Each year, the world’s food and beverage companies spend billions on marketing and advertising their products to children and teenagers. The overwhelming majority of these products are high in calories, added sugar, saturated fat and sodium – fast food, fizzy drinks, sweets and chocolate to name just a few. Ask your child to recall a food advert and chances are that it won’t be one for apples or broccoli.

US fast food restaurants alone spent $4.6bn on advertising to children and teens in 2012. According to Fast Food Facts 2013, children under six saw almost three adverts for fast foods every day, while 12-17-year-olds saw almost five adverts a day.

Between 2010 and 2013, the number of kids’ meals at fast-food restaurants increased by 54%. But the percentage of items that qualified as healthy – less than 1% – remained stagnant.

Report lead author Jennifer Harris, director of marketing at the Yale Rudd Center for Food Policy & Obesity, is concerned that many companies are shifting their focus to increase reach into markets not currently covered by the current system of voluntary self regulation.

“A lot of companies have switched their marketing target to the 12-14 [age] group. This is a really vulnerable time for kids; they are seeing more media and making more decisions on their own,” Harris says.

Around one in three children in the US – and in the UK – is overweight or obese. A study published this month by Roberto De Vogli of UC Davis in California found that fast food purchases were independent predictors of increases in the average body mass index (BMI) in the US and 24 other wealthy nations between 1999 to 2008.

So what is business doing?

Encouraging food and drink companies to rethink their messages is the aim of the first White House convening on food marketing to children. Launching the meeting last September, US First Lady Michelle Obama called on the private sector to “move faster” to market responsibly to children.

In January 2014, Subway became the first quick service chain to join Partnership for a Healthy America, a campaign endorsed by Obama to bring together business, non-profits and health advisers to tackle childhood obesity. A three-year commitment worth $41m will see it market healthier options and promote fruit and veg consumption.

Disney has pledged that by 2015, all food and beverage products advertised, sponsored, or promoted on Disney-owned media channels, online destinations and theme parks will be required to meet nutritional guidelines that align with federal standards to promote fruit and vegetables and limit calories, sugar, sodium, and saturated fat.

Earlier this year, Lidl became the first supermarket group in the UK to remove unhealthy products from all tills across its stores, with no seasonal exceptions for Christmas or Easter confectionery. Lidl is replacing these products with healthier options including fresh and dried fruits, nuts and bottled water.

Should regulation be playing a bigger role?

In the UK, regulation exists to prevent adverts for unhealthy foods from being broadcast during or around programmes specifically made for children. But the Children’s Food Campaign (CFC) argues that the popularity of family entertainment shows like The X-Factor means later bedtimes for many children – and advertisers are taking advantage by promoting unhealthy foods at these times.

In a joint campaign with the British Heart Foundation, the CFC will next month call for a 9pm watershed for fast food and drinks ads and clearer definition of ‘healthy’ and ‘unhealthy’ foods, to close existing loopholes.

But the ISBA, which represents British advertisers, argues that the causal link between the ads that viewers watch, and the food choices they make, is “nominal”, and ad prohibitions are currently viewed at the “silver bullet” for tackling a complex public health issue.

Ian Twinn, ISBA’s director of public affairs says: “Encouraging people to change their lifestyle rather than slapping bans on ads is what will make a difference.

“There are plenty of good examples of big brands changing their messages to ensure they stay relevant to their consumers but support the overall message for a healthier lifestyle. Coca-Cola, for instance, only advertises its low calorie or sugar-free products.”

The UC Davis study suggests that if governments take action to control food industries, they can help prevent obesity and its serious health consequences, including cardiovascular disease and diabetes. This echoes calls in the UK and US for more robust, government-led regulation of the industry, rather than voluntary self-regulation.

In the UK, the CFC hopes the government’s food promotion pledge – expected late spring as part of its public health responsibility deal – will target point-of-sale, product packaging, digital marketing and in-school promotion.

Beyond the supermarket

The CFC’s Junk Free Checkouts campaign, launched last September, challenged supermarkets to act on consumer concerns about “pester power” and remove unhealthy snacks from checkouts and queuing areas. Shoppers were urged to hand in pass or fail cards to store managers, and name and shame supermarkets via a dedicated website.

Malcolm Clark, CFC co-ordinator, says: “The government’s responsibility pledge covers supermarkets, but WH Smith and Boots have chocolate at the checkout, so the question will be whether they engage with the other companies.”

Dr Emma Boyland, a psychologist at the University of Liverpool who specialises in the effects of food marketing on children’s diets, says the next challenge is to tackle promotion to children via advergaming and social media.

“The cross-border nature of this [area] means that government can only tackle .co.uk. A little progress has been made with TV but advertising has moved to the Internet.. and into another sphere.”