An accountability evaluation for the responsible use of celebrity endorsement by the food and beverage industry to promote healthy food environments for young Americans: A narrative review to inform obesity prevention policy

Abstract

Research has shown that celebrity endorsement is a marketing strategy primarily used to promote highly processed food and beverage products to children and adolescents, which negatively influences their diet quality and increases their risks of obesity. This study conducted an accountability evaluation to examine government, expert, and industry policies, guidelines, recommendations, and practices regarding using celebrity endorsement to support healthy marketing environment for young Americans. This study used the National Academy of Medicine's LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) to identify and synthesize relevant evidence between January 2000 and December 2019. We categorized the evidence in a five-step accountability framework and assigned each step a progress score (i.e., none, limited, some, and extensive). The findings showed that the US government made no progress to appoint an independent empowered body to evaluate celebrity endorsement practices. Stakeholders made some progress to take and hold industry and government to account and limited progress to share the account and to strengthen accountability structures. We suggest actions for diverse stakeholders to substantially strengthen accountability structures to ensure that celebrity endorsement is used to promote only healthy food environments to reduce obesity risks for young Americans. K E Y W O R D S accountability, celebrity endorsement, food and beverage products, food environments, obesity, policies and actions 1 | INTRODUCTION Obesity is a worldwide pandemic with rates that have nearly tripled since 1975. 1 In 2016, about 41 million children under 5 years of age and over 340 million children and adolescents aged 5-19 years were affected by overweight or obesity. 1 The World Obesity Federation has projected that by 2020, 158 million children and adolescents will have obesity that will increase to 254 million by 2030. 2 In the United States (US), 25.4% of children and 21.0% of adolescents had obesity in 2017, and 26.3% and 24.2% of children and adolescents may be affected by obesity by 2030. 2 Robust evidence suggests that food and beverage marketing practices (e.g., print and broadcast media, celebrity endorsement, or interactive social media) negatively influence the dietary behaviors of children (0-11 years), adolescents (12-18 years), and young adults (19-35 years), which increases their risk of obesity and diet-related noncommunicable diseases (NCD). 3-7

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