The NFA proposes that the Guidance Note on Food and Drink should bring together all rules relevant to the advertising of these products. [n this section, we propose rules specifically dealing with nutrition and health, which is the focus of the NFA's concern.

9. Scientific Basis for Food and Drink Advertising

One of the recurrent findings of research on nutrition is that consumers report confusion over basic nutritional principles and over the properties of specific foods. The lack of certainty about the best way forward acts as a barrier to change. There are many possible explanations for this confusion, but advertising is one contributory cause.

Precisely because foods and drinks in recent years have increasingly been promoted on health platforms, advertising has become an important influence on popular understanding of nutrition. In many ways, this educational role of advertising has been positive, contributing to the wider public awareness of the nutritional problems with our current national diet.

But there are negative consequences as well. The claims and counterclaims of rival manufacturers about the health virtues of their own products and the health risks of competitors, all apparently supported by evidence, create a sense of dispute within nutrition. The battle between butter and margarine manufacturers over the different fats in their products and their effects on heart disease is a good example. In such advertisements, nutritional science appears to be supporting incompatible claims. This is one major source of consumer confusion (National Dairy Council, 1992)

The root of the problem lies in the selective use of scientific evidence and the exaggeration of new research, creating an inaccurate impression of nutritional science.

In fact, there is an overwhelming scientific consensus on the fundamental principles of healthy eating. The Consumer Association's analysis of 100 expert nutrition reports over the past 30 years, The Experts Agree (Cannon, 1992), documents the breadth of agreement in great detail.

In Britain, this consensus is expressed through the reports of various expert advisory committees which government departments have established explicitly to keep them abreast of scientific developments. The most obviously relevant of these bodies are the Committee on the Medical Aspects of Food Policy (COMA) and the Food Advisory Committee (FAC). But the reports of the Food Surveillance Programme, the Committee on Novel Foods and Processes, the Committee on Toxicity and others also provide relevant scientific evidence.

We are in the fortunate position, therefore, of having a well-established body of principles in nutritional science. They provide a firm scientific foundation for the nutritional aspects of food and drinks. Advertising based on these core nutritional principles will be uncontentious, unchallengeable and unconfusing.

The Food Safety Act 1990 (section 15, 2a and b) makes it an offence to publish or be party to a publication of an advertisement which falsely describes any food or is likely to mislead as to the nature or substance or quality of any food. As a general rule, the NFA believes that all advertising about the nutritional aspects of foods and drinks should be based on established scientific principles.

We propose that this principle should be translated into the revised British Code of Advertising Practice through the inclusion of the following clauses. First, the NFA proposes:

We recognise that there may be some areas not yet covered by expert advisory committee reports and that new scientific evidence may have been gathered since the last relevant report was published. We have no wish to stop new material being brought to public attention through advertisements. But we should not tolerate speculative interpretations of new or novel research which has not withstood the test of scientific replication. Again we must ensure that any such new claims by advertisers have a sound scientific basis. Therefore, the NFA also proposes:

Some advertisers may not find established nutritional principles congenial to their products. But any defence they make of their products should not create confusion in consumers' minds about nutritional science. Therefore, the NFA proposes:

Based on the findings of its expert advisory committees, the government from time to time makes dietary recommendations to the nation. Other governments do the same for their citizens and again there is a remarkable international consensus on this advice. These recommendations are guidelines on the composition of a healthy diet. The most recent and comprehensive set of dietary recommendations issued by the UK government are those contained in the COMA report on 'Dietary Reference Values' (COMA, 1991).

The NFA considers that advertisers should respect the scientific consensus which underlies these recommendations. Therefore, we propose:

10. Interpretation

While all advertising relating to nutrition and health should have a scientific basis, we recognise that most advertisements directed at ordinary consumers will be expressed in non-technical language. And we realise as well that advertisers always want to present their products in the best possible light.

