Vivica Kraak, M.S., R.D.The StanMark Project Meeting

Copenhagen, Denmark May 29-30, 2010

Report Background and Process

• Congressional request to CDC

• CDC asked IOM to conduct 18-month study

• 16-member committee with diverse expertise

• 18 external reviewers

• Public release of consensus report in December 2005

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Committee on Food Marketing and the Diets of Children and Youth

J. Michael McGinnis (Chair), Institute of Medicine

Daniel Anderson, University of Massachusetts, Amherst

J. Howard Beales III, George Washington University

David Britt, Sesame Workshop (retired)

Sandra Calvert, Georgetown University

Keith Darcy, Ethics Officer Association

Aimee Dorr, University of California, Los Angeles

Lloyd Kolbe, University of Indiana

Dale Kunkel, University of ArizonaPaul Kurnit, Kurnit

Communications & KidShopRobert Post, Yale Law SchoolRichard Scheines, Carnegie

Mellon University Frances Seligson, Pennsylvania

State University Mary Story, University of

Minnesota, MinneapolisEllen Wartella, University of

California, RiversideJerome Williams, University of

Texas, AustinCo-study Directors:Jennifer Gootman & Vivica Kraak

Factors Shaping Food and Beverage Consumption

Individual &Developmental

Factors

Family&

Home

School&

Peers

Neighborhood&

Community

Marketing

Product, Place,Price, Promotion

Culture & Values

Economic Factors

Public Policies

Production, Distribution, Promotion

Genetics & Biology

HealthOutcomes for

Children and YouthPhysical Activity

Diet StanMark

Marketing Mix Components and Other External Factors Influencing Diets and Health

Social Norms & CultureConsumer

Productquality, quantity

packaging, portionslabeling, health claims

Placevenues & settings

schools,  retail storesmedia platforms

print, broadcast, digital mobile & social 

networksPromotionchild‐directed advertising

public relationssales & trade promotion

target marketing Integrated branding strategy

Pricecompetitive positioningvending & procurement 

contracts & agreements

taxes & subsidies

Legal  & Regulatory 

EnvironmentLobbying 

Public‐P

rivate 

Partners

hipsCorporate Philanthropy

Social Norms & Culture

Econom

ic 

Environm

ent

Policies

Competitive

Market

Technology

Media 

Evidence Review

• Multiple sources of evidence

• Peer-reviewed literature– Disciplined process to gather, classify, interpret

scientific literature– 123 out of 200 articles met evidence review

standards

• Industry and marketing sources– Articles, trade journals, popular magazines, books,

company websites, annual reports, news releases

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Marketing Strategies

• Many venues• Schools, grocery stores, malls, theaters, sporting events

• Many media vehicles• Print (magazines), broadcast (TV, DVDs), digital (Internet,

videogames, advergames, mobile phones)

• Many techniques• Branded spokescharacters, co-branding, cross-promotions,

celebrity endorsement, toys and premiums, mobile marketing, product placement

• Integrated marketing of brands, products, lifestyles across all media platforms

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Reported 2006 Marketing Expenditures* to Reach Childrenand Adolescents by Food and Beverage Category

*Expenditures for food and beverage brands by 44 of the nation’s largest food, beverage and restaurant companies.

Source: Kovacic W, Harbour P, Leibowitz J, Rosch J. Marketing Food to Children & Adolescents: A Review of Industry Expenditures, Activities, and Self-Regulation. July 2008.

Category 2006 Spending (thousands of dollars)Carbonated beverages $ 492,495

Restaurant foods and meals 293,645

Breakfast cereal 236,553

Juices and noncarbonated beverages 146,731

Snack foods 138,713

Candy and frozen desserts 117,694

Prepared foods and meals 64,283

Baked goods 62,549

Dairy products 54,475

Fruits and vegetables 11,463

Sub-total $1.62 million

Toys sold with restaurant meals 360,000

Total $1.98 million

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Age Category

Foods and Beverages for which Intakes are Inadequate

Shortfall Nutrients for which Intakes are Inadequate

Foods and Beverages for which Intakes are Excessive

Nutrients of Concern for which Intakes are Excessive

Boys and Girls Boys Girls Boys and Girls Boys Girls6-8b fruit

total vegetablesdark green and orangevegetables and legumeswhole grainstotal meat and beansmilk

potassiumfiber

potassiumfiber

french fries, fried potatoessweetened beverages (fruit juices, soda)snack foods (candy, cookies, chips)meals at quick-serve restaurants

sodiumsaturated fattotal fatadded sugarenergyc

sodiumsaturated fattotal fatadded sugarenergyc

9-13 fruittotal vegetablesdark green and orangevegetables and legumeswhole grainstotal meat and beansmilk

magnesiumpotassiumvitamins A, Efiber

calciummagnesiumphosphoruspotassiumzincvitamins A, C, Efiber

french fries, fried potatoessweetened beverages (fruit juices, soda)snack foods (candy, cookies, chips)meals at quick-serve restaurants

