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Research has shown that celebrity endorsement is a marketing strategy primarily used to promote highly processed food and beverage products to children and adolescents, which negatively influences their diet quality and increases their risks of obesity. This study conducted an accountability evaluation to examine government, expert, and industry policies, guidelines, recommendations, and practices regarding using celebrity endorsement to support healthy marketing environment for young Americans. This study used the National Academy of Medicine's LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) to identify and synthesize relevant evidence between January 2000 and December 2019. We categorized the evidence in a five-step accountability framework and assigned each step a progress score (i.e., none, limited, some, and extensive). The findings showed that the US government made no progress to appoint an independent empowered body to evaluate celebrity endorsement practices. Stakeholders made some progress to take and hold industry and government to account and limited progress to share the account and to strengthen accountability structures. We suggest actions for diverse stakeholders to substantially strengthen accountability structures to ensure that celebrity endorsement is used to promote only healthy food environments to reduce obesity risks for young Americans.
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