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Join Manuel Arango, the director of Health Policy & Advocacy at the Heart and Stroke Foundation of Canada. We dive into the pressing issue of food marketing to children, exploring how these strategies impact kids’ health and dietary habits. Manuel shares insights into the ongoing efforts to regulate unhealthy food and beverage marketing in Canada, why it’s crucial for the government to act, and how parents can navigate the challenges posed by aggressive marketing tactics.
Manuel Arango is the director of Health Policy & Advocacy at the Heart and Stroke Foundation of Canada.
He discusses the KevinMD article, “Why my 5-year-old is helping with my PhD thesis.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Manuel Arango. He’s the director of health policy and advocacy at the Heart and Stroke Foundation of Canada. Today’s KevinMD article is “Why My Five-Year-Old is Helping with My PhD Thesis.” Manuel, welcome to the show.
Manuel Arango: Great to be here.
Kevin Pho: All right, we’ll get into that article in a little bit. First off, briefly share your story and journey.
Manuel Arango: Absolutely. So, I’ve been at Heart and Stroke for over 25 years, and I have to say that a good portion of that time at Heart and Stroke has been dedicated to nutrition policy and advocacy.
We do a lot of other things for sure, such as tobacco control, vaping control, nicotine control, drug access, encouraging physical activity, etc., but I think my organization is known for its focus on nutrition policy. So, that’s our niche, basically. In particular, I have to say that what we’ve been really interested in is health-promoting environments.
So, that’s the way we believe you can truly change individual behavior, as opposed to a program or a brochure to provide information. What I mean by health-promoting environments are environments that make the healthy choice the easy choice. Examples of that are things like changing the pricing environment, such as having healthy food cheaper than unhealthy food—the junk food. Having a point-of-sale environment, such as a grocery store where kids can’t see unhealthy cereals at eye level. Marketing environments—ensuring kids aren’t bombarded with unhealthy food and beverages in different environments—and even things like mandatory reformulation of food.
In the United States, just like in Canada, trans fats, industrial trans fats, were banned, so that’s a really effective way to change the food environment versus trying to push an individual to make different choices. That’s been a big focus for us.
Kevin Pho: All right, let’s talk about this KevinMD article, “Why My Five-Year-Old is Helping with My PhD Thesis.” So, what led your organization to write this article, and tell us about the article itself?
Manuel Arango: For sure. One thing that’s important when it comes to advocacy in public health, or in any area, is that it’s not just one organization that should be front and center in the advocacy. You have to have a broad swath of society, civil society, behind you and others. Using youth front and center is key. Julia Chen, the author of this article, is a member of our Heart & Stroke Marching Into Kids Youth Council.
We like to use youth, people with lived experience, academics, experts, other health organizations, and even sometimes certain industry groups if they’re aligned with us. So, that’s why we wanted Julia to do this for us. People really pay attention when you have an article written by a youth or parent, and she’s both. That really resonates with the public.
The article focuses on the extent and breadth to which kids are bombarded with marketing of unhealthy foods and beverages. It’s everywhere—in social media, on the internet, in advert games, and video games. The list goes on and on. We know that in places like the province of Quebec, they’ve tried to address this with some success. In Chile and the UK, there’s been some early success as well.
We know that when it comes to marketing unhealthy foods and beverages to kids, like many other health issues, industry self-regulatory initiatives are not enough. You need government intervention to change the environment, whether that’s through legislation or regulations.
Certainly, parents have a role to play in providing a good nutrition environment for their kids, but when you’re up against a multi-billion-dollar multinational food and beverage industry with billions of dollars of marketing at their disposal, it’s not an even playing field. So, we have to help parents make the healthy choice.
Kevin Pho: So, give us an example of some of the marketing tactics that food companies use to push unhealthy foods on kids. What would be some examples?
Manuel Arango: Well, the obvious ones are the traditional cartoons and infomercials on kids’ TV shows like Nickelodeon and others. That’s been the number one tactic for years—TV—but it’s transformed well beyond TV. Now, on social media, they have influencers reaching children. You’ll see it around schools, on billboards, in convenience stores, and all kinds of signs in grocery stores. Sometimes the sugary cereals are placed at kids’ eye level, and lots of unhealthy food is at checkout, right there to attract kids.
Even in games like video games and advert games created by the industry, those messages are presented there. So, it’s a really complicated and complex environment, and kids can’t escape it. The industry has wanted to handle this voluntarily in the United States and Canada, but we know it doesn’t work. It’s proven not to work, which is why we’re pushing for government intervention in Canada.
Kevin Pho: In terms of the role of parents, you give the impression that parents sometimes are overpowered by the billions of dollars of marketing that food companies put behind unhealthy foods. Are there any practical things that parents can do to shield and guide their kids toward better food choices, despite the onslaught of marketing? What can parents do?
Manuel Arango: In an ideal world, don’t take your kids to the grocery store because they’ll pester you for unhealthy food and beverages. But that’s not a practical approach. One thing parents can do is limit screen time—limit TV, cartoons, social media, phone, and tablet use—because there’s a lot of advertising there. Instead, have kids play outside or in the playground, which gives them physical activity, a double whammy, while avoiding unhealthy marketing.
Those are a few things parents can do, but it’s not easy. Especially when you consider single parents with three kids—it’s tough. It’s very difficult. That’s why we need to level the playing field and make it easier for parents to make healthy choices for their families.