But many advertisements for foods and drinks go beyond this to suggest greater virtues than reason or evidence would allow. In an earlier period, when people were not so concerned about nutrition, many loose phrasings became conventional in food and drink advertising, like 'packed with vitamins or 'contains the protein/calcium necessary for building healthy bodies' or 'helps you work, rest and play.

Now, when concern about nutrition is a more important influence on consumers food choices and a more frequent theme in advertising, there should be a correspondence between the vernacular in which advertisements are expressed and the scientific rationale which underlies them.

This standard should apply with equal force to long-running as well as new advertisements. The ASA/CAP should not exonerate ads on grounds of precedent or established usage. Nor should it excuse familiar, loose wordings because they may be discounted by consumers. In fact, such casual hyperbole only adds to the general confusion about nutrition.

In applying this rule, the ASA/CAP will have to determine what the popular language of the ad is actually asserting. This is the process covered in the current BCAP, Part A, Section 3, under the heading of 'Interpretation'.

The NFA supports the core principle of the existing Code that 'Conformity with the Code is assessed in the light of an advertisement's probable effect when taken as a whole, and in context'. But the ASA/CAP's work would be greatly assisted, we believe, if additional interpretative principles were made explicit in the Code and the Guidance Note on Food and Drink. First. the NFA proposes:

Further, in our experience, companies sometimes try to justify prima facie inaccurate or misleading statements by reference to technical data which is not mentioned in the advertisements and which non-specialist readers could not reasonably be expected to know. Therefore, the NFA proposes:

To resolve any residual ambiguity, the NFA believes that the current rule on the spirit of the Code (Part A, Para. 3.3) should receive greater emphasis in practice. The NFA proposes:

11. Claims in Food and Drink Advertisements

The principal way in which nutrition enters food and drink advertising is through claims made about the virtues of products. Ensuring that such claims are accurate, have a scientific foundation and do not mislead consumers is the principal regulatory challenge facing the ASA/CAP.

The credibility of such claims is already low. In a major government-sponsored consumer survey (FAC, 1991, Appendix 2), a majority found some health-related claims 'difficult to believe'. The NFA considers that it is important to re-establish the integrity of claims, to protect both consumers and conscientious manufacturers.

The BCAP already contains general provisions against inaccurate and misleading ads. In the light of widespread government conceni and consumer scepticism, these need to be much more rigorously defined and enforced. But in the new Guidance Note we propose, there should also be explicit statements of what these prohibitions mean in the context of food and drink advertising.

A pre-requisite for effective regulation is a general definition of food claims. In recent drafts of its directive on this subject, the EU has settled on an acceptable definition (Commission, 1992). The NFA proposes that the ASA/CAP adopt it now, rather than waiting until it becomes obligatory:

The current BCAP (Part A) explicitly applies to both 'express and implied claims'. The NFA supports this principle, but feels it needs greater emphasis in practice.

Inevitably, some degree of interpretation will be involved in the assessment of implied claims, not least because they are nowhere formally defined, neither in the BCAP nor, to the best of our knowledge, in other relevant food law.

But as nutrition becomes more important in food and drink advertising, creative ingenuity is increasingly suggesting health virtues without explicitly stating them. The most common example is the use of heart-shaped symbols to imply that a product conveys some benefits in the prevention of heart disease.

If the regulation of implied claims is to become effective in practice, then there is a need to clarify the techniques by which claims are implied. We note that the existing BCAP already contains, in the specific context of slimming claims (Part C.IV.3.3), a phrase which might serve as the starting point for such clarification: 'hint or suggestion.. .in either copy or illustration which might lead a reader to suppose that...'

From its experience, the NFA has identified three general forms in which claims are implied: (1) the juxtaposition of two or more verbal and/or graphic elements to suggest an association between them without an explicit connection; (2) the testimonial or association suggested through the use of a real or fictional person or animal in an advertisement, even though no explicit endorsement is made and (3) the use of 'qualifying' language such as 'can help' or 'may improve'.

