Research Summary: Impact of a health marketing campaign on sugars intake by children aged 5–11 years and parental views on reducing children’s consumption

A summary of: Bradley et al. 2020. Impact of a health marketing campaign on sugars intake by children aged 5–11 years and parental views on reducing children’s consumption. BMD Public Health.

Increased free sugar intake is an established risk factor of non-communicable diseases (NCDs) such as dental caries and obesity. Such NCDs present a global public health burden with significant impacts on children, families and health services. The factors contributing to the increased free sugar consumption are wide-ranging, from marketing and trade policies to food supply in schools and workplaces. Efforts have been made through up-stream and down-stream preventative measures to bring sugar intake in line with current recommendations. Public Health England (PHE) instigated a wide range of measures on both up- and down-stream levels. These measures included a downstream measure through a national health marketing campaign known as the Change4Life Sugar Smart campaign. The main aims of this campaign are to raise awareness of children’s sugar intake in comparison to government dietary recommendation and to encourage parents in cutting the amount of sugar in their children’s diets. This campaign was advertised through various media outlets and packs were distributed via schools providing parents of the guidelines on sugar intake along with practical advice to help them reduce sugar intake. In addition, a free smartphone app was available to download enabling parents to scan barcodes on food packs to reveal the amounts of sugar in them.


This study employed the use of mixed methods to assess the effectiveness of the campaign in altering dietary behaviours and identify parental perceptions on the campaign. The quantitative component of this study involved dietary information of 873 children aged 5-11, these were collected online at five time points; baseline, peak campaign, immediately post campaign, 10-months and 12-months post campaign. Such range of time points aids the identification of any short-term and sustained effects.

The qualitative component of the study included 20 one-to-one semi-structured interviews conducted by telephone with parents following the launch of the campaign. The interviews explored a range of topics including: 1) understanding of the campaign’s messages; 2) understanding of sugar and its impact on health; and 3) individual and social barriers experienced by families with respect to reducing children’s sugar intake.


The quantitative analysis showed a statistically significant decrease in the percentage energy from total sugars across all time points compared to baseline. It is worth noting that completion rates for dietary assessment ranged from 61 to 72% across the follow up time points.

The qualitative findings were analysed through thematic analysis which yielded various themes as summarised in Figure 1 along with some of the findings associated with each theme.

Figure 1: A summary of the 3 main themes by Bradley et al (2020) along with some of the findings associated with each theme, adapted from Bradley et al (2020).

To conclude, Change4Life Sugar Smart (a health marketing campaign) contributed to a decrease in children’s sugar intake, however, these reductions were not sustained long term. The qualitative findings prompt improved food labelling and highlight the influence the food industry has when it comes to misleading food marketing claims where sugary snacks are advertised as ‘healthy.’ While down-stream actions such as this campaign can contribute to raising awareness of increased sugar intake and its impact, it is important to note that there exist factors that need to be tackled from an up-stream level, such as fiscal measures when it comes to food marketing.

Summary by Haleema Rabeea, Queen Mary University of London

BRADLEY, J., GARDNER, G., ROWLAND, M. K., FAY, M., MANN, K., HOLMES, R., FOSTER, E., EXLEY, C., DON BOSCO, A., HUGUENIOT, O. & MOYNIHAN, P. 2020. Impact of a health marketing campaign on sugars intake by children aged 5–11 years and parental views on reducing children’s consumption. BMC Public Health, 20, 331.

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