Kevin Pho: So, talk to us about some of the data that shows the impact of unhealthy food choices on kids. Intuitively, we can kind of guess what happens, but what’s the data that really supports this?
Manuel Arango: Right. So, there’s a lot of evidence. We know that 90 percent of the food marketed to kids is unhealthy. It’s all ultra-processed foods, high in sugar, sodium, saturated fat, and a host of other chemicals and additives. It’s not fruits and vegetables being marketed to kids—it’s very unhealthy food.
What we know is that if kids get habituated to unhealthy foods early in life, that tracks into adulthood. In adulthood, that’s when ultra-processed foods really start increasing the incidence of chronic disease, high blood pressure, overweight, obesity, heart disease, stroke, cancer, and diabetes. The list goes on.
If you can address marketing early and change those habits early in life, it won’t track into adulthood, and we’ll have healthier kids. One condition that can happen early in life is overweight and obesity. If kids eat ultra-processed, energy-dense foods with low nutritional value, that can immediately impact overweight and obesity among children.
Kevin Pho: I want to talk about your policy suggestions and government intervention recommendations in just a little bit, but before that—historically, has there been anything short of government intervention that has worked in swaying kids away from unhealthy food?
Manuel Arango: Yes. There have been some innovative things. I’ve seen in the U.S., for example, at one point, there was some marketing of baby carrots that was done in a very attractive and well-marketed way for kids. That’s interesting, and it’s good, but if only a small portion of marketing goes to healthy foods while billions of dollars go to unhealthy food and beverage marketing, it’s not enough. It doesn’t work.
We applaud the efforts of the healthy food and beverage industry—fruit and vegetable producers—to do things like that, but unfortunately, it’s like swimming upstream against a heavy current. You really need to address this at the government level to see significant change.
Kevin Pho: So, what do you propose on a policy level? How would you like the government to intervene?
Manuel Arango: First, I want to give some credit to the Canadian government because they’ve developed a healthy eating strategy and done some good things. They banned trans fats, like the U.S. did, which is great. They created a new food guide, which is world-class and focuses on encouraging the consumption of whole, real food while discouraging ultra-processed foods and sugary drinks. That’s a huge step forward.
Another thing they did was pass regulations to ensure front-of-package nutritional labeling. This will be a symbol on the front of the pack indicating whether the product is high in sugars, sodium, or saturated fat. That will come into effect in January 2026. They also recently funded a national school food program. It’s not very comprehensive, but it’s a start, and it’s very good.
The last outstanding item of the Canadian government’s healthy eating strategy is the commitment to restrict the marketing of unhealthy foods and beverages to kids. This commitment has been made since 2015, in two election platforms, in a federal budget, and in four mandate letters to the health minister. Seven times over nine years, it’s been committed to, and here we are, still waiting for the first steps for the introduction of draft regulations.
Kevin Pho: So, how do you envision restricting the marketing of unhealthy foods on social media? What exactly would that look like? Would that be a ban? How is unhealthy food defined? How would you envision something like this being implemented?
Manuel Arango: Well, we have a means of defining healthy and unhealthy foods. There are a lot of different approaches to this. In Canada, for example, we’ve defined this through our front-of-package nutritional labeling regulations. So, the industry would be obliged to follow these criteria, and for foods that are in the unhealthy category, they simply would not be permitted to advertise on social media. There would also need to be penalties and fines for companies that violate this.
Likely, we would also rely on public complaints, which is what happens in many countries. Complaints from the public could then be followed up by the government, which would take the appropriate enforcement measures. But what we find is that most industries will comply because they don’t want to look bad with the public if government action is taken against them, if they’re fined, etc., and they end up in the newspaper. That’s not the kind of publicity they want. So, there would need to be enforcement.
Kevin Pho: We’re talking to Manuel Arango. He’s the director of health policy and advocacy at the Heart and Stroke Foundation of Canada. Today’s KevinMD article is “Why My Five-Year-Old is Helping with My PhD Thesis.” Manuel, we’ll end with some of your take-home messages that you want to leave with the KevinMD audience.
Manuel Arango: I think one thing for sure is that we have to really understand and digest the fact that industry self-regulation does not work. This is something industry always pushes, but we have all kinds of evidence, not just in the nutrition and food space, that these don’t work in other areas either. So, we need government intervention. There’s a role for government to play in this area, and it’s worked in other places. In the province of Quebec, they’ve had a ban on all commercial marketing, and there’s been good success there. In Chile, as well, there’s good evidence that government-led marketing and restriction policies do work.
It’s key for the government to act because industry is focused on profit, right? We can’t simply allow industry to voluntarily come up with self-regulations that suit them. Only governments can truly implement these very effective restrictions. So, we need to even the playing field and give parents a chance. We really need to encourage governments to have the political will to move forward and implement restrictions because they’ve worked in other places.
Lastly, for those working in this area—whether physicians or others in public health advocacy—perseverance is key. When you’re up against industry opposition, it’s just not going to get done in a year or two. It requires an ongoing effort with great perseverance. There will always be ups and downs and setbacks. Sometimes, when the political environment isn’t favorable, you have to be knowledgeable enough to take a pause but be prepared to come back when the opportunity arises. So, perseverance is crucial. It’s not done overnight, and you’ve got to be in for the long haul for something like this.
Kevin Pho: Well, thank you so much for sharing your perspective and insight. Thanks again for coming on the show. I appreciate speaking with you.
Manuel Arango: Thank you very much.