Next we consider the most common types of claims which have given rise to concern. In each case, we provide a definition of the claim, explain why regulation is needed, then propose an appropriate rule.

a.(i) Generalised health claims:: assertions that a product is in some general way beneficial. Such claims are commonly expressed in abstract and ambiguous concepts, like 'nutritious', 'wholesome', 'healthy', 'full of goodness' and a host of similar words and phrases. There are several reasons why such claims are unacceptable.

First, no single food is in general beneficial. As food manufacturers themselves repeatedly assert, no single food is healthy or unhealthy, only total diets. No advertiser should then violate that nutritional principle through generalised claims in its advertisements.

Second, the FAC (1991) has endorsed the principle that claims should only be allowed if they refer to 'measurable and objective characteristics'. The NFA agrees. In practice, that means that all claims which are incapable of scientific substantiation should not be allowed.

Third, generalised claims are commonly so abstract and so ambiguous that they cannot be given any consistent interpretation. On this point, the FAC (1991) is totally unambiguous:' meaningless descriptions (such as the use of 'special', 'selected', 'healthy', 'wholesome' without further explanation) should not be used'.

The NFA proposes that the ASA/CAP should translate this recommendation into its regulations through:

(ii) Generalised claims: claims extend beyond nutrition to include those which are well defined such as 'organic' or 'free range', those for which guidelines on their use exist, such the use of the word 'natural' and others where no clear definitions of use exist, such as 'traditional', 'farm fresh', 'original', 'pure', 'special' etc. As above, the FAC (1991) recommended that meaningless descriptions should not be used.

The NFA recommends

b. Nutrition claims: assertions about the nutrient content of foods. These include, for example, claims that a product is low/high, free from/rich in some nutrient.

Nutrition claims are important because they are widely used by consumers in selecting foods. In health terms, they arc potentially beneficial. By drawing attention to the distinctive properties of a product, they may help consumers modify the nutritional composition of the diet and thereby meet dietary recommendations.

But if they are to fulfil this potential, nutrition claims must be accurate. In fact, many are misleading and false. In a major survey of claims niade on the labels of manufactured foods, the Coronary Prevention Group documented numerous problems (CPG, 1991). Most importantly, 'Many foods claiming to be low in a nutrient were in fact high in that nutrient'.

While we have no comparable survey of claims in advertising, they are even more important than claims on labels. It is prudent to protect consumers by establishing rules to ensure the consistency and accuracy of nutrition claims in advertisements. Some nutrition claims are already covered by the Food Labelling Regulations. The European Commission is currently drafting a directive to regulate such claims more broadly. Pending its completion, the UK government is proposing 'voluntary guidelines' in the same area.

This is an untidy legal situation. But it is too important an area to leave unregulated until a European solution emerges. Therefore, we suggest that the ASA/CAP adopts the best available combination of UK standards. To realise this principle, the NFA proposes:

c. Health claims: assertions about the positive effects that a food or drink may have on the consumer. In contrast to the 'generalised claims' above, 'health claims' allege that specific beneficial consequences will follow from consuming a product.

The FAC's formal definition of such claims is 'any statement, suggestion or implication in food labelling or advertising (including brand names and pictures) that a food is in some way beneficial to health' (FAC, 1991).

The ASA/CAP already has an eve" niore detailed definition in Section C.I.2.2 of the present Code, that a product 'may improve, restore or maintain a user's health or physical or mental condition'.

However, an increasingly common practice in food and drink advertising circumvents both these definitions, namely the use of 'indirect health claims'. Products do not claim to improve health directly, but through action on some agent which in turn influences health. For example, oat bran is only claimed to reduce cholesterol levels in the blood. But in adjacent text it is then asserted that lower serum cholesterol will help prevent heart disease. The juxtaposition makes the connection.

