Accelerating Progress in Obesity Prevention Solving the Weight of the Nation (2012) / Chapter Skim
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7 Message Environments
7 Message Environments
Pages 235-284
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Strategy 3-1: Develop and support a sustained, targeted physical activity and nutrition social marketing program. Congress, the Administration, other federal policy makers, and foundations should dedicate substantial funding and support to the development and implementation of a robust and sustained social marketing program on physical activity and nutrition.
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All foods and beverages marketed to this age group should support a diet that accords with the Dietary Guidelines for Americans in order to prevent obesity and risk factors associated with chronic disease risk. Children and adolescents should be encouraged to avoid calories from foods that they generally overconsume (e.g., products high in sugar, fat, and sodium)
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Potential actions include • all food and beverage companies, including chain and quick-service restaurants, adopting and implementing voluntary nutrition standards for foods and beverages marketed to children and adolescents; • the Children's Food and Beverage Advertising Initiative and National Restaurant Association Initiative, as major self-regulatory marketing efforts, adopting common marketing standards for all member companies, and actively recruiting additional members to increase the impact of improved food marketing to children and adolescents; • media companies adopting nutrition standards for all foods they market to young people; and • the Federal Trade Commission regularly tracking the marketing standards adopted by food and beverage companies, restaurants, and media companies. Strategy 3-3: Ensure consistent nutrition labeling for the front of packages, retail store shelves, and menus and menu boards that encourages healthier food choices.
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and the policies for other federal programs with nutrition education components to explicitly encourage the provision of advice about types of foods to reduce in the diet, consistent with the Dietary Guidelines for Americans. Potential actions include • removing the restrictions on the types of information that can be included in SNAP-Ed programs and encouraging advice about types of foods to reduce; • disseminating, immediately and effectively, notification of the revised regu lations, along with authoritative guidance on how to align federally funded nutrition education programs with the Dietary Guidelines; and Accelerating Progress in Obesity Prevention 238
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This chapter addresses these message environments, including marketing and the provision of nutrition education within federal programs with nutrition education components; Chapter 9 covers instruction in food and nutrition for children and adolescents in schools. 239 Message Environments
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RECOMMENDATION 3 Industry, educators, and governments should act quickly, aggressively, and in a sustained manner on many levels to transform the environment that surrounds Americans with messages about physical activity, food, and nutrition. 7-1 While changing the physical environment is critical to accelerating progress in preventing obesity -- whether by expanding bike paths or building more grocery stores -- equally important is changing the message environments in which people function every day.
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are presented in a box following the discussion of that strategy. STRATEGIES AND ACTIONS FOR IMPLEMENTATION Strategy 3-1: Develop and Support a Sustained, Targeted Physical Activity and Nutrition Social Marketing Program Congress, the Administration, other federal policy makers, and foundations should dedicate substantial funding and support to the development and implementation of a robust and sustained social marketing program on physical 241 Message Environments
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. For Congress, the Administration, and other federal policy makers, working with entertainment media, potential actions include • providing a sustained source of funding for a major national social market ing program on physical activity and nutrition; and • designating a lead agency to guide and oversee the federal program and appointing a small advisory group of physical activity, nutrition, and marketing experts to recommend message and audience priorities for the program; ensuring that the program includes a balance of messages on physical activity and nutrition, and on both individual behavior change and related environmental change goals; and exploring all forms of marketing, including message placement in popular entertainment, viral and social marketing, and multiplatform advertising -- including online, outdoor, radio, television, and print.
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found that children aged 8-12 viewed approximately 8,400 promotions for upcoming television shows and approximately 5,000 ads for entertainment media products each year. The news media also are a key part of the message environments that surround Americans.
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. Because many health-based social marketing campaigns are insufficiently funded, assessing their effectiveness accurately is difficult.
