The normative power of food promotions: Australian children's attachments to unhealthy food brands

Testing a conceptual Hierarchy of Effects model of food marketing exposure and associations with children and adolescents' diet-related outcomes

OBJECTIVE

Children's exposure to unhealthy food marketing contributes to poor diets by influencing the foods that children like, request, buy and consume. This study aimed to use confirmatory mediational analyses to test a hypothetical model of marketing effects, to better understand the mechanisms behind food marketing's impacts on children.

DESIGN

Children responded to a cross-sectional online survey about their attitudes towards, and purchase and consumption behaviours of, ten frequently promoted food/beverage brands and their media use. Structural equation modelling tested a priori potential pathways for the effects of food marketing exposure on children's diets.

PARTICIPANTS

10-16-year-old children (n 400).

SETTING

Australia.

RESULTS

There was a significant positive correlation between children's commercial screen media use and their attitudes towards brands (related to perceived social norms) and their brand purchasing behaviours, including their own purchases and requests to parents. The use of strategies to avoid advertising in commercial screen media reduced but did not remove the association between media use and brand purchases. Other brand exposures (on clothing, outdoor advertising, sponsorships) had a positive association with children's perceived social norms about brands and their brand purchases and requests. Non-commercial screen media use was not associated with any brand-related outcomes.

CONCLUSIONS

Commercial screen media use and other brand exposures were strongly positively associated with children's perceptions and purchasing behaviours of frequently marketed food/beverages. Regulations to restrict children's exposures to food marketing on-screen and through other media are required to reduce the effect of marketing exposure on children's food purchasing behaviours.

Revisiting 42 Years of literature on food marketing to children: A morphological analysis

Despite the preventive measures taken by the WHO, childhood obesity is still on the rise and is expected to increase by 100% between 2020 and 2035. Food marketing continues to permeate children's environments in numerous ways and influence the food behaviour of children, thus significantly contributing to the rise of obesity. Studies suggest that the literature on the effects of food marketing on children is complex and multidimensional. To fully understand these effects, a comprehensive and systematic approach is required. Nonetheless, existing reviews have focused only on specific aspects and have not comprehensively covered the literature on food marketing to children. Therefore, this review aims to navigate potential research gaps in the existing literature through a comprehensive examination of the literature by using morphological analysis (MA) methodology, the first time in this domain. Using PRISMA, 202 papers were considered eligible for inclusion and further analysed using MA. The articles were categorised into three dimensions to develop the MA framework: Stimuli (Food well-being), Organism, and Response, and 34 variants. The review has presented future research prospects by identifying at least 218 research gaps. With these findings, researchers can further explore the gaps and develop new research questions that could foster an understanding of the multifarious literature. Moreover, these findings can also provide marketers and practitioners with a better comprehension of the current state of the literature and develop more effective strategies for responsible marketing practices and policies.

TV exposure, attitudes about targeted food ads and brands, and unhealthy consumption by adolescents: Modeling a hierarchical relationship

Public health experts raise concerns that extensive exposure to advertising for calorie-dense nutrient-poor food negatively influences adolescents' diets, but few studies have explored how food advertising affects children over age 12. This study examines adolescents' attitudes about highly targeted unhealthy food brands and assesses the hierarchical relationship between TV exposure, intermediary measures of advertising effects, and healthy and unhealthy food consumption. A cross-sectional online survey of 1566 adolescents (13-17 years) measured TV exposure, attitudes about eight highly advertised teen-targeted food brands and their advertising, and unhealthy and healthy food consumption. A theory-based structural equation model (SEM) tested hypothesized paths from TV exposure to unhealthy food consumption, with attitudes about teen-targeted TV ads and brands as intermediary variables, controlling for healthy food consumption and demographic characteristics. Participants reported high liking of targeted-brand advertising (M = 4.05/5.0, SD = 0.65), strong perceptions that the ads were targeted to someone like them (M = 4.07/5.0, SD = 0.66), positive brand attitudes (M = 4.07/5.0, SD = 0.56), brand popularity (M = 4.01/5.0, SD = 0.63), and consuming the brands a few times in the past month on average. As hypothesized, the SEM supported significant positive paths from TV exposure to ad attitudes (β = 0.50, 95% CI = 0.40-0.60) to brand attitudes (β = 0.90, 95% CI = 0.87-0.92) to unhealthy food consumption (β = 0.41, 95% CI = 0.32-0.50). Contrary to expectations, healthy consumption was positively associated with both brand attitudes (β = 0.11, 95% CI = 0.04-0.18) and unhealthy consumption (β = 0.42, 95% CI = 0.33-0.51). These results further public health concerns about the potential impact of adolescents' exposure to unhealthy food advertising on brand consumption and unhealthy food consumption more broadly. They also support marketing theories that ad liking and perceived targeting may increase the influence of ad exposure on brand attitudes and unhealthy consumption.

