Effect of television advertisements for foods on food consumption in children

Examining school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising

OBJECTIVES

Despite recommendations to implement nutrition standards in schools, low-nutrient foods and high-energy drinks are still some of the most important challenges for school management and students' purchasing and consumption behavior. In this regard, the aim of the present study is to examine school nutrition policies and their effect on the promotion of low-nutrient foods in the context of sports advertising.

METHODS

A partial least square technique with SmartPLS 3.0 and bootstrapping with 500 resamples was used to examine the effect of food marketing on school nutrition policies and students' nutritional involvement. Online surveys were done through The Iranian Educational Network of students and measured on a 5-point Likert scale. The survey questionnaire consisted of 3 scales to measure the following: school nutrition policies, advertising of low-nutrient foods, and student nutritional involvement.

RESULTS

Results from a sample of 382 Iranian high school students revealed that low-nutrient food advertising has a significant effect on student consumption, and the greatest overall effect on students' nutritional involvement. School nutrition policies were affected by media, endorsement, and the environmental advertising, whereas school financial capabilities had the greatest direct effect on students' nutritional involvement.

CONCLUSIONS

These findings suggest that advertising through sports media plays a mediating role in school nutrition policies and student nutritional involvement. Policy changes to restrict food marketing for young people must include both television and non-broadcast media.

Effects of Food Depictions in Entertainment Media on Children's Unhealthy Food Preferences: Content Analysis Linked With Panel Data

Background

Entertainment media content is often mentioned as one of the roots of children's unhealthy food consumption. This might be due to the high quantity of unhealthy foods presented in children's media environments. However, less is known about the role of the centrality of food placement, that is, whether foods are interacted with, consumed, verbally mentioned, or appear unobtrusively. We also lack longitudinal research measuring both children's unhealthy and healthy food consumption behaviors as outcomes.

Objective

The aim is to connect content analytical data based on children's actual media diet with panel data in order to explain children's food preferences. Moreover, this study not only focuses on the amount of healthy and unhealthy foods children are exposed to, but also on how these foods are presented (ie, centrally or not). Furthermore, we looked at the question of how parental coviewing can diminish (or enhance) the effects of unhealthy (or healthy) food depictions, and we measured healthy and unhealthy consumption as dependent variables.

Methods

We conducted a 2-wave panel study with children and one of their parents (of 2250 parents contacted, 829 responded, for a response rate of 36.84%; 648 valid cases, ie, parent-child pairs, were used for analysis), with 6 months between the 2 panel waves. We linked the 2-wave panel data for the children and their parents to content analytical data for movies (n=113) and TV series (n=134; 3 randomly chosen episodes per TV series were used) that children were exposed to over the course of 6 months.

Results

There was no significant relationship between exposure to unhealthy food presentation and unhealthy (b=0.008; P=.07) or healthy (b=-0.003; P=.57) food consumption over time. Also, healthy food presentation was unrelated to unhealthy (b=0.009; P=.18) or healthy (b=0.000; P=.99) food consumption over time. However, there was a significant, positive interaction between unhealthy food presentation and presentation centrality on unhealthy food consumption (b=0.000; P=.03), suggesting that the effects of unhealthy food presentation rise with increasing levels of centrality. There was no interaction between unhealthy food presentation and presentation centrality on the consumption of healthy foods (b=0.000; P=.10). Also, exposure to healthy food presentation interacted with centrality (b=-0.001; P=.003). That is, when a healthy product was presented at maximum centrality, it led to less unhealthy food consumption in children. Coviewing did not interact with exposure to unhealthy foods when explaining unhealthy (b=0.003; P=.08) or healthy (b=-0.001; P=.70) food consumption.

Conclusions

We conclude that simply presenting more healthy foods is not sufficient to combat children's unhealthy food preferences. Further regulations may be necessary with respect to representations of unhealthy foods in children's media.

Comparison of ten policy options to equitably reduce children's exposure to unhealthy food marketing

OBJECTIVE

Reducing children's exposure to unhealthy food marketing is crucial to combat childhood obesity. We aimed to estimate the reduction of children's exposure to food marketing under different policy scenarios and assess exposure differences by socio-economic status.

DESIGN

Data on children's exposure to unhealthy food marketing were compiled from a previous cross-sectional study in which children (n 168) wore wearable cameras and Global Positioning System (GPS) units for 4 consecutive days. For each exposure, we identified the setting, the marketing medium and food/beverage product category. We analysed the percentage reduction in food marketing exposure for ten policy scenarios and by socio-economic deprivation: (1) no product packaging, (2) no merchandise marketing, (3) no sugary drink marketing, (4) no confectionary marketing in schools, (5) no sugary drink marketing in schools, (6) no marketing in public spaces, (7) no marketing within 400 m of schools, (8) no marketing within 400 m of recreation venues, (9) no marketing within 400 m of bus stops and (10) no marketing within 400 m of major roads.

SETTING

Wellington region of New Zealand.

PARTICIPANTS

168 children aged 11-14 years.

RESULTS

Exposure to food marketing varied by setting, marketing medium and product category. Among the ten policy scenarios, the largest reductions were for plain packaging (60·3 %), no sugary drink marketing (28·8 %) and no marketing in public spaces (22·2 %). There were no differences by socio-economic deprivation.

CONCLUSIONS

The results suggest that plain packaging would result in the greatest decrease in children's exposure to food marketing. However, given that children are regularly exposed to unhealthy food marketing in multiple settings through a range of marketing mediums, comprehensive bans are needed to protect children's health.

Exposure or pandemic effect: Export boom in instant noodles from South Korea during COVID-19

Amid the pandemic, it is crucial to comprehend both people's preferred food choices and the factors influencing food consumption. This understanding not only guarantees a stable food supply but also plays a pivotal role in economic recovery during times of recession. In 2020, South Korean instant noodles experienced an unprecedented surge in exports, catapulting the nation to the forefront of the global instant noodle market. The surge in the popularity of instant noodles during the pandemic can be partly attributed to their unique characteristics. However, the South Korean film Parasite, which garnered global acclaim around the same time, prominently featured instant noodle products. This exposure led to an extraordinary increase in internet searches for Korean-brand instant noodles. Therefore, this study utilized an interrupted time series model to investigate whether the surge in South Korean instant noodle exports was primarily a result of the 2019 coronavirus pandemic or the influence of the film. Our estimations indicate that the film's exposure effect predominantly explains the export boom of South Korean instant noodles.

Effects of a health versus hedonic mindset on daily-life snacking behaviour

BACKGROUND

In today's obesogenic environment high-caloric palatable foods are omnipresent, making it hard for many to reach and maintain a healthy body weight. This study investigates the effects of a health versus hedonic mindset on daily-life snacking behaviour. The hypothesis is that a health mindset leads to reduced snacking behaviour compared to a hedonic mindset. This effect is expected to be most pronounced with high dietary restraint and least pronounced with high trait self-control.

METHODS

For 3 weeks, degree of craving and amount of snacks that were craved and consumed were assessed four times a day, using smartphone Ecological Momentary Assessment (EMA). A total of 111 female participants (body mass index range: 20-23.5) were randomly assigned to a 1-week health (n = 53) or hedonic (n = 58) mindset, occurring in week 2 of the EMA protocol. The mindset manipulations consisted of text messages, focusing either on the enjoyment of tasty food (hedonic) or on healthy living and eating (health).

