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Ezejibuaku OP, Oldroyd J. Regulation of digital marketing of ultra-processed food to adolescents is urgently needed. BMJ 2024; 386:q1517. [PMID: 38991698 DOI: 10.1136/bmj.q1517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Affiliation(s)
| | - John Oldroyd
- Australian Catholic University, Melbourne, Victoria, Australia
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2
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Potvin Kent M, Bagnato M, Remedios L, Soares Guimarães J, Gillis G, Soto C, Hatoum F, Pritchard M. Child and adolescent exposure to unhealthy food marketing across digital platforms in Canada. BMC Public Health 2024; 24:1740. [PMID: 38951838 PMCID: PMC11218052 DOI: 10.1186/s12889-024-19094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 06/10/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Children and adolescents are exposed to a high volume of unhealthy food marketing across digital media. No previous Canadian data has estimated child exposure to food marketing across digital media platforms. This study aimed to compare the frequency, healthfulness and power of food marketing viewed by children and adolescents across all digital platforms in Canada. METHODS For this cross-sectional study, a quota sample of 100 youth aged 6-17 years old (50 children, 50 adolescents distributed equally by sex) were recruited online and in-person in Canada in 2022. Each participant completed the WHO screen capture protocol where they were recorded using their smartphone or tablet for 30-min in an online Zoom session. Research assistants identified all instances of food marketing in the captured video footage. A content analysis of each marketing instance was then completed to examine the use of marketing techniques. Nutritional data were collected on each product viewed and healthfulness was determined using Health Canada's 2018 Nutrient Profile Model. Estimated daily and yearly exposure to food marketing was calculated using self-reported device usage data. RESULTS 51% of youth were exposed to food marketing. On average, we estimated that children are exposed to 1.96 marketing instances/child/30-min (4067 marketing instances/child/year) and adolescents are exposed to 2.56 marketing instances/adolescent/30-min (8301 marketing instances/adolescent/year). Both children and adolescents were most exposed on social media platforms (83%), followed by mobile games (13%). Both age groups were most exposed to fast food (22% of marketing instances) compared to other food categories. Nearly 90% of all marketing instances were considered less healthy according to Health Canada's proposed 2018 Nutrient Profile Model, and youth-appealing marketing techniques such as graphic effects and music were used frequently. CONCLUSIONS Using the WHO screen capture protocol, we were able to determine that child and adolescent exposure to the marketing of unhealthy foods across digital media platforms is likely high. Government regulation to protect these vulnerable populations from the negative effects of this marketing is warranted.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada.
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Lauren Remedios
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | | | - Grace Gillis
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Carolina Soto
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
| | - Farah Hatoum
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Meghan Pritchard
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand, Room 301J, Ottawa, ON, K1G 5Z3, Canada
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Coro DG, Schirmer K, van Rhoda M, McQueen B, Morris C. An environmental scan of food and drink advertising on public transport around Adelaide schools. Health Promot J Austr 2024. [PMID: 38840470 DOI: 10.1002/hpja.886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 05/08/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
ISSUE ADDRESSED Children and adolescents are particularly receptive to cues from food and drink advertising. Several policies recommend restricting unhealthy or discretionary ('junk') food advertising on government infrastructure such as public transport. Prior research in New South Wales (NSW) and Western Australia (WA) reveals a high proportion of discretionary food advertising outdoors and on public transport. The aim of this study was to identify the landscape of food and drink advertising on public transport assets around Adelaide schools. METHODS An environmental scan of food and drink advertising on public transport assets within 500 m of 65 Adelaide schools was conducted. The Council of Australian Governments Health Council's interim guide was used to categorise advertisements as 'suitable' or 'unsuitable' for promotion. RESULTS Almost four in every five food and drink advertisements on public-transport assets observed around Adelaide schools included discretionary food or drink, and therefore were categorised as unsuitable for promotion. Advertisements on bus exteriors were more likely to promote discretionary foods, compared with bus shelters. CONCLUSIONS This proportion of 'unhealthy' food advertising was comparable to previous research conducted in WA and NSW. SO WHAT?: In light of historic state/territory actions such as the ACT preventing discretionary food advertising on public transport, these findings should prompt a review and discussion of the suitability of food and drink promotion on government-owned South Australian transport and their associated assets.
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Affiliation(s)
- Daniel G Coro
- Behavioural Research Evaluation Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Kristy Schirmer
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Mollie van Rhoda
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Bronte McQueen
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Christine Morris
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
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Patte KA, Duncan MJ, Amores A, Belita E, Kocsis R, Riazi NA, Laxer R, Leatherdale ST. Inequities in dietary intake and eating behaviours among adolescents in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:507-520. [PMID: 38381304 PMCID: PMC11133286 DOI: 10.17269/s41997-024-00854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents. METHODS We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES). RESULTS Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES. CONCLUSION Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.
