examining the influence of food and beverage ......examining the influence of food and beverage...

Examining the Influence of Food and Beverage Advertisements on Childhood Obesity

EXAMINING THE INFLUENCE OF FOOD AND BEVERAGE ADVERTISEMENTS ON

CHILDHOOD OBESITY: A LITERATURE REVIEW

ELISABETH TYLER

UNIVERSITY OF GEORGIA

HPRB5410W

DR. WALTERS

MARCH 8TH, 2018


2

Research Question: How have junk food advertisements influenced the increase in childhood

obesity in the United States?

Abstract

Within the past thirty years, childhood obesity rates have tripled in the United States.

About one-third of American children are overweight or obese. Obesity has been shown to cause

a number of health concerns including heart disease, diabetes, asthma, sleep apnea, as well as

emotional stress such as low self-esteem or depression. Many factors such as genetics,

environment, and personal behavior have been linked to obesity. However, there has been a

strong association with the increased number of food and beverage advertisements targeting

children to the increase in childhood obesity. Little research has been done to show the effects of

advertisements for products with high sugar and sodium content have on children and their

eating habits. This literature review examines the relationship between increased exposure to

food and beverage advertisements along with increased habits that contribute to obesity in

children in the United States. Ten peer-reviewed articles discussed the increased number of food

advertisements that are directed towards children, the strategies used by corporations to target

children, as well as the short-term effects the advertisements have on children ages 2 to 18. This

review found that the more exposure children had to food and beverage advertisements, the more

they preferred, requested, and consumed the product being advertised. Regulations on how

much advertisers can market to children, and exposure to correct information pose possible

solutions to decrease rates of childhood obesity.


3

Table of Contents

Introduction ................................................................................................................................... 4

Childhood Obesity .......................................................................................................................... 4

Risks ................................................................................................................................................ 4

Causes ............................................................................................................................................. 5

Food and Beverage Advertisements During Children’s Television ............................................... 6

Overview ......................................................................................................................................... 7

Methods .......................................................................................................................................... 8

Searched Databases and Terms ...................................................................................................... 8

Criteria ............................................................................................................................................ 8

Figure 1. Article selection process for literature review .............................................................. 10

Results .......................................................................................................................................... 11

Food and Beverage Industries Target Children ....................................................................... 12

Manipulative Techniques used by Advertisers .......................................................................... 12

Short-Term Negative Health Consequences ............................................................................. 13

Long-term Negative Health Consequences ............................................................................... 14

Figure 2. Summary of information from articles reviewed........................................................... 15

Discussion..................................................................................................................................... 19

Review ....................................................................................................................................... 19

Limitations ................................................................................................................................ 21

Future Research Opportunities................................................................................................. 21

Conclusion ................................................................................................................................... 22


4

Introduction

Childhood Obesity

This literature review addresses the issues and contributing factors to the growing rates of

childhood obesity. Childhood obesity has become the number one concern of parents for their

children (American Heart Association, 2016). In the United States, research has shown that

about one in five children ages 2 to 18 years old are considered obese. Body Mass Index (BMI)

is the most common tool used by health professionals to measure obesity. It takes into account

both height and weight to determine the healthy range an individual should be at. Health

professionals taking BMI for children also must consider that adolescents are still growing at

different rates depending on age and sex. Children are considered overweight if their BMI falls

above the 85th percentile and below the 95th percentile. Children with a BMI above the 95th

percentile are considered obese (CDC, 2018).

Children ages 2 to 19 have shown a large increase in obesity rates from 1974. Mexican-

American males exhibit the highest rates of childhood obesity at 28.9 percent, followed by

Black-American females at 24.8% (American Heart Association, 2016). Obesity is such a

growing concern for its connections with non-communicable disease, as well as social and

economic consequences into adulthood.

Risks

Childhood obesity contributes to a number of diseases as well as an increase in morbidity

and mortality (APA, 2018). Children who are overweight or obese are more likely to suffer from

breathing problems (such as asthma), sleep apnea, bone and joint problems, and type 2 diabetes

(CDC, 2018). High blood pressure and high cholesterol are common consequences associated

with obesity (CDC, 2016). Beyond physical issues, children who are considered obese can often


5

experience psychological and emotional strain. Overweight children are often subject to teasing

or bullying from their peers which can lead to low self-esteem, social isolation, and depression.