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. The VERB™ campaign provided evidence that the development of a national media campaign with social marketing messages for young people can help address a significant public health issue such as physical activity (Asbury et al., 2008; Banspach, 2008; Huhman et al., 2010)
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To help overcome these challenges, the committee recommends -- as is reflected in its recommended potential actions for implementing this strategy -- that the pro posed new social marketing campaign • identify a specific set of narrowly targeted audiences; • focus on a specific set of narrowly defined goals for behavior change among each audience; • craft tailored messages for each audience; • sustain each message/audience focus over a period of several years; • use multiple media platforms, including television, online, print, mobile, and social media platforms; • enlist support from and develop partnerships with communities, nongovern mental organizations, and for-profit companies to help broaden and sustain the campaign; and • be sufficiently funded to conduct extensive message-testing research, secure high-quality creative communication experts, and purchase advertising space in media that are highly rated among the target audience, rather than having to rely on donated placements. Accelerating Progress in Obesity Prevention 246
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Developing the communication skills of health organizations and supporting journalism education programs can help contribute to a more balanced message environment and promote citizen engagement in the critical policy issues that affect individual behavior change. Too often, social marketing campaigns are paid lip service by policy makers and expert committees.
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. Costs associated with an effective long-term social marketing program will be significant, but represent only a small fraction of the increasing health care costs associated with obesity each year.
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All foods and beverages marketed to this age group should support a diet that accords with the Dietary Guidelines for Americans in order to prevent obesity and risk factors associated with chronic disease risk. Children and adolescents should be encouraged to avoid calories from foods that they generally overconsume (e.g., products high in 249 Message Environments
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Potential actions include • all food and beverage companies, including chain and quick-service restau rants, adopting and implementing voluntary nutrition standards for foods and beverages marketed to children and adolescents; • the Children's Food and Beverage Advertising Initiative (CFBAI) and National Restaurant Association Initiative, as major self-regulatory market ing efforts, adopting common marketing standards for all member compa nies, and actively recruiting additional members to increase the impact of improved food marketing to children and adolescents; • media companies adopting nutrition standards for all foods they market to young people; and • the Federal Trade Commission (FTC)
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. The message environments directly targeting children and adolescents show year-to-year variations in product mix, dollars spent, and media mix in food and beverage marketing.
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. The report also calls on industry to reformulate products to be "substantially lower in fats, salt and Accelerating Progress in Obesity Prevention 252
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. Independent researchers, using uniform and more stringent nutrition standards of independent authorities such as the HHS "Go-Slow-Whoa" food rating system or recommended school meal standards, have found that since the CFBAI began, most advertisements directly targeting children have continued to be for products high in calories, fats, sugars, and sodium and low in other nutrients underrepresented in children's diets -- a reported 72 percent of all food and beverage advertisements for children's programming and 86 percent of food and beverage 253 Message Environments
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1 Accelerating Progress in Obesity Prevention 254
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Adoption of uniform guidelines developed around a central goal of healthy dietary patterns and covering all foods and beverages marketed to children and adolescents will help all families and their children prefer, request, and consume healthier foods and meals. The recent activity of the food and beverage manufacturing and restaurant industries to this end is welcome and encouraging, but food marketing targeting children and adolescents continues to heavily promote products high in sugar, fat, and sodium.
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Sources for measuring indicator: CFBAI reports or other industry-related tracking reports • Continued monitoring of food marketing to children and adolescents by the FTC. Source for measuring indicator: FTC follow-up study Accelerating Progress in Obesity Prevention 256
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should implement a standard system of nutrition labeling for the front of packages and retail store shelves that is harmonious with the Nutrition Facts panel, and restaurants should provide calorie labeling on all menus and menu boards. Potential actions include • The FDA and USDA adopting a single standard nutrition labeling system for all fronts of packages and retail store shelves, the FDA and USDA con sidering making this system mandatory to enable consumers to compare products on a standard nutrition profile, and the guidelines provided by the Institute of Medicine (2011a)
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. Accelerating Progress in Obesity Prevention 258
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Compared with detailed nutrition labeling, more positive evidence has been gathered on the impact of front-of-package labeling on consumer comprehension and healthier food purchases, although some of the evidence in this regard is mixed (Larsson et al., 1999; Morestin et al., 2011; Sacks et al., 2011; Sutherland et al., 2010)
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provide insight on how front-of-package systems should be used as a tool in the future, their target audience, nutrient information that would be most use Accelerating Progress in Obesity Prevention 260
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Although a number of menu labeling policies have been introduced and implemented over the past decade, a majority of the population is not impacted by these policies. Additionally, although recent actions of the food and beverage industry are encouraging, the recently developed voluntary front-of-package system may not be easily understood by all consumers or maximize the opportunity for them to make healthier food choices.