Health claims are a genuinely difficult area for regulation. Some health claims are scientifically justified and assist consumers in composing their diet. But the potential for abuse is great. The European Commission's prolonged and changing efforts to deal with the issue illustrate the difficulties.

In the UK, the government is seeking a balance between the goals of providing consumers with additional helpful iii formation and ensuring the accuracy of such information. It has repeatedly expressed concern (MAFF 1991 and 1992b) about the potentially misleading nature of some health claims and recognised the need for additional controls.

Specifically, it has accepted in principle (MAFF,1992b) three new controls for negotiations over a new EU claims directive. But that directive has already been 14 years in the drafting with no end in sight yet. Thercfore, as an interim measure, we propose that the ASA/CAP adopts these three regulations:

However, there have been two important developments in the area of health claims since the government announced its position.

First, the number and variety of health claims is increasing, particularly in the area of vitamin-fortified foods. We can already see increased emphasis on the value of the anti-oxidant vitamins in preventing heart disease. All manner of claims for vitamin-enriched 'functional foods' and 'nutraccuticals' are common in Japan. Hyperbole and pseudo-science are commonplace in the rapidly growing area of 'sports' drinks and foods. Some of these assertions are a modern, high-tech version of the all embracing claims made for "patent medicines" in an earlier era.

The NFA anticipates that there will be substantial increased use of health claims in all these fields in the medium-term. If adequate controls arc not in place, the already low credibility of food claims will be further undermined.

This is a serious risk, even if the ASNCAP rigorously enforces its substantiation rules in dealing with complaints. Speculative health claims will receive wide public exposure even if a complaint is subsequently upheld. We feel this particularly important area requires pre-emptive measures.

Second, the US government has recently adopted and implemented a rigorous certification programme for health claims (FDA, 1994). Leading scientists assess the validity of proposed health claims. If they conform to generally accepted scientific criteria, the government permits such claims to be made, under demanding conditions. So far, seven such claims have been authorised and others arc being considered. All other health claims are prohibited. The intention is to ensure that only health claims which are genuinely useful to consumers are permitted.

In sum, the issue of health claims has become more urgent and an alternative regulatory approach has emerged. The NFA intends to appeal directly to the government to re-engage with the issue of health claims and to strengthen its own proposals. But pending that, the NFA proposes that:

This would effectively mean establishing a narrow and focused pre-vetting scheme for health claims - a principle already accepted for tobacco advertising and slimming product claims.

d. Energy claims: assertions that a food or drink provides energy in some distinctively beneficial way. The government report, Dietary Sugars and Human Disease (COMA, 1989), dealt with this issue directly and unambiguously: 'The availability of energy to the body is.. regulated at a fairly constant level and, except in situations of starvation, is virtually independent of food intake'.

COMA also rejected the related refreshment or restorative claims: 'The argument that consumption of sugars or other energy rich foods will raise the blood glucose concentration and promptly reinvigorate the fatigued individual is false'. Therefore, the NFA proposes:

This prohibition should include similar claims expressed in non-technical language, such as 'adds vitality', 'gives vigour', etc. Alid it should cover the implied claims made through associations of the product with athletes or other conspicuous exemplars of health, fitness and physical vigour.

e. Light and diet claims: many products making these ambiguous claims are explicitly directed at people trying to reduce or control their weight and we consider them under the specific section on slimming claims below. But because of general public concern about healthy eating and excessive consumption, many products marketed to the general public are making similar assertions. 'Diet' colas, for example, are now widely consumed by non-dieters.

'Light/Lite' and its synonyms have different meanings in commercial use. They may refer to reductions in the energy, fat or sugar content of a product, to changes in its colour, taste or texture. All may be relevant consumer information. But it is not in the public interest if the meaning is ambiguous. Therefore, we propose:

'Diet' claims could also conveniently direct consumers to products with significantly reduced energy content. But the absence of any definition for this word deprives it of any consistent meaning. As a result, consumers do not receive usable guidance.
For example, it used to be a convention in the soft drinks industry that 'diet' drinks contained less than one calorie per can. But there are now 'diet' products on the market with a range of caloric contents, as high as 60 calories per can (Diet Ribena). Allowing the same claim to describe such different products misleads consumers.