RESULTS

contrary to our hypotheses, mindset did not affect snacking behaviour. Instead, degree of craving and intake of snacks reduced significantly over time, not moderated by mindset, dietary restraint (Restraint Scale) or trait self-control (Brief Self-Control Scale). Importantly, this was not due to reduced compliance. Possibly, the reduced craving and snacking behaviour were due to monitoring and/or socially desirable answering tendencies. Additional time point analyses showed that craving was strongest in the late afternoon (3:30-5:00 PM), and-across mindset conditions-degree of craving correlated negatively with trait self-control.

CONCLUSIONS

future studies could manipulate degree of monitoring and design individually tailored manipulations.

Recreational screen time trajectories during early childhood and imaging-measured body composition at age 7 in the Odense child cohort

BACKGROUND

Children spend increasing amounts of time on recreational screen media, which may lead to an obesogenic environment.

OBJECTIVES

We investigated the association of trajectories of screen time across ages 3, 5 and 7 years with body composition at age 7 in the Odense Child Cohort.

METHODS

Data were collected in the Municipality of Odense, Denmark, between 2010 and 2019. Group-based trajectory modelling was applied to group participants into four trajectories of prospective parent-reported screen time. Body composition was assessed using dual-energy x-ray absorptiometry with calculated fat-mass index (FMI) as the primary outcome. Primary models were linear multivariable regression models adjusted for participants' sex, age, birthweight, maternal origin, maternal education, maternal body-mass-index, and maternal age. Further models were adjusted for additional possible confounders. Selection bias was addressed by inverse probability weighting.

RESULTS

In total, 803 children (48.2% female) were included in the primary analysis. Participants with screen time at all time points were assigned to four trajectory groups [constant low screen time (12.7%), low increase (36.3%), high increase between ages 3 and 5 (33.5%) and high increase in screen time (17.5%)]. Sample characteristics differed across missing data status and trajectories. Mean FMI (kg/m² ) and standard deviation (SD) were 3.7 (SD 1.3) and 3.9 (SD 1.6) for the constant low versus high screen time, respectively. No differences in FMI were found between screen time trajectory groups at age 7 (adjusted mean difference 0.1 kg/m² , 95% confidence interval -0.3, 0.5 for constant low versus high screen time). No consistent associations between screen time groups and secondary body composition outcomes were found.

CONCLUSIONS

Results from this study do not suggest that recreational screen time from age 3 to 7 years is associated with adiposity or other measures of body composition.

Modern pied pipers: Child social media influencers and junk food on YouTube: A study from Germany

Kid influencers (under the age of 13) have profiles on social media platforms and create content to generate views and engagements. To reach young consumers, food companies are increasingly using kid influencers, perceived as highly trustworthy among children of the same age, to promote their (high-calorie) food products. Exposure to such content can lead to an increase in calorie intake. Therefore, this study aimed to identify which foods and beverages are featured in the videos of the four kid influencer channels most popular in Germany and, if possible, which Nutri-Score category these products receive. Of each channel, 50 of the most popular and 50 of the newest videos were analyzed regarding the food and beverage products and brands appearing in the video and the thumbnail. To analyze the number of appearances, each product was categorized as to whether it was branded or unbranded. Where possible, the Nutri-Score was then calculated for each product that appeared. Within the total video sample (N = 373), food and/or beverages appeared in almost 70% of the videos, of which 220 were branded and 178 were unbranded products. Due to incomplete nutrition labels of branded products, only 146 branded products could be analyzed, from which 66% received the worst Nutri-Score categories D and E. The unbranded foods were evaluated using products as similar as possible, of which the majority received Nutri-Score A. The most common brands included McDonald's, Kinder, and Coca-Cola, and the most frequent product categories were chocolate, candy, soft drinks, and fruit. The high number of high-calorie products in the videos shows that kid influencers might be regarded as a risk factor when it comes to childhood obesity.

Food and Beverage Product Appearances in Educational, Child-Targeted YouTube Videos

Background: Food advertisement exposure is associated with children's increased caloric intake, but little is known about food/beverage placements in child-oriented educational YouTube videos. We aimed to quantify the prevalence of food/beverages in these videos and assess their nutritional quality. Methods: Researchers identified child-oriented educational YouTube videos from 2020, using keyword searches. We coded the names of featured food/beverages, coded how the food/beverages were interacted with, quantified the number of minutes the food/beverages appeared, and assessed the nutritional quality of the food/beverages. Results: A sample of 400 videos with the highest number of views was identified, 165 of which featured food/beverages. These 165 videos were collectively viewed over 1.1 billion times. Among these videos, 108 (67.4%) featured unhealthy foods and 86 (52.1%) featured branded products. Most food/beverages were used in experiment/tutorials (n = 143, 86.7%). Of the 165 videos featuring food/beverages, 91 (55.2%) did not depict food/beverages in their video thumbnail. Conclusions: While unhealthy food/beverages appear frequently in child-oriented educational YouTube videos, parents and teachers may not be aware of the presence of branded food/beverage products in these videos that could influence their children's food and brand preferences. The Federal Trade Commission should collect data on food and beverage company sponsorship of educational videos aimed at children and adolescents.

Towards a regulation of food advertising?

For 20 years the UK Government has recognised that food advertising plays a part in food choices and hence diets of the population, particularly for children. In 2007 the UK brought in regulations to stop the advertising of less healthy foods on television (TV) during child-specific programming. Less healthy foods were defined using the 2004/2005 nutrient profiling model (NPM) as products high in saturated fat, salt and sugar (HFSS). Evaluations showed that children were still seeing and being affected by the adverts for less healthy foods. To try to mitigate childhood obesity, in 2018, the UK Government announced its intention to consult on further restrictions on the advertising of HFSS products on TV and online. Two years later, the intention to implement a 9pm advertising ban on TV and a further consultation on restricting online advertising of HFSS products was announced. New legislative controls on the advertising of HFSS foods are expected to be brought into legislation in the UK in January 2024. In the present paper, the history of advertising restrictions in the UK and the evidence informing them is reviewed. There will also be a reflection on where further actions might be needed in due course.

Cross-sectional associations between screen time and the selected lifestyle behaviors in adolescents

Background

In adolescents, excessive screen time leads to many adverse health outcomes and is associated with a variety of lifestyle behaviors. This study was conducted to investigate the associations between the two types of screen time and a variety of lifestyle behaviors in American adolescents.

Methods

Based on the Youth Risk Behavior Surveillance System, this cross-sectional study was conducted. With the help of data collectors, participants self-reported screening time, lifestyle behaviors, and demographic data via well-validated tools.

Results

19% and 43.4% of the participants spent more than two hours a day watching television and using the computer, respectively, while the prevalence of physical inactivity and insufficient sleep was 75.1 and 74.4% respectively. Furthermore, 11.9, 7.3, 14.3, and 21.3% of the participants reported skipping fruits, vegetables, breakfast and milk, respectively. Moreover, the prevalence of alcohol and tobacco consumption and sexual activity was 26.8, 5.3, and 23.5% respectively. More than two hours of television time was significantly associated with high risks of fewer frequency for eating fruit (OR = 1.605, 95%CI: 1.308-1.970), vegetables (OR = 1.389, 95%CI: 1.029-1.873), and smoking (OR = 1.465, 95%CI: 1.088-1.972). Computer/video time for more than two hours was significantly associated with high risks of physical inactivity (OR = 1.724, 95%CI: 1.531-1.941), insufficient sleep (OR = 1.354, 95%CI: 1.151-1.592), and not eating fruit (OR = 1.434, 95%CI: 1.179-1.745).

