Anew research report published last week titled “An assessment of compliance with proposed regulations to restrict on-package marketing of packaged foods to improve nutrition in South Africa” about on-package marketing in South Africa finds significant child-directed marketing, high levels of health claims on products with unhealthy ingredients, and that most products would require a warning label.
The research found that:
80% of packaged products in a new study would require warning labels (under Draft R3337) due to high levels of sugar, sodium, or saturated fats, known as ultra-processed products.
Child-directed marketing sat at 59.26% of products analysed.
83% of products with health claims would require a warning label.
The study analysed 6,768 packaged food products from six national grocery stores in Cape Town. It’s a representative sample of South Africa’s formal food supply, as it accounts for more than 50% of the grocery retail market.
Some products did not have a Nutritional Informational Panel, so could not be analysed. It’s not compulsory on packaged food until R3337 is implemented.
“First, there is a real need for regulating on-package marketing. Our packaged food supply is so unhealthy, a majority of the food currently on sale would carry a warning label, and that won’t change unless food producers have a reason to make healthier products,” said first author, Safura Abdool Karim, a joint Postdoctoral Fellow in Global Infectious Disease Ethics at Berman Institute-Oxford, and Adjunct-Assistant Professor, Department of Population and Family Health in the Mailman School of Public Health, Columbia University.
“Second, we need specific and measurable regulations to ensure they are enforceable. Conducting this study was challenging because it was not always clear (based on the regulations) whether marketing was covered or not. We excluded some of the regulations because they were too vague to measure compliance with. If we can’t measure compliance now, it raises the question of how will these regulations be enforced when adopted?” questioned Karim.
Expanding regulations
Using warning labels could target the marketing of unhealthy products, given the widespread presence of child-directed marketing and health claims on products likely to carry warning labels, said the study.
Some forms of child-directed marketing are not regulated under R3337, and the study recommends expanding the regulation to include these.
It found 13,115 instances of marketing on the products.
It identified 10 547 instances (80,04%) of marketing on warning label products, and 2,568 instances (19,58%) were found on products that would not carry warning labels.
The levels of child-directed marketing were higher in warning label products than in non-warning label products (412 and 119 respectively).
It found 83,05% of health claims found on products subject to a warning label.
Gaps and loopholes
Front-of-package warning labels and restrictions on child-directed marketing are evidence-informed measures to help improve diet and prevent non-communicable diseases, the study outlined. With warning labels, people can quickly understand nutritional content and change what they buy. The labels also encourage companies to redevelop unhealthy products.
The regulations in South Africa will require packaged products that are high in sodium, saturated fat, and sugar, or with non-sugar sweeteners, to carry a warning label.
On-package marketing is an advertising tactic for unhealthy foods, where cartoons, games and competitions target children, the study continued. Similarly, marketing with health claims may lead parents to believe products are healthier than they are and influence purchasing decisions.
The success of packaging restrictions depends on their design, the study outlined.
“If regulations are poorly crafted, food producers may exploit loopholes or shift to unregulated marketing strategies. Therefore, governments must thoroughly understand the marketing landscape to develop effective restrictions.”
Research for the labelling scheme has been done. The advertising area of the regulation is not as well understood, and this study wanted to fill this gap.
So, it analysed the advertised nutritional makeup and on-package marketing to create a baseline dataset to evaluate R3337 when it is implemented.
How did it assess compliance?
R3337 does not allow for some child-directed marketing and health claims on products carrying warning labels, which can be found in regulation 52 of the Draft (Pg 94-97).
Drawing on legal expertise, the study identified regulated marketing and developed a framework to find compliance with R3337, creating a codebook.
The codebook was also used to find common unregulated child-directed marketing strategies; the promotion of sports and events, depictions of children without adults, bundling packages, references to education, and whether the product encourages a healthy lifestyle (an example of health-washing).
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It included unregulated forms of marketing to see the extent of “regulatory escape” for marketing under R3337.
Regulation of health claims was more complex than child-directed marketing, the study said. Given the study’s aims, it limited analysis to whether a regulated health claim was present on a product that would be subject to a warning label.
What would need warning labels?
A total of 80.16% of products analysed would carry one or more warning labels. Beverages (74.95%) had the highest number of products subject to carrying a warning label, followed by confectionary and then cereals and cereal products.
Legumes, meat and dairy substitutes had the lowest number of products carrying warning labels.
The most frequent warning label would be for high sugar content (36.1%), then saturated fat (29.13%), sodium (22.63%) and non-sugar sweeteners (12.14%).
How much marketing was directed at children?
A total of 59.26% of products sampled carried some form of child-directed marketing, including regulated and unregulated forms.
In regulated child-directed marketing, the study found 77.98% occurred on products that would have a warning label. The highest occurring instances of child-directed marketing were animated characters, cartoons, and depictions of children in mixed groups.
Trademarked illustrations were found in 1,023 products; 795 of these were warning label products while 228 were non-warning label products.
The highest occurring instance of unregulated child-directed marketing was depictions of sporting events, followed by bundling of products and depictions of children without adults.
“It’s quite strange to only have a prohibition when children are with adults but not just children on their own,” said Karim.
What about health claims?
The regulations don’t allow some health claims if they would have warning labels, such as:
Claim that the product contains sweetener.
Claim that the product has reduced or limited amounts certain ingredients or nutrients.
Claim that the product is “High In” a particular nutrient.
Claim that one may get health benefits from consuming the product.
Endorsements/Health Seals from a medical institution.
A seal regarding non-communicable diseases.
Claim that the product is fresh or natural.
“Purity” claims (such as being organic, non-GMO, no colourants etc).
It found 6,531 instances of health claims on products.
The most common health claims were the product being organic, not genetically modified or being free from colorants, preservatives or flavourants (2,291 on warning label products and 520 non-warning label products).
Claims that the product was “fresh” or “natural” were common in warning label products (1,385) and uncommon in non-warning label products (35).
The claim of a product having reduced or no sugar, sodium or saturated fat was common in non-warning label products. The regulations have stringent criteria for the types of institutes that may provide endorsements or health seals on products.
In the samples, health seals were given by the Heart and Stroke Foundation, Cansa, the Diabetes Association, Weigh-less and the Glycemic Index Foundation. They also found products recommended by “doctors or dieticians”. Of the 137 seals or endorsements, 103 of them related to non-communicable diseases.
Institutes referencing non-communicable diseases must be “actively involved in generic evidence-based health promotion activities which promote reducing the risk of developing non-communicable diseases, and be free from influence of suppliers and food business operators”, said Karim. “What is challenging is that there isn’t a mechanism to check or assess whether the organisations are independent,” said Karim.
