A Rapid Evidence Assessment: Does Marketing of Commercially Available
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A rapid evidence assessment Does marketing of commercially available complementary foods affect infant and young child feeding? Commissioned by the World Health Organization May 2015 Authors Dr Julie P Smith 1 Dr Ginny M Sargent 2 Dr Kaye Mehta 3 Dr Jennifer James 4 Dr Nina Berry 5 Colleen Koh 7 Libby Salmon 1 Miranda Blake 6 1. Regulatory Institutions Network, The Australian National University, Canberra ACT 2601 Australia www.anu.edu.au CRICOS Provider No. 00120C. 2. National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University. 3. Nutrition & Dietetics, Flinders University, Adelaide, South Australia. 4. RMIT University, Bundoora, Victoria. 5. Sydney School of Public Health, University of Sydney NSW 2006. 6. School of Public Health and Preventative Medicine, Monash University, Australia. 7. Epidemiology Branch, Western Australia Department of Health, Western Australia Study expert panel Alessandro Iellamo, Independent Consultant, member of WHO STAG, formerly WHO WPRO. Dr Adriano Cattaneo, Health Services Research and International Health, Institute for Maternal and Child Health, Via dell'Istria 65/1, Trieste 34137, Italy. Professor Gerard Hastings, OBE, Professor of Social Marketing, University of Stirling and the Open University and L’École des Hautes Etudes en Santé Publique. Dr Peter Mansfield, OAM, Visiting Research Fellow, Discipline of General Practice, University of Adelaide. Corresponding author Dr Julie P Smith, Ph. +61 4 16099630, Email: [email protected] Rapid review on the effects of marketing of complementary foods page ii Acknowledgments The assistance of Dr Lucinda Bell, Nutrition & Dietetics, Flinders University, Ms Claire Caldwell and Dr Phil Baker, The Australian National University, in the preparation of this study is gratefully acknowledged. Rapid review on the effects of marketing of complementary foods page iii Contents Acknowledgments ............................................................................................................... iii Executive summary ............................................................................................................. 1 Introduction .......................................................................................................................... 8 Objectives and context ...................................................................................................... 9 Methods ............................................................................................................................. 12 Key questions ................................................................................................................. 12 Information sources and search strategies ..................................................................... 13 Quality appraisal ................................................................................................................ 15 Analysis and reporting ....................................................................................................... 16 Results ............................................................................................................................... 17 Study selection ............................................................................................................... 17 Evidence from the review to answer primary research question ..................................... 17 Industry literature – study characteristics, and summary of findings ............................ 17 Academic literature – study characteristics, quality and summary of findings .............. 18 Evidence to answer secondary research question .......................................................... 26 Summary – Reviews of marketing of health-related products ...................................... 26 Discussion ......................................................................................................................... 30 Industry studies – summary of key findings and interpretation .................................... 30 Academic studies – summary of key findings and interpretation ................................. 31 Limitations of the data at the study and outcome level ................................................ 33 Future research ................................................................................................................. 34 Conclusions ....................................................................................................................... 36 References ........................................................................................................................ 40 Annex A: Further context for consideration ........................................................................ 49 Annex B: Detailed methods with search strategies ............................................................ 56 Source A. Marketing industry literature search ............................................................... 56 Source B. Systematic review of academic literature ....................................................... 56 Source C. Identification of papers by expert panel to inform the second research question .......................................................................................................................... 61 Rapid review on the effects of marketing of complementary foods page iv Study selection and review procedure ............................................................................ 61 Annex C: Flow of papers .................................................................................................... 65 Annex D: List of included studies ....................................................................................... 66 Marketing industry literature (Source A) .......................................................................... 66 Academic literature (Source B) ....................................................................................... 67 Review of reviews literature (Source C) .......................................................................... 72 Annex E: Narrative summary of industry literature ............................................................. 74 Studies of attitudes, knowledge, preferences (n = 9) ...................................................... 74 Studies including behaviour changes (n = 13) ................................................................ 76 Annex F: CACF product descriptions reported in reviewed academic studies ................... 81 Annex G: Narrative summary of academic literature for primary question ......................... 82 Annex H: Narrative summary of academic literature for secondary question ................... 115 Annex I: Summary table of individual studies .................................................................. 121 Table 1: Studies reporting both behavioural and attitudinal outcomes of marketing: ordered by quality, most recent first .............................................................................. 121 Table 2: Studies reporting only behavioural outcomes of marketing: ordered by quality, most recent first ............................................................................................................ 127 Table 3: Studies reporting only attitudinal outcomes of marketing: ordered by quality, most recent first ............................................................................................................ 133 Annex J: Baby Food, 1999-2013, sales of top ten companies ......................................... 139 Annex K: Humanitarian programs and the Women Infants and Children (WIC) program 140 Glossary of terms and abbreviations ............................................................................... 142 Rapid review on the effects of marketing of complementary foods page v Executive summary This report contains the rationale, methods and outcomes of a rapid evidence review conducted to identify the available evidence to inform two research questions asked by the World Health Organization (WHO) Scientific Technical Advisory Committee; 1. What does the literature report on the effects of marketing of commercially available complementary food (including drink) products for infants and young children, on the feeding attitudes and behaviours of their caregivers? 2. What do recent systematic reviews of the literature report regarding the effects of marketing of: child-oriented food products, pharmaceutical products, BMS, alcohol, tobacco and tobacco related products to women especially parents, on outcomes which will usefully inform the primary research question? The review was conducted over eight weeks in April-May 2015. The review used a systematic search and review strategy to identify relevant articles. This report summarises the number, range and broad quality of studies providing evidence of actual or potential effects of marketing of commercial available complementary foods (CACF) on caregiver Infant and Young Child Feeding (IYCF) attitudes or behaviours regarding complementary feeding. Articles were included if they described investigations pertaining to the effect of IYC food product marketing to caregivers of infants or young children under 3 years of age, and also considered IYCF outcomes > 6 months, or early introduction of complementary foods (CF) or follow-up formulas/formula milks (< 6 months). Studies that considered a relevant marketing exposure