A Qualitative Analysis of Black and White Adolescents' Perceptions of and Responses to Racially Targeted Food and Drink Commercials on Television

Food and beverage marketing is a major driver of childhood obesity, and companies target their least nutritious products to Black youth. However, little is known about adolescents' perceptions of and responses to racially targeted food marketing. In this qualitative study, we investigated how Black and White adolescents perceived and responded to racially targeted television commercials for food and beverages. We recruited 39 adolescents aged 12-17 years in New York City to watch a series of commercials and then participate in an in-depth interview using a semi-structured interview guide. The research team recorded, transcribed, and analyzed interviews using ATLAS.ti. Overall, participants responded positively to commercials that featured celebrities. They were also able to recognize the commercials and reported they had been exposed to marketing from these companies on social media and in subways/buses. Many participants considered the advertised brands as healthy or able to enhance athletic performance because of their endorsement by or association with athletes. Participants also understood that marketers were using racial targeting in their ads but that targeting did not translate into improved perceptions or responses towards advertised products. These findings suggest the need to empirically evaluate and further explore Black and White adolescents' responses to racially targeted food marketing.

Implications of international trade and investment agreements on policy space for restricting marketing of unhealthy food and beverages to children: lessons from inter-disciplinary expert interviews

OBJECTIVE

To determine the implications of international trade and investment agreements (TIA) for national governments' policy space to restrict the marketing of unhealthy food and beverages to children.

DESIGN

In-depth interviews based on a series of policy scenario 'vignettes,' guided by an adapted scenario analysis methodology.

SETTING

Global.

PARTICIPANTS

Nine key informants from relevant sectors, with expertise regarding the intersection of public health nutrition policy, international trade law and international investment law.

RESULTS

Participants consistently identified the relevance of several principles, common to many TIA: non-discrimination, necessity and justification, market access requirements and quantitative restrictions, intellectual property rights and trademark protections and fair and equitable treatment of investors. Two main policy design factors that interact heavily with TIA-related policy space were the framing of objectives and regulatory distinctions drawn. Contextual factors may shape the analysis of TIA-related policy space on a case-by-case basis, while the relative power of the actors and institutions involved in both domestic and international policy spheres may influence whether and how such legal constraints to policy space are activated.

CONCLUSIONS

Regulatory marketing restrictions run the risk of incurring challenges under World Trade Organization agreements and other free TIA. However, concerned policymakers should be aware of the difference between theoretical risk, threat of a challenge and realistic initiation and/or loss of a formal dispute. Our findings indicate that there is policy space to adopt significant marketing restrictions, though an understanding of these legal risks and strategic policy design are important.

Measuring the Power of Food Marketing to Children: a Review of Recent Literature

PURPOSE OF REVIEW

This scoping review examines literature from the past 5 years (June 2014 to June 2019) across three databases (PubMed, MEDLINE, and Scopus) to detail how the persuasive power of child-targeted food marketing content is addressed and evaluated in current research, to document trends and gaps in research, and to identify opportunities for future focus.

