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Worldwide Trends in Childhood Obesity

1.    Increasing rates of childhood obesity have been reported in many countries over the last 20 to 30 years1, 2, 3. Similarly, the prevalence of childhood overweight/obesity in Singapore has increased over the past few decades and currently stands at 11%4, 5.

2.    Obesity ranks as the fifth leading risk for death globally6. Childhood obesity is an international public health concern as it is associated not only with an increased risk of adult obesity and non-communicable diseases (e.g. cardiovascular diseases, cancers, diabetes), but also with a number of immediate health-related problems (e.g. hypertension, insulin resistance)6. The risk factors for obesity include a sedentary lifestyle and consumption of energy-dense and nutrient-poor foods and beverages.

Effects of Food Advertising on Children

3.    International reviews by organisations such as the World Health Organisation (WHO) and the Institute of Medicine (IOM) found evidence that links the commercial marketing of foods to poor diets in children7, 8, 9, 10, 11. The evidence showed that there is extensive food advertising to children. Such advertising tends to focus on energy-dense and nutrient-poor foods, which undermines recommendations for a healthy diet by health professionals. The evidence also revealed that food advertising influences children’s food preferences, purchase requests to parents, food choices and consumption patterns.

4.    In addition, research found that children, especially the younger ones, do not comprehend the persuasive intent of advertising12. They generally lack the capability to effectively evaluate commercial claims and appeals, and therefore tend to accept the information conveyed in advertising as truthful, accurate and unbiased. They are thus more susceptible to commercial persuasion.

International Calls for Restriction of Food Advertising to Children

5.    In view of the growing scientific evidence that food advertising affects children’s food choices and dietary habits, WHO has called for action to restrict the advertising of foods and beverages high in fat, sugar or salt to children. In 2010, the World Health Assembly passed a Resolution urging Member States to introduce controls on the advertising of such foods and beverages to children6.

6.    The different approaches across the policy spectrum, adopted by various countries to strengthen food marketing standards for children, are as follows

-    Statutory regulation, which is part of national legislation, adopted in countries such as Quebec (Canada), the United Kingdom and South Korea
-    Government-approved guidelines which are issued or implemented by a government or mandated body, adopted in countries such as Finland, Denmark and Malaysia
-    Self-regulation by industry, adopted in countries such as Australia and the United States

Government-approved forms of self-regulation have been the dominant approach undertaken globally.


7.    In line with these international efforts, the Ministry of Health (MOH) and Health Promotion Board (HPB) are currently working to review and strengthen the marketing standards for advertising of food and drink products high in fat, sugar or salt to children in Singapore. In the developmental process, steps undertaken include a review of the current practice and collation/analysis/assessment of relevant local data. Consultations were also held with key stakeholders in the public, private and people sectors.

Current Practice

8.    Advertisements in Singapore are guided by the Singapore Code of Advertising Practice (SCAP)14. While SCAP has guidelines governing the  types of advertisements that can be directed to children, only one clause relates to food and beverage advertisements currently:

“Advertisements should not actively encourage children to eat excessively throughout the day or to replace main meals with confectionery or snack foods.”

Leisure Activities of Children in Singapore

9.    Studies assessing the leisure time activities of children in Singapore found that television watching and reading were ranked among the most preferred or most frequently undertaken leisure activities of the young15, 16, 17.

Food and Beverage Advertising in Singapore

10.    An analysis of data on advertising dollars spent by the food and beverage industry in Singapore in 2011 found that almost four-fifth of the advertising dollars went to television and print media18.

Consultations with Stakeholders in Public, Private and People Sectors

11.    Consultations have been conducted with stakeholders from the public/regulatory sector [e.g. Ministry of Information, Communications and the Arts (MICA), Media Development Authority (MDA), Advertising Standards Authority of Singapore (ASAS)], private sector (e.g. food industry, media owners and advertising agencies) and people sector (e.g. focus group discussions with parents). The general agreement is that this is an important initiative and more robust standards for food advertising to children should be developed.

