points throughout the NRL season: pre-, mid-, and end-season. The Veggie Meter® was used to assess carotenoids alongside a single 24 h dietary recall at each time point. Dietary data for each player were scored using the Healthy Eating Index for Australian Adults 2013 (HEIFA-2013) to calculate a score out of 100. Correlations were explored via Pearson correlation coefficients, and linear mixed models were used to compare data over the season. RESULTS:Correlations between carotenoid status and diet quality score varied across time points: pre-season, r = 0.297, 95% CI -0.094 to 0.608, p = 0.196; mid-season, r = 0.451, 95% CI 0.108 to 0.698, p = 0.012; and end-season, r = 0.335, 95% CI -0.036 to 0.625, p = 0.076. Mean carotenoid scores did not differ significantly across the season: 294 in pre-season (n = 27), 314 in mid-season (n = 30), and 318 in end-season (n = 29), p = 0.16. Mean HEIFA-2013 scores also did not differ significantly across the season: 66.4 in pre-season, 64.6 in mid-season, and 62.6 in end-season, p = 0.38. CONCLUSIONS:This exploratory study provides preliminary evidence that skin carotenoid status may reflect aspects of diet quality in elite NRL players, although associations varied across time points and only reached statistical significance at mid-season. Non-invasive tools such as the Veggie Meter® may complement traditional dietary assessment methods, although further validation is required in larger, adequately powered studies of elite athletes.

Objective: To analyse food and nutrition labelling policies in Mongolia, with the aim to identify key facilitators and barriers in the policy process and to propose priority actions to address these challenges.Design: A qualitative study utilising semi-structured individual interviews explored opinions and views of policy stakeholders on Mongolian food and nutrition labelling policies.Setting: Ulaanbaatar city, MongoliaParticipants: Eighteen policy stakeholders, including government officials, representatives of consumer organisations and food producers.Results: Food labelling regulations in Mongolia were developed as part of broader reforms of the food system control to respond to changes related to the country's transition to a market economy. Government leadership, along with technical support from international agencies, facilitated the development of these regulations. Key barriers identified in policy development were industry opposition, lack of consumer engagement, disruptions from government changes and funding shortages. Policy implementation was hindered by delays in operational regulations, inadequate infrastructure and limited knowledge and funding.Conclusions: To date, the development and implementation of food and nutrition labelling policies in Mongolia have been limited and insufficient. Given the health and nutritional impacts of the nutrition transition, prioritising nutrition labelling policies is essential and should emphasise consumer needs. Key actions should include the establishment of clear regulations, active stakeholder engagement, well-resourced implementation, capacity building among regulators and producers, and consumer education.

OBJECTIVE:This study aimed to quantify the impact of adolescents' exposure to unhealthy food marketing in real-world digital environments. METHODS:We conducted a single-blinded randomized field experiment including 121 Australian adolescents aged 16-17. A latent class analysis was used to identify personas, and participants were randomized (1:1) to an intervention or control group. Using retargeting pixels, the intervention group was exposed to advertisements for a fictitious sugar-sweetened beverage "Clu" embedded in their feed for 2 weeks. The control group was not exposed to Clu advertisements. An exit survey collected data on purchase intention for Clu. Exposure effect on purchase intention was estimated using logistic regression, reported as a risk ratio. RESULTS:An intention to purchase Clu was reported by 26.2% of participants (n = 16) in the control and 71.6% in the intervention group (n = 43). Participants in the intervention group were 2.73 times more likely to report intention to purchase Clu than those in the control (RR = 2.73; 95% CI: 1.74-4.28). CONCLUSIONS:Social media advertisements for sugar-sweetened beverages significantly influence adolescents' purchase intentions of the beverages, highlighting digital advertising as a modifiable commercial determinant of dietary risks. These findings underscore the need for policy interventions that address unhealthy food digital marketing to reduce obesity-related behaviors among adolescents.