sodiumcholesterolsaturated fat

sodiumenergyc

total fatsaturated fat

14-18 fruittotal vegetablesdark green and orangevegetables and legumeswhole grainstotal meat and beansmilk

magnesiumpotassiumvitamins A, C, Eenergyc

fiber

calciumironmagnesiumphosphoruspotassiumzincvitamins A, C, E, B6, B12

folatethiaminenergyc

fiber

french fries, fried potatoessweetened beverages (fruit juices, soda)snack foods (candy, cookies, chips)meals at quick-serve restaurants

sodiumcholesterolsaturated fattotal fat

sodiumcholesterolsaturated fattotal fat

Adapted from: Institute of Medicine. Nutrition Standards and Meal Requirements for National School Lunch and Breakfast Programs: Phase I. Proposed Approach for Recommending Revisions. Washington, DC: The National Academies Press, 2008.

Food, Beverage and Nutrient Adequacy for the Diets of American Children and Adolescents

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IOM Evidence Review Findings

Marketing influence on dietary precursors:

• Strong evidence that television advertising influences food and beverage preferences and purchase requests of children 2–11 yrs

Marketing influence on diets:

• Strong evidence that television advertising influences short-term consumption of children 2–11 yrs

Marketing influence on diet-related health:• Food and beverage advertising on television is associated with body

fatness of children and youth.

• Strong evidence associated with adiposity in children ages 2–11 yrs and teens 12–18 yrs

IOM Report Conclusions • Along with many other intersecting factors, food and beverage marketing

influences the diets and health prospects of children and youth

• Food and beverage marketing practices geared to children and youth are out of balance with healthful diets and contribute to an environment that puts their health at risk

• Food and beverage companies, restaurants, and marketers have underutilized potential to devote creativity and resources to develop and promote food, beverages, and meals that support healthful diets for children and youth

• Achieving healthful diets for children and youth will require sustained, multisectoral, and integrated efforts that include industry leadership and initiative

• Public policy programs and incentives do not currently have the support or authority to address many of the current and emerging marketing practices that influence the diets of children and youth

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Products and Promotion

Food and beverage companies should:– Use creativity, resources and marketing practices to

promote and support more healthful diets and meals for children and youth

Food, beverage, restaurant, retail, and marketing

industry trade associations should:– Assume leadership roles in harnessing industry

creativity, resources, and marketing on behalf of healthful diets for children and youth

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Marketing Practice Standards

Food, beverage, restaurant, and marketing industries should:

• Establish and enforce the highest standards for the marketing offoods, beverages, and meals to children and youth.

– Use licensed characters only to promote foods and beverages thatsupport healthful diets for children and youth.

– Work through CARU to revise, expand, apply, enforce, and evaluate explicit industry self-regulatory guidelines beyond traditional advertising.

– CARU and the Federal Trade Commission should cooperate in evaluating and enforcing the expanded self-regulatory guidelines.

Media and Entertainment Industry

Media and entertainment industry should:• Direct its extensive power to promote healthful foods

and beverages for children and youth– Incorporate foods, beverages, and storylines that promote

healthful diets into multiple media platforms

– Serve as accurate interpreters and reporters on findings, claims, and practices related to the diets of children and youth

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Parents, Caregivers, Families

Government and the private sector should:• Create a long-term social marketing program supporting

parents, caregivers, and families in promoting healthful diets for children and youth– Direct at parents of young children (<4 years) through

marketing and widespread educational and community-based efforts

– Reliable and sustained support stream, through public-appropriated funds and counterpart cooperative support.

– Mechanism for proprietary marketing data to be available to inform social marketing program

Research

• Research capacity should be substantially better directed to review how marketing influences the food and beverage choices of children and youth. – Illuminate ways that marketing influences children’s

attitudes and behaviors – Study newer promotion techniques and venues,

healthier foods and beverages and portion sizes, product availability

– Study impact of television advertising on diet and diet-related health

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Monitoring Progress

DHHS Secretary should:• Designate a responsible agency to formally monitor and

report regularly on the progress related to the recommendations included in this report – Secretary should consult with other relevant cabinet

officers and agency heads to develop and implement required monitoring and reporting

– Secretary should report to Congress within 2 years on progress and on any additional actions necessary

Assessment of Progress Underway Dec 2005 to June 2010

• HER-commissioned paper– Kraak, Story, Wartella and Ginter

– Policy analysis of progress made toward each IOM recommendation

– Priority steps recommended to advance progress

– Target date for completion is August 2010

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Summary of Progress by Stakeholders & SectorPreliminary Findings

# Stakeholders & Sector Progress Score

1 Food & Beverage Companies 2

2 Restaurants 1

3 Industry Trade Associations 1.5

4 Marketing Practice Standards 2

5 Media & Entertainment Companies 2

6 Parents, Caregivers & Families 0

7 Schools 2

8 Government 1

9 Public & Private Research Capacity 1

10 HHS Secretary Monitor & Report on All Actions 0

Scoring System: 0 (no progress), 1 (limited progress), 2 (some progress), 3 (extensive progress)

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