They also can suffer from behavioral problems and difficulty learning at the same rate as their

peers (Mayo Clinic, 2016).

Causes

There are many factors that contribute to the growing rates of childhood obesity that

include both individual behavior as well as total ecology. The CDC lists the top causes of

obesity to be an overconsumption of calories, genetics, metabolism, community environment,

sleep habits, and physical activity, often times a combination of different elements (CDC, 2018).

Although it is difficult to alter genetic factors, obesity is still largely preventable as most of the

causes are from external sources. The Dietary Guidelines for Americans suggests eating a diet

rich in fruits and vegetables, whole grains, lean proteins, and low-fat dairy products, as well as at

least sixty minutes of exercise a day. Behaviors such as eating foods high in sugar and sodium,

lack of exercise, inadequate sleep patterns, as well as medications can contribute to obesity

(CDC, 2016). These unhealthy habits are typical of American culture. Excess weight can be

gained from just an extra hundred and fifty calories a day (APA, 2018).

Family, psychological, and socioeconomic status also play a part. Children who live with

other overweight family members are more likely to be overweight as well due to the fact that

high calorie foods are generally more available, and physical activity is not encouraged. Stress

can also cause an overconsumption of food, as well as boredom in order to cope emotionally.

Socioeconomic factors include limited resources or access to healthy food (i.e. food deserts) and

lacking a safe space to exercise. People who have a poorer socioeconomic status tend to buy


6

foods that are more convenient and cheap such as fast food, frozen meals, and packaged items

that will last longer (Mayo Clinic, 2016).

Food and Beverage Advertisements During Children’s Television

Obese and overweight children commonly engage in sedentary activities including

television, computer, and video game screen time (CDC, 2016). Since the 1970s, there has been

an increase in advertising for unhealthy foods that has shown strong correlation with the increase

in childhood obesity. On average, young people ages 8 to 18 spend 44.5 hours per week in front

of a screen, which is more than any other activity they engage in besides sleeping. With

advancements in technology, Americans are becoming more sedentary. Most of the food and

beverage advertising is aimed at children age 8 to 12 because this age is impressionable, and it is

the beginning of when adolescents form their own food habits. They are at an age where they

can start purchasing their own food. Children this age can also recall content from

advertisements after just one view, and their preference for that product increases with repeated

exposure (APA, 2018).

About 3 out of 4 advertisements targeted towards children are for unhealthy foods. Half

of the advertisements on children’s networks are food and beverage products. The American

Psychological Association found that just one hour of television per day increased children’s

intake and preferences of sugary beverages, fast food, and processed meat. Children who watch

more television are more likely to become obese, increasing their chances of up to 50% only by

watching three more hours of television (APA, 2018).

The food industry targeting children can be linked to obesity in a similar way that other

industries objectify women and contribute to body dissatisfaction and eating disorders.


7

Unhealthy weight control behaviors have been shown to go hand in hand with rates of obesity.

The food industry capitalizes on this and marginalizes a specific demographic (APA, 2018).

Overview

Childhood obesity is a threatening endemic to the health of future generations in the

United States. It can lead to a number of issues including heart disease, diabetes, fatty liver

disease, as well as psychological damage such as a lack of self-confidence and depression (CDC,

2016).

Although there is little research done as far as the long-term effects that advertising has

on children, researchers have found that it can affect their product preference. Creating a

preference for their product when their young can develop habits and in turn children may

continue to prefer those products as adults. Advertisements aimed towards children for food and

beverages with high sodium and high sugar content have shown a strong association to the

increase in childhood obesity.

The purpose of this literature review is to examine the influence that food and beverage

advertisements have on the growing rates of childhood obesity. This paper aims to (1) explore

the amount of advertising for unhealthy foods that is exposed to children in the United States and

(2) the effects that advertising has on their eating habits and product preferences. This review

will explore the possibility that food and beverage advertisements that target children can be

linked to the increase in overweight and obese children.