Exposure to audiovisual advertising for unhealthy food products increases children’s immediate food consumption and effects may persist to subsequent meals. The impacts of food advertising that is brand-only or in other formats is unknown. This study aimed to quantify the impact of unhealthy food advertising on children’s immediate and later intake; and assess differences in impacts for different advertisement content (brand-only vs. product), format (audiovisual vs. visual vs. audio vs. static), or sociodemographic characteristics. A pre-registered randomised controlled trial was conducted in schools in Merseyside, UK. Across two sessions, child participants (n=240, 7-15 years, M=11.0±2.0) were exposed to 5-minutes of unhealthy food (intervention condition) and non-food (control condition) advertisements that were brand-only or product-based and in one of four media formats. Measurements included ad libitum intake of snacks and lunch, and height and weight. Area-level socioeconomic deprivation was calculated using home postcode. Data were analysed using linear mixed models. After food advertising (vs non-food), children consumed more energy at snack (+58.73kcal; p<.001) and lunch (+72.93kcal; p<.001). Holding advertisement exposure constant, for each +1 standard deviation increase in body mass index z-score, children consumed 49.29 additional kcal. There was no statistically significant difference in effects by advertisement content, media format, or deprivation. This is the first study to show that brand-only food advertisements increase children’s food intake, with effects not statistically different to that for product ads and that impact is similar across advertising formats. Findings have implications for the design of restrictive food marketing policies in the UK and globally.

This study aimed to prioritise key indicators for monitoring and assessing the healthiness of food environments, including at the country level. We conducted a literature review and engaged a consortium of researchers from the International Network for Food environments Research, Monitoring and Action Support (INFORMAS) as part of a prioritisation process. We identified 375 existing indicators that had been used to measure food environments. Researchers were consulted on priorities and implementation considerations through a series of interviews, focus groups and an online survey. Sixteen indicators were short-listed for prioritisation, and five indicators were identified as key priorities: proportion of packaged food and drinks products classified as unhealthy; frequency of exposure to unhealthy food promotion; price of a healthy diet and the price of the current diet as a proportion of income; proportion of schools in which unhealthy foods are provided or available for sale regularly; and application of back of package and front of package food labelling. This study lays the groundwork for standardised and scalable food environment monitoring that can drive policy action to support healthier food environments globally. Future areas for inquiry include tools to classify healthy foods and outlets, which could be adapted across policy areas, and the establishment of evidence-informed benchmarks for assessment of each indicator.

IntroductionUnder Section 564 of the Federal Food, Drug and Cosmetic Act, the United States (US) Food and Drug Administration (FDA) may, pursuant to a declaration by the US Department of Health and Human Services Secretary, based on one of four types of determinations, authorize an unapproved product or unapproved uses of an approved product for emergency use. Although sponsors are not prohibited from promoting products with Emergency Use Authorizations (EUAs), little is known about how they promote these products.ObjectivesThe aim of this study was to investigate how EUAs are being described in promotional materials disseminated to health care providers (HCPs) and consumer audiences.MethodsA content analysis was conducted on promotional materials for drugs authorized under an EUA that were submitted to the FDA between April 2020 and April 2023. Each material was coded for the presence or absence and location of certain words, phrases, or resources relating to EUAs and product risk information. Statistical analyses include descriptive statistics and bivariate analyses comparing materials created for consumer and HCP audiences. Readability statistics were also conducted for consumer materials.ResultsThe sample included 423 promotional materials. Most materials included risk information; however, few included a formal definition of an EUA. Materials for HCPs were more likely to contain links to fact sheets and other information and resources related to EUAs. The reading level of consumer materials was very difficult (requiring graduate-level education).ConclusionAlthough most of the materials contained risk and benefit information in promotional materials about EUAs, improvements could be made through the inclusion of a specific definition of "EUA" and more prominent information about limitations of use in consumer materials. Readability could also be improved for consumer materials by applying plain language principles.

