Including all the data collected, we can conclude that nearly 9 out of 10 FBA parts did not comply with any of the PAOS Code standards. It should also be noted that the standards with the highest levels of incompatibility with this code are those that attempt to safeguard the vulnerability and innocence of children by exposing pieces with clarity and simplicity of information to the recipient who escapes their intellectual level and of understanding by inhibiting their scarce critical vision. Non-compliance with the PAOS Code was substantially greater in the case of specialized channels as opposed to generalist channels because of their greater frequency of pieces that violate their innocence, these channels being directed at their intellectual development, the backbone of which is correct nutrition.
Self-regulation by those companies that make commercial pieces aimed at minors seems insignificant, with children being the main victims. On the other hand, since the state measures of voluntary adhesion are supposed to be of a lax condition, this implies the need to print a greater legislative rigidity and to integrate all those agencies and advertisers whose target are minors.
Non-compliance with this code is continuous, given that two situations occur: Firstly, the non-adherence to the PAOS Code, which prevents the establishment of a review of the spots in order to 'reduce the prevalence of obesity and overweight and its consequences, both in the area of public health and its social repercussions', an objective that is shared with global organizations such as the WHO and, secondly, the existence of conflicts of interest, which are latent when, on reviewing recent campaigns and an evaluation of a multitude of products, we see how associations whose purpose is to guarantee and safeguard the health of the population, promote food that is clearly detrimental to our health.
Through the Higher Sports Council, whose function is to promote modernisation and innovation in all areas of the sports system, a strategy was created to awaken interest in sport among children and young people, known as the ADB 2020 Plan (Support Plan for Grassroots Sport). This plan aimed at supporting grassroots sport and increasing the number of practitioners established a communication strategy seeking to generate greater impact and visibility through participation in spots with a number of promoting brands, in this case reference is made to the brand Cola Cao and its spot Cola Cao - Music Boom. According to a recent study launched by the American Heart Association (AHA) called "Added Sugars and Cardiovascular Disease Risk in Children" (Vos et al., 2017), the mission of the added sugars is to increase the palatability of the food and its conservation, this added sugar being an addiction to the product. Some of the conclusions we can draw about this study are:
- The increase in suffering from cardiovascular diseases due to the consumption of added sugars.
- Consumption should be limited to less than 25 grams of added sugars per day.
- Weight loss in children who modify their diet by replacing sugary drinks with sweetened or caloric ones.
The incongruity of promoting sporting activities and in turn encouraging the intake of ultraprocessed foods with a zero nutritional profile is contrary to the supposed healthy impulse carried out through the ADB Plan. The practice of sports must be adequately accompanied by an optimal supply of nutrients seeking to maximize performance, and not based on free sugars whose physiological response is the main cause of the world's largest pandemic, childhood obesity.
Through the data provided by the WHO it is indicated how the rates of childhood obesity for the year 2022 will surpass those of underweight, unless certain trade policies are modified at an international level and their recommendations are respected. In addition, the former Director-General of the World Health Organization, Margaret Chan, in her opening address to the 3rd Meeting of the Commission to End Childhood Obesity, delivered the following words:
“Childhood obesity does not arise from lifestyle choices made by the child. It arises from environments created by society and supported by government policies. The argument that obesity is the result of personal lifestyle choices, often used to excuse governments from any responsibility to intervene, cannot apply to childhood obesity”.
It is also interesting to note that the consumption of the amounts currently ingested of ultra-processed foods with low nutritional intake and high glycemic load pose a potential risk given the misinformation that exists about the harmfulness of this matter. All of this is sheltered under the mantle of the emerging obesogenic society that supposes a strong genetic influence that carries the "weapon" and, consequently, causes our diet to pull the "trigger" (Bray and Popkin, 2014).
On the other hand, according to recent studies (Greenwood, et al., 2014; Malik, Schulze, Hu, 2006; Hu, 2013; Malik, Pan, Willett, Hu, 2013), the intake of sugary beverages, such as the one sponsored by the Higher Sports Council, demonstrates an evident positive association between their consumption and the growing incidence of metabolic diseases, such as type 2 diabetes.
Obesity is increasing in epidemic proportions worldwide and, above all, with a higher incidence in children and adolescents. It is therefore imperative to devise strategies to curb these constantly growing rates, as this is a target with a greater vulnerability than adults, given their cognitive immaturity, which becomes more noticeable the younger their age range. This means that, being exempt from the development of their capacities, they passively decode messages (Schiffman, 2001), increasing children's preferences for those advertising brands that promote nutritionally poor products (Harris and Kalnova, 2017).
Given the above, the latent persuasive capacity of advertising can be observed how it generates certain stimuli in brain regions of cognitive control towards high-calorie and ultra-processed foods in young children both normal weight and obese (Samara et al., 2018) and that the accumulated exposure to television advertising, which is composed of 33.2% of food spots mostly insane, are positively linked to food choices of high-calorie products, energy and low level (Scully et al., 2012). We understand that this reality, shown by numerous studies, invites reflection on the importance of early education for children when it comes to properly selecting healthy food choices, and how harmful it is to use children's vulnerability as a business strategy for children's health.
It is also observed how the results of the present study consisting of direct observation reported a perspective free of suspicions of how the advertising companies and the organizations that endorse them were not exempt from conflicts of interest, and it is that these facts are becoming increasingly evident as stated by the former WHO Director General, Margaret Chan:
"Efforts to prevent non-communicable diseases run counter to the commercial interests of powerful economic agents”.