8

Methods

Searched Databases and Terms

This literature review involved a search of CINAHL, MEDLINE, Food Science Source,

PsycINFO, ERIC, and the Science Citation Index through a multi-search database as well as

through PubMed. This study focused on children in the United States and aimed to find the

relationship between food and beverage advertisements directed towards children and the

growing rates of obesity. Search terms included variations of children, obesity, advertising, junk

food, and United States.

In the multi-search database, the terms “childhood obesity AND advertisements” were

used. This resulted in 1,901 results. By putting “obesity” ensured that the advertisements would

be focused on unhealthy food items, rather than advertisements for toys, movies, or other

children’s products. Also, specifying obesity kept the focus on foods that are considered high in

fat and sugar and not advertisements for healthy foods.

Criteria

Data was gathered from the CINAHL, MEDLINE, Food Science Source, PsycINFO,

ERIC, Science Citation Index and PubMed databases. The results were limited to 2007 to 2017

to ensure the most recent information in this field. The results were narrowed to show only

articles that had been peer-reviewed. From this refined list, 10 articles were chosen as the most

appropriate for this literature review.

Articles included from the multi-search in this literature review were mostly from the

United States. Although childhood obesity is a global epidemic, each nation has their own

cultural norms and values that might contribute to obesity in a different way. The United States

has products and advertisements that may not be seen in other countries, therefore restricting to


9

United States advertisements reduces the number of confounding variables. One article from

Food Science Source was not from the United States as the study was relevant to this review.

The article from PubMed was also not restricted to the United States as it was a generalized view

of the topic and was found still relevant to the review.

Articles in this literature included both the amount of television advertisements on

children, as well as the effects the advertisements had. The articles discussed the biological

impact that occurs when children are exposed to unhealthy food advertisements as well as the

policy surrounding the regulation of advertising targeting children. Although, there were studies

that remained relevant from many years ago, the data only reflected articles written in the past

ten years to ensure reliability.

Data that did not support the hypothesis that advertisements of junk food increased

childhood obesity were also included in order to further discuss the gaps within the study and

that there is a need for further research to encourage a policy change.


10

Figure 1. Article selection process for literature review

PubMed Search Multi-Search

Search 1: “childhood obesity”

AND “food advertisements”

1 article selected for this

literature review

Search 1: “childhood

obesity” AND

“advertisements” AND

“United States”

N=626

Limited to:

2007-2017 (no data yet for

2018)

Peer-reviewed articles only

N=224

9 articles selected for this

literature review

N=69


11

Results

A summary of the literature reviewed can be found in detail in Table 1. Summary of

information from articles reviewed. In general, all ten articles reviewed provided information on

the influence of food and beverage advertisements had on childhood obesity. Individuals

included in the data from the articles were children ages 2-18 and parents of children ages 2-18.

Overall, the studies found that children were exposed to more food and beverage

advertisements than any other product. On average, children are exposed to fifteen

advertisements for food and beverages a day (Tripicchio et al., 2016). Advertisements for candy

and snacks made up 34% and advertisements for cereal made up 29%, others for fast food

restaurants, and sugary beverages, with almost no advertisements for fruit or vegetables.

Children’s television networks such as ABC Family, Cartoon Network, and Nickelodeon, were

targeted more for food advertisements than adult programming networks such as ABC, CBS, or

NBC (Harvey, 2013). Almost none of the products advertised met the standards for nutritional

guidelines, most of them exceeding the standards for sugar and sodium content. Products were

considered high in sodium if it had more than 450 mg per serving size and high in sugar if it had

more than 13g (Powell, Schermbeck, & Chaloupka, 2013).

The information showed that generally, children who are exposed to more food and

beverage advertisements are more likely to become overweight or obese. Children who entered

kindergarten overweight were four times more likely to be overweight as eighth graders than

those who entered school at a normal weight (Vilaro, Barnett, Watson, Merten, & Mathews,

2017). Advertisements shape children’s preferences to favor unhealthy foods and can contribute

to specific attitudes about products (LoDolce, Harris, & Schwartz, 2013). It was consistent that

short-term effects of exposure to food and beverage advertisements included increased


12

consumption as well as increasing their persistence to request these products from their parents

(Harvey, 2013). It takes as little as a ten to thirty second exposure of a product to influence the

short-term preference for preschoolers (Castonguay, 2015).

