Abstract
BACKGROUND: Food advertising, which largely affects the most vulnerable children, contributes to childhood obesity by fostering the consumption of ultra-processed foods and beverages. Portugal passed Act 30/2019 which introduces food advertising restrictions targeted at children. The aim of this study was to assess the Act's effectiveness in reducing the exposure of children under 14 years of age to television advertising of unhealthy foods and beverages. METHODS: We conducted a before-and-after study by measuring children's exposure to unhealthy food television advertising (mean number of impressions and coverage) over two, week-long periods, in February 2019 and February 2022. This study analysed data from a NielsenIQ consumer panel made up of 1100 households which uses audiometers to record television viewing by all the family members. The respective samples included 1121 and 983 children aged 4 to 14 years. The nutritional quality of the products was analysed using the nutritional profile issued by the Directorate-General of Health. Before-and-after mean impressions and coverages were compared using the Chi-squared test to analyse differences in the latter. RESULTS: The weekly mean impressions of unhealthy food and beverage advertisements remained stable from 2019 to 2022 (18.9 vs. 18.7). Even so, impressions decreased in low socioeconomic status children and increased in the case of middle and high socioeconomic status children. While overall coverage did not vary, it decreased in the morning and afternoon time slots, and increased across the night time slot. As compared to 2019, the weekly number of unhealthy food and beverage advertisements increased by 25% in 2022. CONCLUSIONS: Act 30/2019 did not reduce Portuguese children's overall exposure to advertisements for unhealthy foods and beverages. In order to be effective, restrictions would, at minimum, have to cover television advertising during the 7 am-12 pm time band, regardless of the intended recipients of the messages, target public or percentage of children's audience.