12.    The above-mentioned factors and feedback obtained would be taken into consideration in developing the guidelines. 


13.    The proposal is to strengthen food advertising standards for children in Singapore in accordance with the recommendations by the WHO6.

Policy approach to be adopted

The intention is to introduce a set of government-approved food advertising guidelines for children which would serve as a code of conduct for the industry.

Target group

The target group would be children, especially the younger ones, as evidence has shown that younger children have little understanding of the persuasive intent of advertising and hence would require protection10,12.

Distinguishing foods and beverages as targets for advertising restriction

Foods and beverages high in fat, sugar or salt would be the targets for the proposed food advertising restriction.

Choice of communication channels

The proposed restriction would apply to television and print media in the initial stage given its potential impact as television watching and reading were ranked among the most preferred leisure activities of the young in Singapore15,16,17. For these media, specific areas will be targeted (e.g. hours during which children’s programmes are aired on free-to-air television; dedicated children’s channels for subscription television; and print media targeted at children), as the audience would be predominantly children.



1 Lobstein, T., Bauer, L. and Uauy, R. (2004). Obesity in children and young people: A crisis in public health. Obesity Reviews, 5 (Supplement 1): 1–104.

2 Wang, Y. (2001). Cross-national comparison of childhood obesity: The epidemic and the relationship between obesity and socioeconomic status. International Journal of Epidemiology, 30: 1129–1136.

3 Wang, Y. and Lobstein, T. (2006). Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity, 1: 11–25.

4 Loke, K.Y., Lin, J.B.Y. and Deurenberg-Yap, M. (2008) Third College of Paediatrics and Child Health Lecture – The past, the present and the future shape of things to come. Annals Academy of Medicine, 37, 429–434.

5 Ministry of Education. (2012) Parliamentary reply on “Obesity and health promotion amongst students”. 13 August 2012.

6 World Health Organisation. (2010) Set of recommendations on the marketing of foods and non-alcoholic beverages to children. World Health Organisation, Geneva.

7 Hastings, G, Stead, M., McDermott, L., Forsyth, A., MacKintosh, A.M., Rayner, M., Godfrey, C., Caraher, M. and Angus K. (2003) Review of research on the effects of food promotion to children. Report to the Food Standards Agency. Glasgow, University of Strathclyde, Centre for Social Marketing.

8 Hastings, G., McDermott, L., Angus, K., Stead, M. and Thomson S. (2006) The extent, nature and effects of food promotion to children: A review of the evidence. Technical Paper prepared for the World Health Organisation. World Health Organisation, Geneva.

9 Cairns, G., Angus, K. and Hastings, G. (2009) The extent, nature and effects of food promotion to children: A review of the evidence to December 2008. Paper prepared for the World Health Organisation. World Health Organisation, Geneva.

10 Institute of Medicine. (2006) Food marketing to children and youth: Threat or opportunity? Institute of Medicine of the National Academies, Washington DC.

11 Livingstone, S. (2006) New research on advertising foods to children – An updated review of the evidence.

12 Wilcox, B.L., Kunkel, D., Cantor, J., Dowrick, P., Linn, S. and Palmer, E. (2004) Report of the APA Task Force on advertising and children. American Psycholgical Association, Washington DC.

13 Hawkes, C., Lobstein, T and Polmark Consortium. (2011) Regulating the commercial promotion of food to children: A survey of actions worldwide. International Journal of Pediatric Obesity, 6, 83–94.

14 Advertising Standards Authority of Singapore. (2008) Singapore Code of Advertising Practice. 3rd ed. Advertising Standards Authority of Singapore, Singapore.

15 Singapore Sports Council. (2004) Children Sports Participation Survey. Singapore Sports Council, Singapore.

16 Majid, S. and Tan, V. (2007). Understanding the reading habits of children in Singapore. Journal of Educational Media and Literary Science, 45, 187–198. 

17 HPB unpublished data (2009).

18 The Nielsen Company. (2012). Data on gross advertising expenditures in major media.