Conclusion

Increased screen time may be associated with specific unhealthy lifestyle behaviors in adolescents. Furthermore, the associations between different types of screen time and various lifestyle behaviors varied.

The distribution of harmful product marketing in public outdoor spaces and the effectiveness of marketing bans

Children's exposure to the marketing of harmful products in public outdoor spaces may influence their consumption of those products and affect health into adulthood. This study aimed to: i) examine the spatial distribution of children's exposure to three types of marketing-related 'harms' (alcohol, unhealthy food, and gambling) in outdoor spaces in the Wellington region, New Zealand/Aotearoa; ii) compare differences in the distribution of harms by socioeconomic deprivation; and iii) estimate the effectiveness of different policies that ban such marketing. Data were from 122 children aged 11-13y who wore wearable cameras and GPS devices for four consecutive days from July 2014 to June 2015. Images were analysed to identify harmful product marketing exposures in public outdoor spaces. Eight policy scenarios were examined to identify the effectiveness of marketing bans, for all children and by socioeconomic deprivation. Children's ratio of harmful marketing was higher for children from high deprivation households and was also found to cluster, with hots spots observed around city centers. The effectiveness of marketing bans depended on the target setting and ban area, with banning 400 m around bus stops leading to the largest reduction. Effectiveness varied also by type of harm and socioeconomic deprivation. For example, banning alcohol marketing in residential areas was estimated to have a larger effect on exposure reduction for children from high deprivation households. Our findings suggest that alcohol, unhealthy food and gambling marketing often cluster outdoors and that targeted bans of such marketing would likely improve child health and, for some banning scenarios, promote equity.

Manipulated exposure to television-style healthy food advertising and children's healthy food intake in nurseries

The detrimental impact of currently disproportionate amounts of digital food advertising for processed foods high in sugar, salt, and fat (HSSF) on children's food intake and dietary health is well-documented. The potential of digital healthy food advertising to encourage healthy eating in children is much less researched. A pre-test post-test control group design was used to compare the effect of specifically designed, television-style advertisements for healthy food versus toys on 172 three-to seven-year-old children's exclusively healthy food intake (vegetable, fruit, whole-grain) in five nurseries in Germany. Within- and between-group comparisons demonstrated the effectiveness of healthy food advertising exposure to increase children's healthy food intake. Three exposures to a 1-min-advertisement for healthy food were sufficient to increase children's healthy food intake by as much as three portions. Children in the control condition ate less healthy foods following viewing of a control advertisement (a matched toy advertisement). We concluded that digital healthy food advertising is likely to increase children's healthy food intake sufficiently to help children meet daily recommended amounts of vegetables, fruit, or whole-grain bread, and that this encouragement may be required as decreases in healthy food intake were found when healthy foods were merely available.

Social Awareness of Whole Grains and the Feasibility of Replacement with Refined Grains: A Qualitative Study

Background

A correlation between type 2 diabetes and refined carbohydrates has been proven, while several studies have indicated that Iranian daily diets are poor in term of proper carbohydrates. It was thus considered absolutely critical to conduct a qualitative study in terms of people's attitudes toward whole grains, and the feasibility of their replacing existing refined carbohydrates in their diets. The aim of this study is to probe Iranian awareness of whole grains, to explore barriers to refined-grain substitution with whole grains and legumes, and to assess whole-grain sensory perceptions.

Methods

Focus group discussions (FGDs) and taste tests conducted between July 2016 and March 2017 in urban and rural areas of Kurdistan, Yazd, and Tehran provinces in Iran. A total of 96 healthy men and women (aged 40-65, BMI ≥25 kg/m²) were selected through purposive sampling with maximum variation. FGDs were categorized by content analysis method. As for taste test, ANOVA analysis with Bonferroni post-hoc was used to determine significant differences (P < 0.05).

Results

Four themes and 11 sub-themes emerged. Cultural beliefs, traditional eating patterns, sensory properties, and familial acceptance were the most influential factors in choosing the type of bread and rice. Simultaneously they are the most prominent barriers to consuming whole grains and legumes. Plain cooked brown rice had the lowest mean sensory attribute score and traditional whole-wheat flatbread was the highest.

Conclusions

There was a higher acceptance tendency toward using traditional whole-wheat flatbread rather than refined grains, as it was consistent with preference and priority. However, low availability was the largest substitution problem.

Social Media Accounts of Food and Beverage Brands Have Disproportionately More Black and Hispanic Followers than White Followers

Introduction: On television, food companies promote their least nutritious products to Black and Hispanic youth more than White youth, but little is known about the extent to which Black and Hispanic adolescents may disproportionately engage with unhealthy food and beverage brands on social media relative to White adolescents. Methods: In 2019, we purchased and analyzed demographic data of social media users who followed 27 of the most marketed food/beverage brands on Instagram and Twitter. We used one-sample t-tests to compare percentages of Black, Hispanic, and White followers of the selected brands' accounts versus all social media accounts, and independent samples t-tests to compare followers of sugary versus low-calorie drink brands. We also used linear regression to examine associations between racially targeted marketing practices and the percentages of Black, Hispanic, and White followers on social media. Results: On Instagram, the percentage of Black followers of the selected brands (12.7%) was higher than the percentage of Black followers of any account (7.8%) (p<0.001). On Twitter, findings were similar for Hispanic users but opposite for White users. A higher racially targeted ratio was positively associated with the percentage of Black followers, and negatively associated with the percentage of White followers. Sugary drink brands had more Hispanic followers than low-calorie drink brands (p<0.001). Conclusions: Unhealthy food/beverage brands that target Black adolescents have a disproportionately higher percentage of Black followers on social media relative to White followers. These findings support the 2019 proposal to restrict racially targeted advertising through the Children's Online Privacy and Protection Act.

The effect of television advertising on soft drink consumption: Individual vulnerabilities in approach bias and inhibitory control

Continual exposure to soft drink cues in the environment is thought to be a major contributor to the rising consumption of soft drinks. This study investigated the effect of one such cue, television advertising, on soft drink choice and intake. Within the context of dual-process models, we examined whether any such effects would be stronger for individuals with an automatic tendency to reach for soft drinks (approach bias) or a difficulty resisting soft drinks (poor inhibitory control). Participants (N = 127; 18-25 years) viewed television advertisements for either soft drinks or control (non-sweetened) beverages. Approach bias and inhibitory control were assessed by soft drink versions of the approach-avoidance and go/no-go tasks, respectively. Participants who had viewed the soft drink advertisements were more likely to choose a soft drink as their first drink than those who had viewed the control advertisements. This effect was stronger for participants with an approach bias for soft drinks. In addition, participants with poorer inhibitory control chose more soft drinks overall following the soft drink advertisements. Although exposure to soft drink advertisements did not affect soft drink intake in the taste test, participants with poorer inhibitory control consumed more of the soft drinks. In line with dual-process models, individuals with strong automatic tendencies or poor self-regulatory control were more responsive to television advertising for soft drinks. At a practical level, these cognitive vulnerabilities provide potential targets for intervention to help resist soft drink cues.

Meal-time Smartphone Use in an Obesogenic Environment: Two Longitudinal Observational Studies

Background

Despite a large volume of research on the impact of other digital screens (eg, televisions) on eating behavior, little is known about the nature and impact of mealtime smartphone use.

Objective

We investigated how smartphones are used in everyday meals, whether phone users differ according to mealtime phone use patterns, and whether specific phone functions (particularly food photography) would affect the amount and enjoyment of food eaten.

