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      The Timing, Nature and Extent of Social Media Marketing by Unhealthy Food and Drinks Brands During the COVID-19 Pandemic in New Zealand

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          Abstract

          Background: Concerns have been raised that health and societal causes surrounding the COVID-19 pandemic were misappropriated by companies to promote their unhealthy products to vulnerable populations during a time of increased stress and hardship (i.e., COVID-washing). Social media is a common medium for unhealthy foods and beverage marketing due to lack of regulation and low levels of monitoring.

          Purpose: This study aimed to investigate the timing, nature and extent of COVID-washing on public social media accounts by New Zealand's major food and drink brands in the initial stage of the pandemic after the first case was detected in New Zealand and when stay-at-home lockdown restrictions (Level 4 and 3 Alert levels) were in place.

          Methods: A content analysis of social media posts from February to May 2020 by the twenty largest confectionery, snacks, non-alcoholic beverages, and quick-service restaurant (fast-food) brands was undertaken. COVID-19 related posts were identified and classified to investigate the timing, themes and engagement with social media marketing campaigns, flagging those that may breach New Zealand's Advertising Standards.

          Results: 14 of 20 unhealthy food and drink brands referenced COVID-19 in posts during the 4-month period, peaking during nationwide lockdown restrictions. Over a quarter of all posts by the 14 brands ( n = 372, 27.2%) were COVID-19 themed. Fast-food brands were most likely to use COVID-19 themed posts ( n = 251/550 posts, 46%). Fast-food brands also had the highest number of posts overall during the pandemic and the highest engagement. The most commonly-used theme, present in 36% of all social media posts referring to COVID-19, was to draw on feelings of community support during this challenging time. Suggesting brand-related isolation activities was also common (23%), and the message that “consumption helps with coping” (22%). Six posts were found to potentially breach one of New Zealand's advertising standards codes by promoting excessive consumption or targeting children.

          Conclusion: COVID-washing was used by unhealthy food and drinks brands to increase brand loyalty and encourage consumption. The current Advertising Standards system is ineffective and must be replaced with a government-led approach to effectively regulate social media advertising to protect all New Zealanders, particularly in times of crisis.

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          Most cited references45

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          Impact of COVID-19 Pandemic on Mental Health in the General Population: A Systematic Review

          Highlights • The Coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hazards to mental health globally. • Relatively high rates of anxiety, depression, post-traumatic stress disorder, psychological distress, and stress were reported in the general population during the COVID-19 pandemic in eight countries. • Common risk factors associated with mental distress during the COVID-19 pandemic include female gender, younger age group (≤40 years), presence of chronic/psychiatric illnesses, unemployment, student status, and frequent exposure to social media/news concerning COVID-19. • Mitigation of COVID-19 induced psychological distress requires government intervention and individual efforts.
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            Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

            Summary Background Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. Methods By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. Findings In 2017, 11 million (95% uncertainty interval [UI] 10–12) deaths and 255 million (234–274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1–5] deaths and 70 million [34–118] DALYs), low intake of whole grains (3 million [2–4] deaths and 82 million [59–109] DALYs), and low intake of fruits (2 million [1–4] deaths and 65 million [41–92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. Interpretation This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. Funding Bill & Melinda Gates Foundation.
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              Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study

              Abstract Objective To describe outcomes of people admitted to hospital with coronavirus disease 2019 (covid-19) in the United States, and the clinical and laboratory characteristics associated with severity of illness. Design Prospective cohort study. Setting Single academic medical center in New York City and Long Island. Participants 5279 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection between 1 March 2020 and 8 April 2020. The final date of follow up was 5 May 2020. Main outcome measures Outcomes were admission to hospital, critical illness (intensive care, mechanical ventilation, discharge to hospice care, or death), and discharge to hospice care or death. Predictors included patient characteristics, medical history, vital signs, and laboratory results. Multivariable logistic regression was conducted to identify risk factors for adverse outcomes, and competing risk survival analysis for mortality. Results Of 11 544 people tested for SARS-Cov-2, 5566 (48.2%) were positive. After exclusions, 5279 were included. 2741 of these 5279 (51.9%) were admitted to hospital, of whom 1904 (69.5%) were discharged alive without hospice care and 665 (24.3%) were discharged to hospice care or died. Of 647 (23.6%) patients requiring mechanical ventilation, 391 (60.4%) died and 170 (26.2%) were extubated or discharged. The strongest risk for hospital admission was associated with age, with an odds ratio of >2 for all age groups older than 44 years and 37.9 (95% confidence interval 26.1 to 56.0) for ages 75 years and older. Other risks were heart failure (4.4, 2.6 to 8.0), male sex (2.8, 2.4 to 3.2), chronic kidney disease (2.6, 1.9 to 3.6), and any increase in body mass index (BMI) (eg, for BMI >40: 2.5, 1.8 to 3.4). The strongest risks for critical illness besides age were associated with heart failure (1.9, 1.4 to 2.5), BMI >40 (1.5, 1.0 to 2.2), and male sex (1.5, 1.3 to 1.8). Admission oxygen saturation of 1 (4.8, 2.1 to 10.9), C reactive protein level >200 (5.1, 2.8 to 9.2), and D-dimer level >2500 (3.9, 2.6 to 6.0) were, however, more strongly associated with critical illness than age or comorbidities. Risk of critical illness decreased significantly over the study period. Similar associations were found for mortality alone. Conclusions Age and comorbidities were found to be strong predictors of hospital admission and to a lesser extent of critical illness and mortality in people with covid-19; however, impairment of oxygen on admission and markers of inflammation were most strongly associated with critical illness and mortality. Outcomes seem to be improving over time, potentially suggesting improvements in care.
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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                05 March 2021
                2021
                05 March 2021
                : 8
                : 645349
                Affiliations
                [1] 1Social and Community Health, School of Population Health, University of Auckland , Auckland, New Zealand
                [2] 2Epidemiology and Biostatistics, School of Population Health, University of Auckland , Auckland, New Zealand
                [3] 3Global Obesity Centre, Institute for Health Transformation, Deakin University , Geelong, VIC, Australia
                [4] 4Healthy Auckland Together, Auckland Regional Public Health Service , Auckland, New Zealand
                Author notes

                Edited by: Igor Pravst, Institute of Nutrition, Slovenia

                Reviewed by: Stephanie R. Partridge, The University of Sydney, Australia; Kim D. Raine, University of Alberta, Canada

                *Correspondence: Sarah Gerritsen s.gerritsen@ 123456auckland.ac.nz

                This article was submitted to Eating Behavior, a section of the journal Frontiers in Nutrition

                Article
                10.3389/fnut.2021.645349
                7973089
                33748177
                259044b4-7808-4c7e-a125-b698a67f90e9
                Copyright © 2021 Gerritsen, Sing, Lin, Martino, Backholer, Culpin and Mackay.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 23 December 2020
                : 08 February 2021
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 59, Pages: 13, Words: 9763
                Funding
                Funded by: National Heart Foundation of New Zealand 10.13039/501100001516
                Categories
                Nutrition
                Original Research

                coronavirus,covid-19,food marketing,advertising,food and beverage,social media,new zealand,commercial determinants of health

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