At the same time, following the change in the Soft Drinks Regulations, some 'regular' drinks, which make no claims about their energy content, have replaced sugars with intense sweeteners and now contain fewer calories than their 'diet' equivalents. This crossover indicates the need for rules to introduce consistency into 'diet' claims.

The NFA will be proposing action to the government in this area as part of its consultation on 'Nutrition Claims'. But pending any official definition, we propose, as an interim measure:

12. Substantiation of Claims

The NFA has been informed by the ASA's director that its current policy is to allow advertisers to make a claim if they have ANY evidence to support it. The NFA believes this principle is too permissive and the ASA/CAP should significantly increase its requirements for the substantiation of claims. See Section 9 for specific standards.

But the distinctive characteristics of print advertising provide an opportunity to inject more scientific rigour and credibility into food and drink advertisements. In contrast to broadcast advertisements, there exists in print media the space in which to provide at least some evidence substantiating health-related claims and assertions. Therefore, the NFA proposes:

The NFA also considers that the print media have the possibility to deal with another common problem in food and drink advertising, the practice of 'highlighting' - that is, the making of partial claims which draw attention to a product's virtues, but which do not provide complete nutritional information. Common examples include ads for 'low fat' yogurts or breakfast cereals which nowhere mention that they are also high in sugars.

It is unrealistic to expect companies to advertise the drawbacks of their products. But they should, in print advertisements, at least provide full nutritional information. Therefore, we propose:

These practical obstacles do not exist in newspaper and magazine advertising. In these media, there is space to provide a nutrition declaration as one component in an ad. The ASA/CAP is not bound merely to conform to the law. It can set a higher standard where appropriate, and often does. This is another appropriate context. In view of all the problems described above, we urge the ASA/CAP to seize this opportunity.

13. Food Categories: The National Food Selection Guide

To aid consumer understanding of food and nutrition, the Department of Health, the Ministry of Agriculture, Fisheries and Food, and the Health Education Authority have for some time been engaged on a major project to develop a National Food Selection Guide. This will shortly be announced. It will include a comprehensive taxonomy of the various types of foods and readily comprehensible guidance on how to compose a healthy diet.

The guide will provide a new conceptual framework for dietary guidance, grounded in nutrition. In time, it will also shape the way consumers think about food.

The guide will categorise foods into five groups: (1) fruit and vegetables, (2) bread, other cereals and potatoes, (3) meat, fish and alternatives, (4) dairy foods, and (5) fatty and sugary foods. We use this terminology in relevant proposals below.

In order to avoid confusion and to ensure consistency between government advice and food advertising, the NFA proposes:

The National Food Selection Guide will define a category of 'fatty and sugary foods'. These are popular products in Britiain but if consumed in excess of dietary recommendations, they may contribute to multiple health problems - tooth decay, overweight and diseases, including heart disease, diabetes and certain forms of cancer.

The government's official 'Dietary Reference Values' (COMA, 1991) recommend substantial decreases in national levels of both fat and sugar consumption. Translating these nutrient targets into guidance on foods, the selection guide will recommend only limited intake of products in the 'fatty and sugary' category.

Yet fatty and sugary products are particularly important in advertising. The NFA calculates that, over the past decade, the principal products in this group account for roughly half of total advertising expenditure on foods and non-alcoholic drinks (Register-MEAL, various years).

Therefore, the NFA considers that special provision needs to be made for the advertising of such products. A subsection within the Guidance Note on Foods and Drinks should include the following rule to ensure that advertising only encourages sensible consumption.

Special care with this category of products is necessary for children, so we make additional proposals below in the Guidance Note for Children.