Food and Beverage Industries Target Children

Advertisers know that the media environment shapes individual knowledge about food,

attitudes, and preferences. In the United States about 20-25% of children’s daily food intake is

consumed in front of the television (Reisch et al., 2013). Children generally are exposed to 11.5

minutes of food-related television advertisements per hour of programming (Veerman, Van

Beeck, Barendregt, & Mackenbach, 2009). The 2009 Nielsen Media Research TV rating data

found that there were more advertisements with high-sodium/high-sugar products during

children’s programming than adult’s programming (Powell et al., 2013).

Children ages 2 to 18 are still developing mentally and tend to be more impressionable.

The Social Learning Theory suggests that children learn and model behaviors by observing

others (i.e. parents, peers, media, etc.). Exposure to advertising can shape beliefs about food and

eating without understanding rational thought (i.e. preferring unhealthy foods). Most

advertisements, however, portray unhealthy behaviors such as snacking that occurs at any time,

as well as promoting unhealthy foods as “cool” (LoDolce et al., 2013).

Manipulative Techniques used by Advertisers

Advertisers use persuasive techniques promote brand loyalty, product recognition,

increased requests, as well as increased consumption. 82% of food advertisements use “fun” to

appeal to their target audience where as 57% use action and 34% use prizes and giveaways

(Vilaro et al., 2017). Children in advertisements are generally portrayed as fun and cool and


13

engaging in interesting, active lifestyles. However, these advertisements are often misleading in

that they enhance physical performance (LoDolce et al., 2013).

In recent years, industries have used physical activity to promote their product. If a

product appears healthier, it generally gains more interest. As of 2011, over half of food

advertisements targeted towards children also promoted some sort of health-related activity. For

example, McDonalds used Ronald McDonald as a fitness ambassador to promote physical

activity. However, they still marketed chicken nuggets and fries within the same advertisement.

Studies found that children expressed a greater interest in foods that they thought promoted

healthier lifestyle (Castonguay, 2015).

Short-Term Negative Health Consequences

Children who watched television programs with food advertisements are more likely to

prefer and recall the product shown to them. A study found that children ate 45% more snack

food when watching programming that contained food advertisements than children who

watched the same show without food advertisements. Children also tended to prefer products

that had a low nutritional content if they were shown an advertisement for it (Vilaro et al., 2017).

A mathematical simulation model was used to show the effects of changes in exposure to

food advertisements in relation to consumption and BMI. One population was unchanged in

their viewing practices while the other had reduced the number of food advertisements they were

exposed to. Less exposure to food advertisements was shown to lower daily food consumption

which in turn lowered average body weight. The model also predicts that by reducing

advertisement exposure from 80.5 minutes per week to none would reduce consumption by 4.5%

and could go up to 6.5% with a complete ban of food advertisements. With zero food


14

advertisements being shown on television, the model predicts that up to one in seven obese

children would not be obese (Veerman et al., 2009).

Long-term Negative Health Consequences

Studies have found that children who are obese during childhood are more likely to be

obese as adults. About two-thirds of children who are overweight or obese, remained obese into

adulthood (Vilaro et al., 2017). However, there are few studies that have linked exposure to food

advertisements as children, to obesity in adulthood.

A longitudinal study done on food advertisements and BMI showed that children who

were exposed to energy-dense food advertisements were more likely to choose healthy foods

(apples) over energy-dense food. Those children were measured two years later and had lower

BMIs and suggested there was no long-term association between food advertisements and BMI

(Folkvord, Anschütz, & Buijzen, 2016). This suggests a need for more long-term research needs

to be done to prove the association between food and beverage advertisements with long-term

eating habits.


Table 1. Summary of information from articles reviewed

Author(s) Year Article Title Journal Purpose of

Article

Sample Info Type of

Research

Research

Findings

Limitations

Castonguay, J 2015 Portraying

physical

activity in food

advertising

targeting

children

Health

education

To examine

depictions of

physical activity in

food advertising

and assess how

recognition of a

promoted food's

healthy and

unhealthy traits

influences dietary

selections among

youth in Southern

Arizona in the

USA.

