Evaluating Childhood Overweight- and Obesity-Related Food Marketing Policies in China Using the Food-Environment Policy Index (Food-EPI)

Objective: Addressing the increasing global health issue of childhood obesity, exacerbated by pervasive food marketing, this study critically evaluated China's food marketing policies in comparison with international best practices, aiming to uncover policy content and implementation gaps and inform policy enhancement strategies. Method: Three key indicators were utilized from the Healthy Food-Environment Policy Index (Food-EPI)'s food promotion domain. A panel of experts (n = 13) from academic institutions, China Centers for Disease Control and Prevention, and the food industry assessed the Chinese government's policy scores and implementation levels concerning food marketing. Benchmarked against international best practices using the Food-EPI process, this evaluation encompassed context analysis, data collection, evidence-based policy action, government validation, policy rating, scoring, and results translation for government and stakeholders. The three chosen indicators specifically addressed childhood overweight- and obesity-related food marketing in broadcast media (Indicator 1), non-broadcast media (Indicator 2), and child gathering settings (Indicator 3). Results: Specifically, Indicator 1, the Single Food Marketing Indicator Score was measured at 2.31 +/- 0.38, with an accompanying Food Marketing Policy Implementation Percentage of 46.2%, and Low Implementation Level. For non-broadcast mediums (Indicator 2), these metrics were gauged at 1.77 +/- 0.27, 35.4%, and Low Implementation Level, respectively. In child gathering settings (Indicator 3), for efforts curbing unhealthy food promotion, a score of 2.77 +/- 0.27, an implementation percentage of 55.4%, and Medium Implementation Level was obtained. Cumulatively, the overarching efficacy of food marketing policy enforcement was determined to be suboptimal, with the consolidated figures being Total Food Marketing Score as 2.28 +/- 0.97, Total Food Marketing Policy Implementation Percentage as 45.6%, and Total Food Marketing Policy Implementation Level as Low. Conclusion: Like many countries, China's food marketing policies and implementation have room for improvement when compared to international best practices. Recommendations include emphasizing nutritional legislation, fostering stakeholder collaboration, bolstering public health campaigns, and leveraging technology for stringent enforcement.