Table 5.
Promotion studies* included in the current systematic review of food environments relevant to obesity and related chronic diseases in Latin America
| Media platform | Country | No. of ads/products | Length of time recorded/other | Promotion element(s) identified† | System for defining healthy/ unhealthy | Monitoring of codes/laws | Key findings | First author, year, reference |
|---|---|---|---|---|---|---|---|---|
| TV | Brazil | 1618 (TV ads) | 162 h/6 channels | Prom char, Health claims, Offers, Appeal | FB | Y | 5·6 % of ads were for food. Some categories fully complied with law, others did not | Britto, 2016(69) |
| Brazil | 4127 (TV ads) | h NS/3 channels | FB | N | 11 % of TV ads in Brazil for food (lowest of all countries studied). 2 food ads/h per channel. 55 % of food ads for ultra-processed nutrient-poor foods | Kelly, 2010(70) | ||
| Chile | 83 (food TV ads) | 350 h/5 channels | Appeal | NP | N | 56 % of food ads targeted to children. 79 % of advertised foods considered not healthy | Castillo-Lancellotti, 2010(71) | |
| Mexico | 9178 (TV ads) | 336 h/10 channels | Health claims, Appeal | NP | N | 17 % of all ads related to food. Ads shown during programming targeted to children longer, and showed less healthy products | Perez-Salgado, 2010(72) | |
| Mexico | 8299 (TV ads) | 235 h/5 channels | Prom char, Appeal | FB | N | 22 % of ads food related and 50 % targeted children. Of those, 64 % were for energy-dense food products | Ramirez-Ley, 2009(73) | |
| Brazil | 2732 (TV ads) | 132 h/4 channels | Prom char, Health claims, Offers, Appeal | FB | N | Ultra-processed foods accounted for majority of food ads | Maia, 2017(74) | |
| Mexico | 2544 (TV ads) | 600 h/4 channels | Appeal | NP | N | 20 % of all ads for foods and beverages. 64 % of foods advertised did not comply with Mexican nutrition standards for foods that can be advertised to children. International standards are stricter | Patino, 2016(75) | |
| Honduras | 2272 (TV ads) | 80 h/4 channels | Prom char, Appeal | FB | N | 17 % were food or beverage ads. 70 % were for unhealthy foods or beverages and 30 % for healthy ones. Most ads for unhealthy foods on cable network targeted children | Gunderson, 2014(76) | |
| Brazil | 3972 (TV ads) | 432 h/3 channels | Appeal | FB | N | 27·4 % were food or beverage ads. 57·8 % were for foods in fats, sugar and sweets group of healthy eating pyramid, 21 % bakery products, 0 for fruits and vegetables. More weekday than weekend ads | Almeida, 2002(77) | |
| Food packages | Guatemala | 106 (cereal boxes) | 1 supermarket | Health claims, Appeal | NP | N | Cereals marketed at children had worse nutrition profile. Half of cereals had child-oriented marketing | Soo, 2016(79) |
| Guatemala | 106 (‘child oriented’ snacks) | 55 shops around 4 schools | Prom char, Offers, Appeal | NP | N | Most common marketing technique was promotional characters (92·5 % of packages) then premium offers (34 % of packages). 97 % of child-oriented snacks classified as ‘less healthy’ | Chacon, 2013(80) | |
| Uruguay | 180 (products) | 2 supermarkets | Prom char, Health claims, Appeal | NP | N | Common category was candy and chocolates, followed by cookies and pastries, dairy products and breakfast cereals. Common strategies were the inclusion of cartoon characters, bright colours, childish lettering | Gimenez, 2017(84) | |
| Fast-food combo meals | Guatemala | 116 (combo meals) | 6 fast-food chain restaurants | Prom char, Offers, Appeal, Price, Time to delivery | NP | N | Nutrition information available in 2 out of 6 restaurants. All combo meals classified as ‘less healthy’. Marketing strategies include licenced characters, certain words and health claims | Mazariegos, 2016(81) |
| Store ads e.g. posters | Guatemala | 321 (food ads) | 55 shops around 2 schools | Prom char, Offers, Appeal | N/A (selected packaged snack foods only) | N | Snack food ads very prevalent around schools. More child-oriented ads in stores that were closer (<170 m) to schools compared with those further away | Chacon, 2015(78) |
| Billboards & wall ads | El Salvador | 100 (ads) | 6 rural villages, roads and urban area | Prom char, Health claims, Offers, Appeal | N/A (did not classify) | N | In urban areas most ads for fast-food restaurant chains. In rural areas most ads for beverages followed by snack. Themes identified were Cheap Price, Fast, Large and Modern. Strategies employed included repetition, placement, redefining foods and meals | Amanzadeh, 2015(82) |
| Leaflets, posters | Brazil | 220 (ads) | 24 shops | Health claims | N/A (all formula milk) | Y | All of the foods analysed violated at least one of the 5 clauses of the law | Pagnoncelli, 2009(83) |
Ad, advertisement; TV, television; NS, not stated; FB, food based; NP, nutrient profiling; N/A, not applicable; Y, yes; N, no.
*
All studies included were descriptive. One intervention study on social marketing of water in schools(68) was excluded.
†
Prom char, promotional characters (e.g. cartoon figures or celebrities) on ads or packages; health claims, statement about a relationship between food and health (e.g. high source of fibre or plant sterols help lower cholesterol); offers, premium offers (e.g. two-for-one, extra product for the same price); appeal, product design, use of colour and fonts appeals to the target population group.