At the same time, the National Food Selection Guide will advise the increased consumption of certain other food categories The NFA considers that food and drink advertisers should respect this guidance and therefore proposes:

14. Slimming Products

The BCAP already has an extensive section regulating the advertising of slimming products. Indeed, some of the most rigorous controls in the whole code apply in this field. Yet the ASA's own monitoring has found this continues to be a significant problem area - two out of three adverts in a recent ASA monitoring exercise were found to flout its code of practice (ASA, 1994). Advertisements for products that contravene the current code appear regularly in national and local press as well as in direct mail and mail order catalogues. Many offenders are persistent offenders. This illustrates the need for more effective implementation of pre-vetting procedures and more effective sanctions against offenders.

(a) Pre-vetting:

The current code states that slimming products are one of the very limited number of product categories that require pre-vetting C1.V. 1 .3 (P52):

'All advertising offered for publication on either a weight loss or a figure control platform has to be checked by publishers with the appropriate media body before it can be accepted for publication'. 'When a new product or new formulation is introduced, or when new claims are made for an existing product, advertisements, when submitted for publication, should be accompanied by full substantiation for all new claims.'

The NFA considers that such pre-vetting is essential but the level of unacceptable advertising for slimming products clearly illustrates that the current system is not working. The NFA considers that this pre-vetting system needs to be effectively implemented and publishers made aware of new sanctions (see below) for not complying. Thus the NFA recommends:

The current pre-vetting system for slimming product
advertising should be retained and implemented
effectively.

(b) Sanctions:

The ASA's own monitoring has shown that advertisers and publishers regularly flout the existing code. If the ASA's continued exhortations have not been effective, it must develop more effective sanctions. Where the ASA has no legal powers offenders should be referred more frequently to the Office of Fair Trading for prosecution under the Misleading Advertisements Regulations (1988).

The NFA thus recommends:

(c) Rate or speed of weight loss:

The Health of the Nation sets targets for reducing obesity in the population. However obesity is a medical problem that requires medical advice and supervision.

Thus the NFA recommends that:

There is growing evidence about the ill-effects on health of rapid weight loss and yo-yo' dieting. Safe weight loss is considered to be no more than 1-2lbs a week. The draft EC 'Parnuts' Directive on Energy Restricted Diets proposes that no advertising or labelling of the product should make any reference to the rate or amount of weight loss which may result from their use or to a reduction in the sense of hunger or an increase in the sense of satiety.

Thus the NFA recommends:

(d) Dieting and underweight:

There are growing concerns about the effects on health of being underweight and of dieting (British Heart Foundation, 1992). A significant proportion of both teenage and pre-adolescent girls say that they arc on weight reducing diets when they not overweight. Under nutrition at a time of physical growth and development has been found to have detrimental effects on metabolism and may lead to retarded growth, delayed puberty and to osteoporosis later in life. Many adult women restrict their diets beyond what is beneficial to their health. Dieting has been shown to have wide-ranging consequences for psychological function including altering the way information is processed, impairing cognitive performance and increasing preoccupation with food. Concern about food and weight can lead to eating problems and in more severe case anorexia and bulimia. Fifteen year old girls who diet are eight times more likely to develop eating disorders than non-dieters (Hill, 1993). Therefore every effort should be made to ensure that all advertisements including those for food products do not encourage preoccupation with undue slimness or dieting or encourage anyone, but particularly children and young adults, to loose weight unnecessarily.

Therefore the NFA recommends:

GUIDANCE NOTE FOR CHILDREN

The NFA considers that the provisions in the existing BCAP Section C.X on Children need to be strengthened and expanded into a separate Guidance Note for Children. None of the rules in that section currently deals with health. The only indirect reference is in rule B.20 prohibiting advertising which might result in physical harm to children. The NFA considers that the concept of 'physical harm' needs to be substantially developed in the new Guidance Note.

