Guest Blog: Where next for food advertising policies? Why outdoor advertising should not be left off the agenda.

Guest Blog: Where next for food advertising policies? Why outdoor advertising should not be left off the agenda.

In our latest guest blog, we hear from PhD student Amy Finlay, who discusses the findings from her scoping review of outdoor food marketing found in bus shelters in a deprived part of Northern England.

It is estimated that we encounter thousands of ads every day[1]. This may seem harmless and just a feature of the modern world, but when these ads promote destructive behaviours (i.e. unhealthy eating, alcohol, gambling, smoking), there are well documented negative effects[2,3]. Food marketing, for example, has been found to increase brand awareness, preference, choice, intended purchase, purchase requests, purchase, consumption and weight gain in children[4]. This is a concern because the majority of foods advertised are less healthy[5]

To date research into the behavioural effects of food marketing has mostly been focused on television and digital media[6], which has consequently prompted policy progress in these areas, for example existing restrictions to children’s TV in the UK[7] as well as the proposed watershed on TV and paid-for marketing ban online[8]. The scarcity of strong policies across other marketing forms (outdoor, print, radio/podcast, food delivery services) could be in part due to the relative lack of research in these areas.

Currently, the Advertising Standards Authority (ASA) enforces guidelines relating to advertising in the UK. These state that HFSS advertising cannot be shown where more than 25% of the audience are under 16 years[9]. To abide by this guidance, outdoor media companies typically interpret this as within 100m of school boundaries9, but this neglects other outdoor spaces where large numbers of children gather such as around nurseries and parks, and children continue to be exposed to this advertising in areas where they make up less than 25% of the audience[10]. This arbitrary cut-off therefore does little to limit children’s exposure outdoors. Additionally, these guidelines are not always strictly followed. In 2018, Food Active partnered with the charity Sustain to document less healthy advertising in public places10, finding that much of it was around schools or other places where large numbers of children are likely to be. The loopholes in the current ASA guidance and failures in compliance show that the current guidelines are not sufficient to protect children.

Our recent review[11] synthesised existing research into outdoor food marketing, specifically looking at exposure (extent of food marketing), power (creative strategies used in the marketing) and the impact of this marketing on behaviour and health. As well as this, we sought to clarify how this marketing is defined differently by researchers, and the methods currently being used to measure it, in an attempt to support future research that is robust and comparable. The review identified 53 relevant studies, conducted across 21 countries (mostly the US, Australia and New Zealand), allowing a for a global perspective of the outdoor marketing environment.

Exposure to outdoor food marketing

All 53 studies measured exposure to outdoor food marketing. On average, 22% of ads identified were for food, and almost two thirds (63%) of foods advertised across studies were less healthy (defined by authors in a number of different ways, but principally those highly processed and energy dense). Healthy foods were rarely advertised, whereas fast food and sugar-sweetened drinks were often named as the most advertised product types.

While advertising was not always present directly surrounding schools (although in most cases it was), children were likely to encounter food marketing on their journeys to and from school, particularly if they were living in urban areas, or used public transport. Across many forms of marketing, it is clear that those from more deprived backgrounds are more exposed to less healthy food advertising; the same is not certain for outdoor advertising and the findings across studies were often contradictory. The eight studies that considered ethnicity as a factor indicated that those from ethnic minority backgrounds were exposed to more food marketing and specifically, more less healthy food marketing than white populations.

Power of outdoor food marketing

Twelve studies assessed the power of outdoor food marketing. Power generally relates to aspects of marketing that increase the appeal. Strategies identified in the included studies were premium offers (e.g. buy one get one free), characters (e.g. people or cartoon characters), price appeals (e.g. cheap price), emotional appeals (e.g. happiness, fun) and taste appeals (e.g. great taste). In some cases, advertisements were classed as being directed at children (less than 1% to 10% of ads), although ads not directed at children can still appeal to children, particularly considering that the strategies identified are all likely to increase appeal to children and young people.

Impact of outdoor food marketing

Only 3 studies assessed the impact of outdoor food marketing on behaviour or health. Two of these found that increased exposure to outdoor food marketing was associated with consumption of less healthy food products, and increased odds of obesity, while another found no relationship between exposure and weight status. These three studies only explored correlations so cannot show a clear cause and effect between exposure to the marketing and reported outcomes. Correlational evidence can be rated on certain criteria to determine the extent of causality, this method has previously showed a causal relationship between food marketing and children’s behaviour[12], although none of the included studies measured food marketing outdoors. More research into the impact of outdoor food marketing will make it possible to rate findings on the same criteria and determine potential causality.

