Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-country Study in Australia, Canada, Mexico, United Kingdom, and United States.

BACKGROUND Food marketing increases product appeal, purchasing and consumption, using diverse strategies and locations to reach consumers. OBJECTIVES The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, sponsorship of sports and cultural events) and locations (television, radio, digital media) across five countries: Australia, Canada, Mexico, the United Kingdom (UK), and the United States (US). METHODS We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study (IFPS). Participants (n = 21,678) aged ≥ 18 years completed an online survey. Exposure to unhealthy food marketing strategies and locations in the last 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries. RESULTS The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the UK to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the last month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations was higher for Mexico compared to the rest of the countries. CONCLUSIONS Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies such as brand characters, licensed characters, and locations such as television, and digital marketing.

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