RECENT FINDINGS

Eighty relevant studies were identified, with varied approaches related to examining food marketing techniques to children (i.e., experimental, survey, meta-analyses, mixed methods, content analyses, focus groups). Few studies specifically defined power, and studies differed in terms of techniques examined. Spokes-characters were the predominant marketing technique measured; television was the platform most analyzed; and dominant messages focused on health/nutrition, taste appeals, and appeals to fun/pleasure. Mapping the current landscape when it comes to the power of food marketing to children reveals concrete details about particular platforms, methods, and strategies, as well as opportunities for future research-particularly with respect to definitions and techniques monitored, digital platforms, qualitative research, and tracking changes in targeted marketing techniques over time.

"It's Just Addictive People That Make Addictive Videos": Children's Understanding of and Attitudes Towards Influencer Marketing of Food and Beverages by YouTube Video Bloggers

Exposure to influencer marketing of foods and beverages high in fat, sugar, and/or salt (HFSS) increases children's immediate intake. This study qualitatively explored children's understanding of, and attitudes towards, this marketing, to elucidate potential mechanisms through which exposure affects behavior. In six focus groups (n = 4) children (10-11 years) were shown a YouTube video featuring influencer marketing of an HFSS product. Inductive thematic analysis identified six themes from children's discussions of this marketing: (1) YouTubers fill a gap in children's lives, (2) the accessibility of YouTubers increases children's understanding of their actions, (3) influencer marketing impacts all-the influencer, the brand, and the viewer, (4) attitudes towards influencer marketing are most affected by a YouTuber's familiarity, (5) YouTuber influencer marketing is effective because they are not 'strangers', (6) children feel able to resist influencer marketing of HFSS products. Children had an understanding of the persuasive intent of this marketing, and although most were sceptical, familiar YouTubers elicited particularly sympathetic attitudes. Children felt affected by influencer marketing of HFSS products, but believed they were able to resist it. Beyond theoretical insight, this study adds to the growing body of evidence to suggest children's exposure to HFSS influencer marketing should be reduced.

Sports Sponsorship as a Cause of Obesity

PURPOSE OF REVIEW

This article investigates the role of food and beverage sponsorship of sports in influencing dietary behaviour, and ultimately obesity, focusing on research published in the past 5 years. A systematic strategy was used to search the health science, social science and marketing databases to identify peer-reviewed literature on food and non-alcoholic beverage company sponsorship of sport published in English from 2015 to 2019.

RECENT FINDINGS

Sixteen discrete studies were identified: six content analyses, two qualitative studies, four cross-sectional surveys and four experimental studies. Findings indicate sports sponsorship is widely used to promote unhealthy foods through professional and community sport, prompting increased awareness and preference for sponsor products. Most studies assessed self-reported responses to sponsorship, with a lack of behavioural data on food purchasing and consumption. Sports sponsorship by unhealthy food brands achieves vast population reach and exposure, promoting increased brand awareness and preference for sponsor products. Research is needed to improve our understanding of the relationship between food and beverage sponsorship and energy intake. Research evaluating the efficacy of strategies to reduce spectator's exposure to unhealthy sports sponsorship is also needed.

Food and Beverage Cues Featured in YouTube Videos of Social Media Influencers Popular With Children: An Exploratory Study