Methods

Across 2 studies, we used the experience sampling method to track 1780 meals in situ. In study 1, a total 137 young adults reported on their mealtime smartphone use 3 times per day over 7 consecutive days. This corresponded to each main meal, with participants recording whether they used their phones and what phone functions they engaged in while eating. In study 2, a total of 71 young adults were similarly tracked for 3 meals per day over 7 days. Across the week, participants’ meals were randomized to 1 of 3 smartphone conditions: food photography while eating, nonfood photography while eating, or no phone use. As the outcome measures, participants reported on the amount and enjoyment of food they ate.

Results

During the week-long tracking, most participants (110/129, 85.3%) recorded at least one instance of mealtime smartphone use, with an average frequency of 1 in 3 meals where phones were used (27.1%; 95% CI 23.6-30.6). Unlike traditional digital screens, mealtime phone use encompassed a wide range of social and nonsocial activities. Further, specific forms of phone use behaviors influenced food intake in different ways. Specifically, in study 2, participants showed the typical pattern of increased food intake across the day when they engaged in nonfood photography during a meal (P<.001); however, this pattern was disrupted when they engaged in food photography (P=.73).

Conclusions

Our findings underscore the prevalence and multifaceted nature of mealtime phone use, distinguishing mobile phones from traditional forms of digital screens.

Trial Registration

ClinicalTrials.gov NCT03299075; https://www.clinicaltrials.gov/ct2/show/NCT03299075 and ClinicalTrials.gov NCT03346785; https://clinicaltrials.gov/ct2/show/NCT03346785

Exposure of Children to Unhealthy Food and Beverage Advertisements in South Africa

Television (TV) is a powerful medium for marketing food and beverages. Food and beverage marketers tend to use this medium to target children with the hope that children will in turn influence their families' food choices. No study has assessed the compliance of TV marketers with the South African Marketing to Children pledge since the enactment of the 2014 food advertising recommendations by the South African Department of Health and the Advertising Standards Authority. This study investigated the extent and nature of advertising of unhealthy versus healthy food and beverages to children in South African TV broadcasting channels. The date, time, type, frequency and target audience of food advertisements (ads) on four free-to-air South African TV channels were recorded and captured using a structured assessment guide. The presence of persuasive marketing techniques was also assessed. Unhealthy food and beverage advertising was recorded at a significantly higher rate compared with healthy food and beverages during the time frame when children were likely to be watching TV. Brand benefit claims, health claims and power strategies (e.g., advertising using cartoon characters and celebrated individuals) were used as persuasive strategies. These persuasive strategies were used more in unhealthy versus healthy food ads. The findings are in breach of the South African Marketing to Children pledge and suggest a failure of the industry self-regulation system. We recommend the introduction of monitored and enforced statutory regulations to ensure healthy TV food advertising space.

How Digital Food Affects Our Analog Lives: The Impact of Food Photography on Healthy Eating Behavior

Obesity continues to be a global issue. In recent years, researchers have started to question the role of our novel yet ubiquitous use of digital media in the development of obesity. With the recent COVID-19 outbreak affecting almost all aspects of society, many people have moved their social eating activities into the digital space, making the question as relevant as ever. The bombardment of appetizing food images and photography – colloquially referred to as “food porn” – has become a significant aspect of the digital food experience. This review presents an overview of whether and how the (1) viewing, (2) creating, and (3) online sharing of digital food photography can influence consumer eating behavior. Moreover, this review provides an outlook of future research opportunities, both to close the gaps in our scientific understanding of the physiological and psychological interaction between digital food photography and actual eating behavior, and, from a practical viewpoint, to optimize our digital food media habits to support an obesity-preventive lifestyle. We do not want to rest on the idea that food imagery’s current prevalence is a core negative influence per se. Instead, we offer the view that active participation in food photography, in conjunction with a selective use of food-related digital media, might contribute to healthy body weight management and enhanced meal pleasure.

Brands with personalities - good for businesses, but bad for public health? A content analysis of how food and beverage brands personify themselves on Twitter

Objective:

To examine the extent to which food and beverage brands exhibit personalities on Twitter, quantify Twitter users’ engagement with posts displaying personality features and determine advertising spending across these brands on Twitter.

Design:

We identified 100 tweets from 10 food and beverage brands that displayed a ‘personality’, and 100 ‘control’ tweets (i.e. a post by that brand on the same day). Our codebook quantified the following personification strategies: (1) humour; (2) trendy language and (3) absence of food product mentions. We used media articles to quantify other personification strategies: (4) referencing trending topics; (5) referencing current events; (6) referencing internet memes and (7) targeting niche audiences. We calculated brands’ number of tweets, re-tweets, ‘likes’, and comments and report the relationship between advertising spending and retweets per follower.

Setting:

Twitter posts.

Participants:

Ten food and beverage brands that were described in media articles (e.g. Forbes) as having distinct personalities.

Results:

Personality tweets earned 123 013 retweets, 732 076 ‘likes’ and 14 806 comments, whereas control tweets earned 61 044 retweets, 256 105 ‘likes’ and 14 572 comments. The strategies used most included humour (n 81), trendy language (n 80) and trending topics (n 47). The three brands that spent the most on advertising had similar or fewer retweets per follower than the four that spent relatively little on advertising.

Conclusions:

Some food and beverage brands have distinct ‘personalities’ on Twitter that generate millions of ‘likes’ and retweets. Some retweets have an inverse relationship with advertising spending, suggesting ‘personalities’ may be a uniquely powerful advertising tool for targeting young adults.

Television advertisements for high-sugar foods and beverages: effect on children's snack food intake

Energy-dense food advertising affects children's eating behaviour. However, the impact of high-sugar food advertising specifically on the intake of sweet foods is underexplored. This study sought to determine whether children would increase their intake of sugar and total energy following high-sugar food advertising (relative to toy advertising) and whether dental health, weight status and socio-economic status (SES) would moderate any effect. In a crossover, randomised controlled trial, 101 UK children (forty male) aged 8-10 years were exposed to high-sugar food/beverage and toy advertisements embedded within a cartoon. Their subsequent intake of snack foods and beverages varying in sugar content was measured. A dental examination was performed, and height and weight measurements were taken. Home postcode provided by parents was used to assign participants to SES quintiles. Children consumed a significantly greater amount of energy (203·3 (95 % CI 56·5, 350·2) kJ (48·6 (95 % CI 13·5, 83·7) kcal); P = 0·007) and sugar (6·0 (95 % CI 1·3, 10·7) g; P = 0·012) following food advertisements compared with after toy advertisements. This was driven by increased intake of the items with most sugar (chocolate and jelly sweets). Children of healthy weight and with dental caries had the greatest intake response to food advertising exposure, but there were no differences by SES. Acute experimental food advertising exposure increases food intake in children. Specifically, high-sugar food and beverage advertising promotes the consumption of high-sugar food items. The debate around the negative health effects of food advertising on children should be widened to include dental health as well as overall dietary health and obesity.