Thus the NFA recommends:

Therefore, the new Guidance Note for Children should include a specific section on foods and drinks. And, as we noted earlier, this section should cover products which appeal to and are consumed substantially BY children, as well as strengthening its controls on advertising TO children.

The Note should begin by including definitions of the various sub-groups of children. The NFA suggests that the ASA/CAP adopt the age limits now becoming conventional in European and UK legislation (MAFF, 1994):

(a) Foods and Drinks Consumed by Children

Most of the principles of healthy eating apply to children as well as adults. Therefore, all proposals in this report should apply to advertisements for foods and drinks principally consumed by children or products for the general public which are consumed in substantial volume by children.

However, in two areas there are important differences which should be reflected in special provision in ASA/CAP regulations.

(i) INFANTS, up to one year of age, have special requirements for growth and development. A COMA report on weaning foods and drinks is expected later this year. Therefore, we propose:

Products for infants are heavily advertised in journals for hcalth visitors, midwives, nurses, doctors, dietitians and nutritionists. Thus, our gcneral recommendation about the need to extend control to publications intended for professionals is particularly important here.

Many infant products are designed for babies at a specific stage of their development (for example, follow on formula), are appropriate only for babies with particular health problems (soya formula) or carry risks if not used very carefully (sweetened baby drinks).

There are numerous cases of misuse of such products because parents received only a general impression from advertisements and overlooked the specific conditions of use and/or warnings in the small print on the label. Therefore, we propose:

This is a requirement in many advertisements for drugs and we believe analogous requirements are appropriate in products for infants.

A significant principle in the promotion of products for iii fants, agreed by all parties, is that advertising should not in any way discourage breastfeeding. The challenge for the ASA/CAP is to translate that principle into workable regulations. Concerns focuses on three aspects of the issue:

1. Bottles, teats and all other components of alternative infant feeding systems.
2. Products which are fed to infants through bottles - all types of formulae, 'baby drinks' and other specialist products for the very young.
3. The age at which any infant product is recommended for use.

The NFA considers that these are specialist products with important nutritional consequences and must be dealt with separately.

However, simultaneous with the preparation of this report, the issue of advertising infant products is the subject of public debate as Parliament considers implementing regulations for the European Union's directive on infant and follow-on formulae.

The NFA will wait until the conclusion of these discussions before making recommendations in this area. But it is such an important subject that the NFA will be making supplementary proposals to the ASA/CAP in the near future.

(ii) DENTAL CARIES is substantially a disease of childhood. Children are the most vulnerable group for tooth decay. The principal cause is the frequent and excessive consumption of refined (non-milk extrinsic) sugars (COMA, 1989). When the sugars are contained in drinks which are acidic in nature, there is the additional problem of the erosion of tooth enamel (Grenby, 1989).

In their practical advice to consumers, Eight Guidelines for a Healthy Diet, MAFF, DH and HEA (1990) caution 'Don't cat sugary foods too often' and recommend that intakes of sugary foods and drinks should be limited to mealtimes.

Special care needs to be taken to ensure that advertising for such products does not encourage inappropriate consumption. Therefore, the NFA proposes:

Advertisements must not encourage children to consume
foods or drinks which contain non-milk extrinsic sugars
or drinks which are acidic in nature frequently
throughout the day or in between meals.

There is a particular problem of consumption late at night, because the neutralising flow of saliva is reduced during sleep, increasing the risk of tooth decay. Therefore, the NFA proposes:

(b) Advertising to Children:

Young children are unable to assess the full purpose and content of advertising. Rule B.20 therefore prohibits exploitation of children's credulity, lack of experience or sense of loyalty, and Section C.X translates this general principle into several specific restrictions on advertising content and techniques.

The NFA considers that there should be parallel specific rules to protect children from inappropriate food and drink advertising. The principal nutrients of concern are fats and sugars, where current consumption is in excess of government dietary recommendations. Therefore, the NFA proposes:

In addition to print media, this rule would cover billboard advertising near schools and advertising during cinema presentations with a large child audience.

