The widespread marketing of food and beverage products high in fat, sugar and salt (HFSS) es is a significant driver of obesity and diet-related non-communicable diseases (NCDs). This PhD dissertation examined the factors related to Member States' capacity and actions to fully implement the 2010 World Health Assembly's Resolution WHA63.14 to restrict the marketing of HFSS food and non-alcoholic beverage products to children up to 18 years by 2025. The first study describes the capacity-building needs of Ministries of Health (MoH) to implement the Resolution WHA63.14. The research used a 28-item web-based survey administered to representatives of MoH from the Pan American Health Organization (PAHO) region (n= 35). A government capacity-building and integrated marketing communications (IMC) frameworks guided this research. The second study examined the government policies to restrict the marketing of HFSS food and beverage products in a purposive sample of countries in the PAHO region (n=14). The WHO policy and IMC frameworks were used to develop a responsible policy index (RESPI). A web-based platform was developed that uses data visualization tools to depict the results. The third study explored the dimensions of power in the Mexican social networks of stakeholders that influenced the policy-making process that enabled the government to enact front-of-pack (FOP) warning labels on HFSS food and beverage products marketed to children and adults in 2020. The study followed a case study approach, using semi-structured interviews with stakeholders, and guided by the Gaventa's power cube framework. Social Network Analyses were conducted using the UCINET software (version 6) that measured centrality, factions and quadratic assignment procedures (QAP). These PhD studies applied several theoretically grounded conceptual frameworks related to nutrition governance that allowed me to draw conclusions from empirical and published evidence to develop and implement comprehensive policies to restrict the marketing of HFSS food and beverage products to children. Results may inform government agencies, civil society organizations, academic researchers, private foundations and industry actors about the areas needed for policy improvement and promising or best practices that should be adopted to implement Resolution WHA63.14 to reduce children's future risks of obesity and diet-related NCDs by 2025. / Ph.D. / The widespread marketing of food and beverage products high in fat, sugar and salt (HFSS) by transnational food and beverage manufacturers, chain restaurants and retailers, entertainment companies and digital technology companies is a significant driver of poor diet quality, obesity and diet-related non-communicable diseases (NCDs) among populations globally. In May 2010, 193 Member States endorsed the World Health Assembly’s Resolution WHA63.14 to restrict the marketing of HFSS food and non-alcoholic beverage products to children up to 18 years to promote healthy diets and reduce their future risk of obesity and NCDs. This PhD dissertation examined the factors related to Member States’ capacity and actions to fully implement the 2010 Resolution WHA63.14 by 2025. The first study describes the capacity-building needs of Ministries of Health (MoH) to restrict the marketing of HFSS food and beverage products to children. Priority actions recommended include governments adopting mechanisms to identify, declare and manage conflicts of interest related to food marketing; better utilization of existing Constitutional requirements of governments to protect children’s health and human rights; and developing comprehensive policies to restrict unhealthy HFSS marketing through digital media. The second study examined the government policies to restrict the marketing of HFSS food and beverage products across 14 countries from the PAHO region. Brazil, Canada, Chile, and Uruguay had the strongest statutory policies that restricted HFSS food and beverage product marketing at point of sale, use of cartoon licensed media characters and celebrities, and marketing in schools and through broadcast media. The third study explored the dimensions of power in the Mexican social networks of stakeholders that influenced the policy-making process that enabled the government to enact front-of-pack (FOP) warning labels on HFSS food and beverage products marketed to children and adults between 2019 and 2020. FOP labeling is a marketing used that have shown impact on children’s choice of food and beverage products. Results revealed that advocacy, collective engagement and building strategic coalitions were forms of power that shifted from a profit-interest-based to an evidence-based policy-making process in Mexico. These PhD studies applied several theoretically grounded conceptual frameworks related to nutrition governance that allowed me to draw conclusions from empirical and published evidence to develop and implement comprehensive policies to restrict the marketing of HFSS food and beverage products to children. The collective results may inform government agencies, civil society organizations, academic researchers, private foundations and industry actors about the areas needed for policy improvement and promising or best practices that should be adopted to implement Resolution WHA63.14 an create healthy food environments to reduce children’s future risks of obesity and diet-related NCDs by 2025.

