The impact of the social media industry as a commercial determinant of health on the digital food environment for children and adolescents: a scoping review.

Introduction: There is emerging evidence that the social media industry contributes to adverse health outcomes by shaping the digital food environment for children and adolescents (aged 0-18). The aim of this scoping review was to determine the extent of research on how the social media industry, including the broader online landscape, influences the digital food environment and affects child and adolescent health.

Methods: A scoping review was conducted in the electronic databases of PubMed, Scopus and PsycINFO, along with forward and reverse citation searching for peer-reviewed articles published in English between 2000 and May 2023. A qualitative descriptive synthesis of the included articles was performed to identify trends, themes and research gaps in the current literature.

Results: The review identified 36 articles for inclusion. Most research was conducted in high-income countries and publications have increased since 2021. The review found most children and adolescents are exposed to food advertisements on social media and most advertised food is ultra-processed. Heightened by a lack of social media advertising awareness, digital food marketing influences children and youth's consumption and food behaviour. Voluntary children's food marketing regulations are ineffective for the online environment. Countering unhealthy food marketing will require media literacy and government regulation.

Conclusion: The social media industry may act as a commercial determinant of health to shape the digital food environment as an extension of the obesogenic environment. Further research should explore approaches to monitor unhealthy food marketing practices and understand social media's role in the digital food environment.