Digital food marketing to children: How an influencer's lifestyle can stimulate healthy food choices among children

While influencer marketing has been shown to be effective at promoting food low in nutritional value among children, it is less clear whether influencers can also be used to promote healthy nutrition. This article reports on the results of an experimental study on whether and how influencer marketing on Instagram can be deployed to stimulate healthy eating behavior among children. In particular, the study examines whether signaling a healthy, athletic lifestyle can affect children's healthy snack choice (i.e., choice of a snack high in nutritional value). To do so, a two (influencer lifestyle: sedentary versus athletic) by two (snack type: low in nutritional value versus high in nutritional value) between-subjects experiment was conducted among 190 children between eight and 12 years. The results show that promoting a sedentary lifestyle (compared to an athletic lifestyle) resulted in more children choosing the product high in nutritional value. In addition, the children chose a healthy snack more frequently when an influencer portraying a sedentary lifestyle (compared to an athletic lifestyle) promoted a product low in nutritional value. There were no significant interaction effects of influencer lifestyle and snack type on the evaluation of the influencer. However, the study did show that there was less admiration for the influencer when they portrayed a sedentary lifestyle versus an athletic lifestyle.

Digital Media Use in Association with Sensory Taste Preferences in European Children and Adolescents-Results from the I.Family Study

Digital media (DM) influences children's food choice. We aim to investigate associations between DM use and taste preferences (TP) for sweet, fatty, bitter, and salty in European children and adolescents. Individuals aged 6-17 years (N = 7094) providing cross-sectional data for DM use: television (TV), computer/game console (PC), smartphone and internet, were included. Children (6 to <12 years) and adolescents (≥12 years) completed a Food and Beverage Preference Questionnaire; scores were calculated for sweet, fatty, salty and bitter preference and categorized (high vs. low). Logistic regression was used to calculate odds ratios as association measures between DM exposure and TP. On average, individuals used media for 2.4 h/day (SD = 1.7). Increasing exposures to DM were associated positively with sweet, fatty and salty TP, while inversely with bitter preference. In female adolescents, DM exposure for >2 h/day was associated with sweet (OR = 1.27, 95% CI = 1.02-1.57) and fatty preference (OR = 1.37; 95% CI = 1.10-1.70). Internet exposure was inversely associated with bitter preference, notably in male adolescents (OR = 0.65, 95% CI = 0.50-0.84), but positively associated with salty preference (OR = 1.29, 95% CI = 1.02-1.64). DM exposure was associated with sweet, fatty, salty and bitter TP in children and adolescents, serving as the basis for future longitudinal studies to shed light on the underlying mechanism by which DM exposure may determine eating habits.

Extent and nutritional quality of foods and beverages to which children are exposed in Colombian TV food advertising

OBJECTIVE

To examine children's exposure to food and beverage advertising across a year of Colombian television based on whether products exceed Pan-American Health Organization (PAHO)-defined nutrient thresholds.

DESIGN

Nutritional information was obtained for all foods and beverages advertised and used to categorise each product according to the product category (e.g. beverage, snack food) and nutritional quality based on the PAHO model for identifying products in excess of free sugars, Na or saturated fat or containing non-caloric sweeteners or trans-fat. Television audience ratings data were used to derive the average child audience (unique child viewers) per ad and the number of times ads were seen by children in a single week (weekly impressions) based on product category and nutritional quality.

SETTING

All food and beverage ads on cable and over-the-air TV in Colombia in 2017.

PARTICIPANTS

N/A.

RESULTS

Of all instances of TV ads, 89·3 % were of unhealthy products. A larger proportion of male and female children, as well as children from low (88·01 %), mid (89·10 %) and high (89·10 %) socio-economic status, are exposed to advertising of unhealthy products, but no significant difference was found between these proportions.

CONCLUSION

The majority of foods and beverages advertised to Colombian children are unhealthy. These findings highlight a need to implement statutory measures to reduce children's exposure to unhealthy food advertising in Colombia, as obesity and overweight have been increasing among school-age children in Colombia, and exposure to television advertising of unhealthy foods is a known contributor to children's food intake and obesity.

AdHealth: a feasibility study to measure digital food marketing to adolescents through Facebook

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.

Do Parent-Child Dyads with Excessive Body Mass Differ from Dyads with Normal Body Mass in Perceptions of Obesogenic Environment?

Background: This study addressed differences between parent–child dyads with excessive body mass (overweight or obesity) and dyads with normal body mass in obesity determinants, derived from social-ecological models. It was hypothesized that parents and their 5–11 years-old children with excessive body mass would (1) report lower availability of healthy food at home, (2) perceive fewer school/local community healthy eating promotion programs, (3) report lower persuasive value of food advertising. Methods: Data were collected twice (T1, baseline; T2, 10-month follow-up), including n = 129 parent–child dyads with excessive body mass and n = 377 parent–child dyads with normal body mass. Self-reported data were collected from parents and children; with body weight and height assessed objectively. General linear models (including analysis of variance with repeated measures) were performed to test the hypotheses. Results: Compared to dyads with normal body mass, dyads of parents and children with excessive body mass perceived lower availability of healthy food at home and fewer healthy eating promotion programs at school/local community (T1 and T2). These effects remained significant after controlling for sociodemographic variables. No significant differences in persuasive value of food advertising were found. Conclusions: Perceptions of availability of healthy food at home and healthy nutrition promotion may be relatively low in parent–child dyads with excessive weight which, in turn, may constitute a risk factor for maintenance of obesity.

Fiction Is Sweet. The Impact of Media Consumption on the Development of Children's Nutritional Knowledge and the Moderating Role of Parental Food-Related Mediation. A Longitudinal Study

Nutritional knowledge is an important cognitive facilitator that potentially helps children to follow a healthy diet. Two main information agents influence children’s development of nutritional knowledge: the media and their parents. While a high amount of media consumption potentially decreases children’s nutritional knowledge, parents may shape the amount of information children can gather about nutrition through their food-related mediation styles. In addition, children’s individual preconditions predict how children can process the provided nutritional information. This two-wave panel study with children (N = 719; 5–11 years) and their parents (N = 719) investigated the main effects and interplay of children’s amount of media consumption and their parents’ food-related mediation styles by performing linear regression analysis. Children’s individual preconditions were also considered. We measured children’s self-reported amount of media consumption, children’s age, sex, weight, and height (BMI). Additionally, in a parent survey we asked parents about how they communicate their rules about eating while especially focusing on active and restrictive food rule communication styles. As a dependent measure, we examined children’s nutritional knowledge at Time 1 and 2. The results show that the amount of media consumption has a negative effect on children’s nutritional knowledge over time. Parents’ restrictive or active food-related mediation asserted no main effects and could not lever out the negative effect of the amount of media consumption. Therefore, we argue that parents should limit children’s amount of media consumption to avoid the manifestation of misperceptions about nutrition.

Food as an eye-catcher. An eye-tracking study on Children's attention to healthy and unhealthy food presentations as well as non-edible objects in audiovisual media

BACKGROUND

Food presentations within media content are often made responsible for todays' obesity epidemic. This assessment is based on the assumption that food presentations create cue reactivity, which in turn affects the amount of food intake.

OBJECTIVE

This study investigates children's implicit reactions (cue reactivity) toward healthy, unhealthy, and non-ediblel objects.

METHODS

We conducted an experimental eye-tracking study comparing children's cue reactivity assessed with visual attention toward healthy and unhealthy food presentations, as well as non-edible objects. We controlled for the role of children's hunger, body mass index (BMI), and age.

RESULTS

Results indicated no difference between healthy and unhealthy food presentations, yet food generally aroused more visual attention in children compared to non-edible objects. Explicit memory for the embedded foods or objects was mediated through visual attention. However, unhealthy food presentations also directly affected children's explicit memory.

