Examining differences in children's reported exposure to food advertising in amateur sports settings in Canada's two policy environments: A cross-sectional study.

Background: Food marketing influences children's diet. Although food companies advertise to children via sports sponsorship, little research has examined this type of advertising.

Objective: Describe and compare children's self-reported exposure to food advertising in amateur sports settings in two Canadian policy environments including Quebec (QC; where sponsorship-related advertising directed to children under 13 years is regulated) and Ontario (ON; where there are no regulations). It was hypothesized a priori that reported exposure to food advertising would be lower among children under 13 years in Quebec.

Design: Cross-sectional online survey.

Participants/setting: 1020 children aged 10-17 years living in Ontario and Quebec were recruited via a commercial panel in February-April 2023. Those who reported playing on sports team outside of school (ON=239; QC=200) were included in the analysis.

Main outcome measures: Children were asked to self-report exposure to food advertising when playing sports including i) signs, ii) branded sports equipment provided by their sports team iii) branded awards iv) free food and v) coupons or gift certificates.

Analysis: Logistic regression analysis was used to examine differences in reported exposure between provinces after adjusting for socio-economic status and child age, sex and race. Interaction terms were included to examine differences between age groups within and between provinces.

Results: The prevalence of reported exposure was highest for branded equipment (ON:57%; QC:44%) and signs (ON:47%; QC:43%), followed by branded prizes (ON:30%; QC:28%), free food (ON:25%; QC:27%) and coupons or gift certificates (ON:26%; QC:20%). The odds of reporting exposure to branded equipment were significantly lower among children in Quebec than those in Ontario (AOR: 0.68 95% CI: 0.46, 0.99, p=.049). No other differences in reported exposure, including differences between children aged 10-12 years in Quebec and other children, were found to be statistically significant for the above outcomes.

Conclusions: Findings suggest Quebec's advertising restrictions are not adequately protecting children from exposure to food advertising in amateur sports settings.