Stealth marketing of food in schools and The BMJ’s 185 year itch

Investing in child health delivers long term benefits and reduces demand on health systems. School breakfast clubs ensure that children of all backgrounds get a good start to the day, while helping their parents stay in work. What could go wrong?

The answer is stealth marketing. Our latest investigation examines the food and drink industry’s widespread influence in schools and nurseries (doi:10.1136/bmj.q2661).1 Companies are targeting young children through “healthy eating” campaigns and “free” materials. The tactics being used resonate with those of the alcohol and tobacco industries, two of the three most harmful industries to health alongside the food and drink industry. Kellogg’s and Greggs are involved with food provision, and companies including Coca-Cola, PepsiCo, Mars, Nestlé, and McDonald’s fund a “policy development” charity.

Conversations about the food and drink industry are complicated, as they’re both necessities, unlike tobacco or alcohol. Even some luxuries might be beneficial to health. A new study published in The BMJ (doi:10.1136/bmj-2023-078386)2 finds that eating dark chocolate can be associated with a lower risk of type 2 diabetes, although milk chocolate, unlike dark chocolate, is associated with long term weight gain.

We do need to tackle the behaviour of companies that produce unhealthy food and drink—products high in fat, salt, and sugar. Regarding stealth marketing by companies, Greg Fell, a director of public health (doi:10.1136/bmj.q2661),1 delivers an unequivocal verdict on “a wealth of evidence that by being involved in school programmes, harmful products are normalised.”

In an open letter to Wes Streeting, the UK’s secretary of state for health and social care, organised by The BMJ, experts make three demands of the government (doi:10.1136/bmj.q2661).1 First, we need national implementation of government funded breakfast clubs that adhere to nutritional standards. Second, schools and nurseries should be included in all future regulation of food and drink advertising and marketing. And third, schools and nurseries should reject all future branded sponsorship or educational materials branded by the industry or its representative organisations.

Elsewhere, other demands of the government include a better approach to involving patients or people with lived experience in guideline development (doi:10.1136/bmj.q2433),3 getting it right on palliative care and assisted dying (doi:10.1136/bmj.q2696 doi:10.1136/bmj.q2691),45 recognition of the harms of direct-to-consumer tests and the need for stronger regulation (doi:10.1136/bmj-2024-080460),6 stronger action on gambling in addition to the newly announced “health” levy on betting companies (doi:10.1136/bmj.q2667),7 and more proactivity in ending the abuse and killing of health professionals, aid workers, and civilians in Gaza (doi:10.1136/bmj.q2672).8

The BMJ’s commitment to prioritising and improving outcomes related to health and wellbeing for people and the planet is unwavering. We will build on our reputation as a trusted information source in a world of disinformation and broken trust, “in thrall to screens and illusions” (doi:10.1136/bmj.q2670),9 where banning children from social media is insufficient to protect them (doi:10.1136/bmj.q2617).10 We will fight inequities (doi:10.1136/bmj.q2557),11 challenge established clinical practice with science and research (doi:10.1136/bmj-2024-080439 doi:10.1136/bmj.q2593),1213 examine clinical uncertainties (doi:10.1136/bmj-2023-078175),14 and bring you the best practice in diagnosis and management (doi:10.1136/bmj-2023-076612).15 We’ll do all of this as we scratch our 185 year itch by becoming a fortnightly print publication (doi:10.1136/bmj.q2701) from 2025.16