Beyond the 2023 FIFA Women's World Cup Australia - New Zealand: Public health advocacy and the absence of health-conscious sport sponsorship

Dear Editor,

We were really interested to read in your renowned journal the paper “Piloting the use of football club community Trust's to create social Hubs for older adults” by Steve Bullough et al. [1].

The use of football club facilities to tackle major public health issues for older adults is a crucially important tool within the broader public health promotion. However, in this letter we would like to stress the importance of sensible sport sponsorship. For example, Sport England's primary source of funding is provided by the National Lottery. Concerns about the ethics of this funding have been raised since 2006 by Elizabeth Winslow McAuliffe [2]. In fact, worldwide gambling is a vital issue for people. On the one hand, we witness the National Lottery engaging in public health promotion activities within Sport England. On the other hand, we observe the persistence and abundance of obesogenic food sport sponsorship on the world stage. A striking example is the multitude of foods high in fat, sugar and salt (HFSS) and sugar-sweetened beverages (SSB) advertised during the FIFA 2023 Women's World Cup in Australia and New Zealand.

This letter aims to shed light on a critical public health concern. Furthermore, we emphasize the need to promote feasible pro-health sport sponsorship. This could be the beginning of a shift in our mindset when considering sponsorship by the National Lottery or HFSS and SSB advertising in the football world arena.

Globally, sport is regarded as a cultural heritage and a regular feature in many people's lives. It is also an ideal vehicle for health-promotion and disease prevention especially in the Pacific region. For instance, awareness of the importance of physical activity during early childhood in preventing non-communicable diseases has led to the Asia-Pacific consensus statement, promoting 24-hour activity guidelines [3]. Since the late 20th century, public health has been persistently working to prevent sport sponsorship by inappropriate advertising [4]. Despite these efforts, HFSS and SSB advertising remain an integral part of sport. At the 2018 FIFA World Cup, pitch-side promotional appearances were a substantial contributor to exposure to HFSS products, leading to potential effects on the consumption patterns of young individuals [5]. Importantly, this sponsorship filters all the way from global events down to Saturday morning kids' clubs [6].

In this letter, we abstain from dedicating time to listing scientific evidence of the negative health impacts of HFSS and SSB sport sponsorship. We will also not delve into the extensive spectrum of literature encompassing the global epidemic of obesity and diet-related diseases. By attempting to confirm causal links that are already well-known, research inadvertently provides businesses with the means to advertise extensively without encountering legal consequences. Food marketing professionals are consistently one step ahead of public health experts, with primary goals often centred around profit. We argue that public health professionals need to advocate for concrete actions by government and policy makers [4,7]

Substantial evidence exists in favour of multi-level interventions to address complex health issues [8]. The domain of public policy stands out as a significant sphere of influence [9]. However, the intersection of political, industrial, economic and public health objectives contribute to the complexity of promoting healthy sponsorships in sport. Worldwide, only a few countries implement legislation to regulate unhealthy food marketing, namely Chile, Canada, the United Kingdom (UK), and Australia [10]. Meanwhile, the industry engages in self-regulation and participates in healthy activities such as football or cricket clubs, similar to what the tobacco industry did [11]. For instance, in New South Wales, parents surveyed reported that only 2–4% of food outlets at swimming pools and outdoor sports fields sold mostly healthy foods [12]. In addition, content analyses of sport-related television advertising demonstrate that televised sport is saturated with promotions for energy-dense and nutrient-poor foods, including fast-food, sugary drinks, cereals, confectionery and high fat, salty snacks [13]. A pilot study exploring the proportion of various food sport sponsorship in New Zealand found that significantly more companies associated with unhealthy food sponsored junior sport than any other sponsor type (RR = 14.72, p < 0.001) [14].

Public health experts have a responsibility to participate to promote viable and profitable pro-healthy sponsorship [15]. To advocate more effectively, we should shift our focus to examining the successful yet challenging journey of past public health policies implementations. Examine the tobacco legislation in the UK [16,17], or the “Evin law” in France as examples [18]. The Chilean food policy's challenging campaign is worth looking into as well [19]. Additionally we suggest public health advocates could work with lawyers who possess a profound comprehension of international laws and are capable of discerning the extent to which a country can enact measures.

In summary, sport is an important part of people's lives, particularly for young individuals in the Pacific region. Sport seems a logical setting in which to promote healthy dietary behaviours and patterns. However, evidence consistently demonstrates that the sport-related food and beverage environment is obesogenic. Although responsibility for the shift in sports financing primarily rests with the willingness of governments, public health experts should also contribute to prevent children from growing up in an obesogenic sports environment inundated with HFSS and SSB advertising. Similarly, involvement of National Lottery funding should be cautiously used, to avoid harmful consequences on people's lives. Public health advocates will be held accountable for their outcomes. Therefore, a robust monitoring and evaluation framework should be employed [20]. Public health advocacy for healthy settings remains paramount in order to improve people's lives.