Food and beverage cues (visual displays of food or beverage products/brands) featured in traditional broadcast and digital marketing are predominantly for products high in fat, sugar and/or salt (HFSS). YouTube is hugely popular with children, and cues featured in content uploaded by YouTube video bloggers (influencers) has been shown to affect children’s eating behavior. However, little is known about the prevalence of such cues, the contexts in which they appear, and the frequency with which they are featured as part of explicit marketing campaigns. The objective of this study was to explore the extent and nature of food and beverage cues featured in YouTube videos of influencers popular with children. All videos uploaded by two influencers (one female, one male) over a year (2017) were analyzed. Based on previous content analyses of broadcast marketing, cues were categorized by product type and classified as “healthy” or “less healthy” according to the UK Nutrient Profiling Model. Cues were also coded for branding status, and other factors related to their display (e.g., description). In total, the sample comprised 380 YouTube videos (119.5 h) and, of these, only 27 videos (7.4%) did not feature any food or beverage cues. Cakes (9.4%) and fast foods (8.9%) were the most frequently featured product types, less frequent were healthier products such as fruits (6.5%) and vegetables (5.8%). Overall, cues were more frequently classified as less healthy (49.4%) than healthy (34.5%) and were presented in different contexts according to nutritional profile. Less healthy foods (compared with healthy foods) were more often; branded, presented in the context of eating out, described positively, not consumed, and featured as part of an explicit marketing campaign. These data provide the first empirical assessment of the extent and nature of food and beverage cue presentation in YouTube videos by influencers popular with children. Given the emerging evidence of the effects of influencer marketing of food and beverages on children’s eating behavior, this exploratory study offers a novel methodological platform for digital food marketing assessment and delivers important contextual information that could inform policy deliberations in this area.

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.

Identifying food marketing to teenagers: a scoping review

Background

Teenagers are aggressively targeted by food marketing messages (primarily for unhealthy foods) and susceptible to this messaging due to developmental vulnerabilities and peer-group influence. Yet limited research exists on the exposure and power of food marketing specifically to teenage populations. Research studies often collapse “teenagers” under the umbrella of children or do not recognize the uniqueness of teen-targeted appeals. Child- and teen-targeted marketing strategies are not the same, and this study aims to advance understanding of teen-targeted food marketing by identifying the teen-specific promotion platforms, techniques and indicators detailed in existing literature.

Methods

A systematic scoping review collected all available literature on food marketing/advertising with the term “teenager” or “adolescent” from nine databases, as well as Google Scholar for grey literature, and a hand search of relevant institutional websites. Included were all peer-reviewed journal articles, book chapters, and grey literature in which food marketing to youth was the central topic of the article, of any study type (i.e., original research, reviews, commentaries and reports), and including any part of the 12–17 age range.

Results

The 122 articles reviewed define the scope of existing literature on food marketing to young people age 17 and under, identifying leading trends in countries studied (United States, 52%), populations identified (children and teens studied concurrently, 36%), outcomes measured (advertising exposure, 54%), study type (cross-sectional, 58%) and methods used (content analysis, 46%). The promotion platforms and techniques used by food marketers to appeal to young people (as reported in the literature) are also identified and classified. Few studies (7%) use indicators to identify teen-targeted food marketing.

Conclusions

Unique treatments of teen populations are limited in food marketing literature, as is the application of clear indicators to identify and differentiate teen-targeted food marketing from child- or adult-targeted content. Given the need to better measure the presence and power of teen food marketing, this is a significant oversight in existing literature. The indicators identified will help researchers to develop more accurate strategies for researching and monitoring teen-targeted food promotion.

Children's Exposure to Television Food Advertising Contributes to Strong Brand Attachments

Children's exposure to unhealthy food marketing is one factor contributing to childhood obesity. The impact of marketing on children's weight likely occurs via a cascade pathway, through influences on children's food brand awareness, emotional responses, purchasing and consumption. Thus, building emotional attachments to brands is a major marketing imperative. This study explored Australian children's emotional attachments to food and drink brands and compared the strength of these attachments to their food marketing exposure, using television viewing as a proxy indicator. A cross-sectional face-to-face survey was conducted with 282 Australian children (8-12 years). Children were asked to indicate their agreement/disagreement with statements about their favourite food and drink brands, as an indicator of the strength and prominence of their brand attachments. Questions captured information about minutes/day of television viewing and the extent that they were exposed to advertising (watched live or did not skip through ads on recorded television). For those children who were exposed to advertisements, their age and commercial television viewing time had significant effects on food and drink brand attachments (p = 0.001). The development of brand attachments is an intermediary pathway through which marketing operates on behavioural and health outcomes. Reducing children's exposure to unhealthy food marketing should be a policy priority for governments towards obesity and non-communicable disease prevention.

