The prevention of overweight in childhood is paramount to long term heart-health. Food marketing predominately promotes unhealthy products which if over-consumed will lead to overweight. International health expert calls for further restriction of children's exposure to food marketing remain relatively unheeded, with a lack of evidence showing a causal link between food marketing and children's dietary behaviours and obesity an oft cited reason for this policy inertia. This direct link is difficult to measure and quantify with a multiplicity of determinants contributing to dietary intake and the development of overweight. The Bradford Hill Criteria provide a credible framework by which epidemiological studies may be examined to consider whether a causal interpretation of an observed association is valid. This paper draws upon current evidence that examines the relationship between food marketing, across a range of different media, and children's food behaviours, and appraises these studies against Bradford Hill's causality framework.
IntroductionCardiovascular disease (CVD) is largely preventable, yet, globally, it contributes to the greatest burden of premature mortality [1]. Modifiable, diet-related CVD risk factors include overweight and obesity and high consumption of saturated and trans fatty acids, refined carbohydrates and sodium [2,3]. Establishing healthy dietary behaviours and maintaining a healthy weight in childhood is paramount for maximising heart-health [4], however within our current food environment, this has never been more challenging.