Food

advertisements

appearing

during

children’s

programming

during 2009-

2013 in

Southern

Arizona, USA

34 children

ages 5-6, 34

children ages

10-11

Journal Article;

Reports-Research

Authors found that

there was an

increase in food

advertisements that

included physical

activity from 2009 to

2013. The study

also found that

younger children

could not grasp the

manipulative nature

of advertisements

whereas older

children could.

Physical activity

was defined as

physical exertion

but did not include

symbols.

Overlooked dietary

complexities.

Further research is

needed to confirm

theories of

cognitive

consistency. Other

variables such as

parental education

and income should

be investigated.

Debra, M. D.,

& Debra, J. H.

2007 Children’s

exposure to

television

advertising:

Implications

for childhood

obesity

Journal of

Public Policy &

Marketing

The primary

objective of this

article is to

emphasize and

summarize the

major findings of

the BE staff report

(Holt et al. 2007).

Four weeks of

data on all

programs

aired, the

audience

composition

for each

program, and

the

advertisements

embedded in

the programs

FTC Investigation Approximately 70%

of children’s

viewing is during

ad-supported

television. Children

are exposed to about

25,600

advertisements per

year and 22% are

food related.

Nonfood

advertisements

might also be

contributing to

obesity.

The data did not

address other

factors that may

contribute to

obesity. It also

only focuses on

television

advertisements and

no other marketing

communications.

The nutritional

content of the food

was also left out

Folkvord, F.,

Anschütz, D. J.,

& Buijzen, M.

2016 The association

between BMI

development

among young

International

Journal of

Behavioral

Nutrition &

To explore if

reactivity to food

cues in an

advertisement was

218 children

ages 5-6

Longitudinal Study Children who chose

apple after playing

the advergame had a

lower BMI two

Only tested food

choices at one

moment instead of

repeated measures.


16

children and

(un)healthy

food choices in

response to

food

advertisements:

a longitudinal

study

Physical

Activity

associated with

weight status two

years later.

years later, but no

association was

found between food

intake and BMI.

BMI was measured

after two years.

Further research is

required to show

long-term effects of

food

advertisements on

BMI.

Harvey, A. 2013 A proposal for

congressionally

mandated

federal

regulation of

child-directed

food and

beverage

television

advertisements

to combat

childhood

obesity

Health Matrix

(Cleveland,

Ohio: 1991)

To encourage a

congressional

mandated federal

regulation on food

and beverage

advertisements that

are targeted towards

children.

Children in the

United States

Congressional

Research

Advertisers spend

millions of dollars

on advertising

towards children.

They use four

techniques; spending

a lot of money,

addictive

ingredients,

outsmarting

children, and

targeting parents to

manipulate young

minds into favoring

their products.

The IWG’s PPNP’s

that are already in

place are unlikely

to have impact, but

low impact is

unlikely to make a

congressional

policy change.

LoDolce, M. E.,

Harris, J. L., &

Schwartz, M. B.

2013 Sugar as part

of a balanced

breakfast?

What cereal

advertisements

teach children

about healthy

eating

Journal of

Health

Communication

The authors

combined content

analysis of product

nutritional quality

and messages

presented in cereal

television

advertisements with

syndicated data on

exposure to those

ads.

Content

analysis of

products and

creative

content of

cereal

advertisements

as well as

Neilsen data to

measure child

and adult

exposure.

Content analysis High-sugar cereals

are advertised more

often to children

than adults. The

advertisements

shown are more

likely to be

misleading about

benefits.

Do not address the

confusing and

misleading

messages and

creative techniques

used to promote the

products.

Powell, L. M.,

Schermbeck, R.

M., &

Chaloupka, F. J.

2013 Nutritional

content of food

and beverage

products in

Childhood

Obesity (Print)

To examine the

nutritional content

of food and

beverage products

TV rating data

for children 2-

5 and 6-11

years of age

Nielsen Media

Research assessed

2009 TV ratings

data

Most food and

beverage products

advertised to

children do not meet

The study did not

distinguish between

added and natural

sugars. The IWG


17

television

advertisements

seen on

children's

programming

in advertisements

seen by children on

all TV

programming and

in the subset of ads

seen on children’s

programming with

35% or greater

child-audience

share

the IWG nutrition

recommendations.

recommendations

also does not

include a limit on

calories.

