Changes in household food and drink purchases following restrictions on the advertisement of high fat, salt, and sugar products across the Transport for London network: A controlled interrupted time series analysis.
Authors
Boyland, Emma J
Lock, Karen
Petticrew, Mark
Publication Date
2022-02Journal Title
PLoS Med
ISSN
0140-6736
Publisher
Public Library of Science (PLoS)
Volume
19
Issue
2
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Yau, A., Berger, N., Law, C., Cornelsen, L., Greener, R., Adams, J., Boyland, E. J., et al. (2022). Changes in household food and drink purchases following restrictions on the advertisement of high fat, salt, and sugar products across the Transport for London network: A controlled interrupted time series analysis.. PLoS Med, 19 (2) https://doi.org/10.1371/journal.pmed.1003915
Description
Funder: Health Data Research UK
Funder: British Heart Foundation
Funder: Cancer Research UK
Funder: Economic and Social Research Council; funder-id: http://dx.doi.org/10.13039/501100000269
Funder: Programme Grants for Applied Research; funder-id: http://dx.doi.org/10.13039/501100007602
Abstract
BACKGROUND: Restricting the advertisement of products with high fat, salt, and sugar (HFSS) content has been recommended as a policy tool to improve diet and tackle obesity, but the impact on HFSS purchasing is unknown. This study aimed to evaluate the impact of HFSS advertising restrictions, implemented across the London (UK) transport network in February 2019, on HFSS purchases. METHODS AND FINDINGS: Over 5 million take-home food and drink purchases were recorded by 1,970 households (London [intervention], n = 977; North of England [control], n = 993) randomly selected from the Kantar Fast Moving Consumer Goods panel. The intervention and control samples were similar in household characteristics but had small differences in main food shopper sex, socioeconomic position, and body mass index. Using a controlled interrupted time series design, we estimated average weekly household purchases of energy and nutrients from HFSS products in the post-intervention period (44 weeks) compared to a counterfactual constructed from the control and pre-intervention (36 weeks) series. Energy purchased from HFSS products was 6.7% (1,001.0 kcal, 95% CI 456.0 to 1,546.0) lower among intervention households compared to the counterfactual. Relative reductions in purchases of fat (57.9 g, 95% CI 22.1 to 93.7), saturated fat (26.4 g, 95% CI 12.4 to 40.4), and sugar (80.7 g, 95% CI 41.4 to 120.1) from HFSS products were also observed. Energy from chocolate and confectionery purchases was 19.4% (317.9 kcal, 95% CI 200.0 to 435.8) lower among intervention households than for the counterfactual, with corresponding relative reductions in fat (13.1 g, 95% CI 7.5 to 18.8), saturated fat (8.7 g, 95% CI 5.7 to 11.7), sugar (41.4 g, 95% CI 27.4 to 55.4), and salt (0.2 g, 95% CI 0.1 to 0.2) purchased from chocolate and confectionery. Relative reductions are in the context of secular increases in HFSS purchases in both the intervention and control areas, so the policy was associated with attenuated growth of HFSS purchases rather than absolute reduction in HFSS purchases. Study limitations include the lack of out-of-home purchases in our analyses and not being able to assess the sustainability of observed changes beyond 44 weeks. CONCLUSIONS: This study finds an association between the implementation of restrictions on outdoor HFSS advertising and relative reductions in energy, sugar, and fat purchased from HFSS products. These findings provide support for policies that restrict HFSS advertising as a tool to reduce purchases of HFSS products.
Keywords
Research Article, Social sciences, Biology and life sciences, Medicine and health sciences
Sponsorship
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Department of Health (via National Institute for Health Research (NIHR)) (unknown)
Department of Health (via National Institute for Health Research (NIHR)) (PD-SPH-2015-10029 BH154142)
MRC (MC_UU_00006/7)
Identifiers
pmedicine-d-21-04172
External DOI: https://doi.org/10.1371/journal.pmed.1003915
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334163
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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