ISSUE ADDRESSED:Nutrition and physical activity practices in Australian family day care are suboptimal. A web-based tool was co-developed with family day care service providers and educators, health promotion staff and the New South Wales Ministry of Health to promote healthier nutrition and physical activity practices through an existing quality improvement process. METHODS:Formative evaluation was conducted in January-February 2023. An online survey included 13 questions relating to content, language, structure, ease of usage and participant satisfaction. Questions used Likert scales to rate participants' experience from poor to excellent. Tool usage data were extracted from the website to reflect user activity. Service providers (n = 3) and educators (n = 9) tested the tool for 4 weeks. RESULTS:Survey questions were grouped into measures of perceived convenience, difficulty and helpfulness. All participants chose a rating of 'good' or 'excellent' across all questions, with a higher proportion of participants rating the questions as 'excellent'. All participants used the tool at least once. Perceived value of research was the main theme that emerged from the open text feedback. CONCLUSIONS:Results suggest that the tool was feasible, easy to use and relevant to practice. SO WHAT?: This is the first known tool designed for family day care to promote healthier nutrition and physical activity practices through an existing quality improvement process to implement change. An efficacy trial will follow to evaluate effectiveness. The tool is predicted to serve as a platform for identifying gaps between policy and practice and for facilitating practice improvements.

Claims relating to foods’ nutrition content and potential health benefits have been shown to influence consumer preferences and purchases regardless of the nutritional quality of the product (1) . In Australia, permitted claims include nutrition content claims, which refer to the presence or absence of a nutrient, and health claims, which refer to health benefits of foods or nutrients in a product. Health claims include general level health claims, which refer to normal processes and functions, and high level health claims, which refer to a disease or biomarker of a disease. Products that display a health claim must meet the Nutrient Profiling Scoring Criterion (NPSC), however this is not required for products to make a nutrition content claim. The aim of this study was to examine the use of nutrition content and health claims made on Australian ready meal products and assess the proportion of products displaying claims that meet the NPSC. Analysis of the ready meal category in the 2023 FoodSwitch database, a repository of Australian food packaging images and label data for over 28,000 foods developed by The George Institute for Global Health, was conducted (2,3) . Foods in the ready meal category were identified and data from the nutrition information panel was collated to calculate whether they met the NPSC. Nutrition content and health claims were extracted from product images and categorised according to claim type (nutrition or health claim) and claimed nutrient or attribute. The proportion of products meeting the NPSC was then calculated overall and by claim type (nutrition content vs health claims). Data were available for 777 ready meal products. Of these, 682 (87.8%) met the NPSC. In total, 2051 nutrition content or health claims were identified across the ready meal products, with 1909 (93.1%) of these categorised as nutrition content claims. The remaining 142 claims identified were general level health claims, with no high level health claims identified. Almost all (n = 1857, 97.3%) nutrition content claims and all general level health claims were made on products which met the NPSC. The most common claims related to protein, energy and fibre content. The use of claims was prevalent across the ready meal food category in Australia, with claims relating to nutrient content being most common. While most claims were made on products that met the NPSC, there is a need for further research to ensure the NPSC appropriately distinguishes between healthy and less healthy food products. This will ensure consumers are equipped to make informed decisions when purchasing food products.

Alcohol advertising on television in China has the potential to target children and adolescents with harmful content. Understanding the extent of this advertising is critical for informing and improving current regulatory approaches. To measure the exposure of alcohol advertisements on television channels popular among children and adolescents in Beijing, China. This cross-sectional study of television advertisements used the 4 most popular television channels for viewers aged 3 to 18 years (2 children's channels and 2 general channels) in Beijing and accessed advertisements recorded from October 19, 2020, to January 17, 2021. Television advertisements were recorded during 4 randomly selected weekdays and 4 randomly selected weekend days (from 6:00 am to 11:59 pm). Data were analyzed from October 1, 2023, to December 31, 2024. Television alcohol advertisements, with food and nonalcoholic beverages (F&B) advertisements classified as not permitted in marketing to children included as comparison. Primary outcomes included frequency and distribution of alcohol advertisements, rate per channel-hour, and potential exposure during peak viewing times (PVT). Secondary outcomes included comparison with F&B advertisements classified as not permitted based on the World Health Organization Western Pacific Region Office Nutrient Profile Model integrated with the International Network for Food and Obesity/Non-communicable Diseases Research, Monitoring and Action Support (INFORMAS) food classification system and analysis of 6 marketing strategies. Among 13 864 total advertisements included in the analysis, 5368 were food advertisements. Among the food advertisements, 321 (6.0%; 95% CI, 5.4%-6.7%) were alcohol advertisements and 2001 (37.3%; 95% CI, 36.0%-38.6%) were F&B advertisements classified as not permitted. On general channels, a mean (SD) of 1.1 (1.7) alcohol advertisements per channel-hour were identified, with significantly higher rates during PVT compared with non-PVT (2.0 [2.4] vs 0.7 [0.9] per channel-hour; P < .001). The highest rate occurred between 9:00 and 9:59 pm, with a mean (SD) of 3.7 (2.8) advertisements per channel-hour and an estimated mean (SD) of 14 303 014 (11 659 096) impressions among children and adolescents. All 321 alcohol advertisements (100%; 95% CI, 98.9%-100%) and 1997 F&B advertisements classified as not permitted (99.8%; 95% CI, 99.5%-99.9%) used at least 1 marketing strategy, predominantly brand benefit claims, which were used in 307 alcohol advertisements (95.6%; 95% CI, 92.8%-97.4%) and 1915 F&B advertisements classified as not permitted (95.7%; 95% CI, 94.7%-96.5%). In this cross-sectional study of television advertising, alcohol advertisements on general channels exceeded regulatory limits, especially during PVT. These findings suggest that current regulations allow exposure of children and adolescents to alcohol marketing and should be strengthened.

