Abstract
BACKGROUND: Evidence regarding the link between digital food marketing and eating habits is lacking in the majority world, i.e., the world regions where most people live. This study sought to investigate (i) self-reported exposure to digital food marketing, (ii) associations between such exposure and socio-demographic characteristics, and (iii) associations between exposure and food consumption frequency among adolescents in a Latin American country (Uruguay). METHODS: A sample of adolescents aged between 11 and 19 years attending 29 public and 10 private high schools (n = 1542) was obtained through a cross-sectional survey using a stratified, two-stage cluster probability-based sampling approach. Participants filled out closed and open-ended questions about exposure to digital food marketing, food consumption frequency, social media usage, and socio-demographic characteristics. The data were analysed through descriptive statistics and ordinal logistic regressions. RESULTS: Almost 90% of participants reported having seen a food or beverage advertisement on digital media in the week prior to the survey, with more than 70% of participants recalling advertisements of fast food, soft drinks, and savoury snacks. Age, socio-economic status, or total social media use did not predict exposure frequency of digital food marketing but females (vs. males) reported higher exposure. Exposure to advertisements of fast food or ultra-processed products on social media or websites and total social media use typically predicted higher reported consumption frequency of such categories. However, exposure to digital food marketing did not predict consumption frequency of fruits, vegetables, meats, or fish, although total social media use predicted lower consumption frequency of fruits and vegetables. CONCLUSIONS: Mere recall of exposure to digital food marketing and total social media use were associated with higher consumption frequency of ultra-processed products and fast food. These findings underscore the need to introduce comprehensive mandatory policies to reduce adolescent exposure to digital food marketing featuring unhealthy foods.