This systematic review and meta-analysis quantifies the association of food and nonalcoholic beverage marketing with behavioral and health outcomes in children and adolescents.

Theoretical models suggest that food-related visual attentional bias (AB) may be related to appetitive motivational states and individual differences in body weight; however, findings in this area are equivocal. We conducted a systematic review and series of metaanalyses to determine if there is a positive association between food-related AB and: (1.) body mass index (BMI) (number of effect sizes (k)=110), (2.) hunger (k=98), (3.) subjective craving for food (k=35), and (4.) food intake (k=44). Food-related AB was robustly associated with craving (r = .134 (95% CI .061, .208); p < .001), food intake (r = .085 (95% CI .038, .132); p < .001), and hunger (r = .048 (95% CI .016, .079); p = .003), but these correlations were small. Food-related AB was unrelated to BMI (r =.008 (95% CI-.020, .035); p = .583) and this result was not moderated by type of food stimuli, method of AB assessment, or the subcomponent of AB that was examined. Furthermore, in a betweengroups analysis (k = 22) which directly compared participants with overweight/obesity to healthy-weight control groups, there was no evidence for an effect of weight status on foodrelated AB (Hedge's g = 0.104, (95% CI-0.050, 0.258); p =.186). Taken together, these findings suggest that food-related AB is sensitive to changes in the motivational value of food, but is unrelated to individual differences in body weight. Our findings question the traditional view of AB as a trait-like index of preoccupation with food and have implications for novel theoretical perspectives on the role of food AB in appetite control and obesity.

Displaying brand equity characters promotes unhealthy food choices in children. The findings are consistent with those of studies exploring other types of promotional characters. In the context of a childhood obesity epidemic, the use of brand equity characters in the promotion of foods high in fat, salt, and sugar to children should be restricted.

Summary This systematic review examined the effectiveness of policies restricting the marketing of foods and/or non‐alcoholic beverages to children to inform updated World Health Organization (WHO) guidelines. Databases were searched to March 2020. Inclusion criteria were primary studies of any design assessing implemented policies to restrict food marketing to children (0–19 years). Critical outcomes were exposure to and power of marketing, dietary intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, diet‐related noncommunicable diseases, product change, and unintended consequences. Forty‐four observational studies met inclusion criteria; most were moderate quality. Pooling was conducted using vote counting by direction of effect, and GRADE was used to judge evidence certainty. Evidence suggests food marketing policies may result in reduced purchases of unhealthy foods and in unintended consequences favorable for public health. Desirable or potentially desirable (for public health) effects of policies on food marketing exposure and power were also found. Evidence on diet and product change was very limited. The certainty of evidence was very low for four outcomes (exposure, power, dietary intake, and product change) and low for two (purchasing and unintended consequences). Policies can effectively limit food marketing to children; policymakers should prioritize mandatory approaches aligned with WHO recommendations.

This report summarises a workshop convened by ILSI Europe on 3 and 4 April 2017 to discuss the issue of dietary sweetness. The objectives were to understand the roles of sweetness in the diet, establish whether exposure to sweetness affects diet quality and energy intake, and consider whether sweetness per se affects health. Although there may be evidence for tracking of intake of some sweet components of the diet through childhood, evidence for tracking of whole diet sweetness, or through other stages of maturity are lacking. The evidence to date does not support adverse effects of sweetness on diet quality or energy intake, except where sweet food choices increase intake of free sugars. There is some evidence for improvements in diet quality and reduced energy intake where sweetness without calories replaces sweetness with calories. There is a need to understand the physiological and metabolic relevance of sweet taste receptors on the tongue, in the gut and elsewhere in the body, as well as possible differentiation in the effects of sustained consumption of individual sweeteners. Despite a plethora of studies, there is no consistent evidence for an association of sweetness sensitivity/preference with obesity or type 2 diabetes. A multifaceted integrated approach, characterising nutritive and sensory aspects of the whole diet or dietary patterns, may be more valuable in providing contextual insight. The outcomes of the workshop could be used as a scientific basis to inform the expert community and create more useful dialogue among health care professionals.

Background: Consumption of large portions of energy-dense foods promotes weight gain in children. Breakfast cereal boxes often show portions much larger than the recommended serving size.Objective: This experimental study investigated whether front-of-package portion size depictions influence children's self-served portions and consumption. Methods:In a between-subjects design, 41 children aged 7-11 years (M= 9.0 ± 1.5y) served themselves breakfast cereal from a box, the front of which depicted either a recommended serving size of cereal (30g) or a larger, more typical front-ofpack portion (90g). Cereal served and consumed and total caloric intake (including milk) was recorded. Height and weight, demographic information and measures of children's food responsiveness and enjoyment of food were collected.Results: MANOVA revealed that children exposed to the larger portion size served themselves (+7g, 37%) and consumed (+6g, 63%) significantly more cereal than those exposed to the smaller portion. Despite this, overall caloric intake (milk included) did not differ between conditions, and no other measured variables (hunger, BMI) significantly affected the outcomes. Conclusion:This study provides novel evidence of the influence portion-size depictions on food packaging have on children's eating behaviour. This offers possible avenues for intervention and policy change; however, more research is needed.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Theoretical models suggest that food-related visual attentional bias (AB) may be related to appetitive motivational states and individual differences in body weight; however, findings in this area are equivocal. We conducted a systematic review and series of meta-analyses to determine if there is a positive association between food-related AB and: (1.) body mass index (BMI) (number of effect sizes (k)=110), (2.) hunger (k=98), (3.) subjective craving for food (k=35), and (4.) food intake (k=44). Food-related AB was robustly associated with craving (r = .134 (95% CI .061, .208); p &lt; .001), food intake (r = .085 (95% CI .038, .132); p &lt; .001), and hunger (r = .048 (95% CI .016, .079); p = .003), but these correlations were small. Food-related AB was unrelated to BMI (r =.008 (95% CI -.020, .035); p = .583) and this result was not moderated by type of food stimuli, method of AB assessment, or the subcomponent of AB that was examined. Furthermore, in a between-groups analysis (k = 22) which directly compared participants with overweight/obesity to healthy-weight control groups, there was no evidence for an effect of weight status on food-related AB (Hedge’s g = 0.104, (95% CI -0.050, 0.258); p =.186). Taken together, these findings suggest that food-related AB is sensitive to changes in the motivational value of food, but is unrelated to individual differences in body weight. Our findings question the traditional view of AB as a trait-like index of preoccupation with food and have implications for novel theoretical perspectives on the role of food AB in appetite control and obesity.