Assessing the public health impacts of the Children's Food and Beverage Advertising Initiative

Executive Summary

The Children’s Food and Beverage Advertising Initiative (CFBAI) is a voluntary industry initiative in which companies commit to feature only foods meeting specific nutrition criteria in advertising directed primarily to children under age 12. New criteria that were announced in 2018 and went into effect in 2020 strengthened the nutrition standards and changed the criteria for total sugars to added sugars for consistency with the new Nutrition Facts label. Prior studies have not yet estimated the relative importance of Children’s Food and Beverage Advertising Initiative (CFBAI)–listed products in children’s diets, which is necessary to understand the potential for the criteria to have a public health impact. In addition, with the recent change in the criteria, the potential for improvements in the children’s diets based on current purchase and consumption patterns can be assessed.
Our study focused on linking household-based scanner data with nutrition label data to determine the extent to which U.S. households with children from 0 to 8 years purchase CFBAI-listed foods and to simulate the potential effects of reformulation as a result of changes to the nutrition criteria. Furthermore, we assessed the relative importance of products on the list compared with substitute products produced by the same manufacturers by comparing product prices and purchase volumes.

Key findings of the study are as follows:
▪ The number of products on the CFBAI list is relatively limited and includes an estimated 696 unique products (i.e., Universal Product Codes [UPCs] in 2017). These products accounted for about 1% of calories, 0.5% of saturated fat, 1.3% of added sugars, 1.0% of sodium, and 1.6% of dietary fiber in purchases by households with children 0 to 8 years of age based on average consumption amounts from “What We Eat in America.” Differences across income groups and race and ethnicity were relatively minor.
▪ About 21% of products on the list as of 2017 would have needed to be reformulated to meet the new criteria in effect in 2020 for calories, saturated fat, added sugars, or sodium. If companies had been using the 2020 criteria in 2017, reformulation of these products would have resulted in reductions of 2.4% for added sugars, 0.8% for calories, and 1.2% for sodium in purchases of foods by households with young children. Because the products comprise a relatively small portion of purchases, the public health significance is somewhat limited.
▪ An estimated 818 substitute products produced by the same manufacturers—but comprising different types, flavors, or varieties than CFBAI-listed products—were identified for the analysis. These products comprise an important share of manufacturers’ product portfolios across all demographic groups, but we detected no substantial differences in product pricing between CFBAI-listed and substitute products.
▪ A loophole that allows companies to advertise some products but not others within a brand family is a real concern because it is difficult to discern whether some individual UPCs are listed products, particularly because there is no indication of listed products on product labels or shelf tags.

The results of this study indicate the need to ensure that the design of voluntary industry initiatives will result in a positive public health impact. Purchase, sales, or consumption data can be used to calculate the baseline contribution of targeted foods and beverages to calories or specific nutrients and to assess the potential changes that could occur under various scenarios. Then it would be possible to assess whether the changes would have a meaningful effect on dietary quality and thus public health.