Defining and measuring outdoor food marketing

In order to influence policy, research findings typically need to be compared across time and place (for example, to demonstrate that a problem exists and is getting worse, or not getting better). This becomes increasingly difficult when the definitions and methods used are inconsistent across research studies. Only 15 out of the 53 studies included in this review attempted to define outdoor food marketing, and often the criteria used were not inclusive of all advertising found outdoors (e.g. visible from the street/sidewalk). Development of an agreed definition would result in improved consistency in how the methods are applied, ensuring that the evidence gathered can be more readily translated to inform policy.

Where do we go from here?

There has been some progress in the last few years in regard to outdoor food advertising. The junk food advertising ban across TfL has shown success, and prompted 80 other local authorities to begin implementing their own restrictions[13], in the hope of improving dietary quality. In light of the attempted U-turn from government relating to obesity policy, it is more important than ever that local authorities act to protect children where possible.

While less healthy food advertising remains unrestricted outdoors, children will continue to be exposed and influenced by the persuasive messaging, and palatable foods. Consistency in regulations across all advertising formats would be the most effective way to protect children from less healthy advertising day-to-day. For this to happen, evidence of the harms is required across all formats, although making an impact will become increasingly difficult if the current government go ahead with plans to scrap the obesity policy. For outdoor advertising specifically, evidence of a link with unhealthy behaviours is warranted but more data would support policymakers with designing appropriate policies with the necessary scope and impact to make a meaningful difference.

Amy is a PhD student at the University of Liverpool, who’s research considers how the out-of-home environment impacts obesity. Amy has conducted a scoping review of outdoor food marketing, an analysis of bus shelter advertising in a deprived area of Northern England. Ongoing work includes an investigation of the relationship between HFSS advertising and purchase of dietary nutrients, and research into the potential impact of proportional pricing and reformulation in the OOH sector.

[1] Simpson J. Finding brand success in the digital world. Forbes. 2017

[2] Boyland EJ, Nolan S, Kelly B, Tudur-Smith C, Jones A, Halford JC, et al. Advertising as a cue to consume: a systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. The American Journal of Clinical Nutrition. 2016;103(2):519-33.

[3] Anderson P, De Bruijn A, Angus K, Gordon R, Hastings G. Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies. Alcohol & Alcoholism. 2009;44(3):229-43.

[4] Kelly B, King M, Lesley, Chapman M, Kathy, Boyland E, Bauman AE, Baur LA. A hierarchy of unhealthy food promotion effects: identifying methodological approaches and knowledge gaps. American Journal of Public Health. 2015;105(4):e86-e95.

[5] Signal LN, Stanley J, Smith M, Barr M, Chambers TJ, Zhou J, et al. Children’s everyday exposure to food marketing: an objective analysis using wearable cameras. International Journal of Behavioural Nutrition and Physical Activity. 2017;14(1):1-11.

[6] Boyland E, Tatlow-Golden M. Exposure, power and impact of food marketing on children: evidence supports strong restrictions. European Journal of Risk Regulation. 2017;8(2):224-36.

[7] Adams J, Tyrrell R, Adamson AJ, White M. Effect of restrictions on television food advertising to children on exposure to advertisements for ‘less healthy’foods: repeat cross-sectional study. PloS One. 2012;7(2):e31578.

[8] Department for Digital Culture Media & Sport, Department of Health and Social Care. Introducing further advertising restrictions on TV and online for products high in fat, salt and sugar: government response. UK; 2021.

[9] Advertising Standards Authority. Food: HFSS Media Placement UK: Advertising Standards Authority 2018 [cited 2021 July 05]. Available from:

[10] Sustain FA. Taking down junk food ads. UK; 2019.

[11] Finlay A, Robinson E, Jones A, Maden M, Cerny C, Muc M, et al. A scoping review of outdoor food marketing: exposure, power and impacts on eating behaviour and health. BMC Public Health. 2022;22(1):1-48.

[12] Norman J, Kelly B, Boyland E, McMahon A-T. The impact of marketing and advertising on food behaviours: evaluating the evidence for a causal relationship. Current Nutrition Reports. 2016;5(3):139-49.

[13] Tatum M. The towns and cities taking junk food bans into their own hands. The Grocer. 2022 April 11.

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