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• Increase in purchases of reformulated foods that meet the definition in the Dietary Guidelines for Americans of foods people should consume in greater quantities. Source for measuring indicator: Nielsen Home scan data Accelerating Progress in Obesity Prevention 262
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Strategy 3-4: Adopt Consistent Nutrition Education Policies for Federal Programs with Nutrition Education Components USDA should update the policies for Supplemental Nutrition Assistance Program Education (SNAP-Ed) and the policies for other federal programs with nutrition education components to explicitly encourage the provision of advice about types of foods to reduce in the diet, consistent with the Dietary Guidelines for Americans.
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. Theoretically, specific strategies to promote health ful food choices among SNAP participants -- such as incentives for healthy food 2 These pre-approved food items make up a portion of the diet, but do not comprise a complete diet.
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Simulations of possible effects require multiple assumptions about how both SNAP participants and the retail food market would react -- for example, respectively, the types of trade-offs SNAP 265 Message Environments
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The USDA Food and Nutrition Service encourages states to provide nutrition education to SNAP participants and eligibles as part of their program operations. The objec Accelerating Progress in Obesity Prevention 266
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72) states that nutrition education messages and social marketing campaigns that convey negative messages or disparage specific foods, beverages, or commodities are not allowed.
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. This is important to note given that SNAP was designed to address food insecurity, and SNAP participants are more likely than nonparticipants to experience food insecurity (Cohen et al., 1999; Jensen, 2002; Wilde and Nord, 2005)
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. The other compelling considerations that justify actions to update federal nutrition education policies relate to food marketing environments.
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The committee suggests a number of actions to imple ment its recommendation to update the policies of federal nutrition education programs to explicitly encourage the provision of advice about the types of foods to reduce in the diet, consistent with the Dietary Guidelines. These actions include disseminating, immediately and effectively, notification of the revised regulations, along with authoritative guidance on how to align federally funded nutrition edu cation programs with the Dietary Guidelines, and ensuring that such alignment applies to all federal programs with a nutrition education component, particularly programs that target primary food shoppers in low-income families (e.g., EFNEP and WIC)
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Source for measuring indicator: USDA regulations NOTE: NHANES = National Health and Nutrition Examination Survey; SNAP = Supplemental Nutrition Assistance Program; SNAP-Ed = Supplemental Nutrition Assistance Program Education; USDA = U.S. Department of Agriculture.
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And changes in federal nutrition education messages would be more effective in reaching popu lations at high risk of overweight and obesity if food and beverage marketing practices reflected the same messages targeting the same populations. Such a com bined approach can shift the overall tone of messaging environments to one that facilitates and encourages healthy living and helps individuals meet the Dietary Guidelines for Americans.
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Journal of Nutrition Education 24(6)
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2011. The Supplemental Nutrition Assistance Program, soda, and USDA policy: who benefits?
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2010. Social marketing as a childhood obesity prevention strategy.
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2005. Social marketing in public health.
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2005. Effects of a mass media campaign to increase physical activity among chil dren: Year-1 results of the VERB campaign.
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2011. Associations between food insecurity, Supplemental Nutrition Assistance Program (SNAP)
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2010. Characteristics of Supplemental Nutrition Assistance Program households: Fiscal year 2009.
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:1078-1086. Accelerating Progress in Obesity Prevention 280
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2007. The meaning, effectiveness and future of social marketing.
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2011c. Supplemental Nutrition Assistance Program: Eligible food items.
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2004. VERB™ -- a social marketing campaign to increase physical activity among youth.
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