Reisch, L. A.,

Gwozdz, W.,

Barba, G., De

Henauw, S.,

Lascorz, N., &

Pigeot, I.

2013 Experimental

Evidence on

the Impact of

Food

Advertising on

Children's

Knowledge

about and

Preferences for

Healthful Food

Journal of

Obesity

Examines the

effects of one of the

constituent factors

of consumer

societies and a

potential

contributory factor

to childhood

obesity: commercial

food

communication

targeted to children.

16,225

children ages

2 to 10 years,

follow up

survey is two

years later

Cohort study with

baseline survey

The study found that

higher food

knowledge is not

linked to healthier

diets and no effect

on weight status.

This study does not

take genetics and

lifestyle factors

into consideration.

Tripicchio, G.

Heo, M.

Diewald, L.

Noar, S. M.

Dooley, R.

Pietrobelli, A.

Burger, K. S.

Faith, M. S.

2016 Restricting

Advertisements

for High-Fat,

High-Sugar

Foods during

Children's

Television

Programs:

Attitudes in a

US Population-

Based Sample

Childhood

Obesity (Print)

The aim of the

current study was to

determine the

extent to which the

US population is

supportive of

greater regulation

of advertisements

for HFHS foods

during children's

TV programs.

Adults age 18

years and

older from

2005 to 2012,

Respondents

(N = 1838)

were 53.2%

female, mean

age 50.0 ±

16.5 years.

Race/ethnic

composition

was 76.8%

white, 7.4%

black, 9.2%

Hispanic, and

6.6% other.

Cross-sectional

survey

Responses indicate

22.7% strongly

support, 33.6%

support, 16.1%

oppose, and 8.2%

strongly oppose

restricting HFHS

advertisement to

children, while

19.5% had no

opinion. Thus,

56.3% of

respondents

supported or

strongly supported

advertisement

restrictions.

This was a self-

report survey and

therefore responses

may be bias.

Racial minorities

were

underrepresented.

Only a subset of

participants were

included in logistic

regression analysis.


18

Veerman, J. L.,

Van Beeck, E.

F., Barendregt,

J. J., &

Mackenbach, J.

P.

2009 By how much

would limiting

TV food

advertising

reduce

childhood

obesity?

European

Journal of

Public Health

To give a quantified

estimate of the

impact of TV food

advertising on

childhood

overweight and

obesity.

Children ages

6-12.

Delphi Study Reducing exposure

to food

advertisements to

zero would lower

average BMI by .38

kg/m^2 and lower

the prevalence of

obesity.

Uncertainty in the

size of these

effects.

Limitations within

the model itself.

Vilaro, M.J.,

Barnett, T.E.,

Watson, A.M.,

Merten, J.W.,

Mathews, A.E.

2017 Weekday and

weekend food

advertising

varies on

children’s

television in

the USA but

persuasive

techniques and

unhealthy

items still

dominate

Public Health This study provides

an analysis of US

food advertisements

during peak

children's viewing

hours focusing on

nutritional content

and persuasiveness

of food and

beverage

advertisements.

32 hours of

children’s

television

programming

recorded on

four days

during the first

week of

February 2013

Content Analysis Over half of food-

related

advertisements

shown to children

are for unhealthy

items. They are

more likely to show

during weekdays

than on Saturday

mornings. Children

get an uneven

amount of exposure

to food advertising

than adults.

Small sample size.

Some products

were considered

healthy according

to the model which

included

McDonald’s

chicken

McNuggets. Less

dominant products

in the

advertisement (i.e.

apples) were not

always included.


Discussion

Review

This review identified three key findings. First, advertisers for food and beverage

products spend more money on advertisements that target children’s programming than adults.

Second, that advertisers use manipulative techniques to take advantage of the impressionable

adolescent mind. Finally, exposure to food and beverage advertisements have been shown to

have short-term effects on children.

Results from this review show that children are more likely to be exposed to food and

beverage advertisements for high-sugar/high-sodium content products than adults. There is a

strong association between the increase in junk food advertisements and increases prevalence of

childhood obesity since the 1970s (Debra & Debra, 2007). Industries are spending $142 million

on cereal product advertisements, $91 million on restaurant food, $69 million on snacks, and $33

million on candy/frozen desserts. In 2007, corporations spent a combined total of almost $15

billion on food and beverage advertisements that targeted children (Harvey, 2013). Food

advertisements make up over half of all advertisement time during children’s programming

(APA, 2018), and in turn obesity increases with the more hours of television watched in a day

(Harvey, 2013).

