Objective: To test the feasibility of a browser extension to estimate the exposure of adolescents to (un)healthy food and beverage advertisements on Facebook and the persuasive techniques used to market these foods and beverages.Design: A Chrome browser extension (AdHealth) was developed to automatically collect advertisements seen by participants on their personal Facebook accounts. Information was extracted and sent to a web server by parsing the Document Object Model tree representation of Facebook web pages. Key information retrieved included the advertisement type seen and duration of each ad sighting. The WHO-Europe Nutrient Profile Model was used to classify the healthiness of products advertised as permitted (healthy) or not permitted (unhealthy) to be advertised to children.Setting: Auckland, New Zealand.Participants: Thirty-four Facebook users aged 16–18 years.Results: The browser extension retrieved 4973 advertisements from thirty-four participants, of which 204 (4 %) were food-related, accounting for 1·1 % of the exposure duration. Of those food advertisements, 98 % were classified as not permitted, and 33·7 and 31·9 %, respectively, of those featured promotional characters or premium offers. The mean rate of exposure to not permitted food was 4·8 (sd = 2·5) advertisements per hour spent on Facebook.Conclusions: Using a Chrome extension to monitor exposure to unhealthy food and beverage advertisements showed that the vast majority of advertisements were for unhealthy products, despite numerous challenges to implementation. Further efforts are needed to develop tools for use across other social media platforms and mobile devices, and policies to protect young people from digital food advertising.

Objective: To compare the costs and climate impact (greenhouse gas emissions) associated with current and healthy diets and two healthy and environmentally friendly dietary patterns: flexitarian and vegan. Design: Modelling study Setting: Aotearoa (New Zealand). Main outcome measures: The distribution of the cost and climate impact (kgCO ₂ e/kg of food per fortnight) of 2 weekly current, healthy, vegan and flexitarian household diets was modelled using a list of commonly consumed foods, a set of quantity/serves constraints for each, and constraints for food group and nutrient intakes based on dietary guidelines (Eating and Activity Guidelines for healthy diets and EAT-Lancet reference diet for vegan and flexitarian diets) or nutrition survey data (current diets). Results: The iterative creation of 210–237 household dietary intakes for each dietary scenario was achieved using computer software adapted for the purpose (DIETCOST). There were stepwise differences between diet scenarios (p<0.001) with the current diet having the lowest mean cost in New Zealand Dollars (NZ$584 (95% CI NZ$580 to NZ$588)) per fortnight for a family of four) but highest mean climate impact (597 kgCO ₂ e (95% CI 590 to 604 kgCO ₂ e)), followed by the healthy diet (NZ$637 (95% CI NZ$632 to NZ$642), 452 kgCO ₂ e (95% CI 446 to 458 kgCO ₂ e)), the flexitarian diet (NZ$728 (95% CI NZ$723 to NZ$734), 263 kgCO ₂ e (95% CI 261 to 265 kgCO ₂ e)) and the vegan diet, which had the highest mean cost and lowest mean climate impact (NZ$789, (95% CI NZ$784 to NZ$794), 203 kgCO ₂ e (95% CI 201 to 204 kgCO ₂ e)). There was a negative relationship between cost and climate impact across diets and a positive relationship within diets. Conclusions: Moving from current diets towards sustainable healthy diets (SHDs) will reduce climate impact but generally at a higher cost to households. The results reflect trade-offs, with the larger constraints placed on diets, the greater cost and factors such as nutritional adequacy, variety, cost and low-emissions foods being considered. Further monitoring and policies are needed to support population transitions that are country specific from current diets to SHD.

The National Healthy Food and Drink Policy (NHFDP) was developed to promote healthy food environments for the New Zealand District Health Board (DHB) staff and visitors. The policy classifies food and drinks as red, amber, or green and sets benchmarks for the proportions of red, amber, and green foods that should be available on-site. The HYPE (Healthy Policy Evaluation) study is the first national evaluation of the implementation and impact of the NHFDP. We designed an electronic audit tool to collect detailed food and drink data across a range of food settings (vending machines and all food outlets) at New Zealand DHBs and some government agencies. The electronic audit tool collects all the information required to classify food and drinks under the NHFDP (photographs of foods and drinks, item weight/volume, energy and nutrient content, ingredient composition, and Health Star Rating). The web-based tool was created using Drupal (web content management framework) and pilot tested. The tool is now in use by the HYPE team in DHBs across New Zealand. Data collection commenced in March 2021 and has been completed for nine DHBs (5700 products) so far. Audit results detailing the proportion of red, amber, and green food items available at all participating institutions will be available in late 2022. Ongoing stakeholder feedback and requirements have been incorporated throughout the design process and used to improve the audit tool. This feedback has informed key lessons such as agreeing the tool’s aims and objectives collectively with stakeholders/potential end users, pilot testing the tool prior to use, and ensuring the tool is simple and accessible for all end-users. This new electronic food setting audit tool has successfully facilitated comprehensive and standardised data collection across a range of retail settings.