BackgroundOnly 2% of 4-8-year-old Australian children consume the daily recommended vegetable serves, with implications on the development of lifelong dietary behaviors. Evidence suggests that enhancing children's access, exposure and familiarity with vegetables can help increase their vegetable intake. Most children attend Early Childhood Education and Care (ECEC) services, which are well placed to increase vegetable consumption through curriculum change, play-based learning and parental education.AimWe aim to determine the efficacy of the 'First Bite-Get it Right' (First Bite) intervention to improve the vegetable intake of 3-5-year-old children in ECEC services compared to a control group.MethodThis 8-week cluster-randomized controlled trial involves ECEC services (n = 30) and children (n∼300) from socioeconomically disadvantaged areas in two local health districts in New South Wales, Australia and includes an intervention and wait-list control group. The First Bite program comprises: 1) Educator professional development; 2) Child daily "Veggie Break"; 3) Child experiential learning activities; and 4) Parent resources. Baseline and post-intervention measures include skin carotenoid scanning, vegetable serves plate waste, lunch box audits, child-reported vegetable preferences, and child parent-reported vegetable intake. Group-by-time interactions will be analyzed by linear mixed model regression, accounting for ECEC clustering.SummaryThis study will evaluate whether a comprehensive ECEC-based intervention can improve children's vegetable consumption in socioeconomically disadvantaged areas. The findings will inform recommendations for ECEC policies, educator training programs, and parent engagement strategies to promote healthy eating in early childhood.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN: 12624000249550 (Date: 14/03/2024). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=387095.

Calls to reduce ultra-processed food (UPF) consumption through population health strategies such as front-of-pack labelling are increasing. Gaining insight into consumer perceptions may help inform effective strategies in this area. This study explored (i) Australian adults' awareness, understanding, and recognition of UPFs and (ii) their interest in front-of-pack labelling to signpost UPFs. Twelve online focus groups were conducted with 112 Australian adults (49 % women, 78 % residing in metropolitan areas). Discussions covered food selection criteria, familiarity with 'processed' and 'ultra-processed' terminology, ability to recognise UPFs, and views on current and desired availability of processing-level information on packaged foods. Images of foods were used as stimuli to facilitate discussion. An inductive thematic analysis was applied to examine the data. Two key themes emerged: (i) concern but confusion around processing and UPFs, and (ii) support for UPF information provision but uncertainty about feasibility. Participants broadly supported strategies to help consumers identify UPFs and their characteristic ingredients, while noting that low awareness of relevant terminology may limit the effectiveness of labelling approaches without accompanying public education efforts. Participants relied on simple packaging cues to assess processing levels, highlighting the need for transparent and salient labelling strategies. There were concerns that co-locating a UPF front-of-pack label alongside existing health labels could cause confusion, particularly where nutritional quality and level of processing are misaligned. Integrating UPF information into existing labelling systems appeared to be an acceptable approach to support healthier food choices and may alleviate these concerns. The findings provide evidence to enhance communication about food processing and support labelling strategies.