This review also showed the manipulative tactics that industries use to promote product

preference in young minds. Children are extremely impressionable and have a high capability to

recall content they have been shown through television programs. A single exposure to an

advertisement has been shown to increase a child’s preference for that product and increases with

repeated exposure (APA, 2018), furthering that it only takes a few seconds for a preschooler to

develop content recollection (Castonguay, 2015). Advertisers associate their products with fun


20

and cool lifestyles by using brand spokes characters, fictional characters, celebrity endorsements,

giveaways (LoDolce et al., 2013), as well as physical activity and the promotion of physical

performance (Castonguay, 2015). These advertisements can often be misleading, as children

cannot always differentiate what they have previously learned (Reisch et al., 2013) or identify

the persuasive nature of the advertisement (Harvey, 2013).

Children that are younger than five years old are not able to distinguish between what is a

food advertisement and the actual television program. Even further, children 7 to 8 are not able

to recognize the manipulative nature behind food and beverage advertisements (Tripicchio et al.,

2016). A study found that 79.4% of older children were able to recognized the incentives behind

advertisements whereas only 20.6% of younger children were able to make that realization

(Castonguay, 2015). Children do not fully understand persuasive intent until around the age of

12 (Vilaro et al., 2017). The American Psychological Association stated that advertisements that

target children are unjust because of the limited comprehension children possess at that age

(Debra & Debra, 2007).

The large exposure children get to food and beverage products during television

programming has shown to have short-term effects on children’s preferences, requests, and

consumption (Tripicchio et al., 2016). Studies have shown that each hour of television viewing

increased intakes of sugary drinks, fast food, processed meat, and calorie intake (APA, 2018).

Television viewing of unhealthy foods in children has been shown to create preferences that

predict future diets among college students. Advertisements can also directly lead to a child’s

normative beliefs about eating behaviors and attitudes (LoDolce et al., 2013). The absence of

food advertisements aimed towards children has predicted a significant decrease in obesity

(Veerman et al., 2009).


21

Limitations

There are some limitations to this review. This review only provided evidence from 10

articles. A small data set was used, and this limited the ability to review all data available. The

data also extended past ten years as there is no information published for 2018 yet, as well as the

limited number of recent studies in general. BMI is also an inconsistent measurement of obesity,

discounting genetics and lifestyle factors.

Another limitation was the lack of data on the long-term effects of advertisement on

childhood obesity. Nine of the articles showed evidence that supported the short-term increase

in preference and consumption that would suggest an increase in weight among children.

However, none of them displayed any evidence that it had a long-term effect. One article even

disproved any long-term consequences, suggesting that there is no long-term association between

BMI and food advertisements. Further research needs to be conducted to see if the short-term

increase in consumption really has an impact in long-term rates of obesity.

Future Research Opportunities

There is little research surrounding the effects of food and beverage advertisements

factoring into childhood obesity. However, a study was done through the Annenberg National

Health Communication Survey that showed people’s changing attitudes towards targeting

children for advertisements. Participants were questioned on whether they support or oppose

restricting advertisements that target children towards unhealthy food and beverages. The data

showed that 22.7% strongly support the restriction of advertisements, 33.6% support, 16.1%

oppose, 8.2% strongly oppose, and 19.5% held no opinion (Tripicchio et al., 2016). This is a

positive shift in attitudes towards the regulation of advertisements that may be misleading or

harmful to children.


22

This shift in attitudes also suggests a need for further research in order to enact policy

change. Although there a few initiatives that have taken place in recent years to help regulate

children’s advertising, it is still up for criticism. The Children’s Food and Beverage Advertising

Initiative (CFBAI) has gotten 16 major food companies to devote at least half of their child-

targeted advertisements to healthy lifestyles (Tripicchio et al., 2016). However, the companies

get to choose their own definitions of what is healthy. For example, Fruit Loops and Reese’s

Peanut Butter Cup cereals are marketed as healthy yet contain 44% sugar (LoDolce et al., 2013).