Marketing of Foods to Children through Food Packaging Is Almost Exclusively Linked to Unhealthy Foods

The nutritional composition of foods marketed to children is important, as it can significantly influence children's preferences. The objective of this research was to evaluate the presence of child-oriented food products in the food supply and to investigate their nutritional composition. The sample included 8191 prepacked foods in the Slovenian food supply available in the market in 2015. The nutrient profile (World Health Organisation Regional Office for Europe nutrient profile model) of the products with child-targeted promotions was compared to the nutrient profile of those without child-targeted promotions. Food categories with the highest proportion of products with child-focused promotions were "Breakfast Cereals" (17%), "Chocolate and Sugar Confectionery" (15%) and "Edible Ices" (13%). Altogether, 93% of all products with child-focused promotions and 73% of products without such promotions were classified as "not permitted". The proportion of "not permitted" foods was significantly higher in products with child-targeted promotions, compared with products without child-targeted promotions (p < 0.0001), and this trend was observed in a majority of food categories. To protect children from exposure to the marketing of foods with less favourable nutritional compositions, public health strategies should be focused also towards limiting promotions of unhealthy foods to children on product packaging, not only in media.

Trends in marketing foods to children in Slovenian magazines: a content analysis

OBJECTIVE

Food marketing is an important factor influencing children's food preferences. In Slovenia the use of magazines is widespread among children. We investigated food advertising in children's and teens' magazines (CTM) in 2013 and 2017. The penetration of food advertising was compared with magazines targeting the adult population.

DESIGN

A repeated cross-sectional study. Magazines were searched for branded food references (BFR). All BFR were categorised and evaluated using the WHO Europe nutrient profile model.

SETTING

Slovenia.

SUBJECTS

All issues of CTM and a selected sample of issues of adult-targeting magazines and newspapers published in Slovenia in 2013 and 2017.

RESULTS

One hundred and seventy-five issues of CTM (ninety-two in 2013, eighty-three in 2017) and 675 issues of adult-targeted magazines and newspapers were analysed (345 in 2013, 330 in 2017). In 2017, food advertising in CTM dropped notably but the opposite was found for adult-targeted magazines. Regular advertisements dominated in 2017 in CTM, while in 2013, 83 % of BFR types were games/puzzles, competitions and product placements. Chocolate and confectionery were the most advertised in CTM and food supplements in adults' magazines. Most foods in CTM were classed as 'not permitted' in both years (98 % in 2013 and 100 % in 2017).

CONCLUSIONS

The advertisements in CTM still mostly refer to unhealthy foods. The extent of food advertising has dropped considerably since 2013. On the contrary, food advertising in printed media targeting adults has increased, chiefly referring to food supplements and foods that do not pass the WHO Europe nutrient profile model criteria.

Like and share: associations between social media engagement and dietary choices in children

Objective

To examine whether social media and online behaviours are associated with unhealthy food and beverage consumption in children.

Design

A cross-sectional online survey was used to assess Internet and social media use, including engagement with food and beverage brand content, and frequency of consumption of unhealthy foods and beverages. Linear regression models were used to examine associations between online behaviours, including engagement with food and beverage brand content, and consumption of unhealthy foods and beverages, adjusting for age, sex and socio-economic status.

Setting

New South Wales, Australia, in 2014.

Subjects

Children aged 10–16 years (n417).

Results

Watching food brand video content on YouTube, purchasing food online and seeing favourite food brands advertised online were significantly associated with higher frequency of consumption of unhealthy foods and drinks after adjustment for age, sex and socio-economic status.

Conclusions

Children who have higher online engagement with food brands and content, particularly through online video, are more likely to consume unhealthy foods and drinks. Our findings highlight the need to include social media in regulations and policies designed to limit children’s exposure to unhealthy food marketing. Social media companies have a greater role to play in protecting children from advertising.