Evaluating the Proportion of Foods and Beverages in the Canadian Grocery and Chain Restaurant Food Supply That Would Be Restricted from Marketing to Children on Television and Digital Media.

Despite evidence on the association between marketing unhealthy foods to children (M2K) and negative health outcomes, M2K remains widespread in Canada. To support mandatory restrictions, Health Canada has prioritized a monitoring strategy to assess the current state of M2K, identify gaps, and establish a baseline for future policy evaluation. This study aimed to support this initiative by updating the University of Toronto (UofT) Food Classification List and evaluating the proportion of foods and beverages in the Canadian grocery and restaurant food supply that would be permitted or restricted from M2K under Health Canada's proposed nutrient profile model. Grocery items from the UofT Food Label Information Price 2020 ( = 24,949) and restaurant menu items from Menu-Food Label Information Price 2020 ( = 14,286) databases were evaluated using Health Canada's M2K nutrient profile model, which assesses foods solely based on thresholds for added sodium, sugars, and saturated fat. The proportion of items permitted for or restricted from M2K was determined overall and by food and menu categories for grocery and restaurant items, respectively. The updated UofT List contained = 24,494 grocery items and = 14,286 menu items. Overall, 83% ( = 32,664/39,235) of foods and beverages in the 2020 Canadian food supply would be restricted from M2K. Among grocery items, 23% ( = 5630) would be permitted and 77% ( = 19,202) would be restricted from M2K. Among restaurant items, only 6% ( = 837) would be permitted and 94% ( = 13,442) restricted. The updated UofT List supports Health Canada's monitoring strategy and highlights the large proportion of unhealthy products in the Canadian food supply that are currently still permitted for M2K. While Health Canada's M2K nutrient profile model is stringent, gaps remain that could allow continued M2K exposure under the current proposed policy. Ongoing monitoring and policy refinement are essential to effectively protect children from M2K and its harmful effects.