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SummaryThe liberalization of international trade and foreign direct investment through multilateral, regional and bilateral agreements has had profound implications for the structure and nature of food systems, and therefore, for the availability, nutritional quality, accessibility, price and promotion of foods in different locations. Public health attention has only relatively recently turned to the links between trade and investment agreements, diets and health, and there is currently no systematic monitoring of this area. This paper reviews the available evidence on the links between trade agreements, food environments and diets from an obesity and non-communicable disease (NCD) perspective. Based on the key issues identified through the review, the paper outlines an approach for monitoring the potential impact of trade agreements on food environments and obesity/NCD risks. The proposed monitoring approach encompasses a set of guiding principles, recommended procedures for data collection and analysis, and quantifiable 'minimal', 'expanded' and 'optimal' measurement indicators to be tailored to national priorities, capacity and resources. Formal risk assessment processes of existing and evolving trade and investment agreements, which focus on their impacts on food environments will help inform the development of healthy trade policy, strengthen domestic nutrition and health policy space and ultimately protect population nutrition.

While there is a recognized link between high levels of exposure to advertising of unhealthy foods and overweight and obesity among children, there is little research on the extent to which these exposures include persuasive marketing techniques. This study aimed to measure children's exposure to the use of persuasive marketing within television food advertisements. Advertisements broadcast on all three commercial Australian television channels were recorded for an equivalent 1 week period in May 2006 and 2007 (714 h). Food advertisements were analysed for their use of persuasive marketing, including premium offers, such as competitions, and the use of promotional characters, including celebrities and cartoon characters. Advertised foods were categorized as core, non-core or miscellaneous foods. Commercial data were purchased to determine children's peak viewing times and popular programs. A total of 20 201 advertisements were recorded, 25.5% of which were for food. Significantly more food advertisements broadcast during children's peak viewing times, compared to non-peak times, contained promotional characters (P < 0.05) and premium offers (P < 0.001). During programs most popular with children, there were 3.3 non-core food advertisements per hour containing premium offers, compared to 0.2 per hour during programs most popular with adults. The majority of advertisements containing persuasive marketing during all viewing periods were for non-core foods. Persuasive marketing techniques are frequently used to advertise non-core foods to children, to promote children's brand recognition and preference for advertised products. Future debate relating to television advertising regulations must consider the need to restrict the use of persuasive marketing techniques to children.

What, when, where and how much people eat is influenced by a complex mix of factors at societal, community and individual levels. These influences operate both directly through the food system and indirectly through political, economic, social and cultural pathways that cause social stratification and influence the quality of conditions in which people live their lives. These factors are the social determinants of inequities in healthy eating. This paper provides an overview of the current evidence base for addressing these determinants and for the promotion of equity in healthy eating.

Objective: To explore knowledge, attitudes and behaviours regarding caloric soft drinks in a group of young adults attending university and to identify opportunities for a health promotion intervention aimed at reducing consumption. Design: In-depth, semi-structured focus groups segmented by gender. Setting: Sydney, Australia. Subjects: Undergraduate University of Sydney students aged 18-30 years (n 35). Results: Social and environmental cues, intrinsic qualities of beverages and personal health beliefs were identified as important influences on consumption. Social cues included settings in which alcohol is usually consumed, socialising with friends, and family influences. Environmental cues included purchasing of fast foods, and ready availability, preferential pricing and promotion of caloric beverages. Reinforcing intrinsic qualities of caloric soft drinks included taste, sugar and caffeine content, and their association with treats and rewards. Major gender differences as well as variations in individual readiness for behaviour change were observed. Raising awareness of the sugar content of various beverages and the potential health impacts associated with their consumption was considered important. Conclusions: The findings provide new insights with important implications for policy and practice, and suggest that there is considerable scope for promoting awareness in this group. Carefully designed social marketing campaigns highlighting the health issues and addressing social and environmental cues relating to caloric soft drink consumption are required. There is a need for gender-differentiated intervention programmes which are both informational and appealing to young adults. Further research is warranted, particularly to investigate beverage consumption relating to fast-food meal deals and young adults' consumption patterns in more depth.