CONCLUSIONS

Compared to non-edible objects, food presentations seem to be eye-catchers that immediately grab children's attention and they are also able to maintain this attention. Yet, for unhealthy food presentations, memory seems to be less dependent on visual attention. That is, compared to healthy products or non-edible objects, unhealthy food presentations do not require the same amount of visual attention in order to be remembered.

The popularity of eating broadcast: Content analysis of "mukbang" YouTube videos, media coverage, and the health impact of "mukbang" on public

As "mukbang" (eating broadcast) becomes increasingly widespread, there is growing interest about the impact of mukbang on public health. This study aimed to analyze the content of mukbang YouTube videos, as well as news articles related to mukbang and the association between watching mukbang videos and health habits. We analyzed 5952 YouTube mukbang videos, 5265 news articles, and a survey of 1200 people in Korea. In this study, we confirmed that the provocative content of mukbang YouTube videos, such as overeating, was related to video popularity (p < 0.001). In addition, more exposure to mukbang was associated with greater effects on dietary health due to mukbang (p < 0.001). The prevalence of news articles on the negative effects of mukbang showed an increasing trend over time, while the articles on "Mukbang is funny" were most common in all the years evaluated. To cope with public health problems such as obesity, it will be necessary to continue to investigate the content and effects of mukbang on public health.

Brain response to food brands correlates with increased intake from branded meals in children: an fMRI study

Food branding is ubiquitous, however, not all children are equally susceptible to its effects. The objectives of this study were to 1) determine whether food brands evoke differential response than non-food brands in brain areas related to motivation and inhibitory control using blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and 2) determine the association between brain response and energy intake at test-meals presented with or without brands. Twenty-eight 7-10 year-old children completed four visits as part of a within-subjects design where they consumed three multi-item test-meals presented with familiar food brands, novel food brand, and no brand. On the fourth visit an fMRI was performed where children passively viewed food brands, non-food brands and control images. A whole-brain analysis was conducted to compare BOLD response between conditions. Pearson's correlations were calculated to determine the association between brain response and meal intake. Relative to non-food brands, food brand images were associated with increased activity in the right lingual gyrus. Relative to control, food and non-food brand images were associated with greater response in bilateral fusiform gyri and decreased response in the cuneus, precuneus, lingual gyrus, and supramarginal gyrus. Less activation in the bilateral fusiform gyrus to both food and non-food brands was associated with greater energy intake of the branded vs unbranded meal. These findings may help explain differences in the susceptibility to the intake-promoting effects of food advertising in children.

Delineating the psychological and behavioural factors of successful weight loss maintenance

Overweight and obesity present alarming global health problems including detrimental health risks that call for effective interventions. Considerable research has examined behavioural and psychological factors associated with weight loss to advance the field of obesity and overweight. In line with the literature, this study aimed to develop a behavioural and psychological profile based on factors of personality, eating behaviours, emotional functioning, physical well-being, and psychopathology. The sample consisted of 105 community participants who had reduced their bodyweight by at least 10% and had either successfully maintained their weight loss for a minimum 12-month period (n = 41) or had regained their weight loss within 12 months (n = 64). Participants completed an online survey comprising demographic items and four empirical measures (Mini Marker Personality Scale, Patient Health Questionnaire, Three-Factor Eating Questionnaire-Revised, and a food screening tool). Based on significant bivariate correlations results, four factors (fat intake, restrained eating, uncontrolled eating, and emotional eating) were entered into a binary logistic regression. Restrained eating was the only factor that significantly increased the likelihood of predicting successful long-term weight loss. Findings have implications for overweight and obesity future research, which may guide the direction of obesity and overweight treatments.

Advertising Placement in Digital Game Design Influences Children's Choices of Advertised Snacks: A Randomized Trial

BACKGROUND

Children are inhabitants of a media-rich environment rife in extensive, sophisticated, and persistent techniques that are used to market unhealthy food. Exposure is known to influence children's attitudes, choices, and consumption, yet further research is required to explore the influence of contemporary techniques within online games.

OBJECTIVE

To explore the influence of modern advertising on children's attitudes, choices, and consumption, techniques (ie, banner advertising, advergame, and rewarded video advertising) were used to promote an unfamiliar confectionery brand within an online game.

DESIGN

A between-subjects randomized experimental study.

PARTICIPANTS/SETTING

Children (aged 7 to 12 years [n=156]) were recruited in New South Wales, Australia, between September and November 2017.

INTERVENTION

Children were required to play a 4-minute online game, complete some questionnaires, and choose one snack to consume afterward. Children were randomly assigned to one of four conditions: a control group with no advertising, and three experimental conditions that promoted an unfamiliar confectionery brand via a banner advertisement, advergame, or rewarded video advertisement.

MAIN OUTCOME MEASURES

Questionnaires included the assessment of attitudes to the test brand before and after the game, enjoyment of the game, and children's awareness of advertising. Food choice was recorded and food consumption was measured by weighing the snack in grams, which was translated into kilocalories.

STATISTICAL ANALYSES PERFORMED

Statistical tests included analyses of variance, Kruskal-Wallis test, and χ² test.

RESULTS

Attitudes toward the perception of fun (P=0.06) and taste (P=0.21) of the test brand were not influenced by condition. Children who were exposed to the rewarded video advertising chose the test brand significantly more than children in the other three conditions (P<0.002). Condition did not influence overall energy intake measured in grams (P=0.78) or kilocalories (P=0.46).

CONCLUSIONS

Children's choice of the test brand was significantly influenced by the rewarded video advertising condition (compared with control, banner advertising, and advergame conditions). This technique is prevalent across online and application games that children play yet the effects of using rewarded video advertising to promote food brands have not been explored from a public health perspective. This study contributes to the understanding of modern strategies used to market unhealthy foods to children.

Evaluating the impact of Chile's marketing regulation of unhealthy foods and beverages: pre-school and adolescent children's changes in exposure to food advertising on television

OBJECTIVE

To evaluate the effects of Chile's 2016 regulation restricting child-directed marketing of products high in energy, saturated fats, sodium and sugars on reducing children's exposure to 'high-in' television food advertising.

DESIGN

Television use by pre-schoolers and adolescents was assessed via surveys in the months prior to implementation and a year after implementation. Hours and channels of television use were linked with the amount of high-in food advertising observed in corresponding content analyses of food advertisements (ads) from popular broadcast and cable channels to estimate changes in exposure to food ads from these channels.

SETTING

Middle-lower and lower-income neighbourhoods in Santiago, Chile.

PARTICIPANTS

Pre-schoolers (n 879; mothers reporting) and adolescents (n 753; self-reporting).

RESULTS

Pre-schoolers' and adolescents' exposure to high-in food advertising in total decreased significantly by an average of 44 and 58 %, respectively. Exposure to high-in food advertising with child-directed appeals, such as cartoon characters, decreased by 35 and 52 % for pre-schoolers and adolescents, respectively. Decreases were more pronounced for children who viewed more television. Products high in sugars were the most prevalent among the high-in ads seen by children after implementation.

CONCLUSIONS

Following Chile's 2016 child-directed marketing regulation, children's exposure to high-in food advertising on popular broadcast and cable television decreased significantly but was not eliminated from their viewing. Later stages of the regulation are expected to eliminate the majority of children's exposure to high-in food advertising from television.

