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Issue addressed: Previous research has highlighted children's frequent exposure to advertisements of unhealthy food and beverages on television. However, the food industry is increasingly utilising non-broadcast channels such as outdoor advertising (eg billboards, bus shelters, shop fronts) for product marketing. Few studies have investigated children's exposure to outdoor food advertising around primary and secondary schools. This study aimed to quantify the presence and content of outdoor food advertisements within a 500 m radius of primary and secondary schools in Perth, Western Australia. Methods:A cross-sectional design was used to capture outdoor advertisements within a 500 m radial buffer around the school boundary. The INFORMAS protocol for monitoring outdoor advertising around child-serving institutions was used. Sixtyfour primary and secondary schools in Perth, Australia, were selected using random sampling within socio-economic and population density strata. Results:In total, 5636 outdoor advertisements were identified within a 500 m radius of all 64 schools combined and 30% were for food. Of the 1708 food advertisements, 74% were for unhealthy (non-core) food. The most frequently advertised food products were alcohol, fast food and sugar-sweetened beverages. Only 8% of food advertisements featured a healthy product. The majority of schools (75%) had at least one food advertisement within 500 m (mean 36, range 3-190). Schools in lower socioeconomic areas had more food advertisements and a significantly higher proportion of unhealthy food advertisements within 250 m. Conclusion:Outdoor advertising around schools constitutes a potential frequent source of children's exposure to unhealthy food and alcohol advertising.

Unhealthy food marketing influences attitudes, preferences, and consumption of unhealthy foods, leading to excess weight gain. Outdoor advertising is highly visible (often displayed on publicly owned assets), but the evidence supporting regulation is unclear. This systematic scoping review of academic and grey literature aimed to (1) describe potential health and economic impacts of implementing government-led policies that restrict unhealthy food advertising in outdoor spaces or on public assets (including studies examining prevalence of advertising, associations with health outcomes and interventional studies); (2) identify and describe existing policies; and(3) identify factors perceived to have influenced policy implementation. Thirty-six academic studies were eligible for inclusion. Most reported on prevalence of

BackgroundFood marketing exposure has the potential to influence children’s dietary behaviours and health status, however, few studies have identified how ‘obesogenic’ the outdoor food marketing environment is along public transport (bus and/or train) or walking routes that children take to school.MethodsAudits of all outdoor advertisements present along likely train, bus and walking routes to 24 secondary schools (ie, 3 routes per school, 72 routes total) were conducted in Perth, Western Australia (WA). The size, content, type and setting of each advertisement were recorded in accordance with the International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support protocol for monitoring outdoor advertising.ResultsOf the 4016 total advertisements observed, almost half were for food (n=1754, 44%) and of these, 80% (n=1397) advertised discretionary (non-core) foods, and 8% (n=138) advertised healthy (core) foods. On average, commuting to school by train, bus and walking exposed Perth schoolchildren to 37.1, 22 and 4.5 discretionary (non-core) food ads per one-way trip to school, respectively.ConclusionsChildren living in Perth, WA experience a high level of exposure to unhealthy outdoor food advertisements during the school commute. Policies which restrict the placement and content of outdoor advertising, could be a useful strategy in the fight against childhood obesity.

This study identified that unhealthy sponsorship is prevalent on AFL club websites and playing uniforms. Implications for public health: Sponsorship offers companies an avenue to expose children and young people to their brand, encouraging a connection with that brand. The AFL could reinforce healthy lifestyle choices by shifting the focus away from the visual presence of unhealthy sponsorship, while taking steps to ensure that clubs remain commercially viable. Policy makers are encouraged to consider innovative health promotion strategies and work with sporting clubs and codes to ensure healthy messages are prominent.