Based on research published in the British Medical Journal, we are aware of another of the main advocates of the endemic world nutritional crisis, the so-called "liquid caramel", a term coined by Dr. Chan, to refer to the business giant of non-alcoholic sugary beverages and which is referred to in the article "The secret influence of Coca-Cola on medical and science journalists" by Paul Thacker. By means of this article, the procedures followed by this company to generate a good brand image and the benefits that this represents for the general population are made known, deflecting any suspicion that its consumption could cause any ailment or diseases such as obesity, blaming any consequence to the inactivity of the population consuming this kind of products. Likewise, it is possible to emphasize how, by chance, many studies that do not demonstrate the causality between obesity and the consumption of sugary drinks are financed by those companies that commercialize them, originating advertising infoxication (Bes-Rastrollo et al., 2013). In relation to the manifest discordance between experts in nutrition and the market offer, the gestation of these conflicts of interest is even more palpable, highlighting not only the use of financing studies as a communication strategy for these brands, but also through the overprinting in packaging or insertions of flies within the advertising piece with the logo of medical entities, whose purpose is to induce consumers to a false belief in a healthy product (Bollycao, Colacao and Puleva cases, supported by entities that prostitute their values for an economic purpose, such as SEDCA, the Spanish Society of Dietetics and Food Sciences, SEPEAP, the Spanish Society of Paediatrics Extrahospitalaria and Primary Care, and the AEP, the Spanish Association of Paediatrics, respectively).
Another case that leaves the existence of this conflict of interests latent is the campaign that was recently launched by McDonald´s with the endorsement of two alleged opinion leaders in the food sector for devoting themselves to it and for being one of the image of the talent show "Masterchef", Samantha Vallejo, as well as Teresa Valero, nutritionist and director of information and scientific dissemination of the Spanish Nutrition Foundation (FEN). Both leaders promote the product Happy Meal in the advertising piece "Happy outside, happy inside", contributing that this is a "super balanced and healthy food". The controversy generated after the launch of the campaign finally forced to withdraw the spot immediately and with the issuance of a statement by the agency involved ensuring that its intention with this project "was to convey the need to improve and expand the balance, variety and moderation in the supply of restaurant chains, we understand that may have generated confusion".
This systematic incongruence to which we refer, based on praising products of dubious quality and origin, cost the foundation part of its reputation when its supposed nature lies in "promoting research and knowledge of the different parcels of nutrition and highlighting the role of the food industry in improving the nutrition of the people".
Once we have carried out this exercise of transparency whose only motive is economic, we will take as a reference the recommendations of the WHO to focus on the nutritional aspects of the campaign of McDonald´s "Happy outside, happy inside". This business giant provides through its website a nutritional calculator where you can quantify the calories, macronutrients and micronutrients ingested through any of the products they offer in their establishments. Specifically, we examined the Happy Meal menu –hamburger, potatoes, orange juice and a small ice cream– following the World Health Organization's dietary guidelines to complete a healthy and balanced diet for children.
Figure 1 shows how, through the Happy Meal menu, half the calories to be ingested by an average child or adult are reached, supported by the recommendations of this international organism, established around 2000 calories and more than doubling the consumption of added sugars daily. The Daily Values (DV) established by this institution define this menu as highly energetic, with a poor lipidic profile, a high surplus in sodium, a null contribution of fiber and a very low protein quality, of uncertain origin, being especially worrying the association of medical entities that supposedly endorse the habits of healthy life and that try to "improve the nutrition of the Spaniards" with companies whose nutritional offer is a nonsense for the Spanish society.
It is worrying how health professionals who, as prescribers and social interveners, with the aim of promoting proposals based on scientific evidence, modifying their environment and guiding them in the choice of healthy habits, not only do not support the Code of self-regulation but also fail to comply with their own code of ethics and Royal Decree 1907/1996, 2 August, on advertising and commercial promotion of products, activities or services with the aim of health and by which any kind of advertising or promotion of products is prohibited.
Finally, another example of a hidden conflict of interest is the promotion of one of the categories of Bimbo products, specifically BollyCao. In this case, by the mere fact of fortifying its product with iron it receives the seal of the Spanish Society of Dietetics and Food Sciences (S.E.D.C.A.) and, therefore, its endorsement, being BollyCao a clear example of ultraprocessed food of high energy density and poor both in nutrients and in the quality of its ingredients.
This is why it is worrying how the vulnerability of children is harmed by an excessive eagerness to increase the capital of companies without taking into account the effects they have on this population. The failure to declare conflicts of interest is something that is emphasised but not analysed in the PAOS Code, a code which is incapable of limiting children's exposure to advertising for unhealthy foods and beverages and which is far from examples of measures taken on other continents, such as that in Fig. 3:
It is evident how the animated and fantastic reclamation disappears as well as measures like the black warning stamps take a strong protagonism of the packaging, helping to limit and warn the parents and instructing them by means of recommendations for portions.
It is surprising, in line with the above, how, of the 177 advertising pieces collected and divided into 11 spots, only one (10.2%) complies with the children's advertising self-regulatory code (PAOS) although with two of the rules analyzed and categorized as of uncertain compliance, corresponding to the spot of the Suchard Christmas campaign "being together is extraordinary".
This assumption occurred repeatedly in all the advertising pieces, assuming one of the main limitations of the study, subjectivity. Some of the standards were complex to analyse and in order to reduce the error and increase the reliability of the investigation, an attempt was made to reach a consensus in those cases in which doubts arose. Once consensus was reached, the category to which it belonged was defined; otherwise uncertain compliance is resorted to. Another limitation we found is the lack of representativeness of the sample and the date on which such data was collected, given that we assume that it was a period that could have been contaminated by the context –winter period– and the boom in purchases of children's leisure products and their constant promotion in the medium analyzed. However, and despite the limitations, we believe that the object of study is highly representative and that the repetition of the FBA - food and beverage advertisements - on the different television channels was of great help, having been an arduous and highly laborious task, although executed with great professionalism and enthusiasm.