Food and non-alcoholic beverage marketing and sponsorship at secondary schools in the City of Cape Town, South Africa
Background: Multinational food and beverage corporations, collectively termed 'Big Food,' contribute substantially to the global obesity crisis through deliberate product formulation, distribution, sales and marketing. Although food marketing in schools is recognized as a contributor to unhealthy dietary behaviors, evidence on its extent in South African secondary schools is limited. Objective: To identify food and non-alcoholic beverage marketing and sponsorship at secondary schools in the City of Cape Town. Methods: An observational, cross-sectional study was conducted in 37 purposively selected public secondary schools from the two largest educational districts in Cape Town. Fieldworkers captured observations of food and non-alcoholic beverage marketing material (names/logos/brands) visible from outside the school premises and within public view. A web-based search was also done to identify marketing and sponsorship activities on schools’ website pages and Twitter/X accounts. Prominently observed food and non-alcoholic beverage companies were invited to complete an online survey. Results: A total of 137 sightings of visible marketing and sponsorship materials from 35 food and non-alcoholic beverage companies were recorded in and around school premises, on school websites and Twitter/X accounts. One hundred sightings were recorded in and around school premises at 89.2% of the schools, with materials mostly displayed on signboards (40%), retail stores (33%), banners (7%), and flags (5%). The predominant company observed was The Coca-Cola Company, contributing 31.4% of the total sightings. Second was the Spar Group (12.4%). The most observed product was sugar-sweetened beverages (SSBs), contributing 29.2% of the total sightings. No online questionnaires were completed by the seven most prominent companies sighted and approached, regardless of repeated reminders. Conclusions: Food and non-alcoholic beverage marketing and sponsorship were widespread across secondary schools, with SSBs being the most prominent single category, followed by companies and supermarkets that manufacture or sell a combination of ultra-processed food and SSBs. These findings support the need for stronger regulatory measures to protect children and adolescents from unhealthy food marketing within school environments.