A/HRC/26/31 more than 42 million were children under the age of five, with 35 million of those children in developing countries.52 35. Children are particularly vulnerable to diet-related NCDs either because they may be dependent on others, such as parents or schools, for food, or because they are more susceptible to marketing pressures.53 In addition, unhealthy childhood diets can have severe health consequences later in life because of the early formation of eating habits and preferences and also because childhood NCDs are likely to persist into adulthood. Addressing unhealthy diets as a risk factor for NCDs in children can bring substantial health gains and reduce the burden of health-care expenditure over their entire life cycle.54 36. In addition to marketing of unhealthy food targeted at children, including through toy giveaways, competitions, social media, cartoon characters, games, television, movies, interactive websites and in youth-oriented settings such as schools and recreation centres, parents are also often targeted by such pervasive marketing.55 This is done to encourage parents to buy unhealthy foods for their children. In many cases, the food industry’s marketing to children and their parents may be disproportionately aimed at particular racial, ethnic or socioeconomic groups, exacerbating health inequities faced by those groups.56 37. Children are also frequently exposed to junk foods in both public and private settings. Food served or sold in institutional settings such as schools may be disproportionately weighted towards junk foods or other foods of limited nutritional value, particularly in school lunch programmes, where funds for healthier foods may be limited.57 Other places serving children and youth, such as sports centres, may also lack healthy food options. In the private sector, meals designed for children are often high in fat, sugar and salt, and fail to meet children’s nutritional needs, especially at fast food establishments. This may be the case even for foods marketed as “healthy” children’s meals. Where genuinely nutritious options are available, the default option may still be the unhealthy one.58 38. States are urged to implement their obligations regarding children’s right to health, which requires States to address obesity in children, limit children’s exposure to fast foods and drinks high in sugar and caffeine and other harmful substances, regulate the marketing of such foods and control their availability in schools and other places frequented by children. States should also ensure that effective health education and awareness programmes are targeted toward children, such as countermarketing campaigns or peer education programmes, and that healthy food options and information relating to them are available at institutions serving children, such as schools, paediatric health facilities or youth centres. 52 53 54 55 56 57 58 14 Ibid, p. 7. NCD Alliance, “Children in every policy: recommendations for a lifecourse approach to NCDs”, briefing paper, May 2011, p. 2. “A focus on children and non-communicable diseases (NCDs)” (see footnote 54 above), p. 5. WHO Regional Office for Europe, Marketing of Foods High in Fat, Salt and Sugar to Children: Update 2012–2013 (Copenhagen, 2013); Consumers International, The Junk Food Trap: Marketing Unhealthy Food to Children in Asia Pacific (London, 2008). Yale Rudd Center for Food Policy and Obesity, Fast Food Facts 2013: Measuring Progress in the Nutritional Quality and Marketing of Fast Food to Children and Teens (Robert Wood Johnson Foundation, Princeton, 2013), p. 63. Patricia M. Anderson and Kristin F. Butcher, “Reading, writing and raisinets: are school finances contributing to obesity?”, National Bureau of Economic Research Working Paper No. 11177, (Cambridge, 2005), p. 5. Available from http://www.nber.org/papers/w11177.pdf. Fast Food Facts 2013 (see footnote 59 above), p. 29.