Media food marketing and eating outcomes among pre-adolescents and adolescents: A systematic review and meta-analysis

The media marketing's effect on child and adult eating has been extensively researched, yet, little is known about its effect on adolescents. The aim of this review is to synthesize available research on the relation between media food marketing and eating-related cognitions, attitudes, and behaviors among pre-adolescents (8-11) and adolescents (12-19). We systematically screened and retrieved 9324 articles, of which 28 were included in the review-analysis and 19 in the meta-analysis. Robust variance estimation with random effect weights indicated a positive small standard effect size (d = 0.26, P < .001) of media food marketing on all unhealthy eating outcomes, and a subgroup analysis revealed a small effect size (d = 0.26, P < .001) on unhealthy eating behaviors specifically. Another subgroup analysis among adolescents revealed an effect of marketing (d = 0.22, P < .05) on unhealthy eating outcomes. This review demonstrates the significance of media marketing on eating in pre-adolescents and adolescents, and highlights limitations in the food marketing and adolescent eating literature specific to eating outcomes and marketing media studied and research designs utilized. We call for properly designed food marketing research exploring digital media's effect on eating attitudes and cognitions, especially among older adolescents.

Systematically testing the effects of promotion techniques on children's fruit and vegetables intake on the long term: a protocol study of a multicenter randomized controlled trial

Background

Eating a diet rich in fruit and vegetables is essential for healthy development, protects against chronicle diseases, and increases mental well-being. Numerous studies have consistently shown that children do not consume enough fruit and vegetables, especially among children from low socioeconomic status, while foods high in fat, sugar and salt are over-consumed. In order to improve children’s eating behavior, there is an urgent need to systematically test novel and effective methods to make fruit and vegetables more appealing and increase the intake among children. Therefore, the main aim of the proposed project is to test if food promotion techniques increase children’s fruit and vegetable intake, both on the short- and long-term.

Methods

Three studies will be conducted. First, to develop the vlogs in co-creation, multiple focus groups will be held with (1) children (N = 25, between 8 and 13 years), (2) parents (N = 10), (3) vloggers (N = 5), and (4) fruit and vegetable producers and marketers (N = 5). Second, a multicenter randomized clinical trial will be conducted among 10 primary schools. A mixed repeated measure design with three different conditions will be used: (1) control, (2) a vlog unboxing fruit and vegetables (preparing and tasting), and (3) a vlog doing a challenge with the fruit and vegetables (e.g., contests, tricks, games). Children between 7 and 13 will participate in the experiments (N = 350). Third, after 6 and 12 months follow-up measurements will take place.

Discussion

HFSS foods have higher intrinsically rewarding properties that make them more “wanted” and “liked” than fruit and vegetables, thereby inducing unhealthy eating behavior among children. Additionally, promotion for HFSS foods is omnipresent and increases the rewarding value of these foods. Moreover, some studies showed that the promotion of fruit and vegetables affects the intake, although a recent systematic review shows that evidence is inconclusive and a theoretical understanding for the underlying mechanism is missing. The current study aims to improve the existing knowledge by experimentally testing a newly developed theoretical model.

Trial registration

Netherlands Trial registration:NL8077, received on 12 October 2019.

The food environment in Latin America: a systematic review with a focus on environments relevant to obesity and related chronic diseases

OBJECTIVE

Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition.

DESIGN

Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings.

SETTING

Studies conducted in LA countries.

PARTICIPANTS

The search yielded 2695 articles of which eighty-four met inclusion criteria.

RESULTS

Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods.

CONCLUSIONS

Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.

Children's consumption of rabbit meat

<p>The nutritional and dietary properties of rabbit meat make it an ideal food for children, recommended by the World Health Organisation. However, the presence of children under 18 in the home has been found to decrease the frequency of rabbit meat consumption. If we focus on households with children under 18, 52.5% of minors do not consume rabbit meat. The main reason why children (intended as people under 18 yr old) do not consume rabbit meat is the fact that they do not like it (40.9%) and because it is not bought/eaten at home (30.9%). Faced with this situation, there is a pressing need to seek appropriate strategies to adapt rabbit meat for consumption by the youngest family members. In light of the results, the following strategies are proposed. First, the development of functional foods for babies and children, such as rabbit meat enriched with ω3 and docosahexaenoic acid. Secondly, improving meat tenderness. Third, adapting rabbit meat presentations for children (burgers, nuggets, sausages, marinades …), converting them into convenience products for parents and extending their shelf life. Fourth, adapting the labelling/packaging for children to attract attention of both parents and offspring. Finally, developing communication strategies on the nutritional value of rabbit meat aimed at both children and parents. It is observed that if minors consume rabbit meat, they also eat other types of meat such as lamb and beef more often. Therefore, in this type of households a varied and complete diet is consumed in terms of meat consumption, so it would be necessary to rethink joint communication strategies among the three meat sectors. Promoting rabbit meat consumption among the under 18s has several consequences, as in the future they will be in charge of household purchases or share this responsibility.</p>

Evaluating the influence of racially targeted food and beverage advertisements on Black and White adolescents' perceptions and preferences

INTRODUCTION

The present study measures how racially-targeted food and beverage ads affect adolescents' attitudes toward ads and brands, purchase intentions for advertised products, and willingness to engage with brands on social media.

METHODS

Black and White adolescents were recruited through Survey Sampling International in 2016. Participants completed an online survey in which they were randomized to view either four food and beverage ads (e.g., soda, candy commercials) featuring Black actors or four food and beverage ads featuring White actors.

RESULTS

For the two components of the attitudinal outcome, Black participants were more likely to report a positive affective response toward racially-similar ads compared to Whites. However, White participants were more likely to like ads that were racially-dissimilar compared to Black participants. Data were analyzed in 2016-2017, and we used an alpha level of 0.05 to denote statistical significance.

CONCLUSIONS

Both Black and White adolescents reported more positive affective responses to ads that featured Blacks compared to ads that featured Whites. Because there were no differences on two outcomes, future research should examine the influence of racially-targeted marketing in real-world contexts (e.g., social media) and longitudinal exposure to targeted advertising on dietary behavior.

Effects of childhood adversity and resilience on Taiwanese youth health behaviors

BACKGROUND

Adverse childhood experiences (ACEs) can leave negative impacts on one's health behaviors or social functioning later in life. Resilient characteristics have been shown to mitigate effects against risk behaviors in developing adolescents. However, clinical and research attention has rarely been given to jointly consider the effects of ACEs and resilient characteristics on health behaviors in Taiwanese youth.

METHOD

A total of 200 individuals aged 15-22 years were recruited from primary care settings, communities, and schools. Participants completed questionnaires assessing their ACEs, resilient characteristics, and health behaviors. Univariate analysis was firstly used to describe the correlates of ACEs and resilient characteristics. Further multivariate logistic regression analysis was used to examine the association of both factors with health behaviors.

RESULTS

More than half (61.5%) of those surveyed had been exposed to at least one category of ACE. Verbal (37%) and physical (21%) abuses were the most common types of ACEs. The counts in the ACE categories were associated with being involved in physical fights (odds ratio 1.28 [confidence interval 1.01-1.63]), property damage (1.29 [1.03-1.61]), running away from home (1.30 [1.05-1.60]), bullying victimization (1.37 [1.16-1.61]), and sleep problems/tiredness (1.25 [1.03-1.52]). Meanwhile, resilience scores were associated with decreased odds of infrequent seatbelt use (0.47 [0.23-0.97]), low fruit and vegetable intake (0.42 [0.21-0.86]) unsatisfied body image (0.46 [0.22-0.97]), and sleep problems/tiredness (0.37 [0.18-0.79]).

