Food marketing, eating and health outcomes in children and adults: a systematic review and meta-analysis.



Boyland, Emma ORCID: 0000-0001-8384-4994, Muc, Magdalena ORCID: 0000-0001-6323-9973, Coates, Anna ORCID: 0000-0003-1339-4419, Ells, Louisa, Halford, Jason CG ORCID: 0000-0003-1629-3189, Hill, Zoe, Maden, Michelle, Matu, Jamie, Maynard, Maria J, Rodgers, Jayne
et al (show 4 more authors) (2025) Food marketing, eating and health outcomes in children and adults: a systematic review and meta-analysis. The British journal of nutrition, 133 (6). pp. 781-805. ISSN 0007-1145, 1475-2662

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Abstract

The marketing of unhealthy foods has been implicated in poor diet and rising levels of obesity. Rapid developments in the digital food marketing ecosystem and associated research mean that contemporary review of the evidence is warranted. This preregistered (CRD420212337091) systematic review and meta-analysis aimed to provide an updated synthesis of the evidence for behavioural and health impacts of food marketing on both children and adults, using the 4Ps framework (Promotion, Product, Price, Place). Ten databases were searched from 2014 to 2021 for primary data articles of quantitative or mixed design, reporting on one or more outcome of interest following food marketing exposure compared with a relevant control. Reviews, abstracts, letters/editorials and qualitative studies were excluded. Eighty-two studies were included in the narrative review and twenty-three in the meta-analyses. Study quality (RoB2/Newcastle-Ottawa scale) was mixed. Studies examined 'promotion' (<i>n</i> 55), 'product' (<i>n</i> 17), 'price' (<i>n</i> 15) and 'place' (<i>n</i> 2) (some > 1 category). There is evidence of impacts of food marketing in multiple media and settings on outcomes, including increased purchase intention, purchase requests, purchase, preference, choice, and consumption in children and adults. Meta-analysis demonstrated a significant impact of food marketing on increased choice of unhealthy foods (OR = 2·45 (95 % CI 1·41, 4·27), Z = 3·18, <i>P</i> = 0·002, I<sup>2</sup> = 93·1 %) and increased food consumption (standardised mean difference = 0·311 (95 % CI 0·185, 0·437), Z = 4·83, <i>P</i> < 0·001, I<sup>2</sup> = 53·0 %). Evidence gaps were identified for the impact of brand-only and outdoor streetscape food marketing, and for data on the extent to which food marketing may contribute to health inequalities which, if available, would support UK and international public health policy development.

Item Type: Article
Uncontrolled Keywords: Humans, Diet, Feeding Behavior, Food Preferences, Marketing, Food, Adolescent, Adult, Child, Consumer Behavior
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 04 Jul 2025 08:21
Last Modified: 12 Aug 2025 11:55
DOI: 10.1017/s0007114524000102
Open Access URL: https://doi.org/10.1017/S0007114524000102
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3193541