In addition, the NFA considers that in advertisements for 'fatty and sugary foods', there should be restrictions on the use of techniques that likely to appeal to children.

Therefore, the NFA proposes:

In conclusion the NFA wishes to reaffirm its support for review of advertising codes of practice. The NFA has carefully examined the existing codes and has sought to put forward realistic proposals. In recognising that advertising has the power to inform as well as persuade, the NFA's proposals aim to ensure that advertising is not only legal, decent, honest and truthful but that it supports rather than undermines accepted healthy eating principles.

The CAP review provides an ideal opportunity for the advertising code to be updated in line with current nutritional guidelines and government policy on health and nutrition. We urge the CAP/ASA to use this valuable opportunity to act in the interests of public health, child welfare and consumer protection.

ASA (1994) Monthly Report No 35, Advertising Standards Authority, London.

British Heart Foundation (1992) Special Diets and the Heart, Factfile 9/92, BHF, London.

Cannon, G. (1992), Food and Health: The Experts Agree, Consumers' Association, London.

Commission of the European Communities (1992), Proposal of a Council Directive on the Use of Claims Concerning Foodstuffs, Doe. 5PN62, Brussels.

Committee on Medical Aspects of Food Policy (1989), Dietary Sugars and Human Disease, Department of Health, HMSO, London.

Committee on Medical Aspects of Food Policy (1991), Dietary Reference Values for Food Energy and Nutrients for the United Kingdom, Department of Health, HMSO, London.

Coronary Prevention Group (1991), The Regulation of Nutrition Claims, London. Dibb, S (1993), Children: Advertisers' Dream, Nutrition Nightmare?, London.

Divisional Court (1988), R v Advertising Standards Authority Ltd ex parte The Insurance Service PLC.

Food Advisory Committee (1991), Report on its Review of Food Labelling and Advertising 1990, FdAC/REP/10, Ministry of Agriculture, Fisheries and Food, HMSO, London.

Grenby, T H, et al (1989) Laboratory Studies of the Dental Properties of Soft Drinks, British Journal ofNutrition, 62, 451-64. See also, Smith A J, Shaw, L (1987) Baby fruit juices and tooth erosion, British Dental Journal, 24 Jan 1987, pp65-7; Duggal, M S, Curzon, E J (1989) An evaluation of the cariogenic potential of baby and infant fruit drinks, British Dental Journal, 166, 327-30.

Food and Drug Administration, The New Food Label, FDA Backgrounder BG94-2 (April 1994), Washington.

Hill, Al (1993) Pre-adolescent dieting, International Review of Psychiatry, Vol 5, 87-100.

Ministry of Agriculture, Fisheries and Food (1990), Food Labelling Survey England and Wales, HMSO, London.

Ministry of Agriculture, Fisheries and Food (1991), 'Food Advisory Committee Review of Food Labelling: Table of Recommendations and the Government's Initial Response, London.

Ministry of Agriculture, Fisheries and Food (1 992a), Draft Food Labelling (Amendment) (Nutrition Claims) Regulations, Reference SFL 132, 4 March, London.

Ministry of Agriculture, Fisheries and Food (1992b), Food Advisory Committee Review of Food Labelling: Table of Recommendations and the Government's Final Response, London.

Ministry of Agriculture, Fisheries and Food (1994), The Infant Formula and Followon Formula Regulations 1994, London.

Ministry of Agriculture, Fisheries and Food, Department of Health and the Health Education Authority (1990), Eight Guidelines for a Healthy Diet, MAFF, London.

National Dairy Council (1992), Food and Health. What Does Britain Think?, NDC.

Nutrition Task Force (1994), Eat Well, Department of Health, London.

Register-MEAL (Quarterly Serial Publication), Advertising Expenditure, London.