Abstract
OBJECTIVE: Canadian front-of-package (FOP) labelling regulations aim to improve dietary patterns by identifying foods high in sodium, sugars and/or saturated fat with a 'high in' FOP nutrition symbol. However, child-appealing marketing on product packaging may undermine these efforts. Therefore, this study (1) compared the prevalence of FOP symbols between products with child-appealing and non-child appealing packaging in the Canadian food supply and (2) identified the number and types of FOP symbols on products with child-appealing packaging (CAP). DESIGN: Using the University of Toronto's Food Label Information and Price 2017 database, 5850 packaged foods were analysed, 746 of which had CAP. Products were assessed against FOP labelling regulations. SETTING: Large grocery retailers by market share in Canada. PARTICIPANTS: Foods and beverages available in 2017. Results: 74·4 % of products with CAP would require a 'high in' FOP symbol, significantly higher than the 65·7 % of products with non-CAP. Notably, 54·4 % of products with CAP exceeded FOP labelling thresholds for sugars compared with 37·8 % of products with non-CAP. CONCLUSIONS: Findings highlight a policy gap in Canadian nutrition regulations, as CAP remains a major source of marketing of unhealthy foods to children, undermining the impact of FOP labelling. To address this, food packaging should be included in Canada's marketing restrictions, and products displaying a 'high in' FOP symbol should be automatically restricted from marketing to children. This study underscores the urgent need to harmonise Canadian nutrition regulations to synergistically promote healthier food choices among children and improve their health.