OBJECTIVE:This study aimed to explore public opinion towards food marketing policies. METHODS:In 2022, a cross-sectional online survey was completed by 3,923 adults in Australia, including 1,152 caregivers of children aged <18 years. Concern about children's exposure to unhealthy food marketing was assessed among caregivers. Public support for seven policy options to restrict unhealthy food marketing in different media and settings (broadcast, online, outdoors, packaging and retail) was quantified. Multivariable regression analyses were conducted to examine sociodemographic differences. RESULTS:Most caregivers (85%) reported some degree of concern about their child's exposure to unhealthy food marketing. Among all respondents, there was a high level of support or neutrality (>70%) for all policies aimed at restricting unhealthy food marketing. Respondents who were female, older, highly educated, who identified as Aboriginal and/or Torres Strait Islander, perceived their monthly income as adequate or had at least one child living in the household reported higher support/neutrality towards several of the assessed policies. CONCLUSIONS:Most Australian adults were supportive or neutral towards policies restricting unhealthy food marketing. The level of support varied depending on the policy's target group and its setting. IMPLICATIONS FOR PUBLIC HEALTH:Implementing unhealthy food marketing policies in Australia would most likely have broad public support and minimal opposition.

Food and physical activity environments in family day care can be improved to better support healthy behaviors. A 6-month two-arm parallel randomized controlled trial evaluated the effectiveness of a web-based tool to promote healthier practices through quality improvement planning among Australian service providers and their educators. Service providers were randomized 1:1 into the intervention group (using the tool for a minimum of 1 month alongside regular quality improvement plan processes) and control group (regular quality improvement plan processes). The primary outcome of change in the quality of the improvement plan (in relation to the incorporation of healthy practices) was assessed using a checklist designed specifically for the study. Secondary outcomes were self-ratings of awareness and knowledge of various topics assessed using a 5-point Likert-type scale. Eight service providers and 22 educators participated (four service providers and 10 educators in the intervention group; four service providers and 12 educators in the control group). Intention-to-treat analyses found significant change in quality of the revised improvement plan for the intervention group. The intervention group showed an increase in self-rated awareness and knowledge on healthy practices and National Quality Standards, and confidence in identifying priority areas. This is the first-known web-based tool designed specifically for family day care to promote healthier practices. There are several opportunities for the tool to be embedded in practice, including delivery of the tool as part of support programs or training. This trial is registered with Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000369628.

BACKGROUND:Encouraging healthy eating and physical activity in children has long-term benefits for their health and development, however many do not meet the requirements for fruit and vegetable consumption, or physical activity. Experiential learning (EL) has been shown to improve children's healthy eating and physical activity-related knowledge, attitudes, and behaviour. Children's museums provide opportunities for hands-on EL activities that can engage families. This study examined stakeholder perspectives on the perceived feasibility, acceptability, fidelity and impact of an EL health-promoting program in a children's museum. METHODS:A qualitative case study was conducted at the Early Start Discovery Space, a university-based children's museum, in Australia. The study involved implementing a 4-week Healthy Living program comprising EL activities related to food and movement for children aged 0-10 years. Perceived feasibility, acceptability, fidelity and impact were assessed through focus groups and observations. Focus groups (23 participants, 17 caregivers and 6 museum staff) were conducted post-implementation. Focus groups were audio-recorded, transcribed verbatim and analysed using thematic analysis. 15 HL sessions were observed throughout implementation. RESULTS:Stakeholders perceived that the HL program was feasible and acceptable. As a result of consultation between researchers and museum staff, the HL program was easily implemented in the museum. Stakeholders suggested that children and their carers enjoyed the HL activities and were engaged in the HL activities. Aspects of fidelity were explored and showed that most sessions were delivered as intended, however, the delivery of the key messages was suboptimal. Perceived changes in children's knowledge, attitudes behaviour relating to healthy eating and physical activity were minimal. CONCLUSIONS:Key stakeholders (museum staff and caregivers) provided insights regarding perceived feasibility and acceptability of the HL program delivered in the children's museum. Preliminary findings highlight the potential of children's museums as a setting for EL health eating and physical activity programs. Further, this study highlights the significance of stakeholder engagement, collaboration, and incorporation of hands-on and enjoyable activities to promote healthy habits in children. Future studies, with larger sample sizes, should be conducted to extend the results from this study.