Researchers have examined the influence of entertainment companies' licensed media characters on children's diet and health. Conversely, limited empirical research exists on how food, beverage and restaurant companies use brand mascots to influence the dietary preferences and choices of children and their parents. This M.S. thesis is comprised of two studies that address this knowledge gap. The first study conducted a nutrient-profile analysis of 20 food, beverage, and restaurant products that use brand mascot marketing to children, whose companies are members of the Children's Food and Beverage Advertising Initiative (CFBAI), an industry self-regulatory program. Products were evaluated using seven nutrient-profile models or nutrition guidelines. Results showed that all twenty products that used brand mascots failed to meet one or more of the guidelines, especially for candy/sweets, children's meals, and snack foods. The second pilot study used Q methodology to explore the views of five child-parent dyads concerning the influence of brand mascots on their diet-related cognitive outcomes. Each child and one parent independently completed a demographic survey, a brand mascot and product association survey, and a card-sort with 48 brand mascot images to determine 'most-liked' versus 'most-disliked' mascots. Factor analysis identified three unique viewpoints that were shared by participants including: 1) Breakfast Cereal Animal Lovers; lover of mascots with eyes/hands of approval; and 3) human, hat-wearing mascot lovers. Participants associated 66 percent of products with the correct brand mascots. These results may inform policy-relevant recommendations to strengthen industry self-regulatory programs to create a more healthful childhood marketing atmosphere. / Master of Science / Researchers have examined the influence of entertainment companies’ cartoon media characters on children’s diet and health. Conversely, limited experimental research exists on how food, beverage and restaurant companies use brand mascots to influence the diets of children and their parents. This M.S. thesis comprises two studies that address this knowledge gap. The first study consists of an analysis of 20 food, beverage, and restaurant products that use unique brand mascots marketed to children, whose companies are members of the Children’s Food and Beverage Advertising Initiative (CFBAI), an industry self-regulatory program. Products were measured up to seven voluntary and/or mandatory nutrition guidelines. All twenty products that used brand mascots failed to meet one or more of the nutrition guidelines, and especially for candy/sweets, children’s meals, and snack foods. The second study used Q methodology to explore the views of five children and their parents (n=10) concerning how brand mascots influence their diet-related cognitive and behavioral outcomes. Children and one of their parents were asked to independently complete three activities: 1) demographic survey; 2) brand mascot and product association survey; and 3) a card-sort with 48 brand mascot images to determine “most-liked” versus “most-disliked” mascots. Factor analysis identified three unique viewpoints shared by participants regarding how brand mascots influence their dietary preferences, dislikes, and intergenerational marketing. Additionally, participants correctly associated 66 percent of products and their respected brand mascots. Results from both studies may be used to inform policy-relevant recommendations to strengthen industry self-regulatory programs such as the CFBAI.

Background: Canadian youth obesity, and comorbidities, have paralleled trends in consuming nutrient-poor foods marketed by the food industry. In Canada, food marketing is largely self-regulated by the food industry under the Canadian Children’s Food and Beverage Advertising Initiative (CAI). Methods: Public television programming records benchmarked the volume of food advertising targeted to preschoolers, children, adolescents, and adults on Canadian television. Food advertising rates and frequencies were compared by age group, television station, month, food category, and company, using regression modelling, chi-square tests and principal component analysis. Results: Food advertising rates significantly differed by all independent variables. Fast food companies dominated advertising during adolescent-programming while food and beverage manufacturers dominated advertising during programming to all other age groups. CAI signatories contributed more advertising during children’s programming than non-signatories. Conclusion: Failings of self-regulation in limiting food advertising to Canadian youth demonstrate the need for statutory restrictions to rectify youth’s obesogenic media environments and their far-reaching health effects.