Advertisers will also get around this initiative by advertising physical activity along with their

unhealthy foods (Castonguay, 2015).

The data from both the research, and criticism of the CFBAI suggests a need for more

long-term research to be done. Increase in consumption in the short-term might lead to obesity

in the future but further research is needed to prove this.

Conclusion

As obesity among children ages 2 to 18 continues to become a growing epidemic, it is

important to consider all contributing factors. Obesity is associated with serious future health

concerns and thus the short-term factors should also be considered. Overall, food and beverage

advertisements that target children towards high-sugar/high-sodium products increase

consumption and develop them into the future market. Regulation of advertisements that take

advantage of the impressionable minds of children needs support of a policy change to set

guidelines of what can be marketed as healthy and not misleading. Restriction and regulation of

food and beverage advertisements can support the decrease of childhood obesity in the United

States as well as encourage the health of future generations.


23

References

American Heart Association. (2016). Overweight in children. American Heart Association.

APA. (2018). The impact of food advertising on childhood obesity.

Castonguay, J. (2015). Portraying Physical Activity in Food Advertising Targeting Children.

Health Education, 115(6), 534-553.

CDC. (2016). Childhood obesity causes & consequences.

CDC. (2018). Childhood obesity facts. Retrieved from

https://www.cdc.gov/healthyschools/obesity/facts.htm

Debra, M. D., & Debra, J. H. (2007). Children's Exposure to Television Advertising:

Implications for Childhood Obesity. Journal of Public Policy & Marketing(2), 182.

Folkvord, F., Anschütz, D. J., & Buijzen, M. (2016). The association between BMI development

among young children and (un)healthy food choices in response to food advertisements: a

longitudinal study. International Journal of Behavioral Nutrition & Physical Activity, 13,

1-7. doi:10.1186/s12966-016-0340-7

Harvey, A. (2013). A proposal for congressionally mandated federal regulation of child-directed

food and beverage television advertisements to combat childhood obesity. Health Matrix

(Cleveland, Ohio: 1991), 23(2), 607-637.

LoDolce, M. E., Harris, J. L., & Schwartz, M. B. (2013). Sugar as part of a balanced breakfast?

What cereal advertisements teach children about healthy eating. Journal of Health

Communication, 18(11), 1293-1309. doi:10.1080/10810730.2013.778366

Mayo Clinic. (2016). Childhood obesity.

https://www.cdc.gov/healthyschools/obesity/facts.htm


24

Powell, L. M., Schermbeck, R. M., & Chaloupka, F. J. (2013). Nutritional content of food and

beverage products in television advertisements seen on children's programming.

Childhood Obesity (Print), 9(6), 524-531. doi:10.1089/chi.2013.0072

Reisch, L. A., Gwozdz, W., Barba, G., De Henauw, S., Lascorz, N., & Pigeot, I. (2013).

Experimental Evidence on the Impact of Food Advertising on Children's Knowledge

about and Preferences for Healthful Food. Journal of Obesity, 2013, 408582.

doi:10.1155/2013/408582

Tripicchio, G., Heo, M., Diewald, L., Noar, S. M., Dooley, R., Pietrobelli, A., . . . Faith, M. S.

(2016). Restricting Advertisements for High-Fat, High-Sugar Foods during Children's

Television Programs: Attitudes in a US Population-Based Sample. Childhood Obesity

(Print), 12(2), 113-118. doi:10.1089/chi.2015.0174

Veerman, J. L., Van Beeck, E. F., Barendregt, J. J., & Mackenbach, J. P. (2009). By how much

would limiting TV food advertising reduce childhood obesity? European Journal of

Public Health, 19(4), 365-369. doi:eurpub/ckp039

Vilaro, M. J., Barnett, T. E., Watson, A. M., Merten, J. W., & Mathews, A. E. (2017). Weekday

and weekend food advertising varies on children's television in the USA but persuasive

techniques and unhealthy items still dominate. Public Health, 142, 22-30.

doi:https://doi.org/10.1016/j.puhe.2016.10.011

https://doi.org/10.1016/j.puhe.2016.10.011

examining the influence of food and beverage ......examining the influence of food and beverage...

Documents