Effects of increased ultra-processed food advertisement (outdoors and digital) exposure on behaviours associated with obesity development in Swedish adolescents, evaluated in a socioeconomic context.

In Sweden adolescent obesity is still a public health issue.

The problem is reinforced by aggressive marketing of ultra-processed foods (UPF), like fast foods and sugary drinks, however real-world research is lacking. Our own research revealed that UPF advertising is more prominent in low socioeconomic (SES) areas.

Digital food marketing (mobiles, TV, computers), especially for adolescents, also appears to be relevant to the challenge.This project will associate the geographic density of UPF advertisements with SES characteristics around 18 schools in 3 Swedish cities (Study 1).

The project will also evaluate (Study 2) the effects of total UPF ad exposure (outdoor and digital) in the same student populations, in association with student BMI, gender and individual objective obesogenic student behaviours (i.e., school meal skipping, food selection habits and physical activity levels).

The project will use tools from our ongoing EU project (BigO: Big Data against Childhood obesity) and will recruit a sample of 300 Swedish high-school students (15-18 yrs) from 6 schools in the same cities, monitoring them for two consecutive years. The project will coordinate with school administrations, through ongoing collaborations in the BigO project.

In Study 3 (qualitative), the attitudes and the awareness of school students and educators on UPF and unhealthy behaviours will be evaluated.

Also, the outcomes of Studies 1 and 2, will be communicated to them through focused school engagement workshops and we will evaluate their attitudes towards novel future interventions (e.g., data-driven awareness campaigns), aiming at limiting the obesogenic effects of increased UPF marketing.The project will provide new knowledge on the associations of food marketing, health behaviors and adolescent obesity, in various SES settings.

It has a strong potential to support unique new strategies for public interventions and policies, promoting population health and limiting social inequalities.