Consumption of non-nutritious foods and beverages has been shown to be a key determinant of the current obesity epidemic among young people aged,18 years.1 These non-nutritious foods and beverages include sugar-sweetened beverages (SSBs), which have been directly associated with the incidence of obesity in children and young people in the U.S.2,3 High school students now consume, on average, more than 300 kilocalories (kcal) of SSBs per day.4 Other examples of non-nutritious foods include candy and snacks that are high in fat, such as high-fat cookies, cakes, or pastries. Changes in intake of these non-nutritious foods and beverages can help to close the “excess energy gap” (i.e., the calories consumed that exceed the calories burned—currently estimated to be 110–165 kcal/day) that has led to recent trends in average excess weight gain among children and young people in the U.S.5
Food advertising has been shown to influence children's food purchase requests, the nutritional quality of their food selections, and their health.6–8 Food and beverage marketing affects students' food selections at school,9 and many foods and beverages of poor nutritional quality are marketed across the nation. Children may be uniquely vulnerable to marketing of poor nutritional quality foods because they lack decision-making skills and maturity to make healthier choices.10 Young children may not understand the persuasive intent of marketing, while older children, who have not yet fully developed their logical, evaluative skills, may have considerable spending money and opportunities to make food choices in the absence of parental guidance. School-based marketing undermines parents' and schools' health promotion efforts. And studies have shown that parents, school administrators, and the general public all support limits on in-school marketing of low-nutrition foods.11
In 2007, Maine became the first state to pass legislation limiting the marketing of foods of minimal nutritional value (FMNV) on public kindergarten through 12th-grade school campuses. Maine's legislation using the FMNV standard implies that foods falling below that standard are considered to be inappropriate for promotion in the school setting. The U.S. Department of Agriculture developed the concept of FMNV and defined those foods as follows: (1) in the case of artificially sweetened foods, a food that provides <5% of the Reference Daily Intake (RDI) for each of eight specified nutrients per serving; and (2) in the case of all other foods, a food that provides <5% of the RDI for each of eight specified nutrients per 100 calories and <5% of the RDI for each of eight specified nutrients per serving. The eight nutrients to be assessed for this purpose include protein, vitamin A, vitamin C, niacin, riboflavin, thiamine, calcium, and iron.12
The current language of Maine's marketing law (commonly referred to as Chapter 156),13 which went into effect in September 2007, states that brand-specific advertising of food or beverages is prohibited in school buildings or on school grounds except for food and beverages meeting state standards for sale or distribution on school grounds. Specifically, the law states that advertising does not include advertising on broadcast media or in print media (e.g., newspapers and magazines), clothing with brand images worn on school grounds, or advertising on product packaging.
School food and beverage promotion activities and materials can be broadly classified into three groups: product sales, direct advertising, and indirect advertising. Direct advertising includes the use of a brand name or logo on a sign or banner or otherwise visible to a target audience to promote the product. Indirect advertising is advertising used to promote a product using brand names or logos on or in conjunction with educational or other activities, corporate sponsorship, commercial food-based reward or incentive programs, scholarships, and textbooks and/or curricula. Product sales marketing is advertising of the product on the product's label and/or packaging itself. The term “marketing” is used broadly to describe these various types of product promotion.14
Maine requires schools to meet the federal FMNV standard for foods that are sold or distributed on school grounds 24 hours a day, seven days a week, with possible exemptions only for teachers' lounges and community events. However, Maine's marketing ban does not allow for exemptions. Therefore, the marketing of food or beverages not meeting the FMNV standard is prohibited everywhere within the school and on school grounds, including teachers' lounges, unless the marketing is on the product packaging itself (Figure 1).
Only a few school food and beverage marketing assessments have been conducted to date,15,16 and none of these reviewed compliance with a policy or law. This study aimed to assess compliance with Maine's legislation and the nature and extent of junk food marketing in a representative statewide sample of high schools in Maine.