CONCLUSIONS

ACEs and resilience characteristics play a significant role in shaping youth health behaviors. Further research should be undertaken to identify ways to build resilience against health risks in youth with prior ACE exposure.

Children's exposure to food advertising: the impact of statutory restrictions

Evidence demonstrating links between exposure to unhealthy food marketing, poor eating behaviours and paediatric obesity has led to calls for regulatory change in many countries, including the UK. However no official monitoring system exists to inform international debate on food advertising policy. This study systematically explores food advertising on UK television in 2010 (post-regulation) and compare this to 2008 (mid-regulation) to assess if food adverts improved in nutritional quality after implementation of regulations. Television was recorded between 6 a.m. and 10 p.m. for one weekday and one weekend day during 6 months of 2010 across 13 commercial television channels popular with children. These data were directly compared with previously published data for 2008. Food and beverages were the third most frequently advertised product type (11.9% of all ads), a decrease of 0.9% from 2008 (12.8%). Non-core food commercials decreased (down 2.2-53.8%) and core food advertising increased (up 0.5-18.6%). Fast food items were the third most frequently advertised food product (15.4%, up 3.5% from 2008). During peak children's viewing times, 17.0% of all commercials were for food, an increase of 4.7% from non-peak children's viewing times and fewer core (-0.9%) and more non-core (+0.5%) foods were advertised at these times. Despite statutory regulation, frequency and balance of food commercials (core, non-core and miscellaneous) remained relatively static over the 2 years. Children are still exposed to high amounts of unhealthy food advertising on television. Continued monitoring of television food advertising remains crucial and policymakers should examine the comparative efficacy of other restrictions.

Time spent looking at food during a delay of gratification task is positively associated with children's consumption at ad libitum laboratory meals

Greater ability to delay gratification for an immediate food reward may protect against the development of obesity. However, it is not known if the behaviors children exhibit during a delay of gratification task are related to overeating in other contexts. The purpose of this analysis was to assess the relationship between observed child coping strategies during a delay of gratification task and laboratory intake from ad libitum test-meals. The sample consisted of 40, 7-9 year old children (40% (N = 16 with overweight/obesity). Across 5 laboratory visits, children consumed 3 identical test-meals presented after varying exposure conditions (i.e., no exposure, exposure to food commercials, exposure to toy commercials). On the first visit, children were recorded during a delay of gratification task which was coded for three behavioral themes: looking at vs. away from food, talking vs. staying silent, and fidgeting vs. sitting still. Pearson correlations and multiple regressions were run to look at the relationships between coping strategies and test-meal intake. Time spent looking away from food was negatively associated with ad libitum food consumption at the meals. Conversely, greater time spent looking at food was positively associated with ad libitum food consumption. These relationships were independent of covariates likely to influence intake (e.g., sex, age, weight status, parent income) and were more robust following food rather than toy commercial exposure. Children who spent more time looking at food and less time looking away during a delay of gratification task may be vulnerable to overeating in other contexts. Upon replication in larger samples, these behaviors could serve as modifiable targets in the development of childhood obesity prevention programs.

Eating Responses to External Food Cues in Weight Discordant Siblings

PURPOSE

Heightened responsivity to external food cues may promote energy intake and account for differences in weight status between nonoverweight and overweight adolescents. Studies of weight-discordant fraternal siblings control for some genetic and shared within-family factors, which allow for testing of other nonshared factors relevant to sibling weight differences.The aim of the study was to determine whether same-sex weight-discordant (one nonoverweight and one overweight) adolescent siblings differ in responsiveness to external food cues.

METHODS

Weight-discordant siblings' (n = 38 pairs) energy consumption was compared following both an appetizing food (pizza) on one day and a control activity (reading) on another day. Multilevel models examined intrafamily similarity, and regressions examined associations with adiposity.

RESULTS

Siblings shared little similarity in cue responsivity (ρ = .10). However, sibling body mass index z-scores difference was not associated with differences in cue responsivity. Moreover, when tested as groups, nonoverweight and overweight siblings did not differ for cue responsivity (p > .84).

CONCLUSION

Weight-discordant adolescent siblings show little similarity in responses to food cues. Differences in sibling weight status were not predicted by differences in responses to food cues. Thus, nonshared factors other than cue responsivity must contribute to weight differences of adolescent siblings.

Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium

OBJECTIVE

To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI.

DESIGN

Children's weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models.

SETTING

Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies.

PARTICIPANTS

Predominantly low-income, racial/ethnic minorities: NET-Works (n 534, 2-4-year-olds); GROW (n 610, 3-5-year-olds); GOALS (n 241, 7-11-year-olds); IMPACT (n 360, 10-13-year-olds).

RESULTS

Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (P for trend < 0⋅01) and snack occasion frequency and HEI-2010 score (β coefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β coefficient (95 % CI): NET-Works, -3⋅15 (-5⋅37, -0⋅92); GROW, -2⋅44 (-4⋅27, -0⋅61); GOALS, -5⋅80 (-8⋅74, -2⋅86)). Associations with BMI were almost all null.

CONCLUSIONS

Meal-like and beverage patterns described most children's snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2-5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.

Food Marketing Influences Children's Attitudes, Preferences and Consumption: A Systematic Critical Review

Exposure to the marketing of unhealthy foods and beverages is a widely acknowledged risk factor for the development of childhood obesity and noncommunicable diseases. Food marketing involves the use of numerous persuasive techniques to influence children's food attitudes, preferences and consumption. This systematic review provides a comprehensive contemporary account of the impact of these marketing techniques on children aged 0-18 years and critically evaluates the methodologies used. Five electronic academic databases were searched using key terms for primary studies (both quantitative and qualitative) published up to September 2018; 71 eligible articles were identified. Significant detrimental effects of food marketing, including enhanced attitudes, preferences and increased consumption of marketed foods were documented for a wide range of marketing techniques, particularly those used in television/movies and product packaging. Together, these studies contribute strong evidence to support the restriction of food marketing to children. However, the review also signposted distinct gaps: Firstly, there is a lack of use of qualitative and physiological methodologies. Secondly, contemporary and sophisticated marketing techniques used in new media warrant increased research attention. Finally, more research is needed to evaluate the longer-term effects of food marketing on children's weight.

The effect of screen advertising on children's dietary intake: A systematic review and meta-analysis

Evidence indicates that screen advertising for unhealthy food results in significant increases in dietary intake among children. This review was undertaken with the main aim of estimating the quantitative effect of screen advertising in experimental and nonexperimental conditions on children's dietary intake. Systematic searches were undertaken of interdisciplinary databases. Studies from 1980 to April 2018, all geography and languages, were included; participants were children and adolescents aged between 2 and 18 years; the intervention was screen advertising; and the outcome was dietary intake. Meta-analyses were conducted for measured and nonmeasured outcomes. Food advertising was found to increase dietary intake among children (age range 2-14, mean 8.8 years) in experimental conditions for television (TV) advertising and advergames. Meta-analysis revealed that children exposed to food advertising on TV (11 studies) and advergames (five studies) respectively consumed an average 60.0 kcal (95% confidence interval [CI], 3.1-116.9) and 53.2 kcal (95% CI, 31.5-74.9) more than children exposed to nonfood advertising. There was also an effect by body mass index (BMI). Findings from nonexperimental studies revealed that exposure to TV food advertising was positively associated with and predictive of dietary intake in children. Short-term exposure to unhealthy food advertising on TV and advergames increases immediate calorie consumption in children.