Public health diplomacy addresses global challenges impacting societies, economies, the environment, and health by integrating foreign policy and development. The University of Memphis School of Public Health hosted a multistakeholder summit to identify strategies and competencies essential for effective public health diplomacy. A 3-day summit included 29 participants from 15 countries, representing the WHO, the World Federation of United Nations, and seven regional public health associations. An iterative human-centered design (HCD) approach and concept mapping were employed to facilitate discussions and generate actionable recommendations. Developed a working definition of Public Health Diplomacy emphasizing cross-disciplinary collaborations, communication, negotiation, and consensus building. Produced a 9-point action plan to establish a global framework, launch capacity-building initiatives, and institutionalize public health diplomacy as a public health discipline.

The objective of this study was to examine associations between children’s exposure to food marketing and their liking, purchase and consumption of unhealthy foods in Thailand. A face-to-face cross-sectional survey was conducted with a nationally representative sample of 4,117 Thai children aged 6–18 years. Ordinal logistic regression models were applied to determine the association between marketing exposures and liking, purchase and consumption of unhealthy foods. Of all children, 78.8% reported seeing cartoons on food packaging in the past week, while 72.5% had seen a celebrity or online influencer endorses a product. Most children (84%) reported being exposed to marketing for unhealthy foods through social media in the past week. Exposure to unhealthy food marketing was positively associated with children’s preferences for, and purchases and intakes of, unhealthy foods. Comprehensive regulations are required in Thailand to limit children’s exposure to, and the persuasive power of, unhealthy food marketing.

Background Food marketing is a key factor that influences children’s dietary behaviors. This study assessed the nature and extent of food and beverage advertising on television (TV) in 2014 and 2022 in Thailand. Methods TV was recorded for one week in March 2014 and in May 2022 from 7-9am and 3-7 pm on weekends, and 3-7 pm on weekdays across two channels (64 h recorded each year). The nutrient profile model from Bureau of Nutrition, Ministry of Public Health Thailand was used to classify food and non-alcoholic beverages as: Group A (‘healthy’), Group B (‘less unhealthy’) or Group C (‘unhealthy’). Results In 2014, 475 food advertisements were identified, with on average of 6.3 unhealthy food advertisements per hour. In 2022, 659 food advertisements were identified, with an average of 9.2 unhealthy food advertisement per hour. In both time periods, the most frequently advertised food products were non-alcoholic beverages. The rate of unhealthy food advertising per hour of broadcast was significantly higher than for other moderately unhealthy and healthy foods, and was also significantly higher in 2022 than in 2014. Conclusions Food and beverage advertising on Thai television is predominantly promotes unhealthy foods and, in particular, sugar-sweetened beverages. Therefore, Thai Government should enact new legislation to protect children from food TV ads in order to control both the frequency and nature of unhealthy TV food marketing to protect the health of Thai children.

INTRODUCTION:In 2020, Google took voluntary action to restrict food and beverage advertising through its online channels in the European Union/United Kingdom using Google's own nutrient profiling model to identify products eligible to be marketed to children through its Google Display Network. The objective of this study was to evaluate the potential impact of the Google policy, if applied to the U.S. market, on restricting online advertising of the top-selling packaged foods and beverages in the U.S. METHODS:The top 25 U.S. food and beverage manufacturers were identified. Nutrient data for products from these manufacturers were sourced from Label Insight (a Nielsen IQ company) in 2021. Each product was examined against four nutrient profiling models: the Google nutrient profiling model, the WHO Europe nutrient profiling model, the Pan American Health Organization nutrient profiling model, and the Chilean government nutrient profiling model. RESULTS:Under Google's nutrient profiling model, 18% of 14,188 products were eligible to be advertised to children, representing $44 billion in revenue for the top 25 U.S. manufacturers of the >$240 billion generated annually. The Google nutrient profiling model permitted the most products to be advertised to children of all four nutrient profiling models examined. CONCLUSIONS:U.S. children engage extensively with online media. In place of government regulation, the Google advertising policy and related nutrient profiling model would limit online advertising of the most unhealthful products to children, if the policy were to be applied to the U.S. market. The effectiveness of the policy would be strengthened by refining the Google nutrient profiling model to better align with nutrient profiling models developed by authoritative health agencies, including the WHO.