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Affiliation(s)
- Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
| | - Markus J Duncan
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Angelica Amores
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Rita Kocsis
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Negin A Riazi
- Student Health & Wellbeing, University of British Columbia, Vancouver, BC, Canada
| | | | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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5
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Gombi-Vaca MF, Martinez-Steele E, Andrade GC, Louzada MLDC, Levy RB. Association between ultra-processed food and snacking behavior in Brazil. Eur J Nutr 2024; 63:1177-1186. [PMID: 38360983 DOI: 10.1007/s00394-024-03340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Ultra-processed food may play a role in facilitating snacking behavior because of their convenience and low satiety potential. This study aimed to describe the association between consumption of ultra-processed foods and frequency of snacking. METHODS We analyzed data from 46,164 participants (≥ 10 years old) in the 2017-2018 Brazilian Household Budget Survey. Dietary data were collected by 24-h dietary recalls over one or two days for each participant. We estimated energy intake, ultra-processed food consumption, and level of snacking. We measured the association between ultra-processed food consumption and level of snacking using multinomial logistic regression, stratified by age group (adolescents, 10-19 years old; adults, 20-64 years old; elders, 65 or older). RESULTS We found a statistically significant tendency of increased daily energy intake and consumption of snacks and that ultra-processed food consumption was positively associated with the level of snacking for all age groups. For adolescents, adults, and elders in the highest quintile of ultra-processed food consumption as a share of their entire diet, the relative risk ratio (95% CI) of having more than two snacks per day compared to no snacks was 14.21 (9.09-22.21), 4.44 (3.54-5.57), and 4.21 (2.67-6.64), respectively, when compared to the lowest quintile. CONCLUSION Higher consumption of ultra-processed food was associated with snacking behavior, and the strength of this association was stronger among adolescents. Efforts to mitigate ultra-processed food attributes that facilitate snacking should be incorporated into strategies to promote healthier food choices, especially among adolescents.
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Affiliation(s)
- Maria Fernanda Gombi-Vaca
- Department of Preventive Medicine, School of Medicine (FMUSP), University of São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246, Brazil.
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil.
- Rudd Center for Food Policy and Health, University of Connecticut, One Constitution Plaza, Suite 600, Hartford, CT, 06103, USA.
| | - Euridice Martinez-Steele
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Maria Laura da Costa Louzada
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine (FMUSP), University of São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246, Brazil
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Harris JL, Taillie LS. More than a Nuisance: Implications of Food Marketing for Public Health Efforts to Curb Childhood Obesity. Annu Rev Public Health 2024; 45:213-233. [PMID: 38109516 DOI: 10.1146/annurev-publhealth-090419-102616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Fifteen years ago, public health experts urged industry, governments, and advocates to take action to dramatically improve the unhealthy food-marketing environment surrounding children in order to address the global childhood obesity crisis. Since then, research has confirmed that food marketing to children has far-reaching negative effects on their diets and health, takes advantage of adolescent vulnerabilities, and contributes to health disparities. In addition, digital marketing has profoundly changed young people's engagement with brands. Moreover, reliance on industry self-regulation as a solution has proven ineffective. Government-led policies have been more successful, but they remain limited in scope and challenging to adopt and implement. New approaches are necessary to increase public and policy maker awareness that food marketing is more than a nuisance, that it threatens the long-term health of children and adolescents worldwide, and that meaningful governmental action is urgently required to curtail industry's negative impact on young people's well-being.
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Affiliation(s)
- Jennifer L Harris
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, Connecticut, USA;
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Tang H, Spreckley M, van Sluijs E, Ahern AL, Smith AD. The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol. BMJ Open 2024; 14:e083465. [PMID: 38670609 PMCID: PMC11057283 DOI: 10.1136/bmjopen-2023-083465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Adolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity to promote healthy eating habits. Social media has become a popular platform for promoting health interventions, particularly among young people. However, there is a lack of consensus on the effectiveness of social media interventions in this population. This mixed-method systematic review aims to synthesise the available evidence on the impact of social media interventions on healthy eating behaviours among young people, their qualitative views and user experiences, and the intervention characteristics, behaviour change theories and techniques used to promote healthy eating. METHODS AND ANALYSIS We will conduct a comprehensive search of seven electronic databases, including ASSIA, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science. The search strategy will use a combination of Medical Subject Headings terms and keywords covering three domains: social media, eating behaviours and young people. The search will be limited to peer-reviewed published papers in any language, published from 2000. Three independent reviewers will screen studies based on predetermined eligibility criteria. Data will be extracted and analysed using a convergent segregated mixed-method approach. We will use random-effect meta-analysis or Synthesis Without Meta-analysis for quantitative data and thematic synthesis for qualitative data. Finally, narrative synthesis using concurrent triangulation will be used to bring together the results of the mixed-method data analysis to provide a comprehensive and integrated understanding of the impact and other features of social media interventions. This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. ETHICS AND DISSEMINATION Ethical approval is not required since this systematic review will not collect original data. The outcomes of this review will be shared through peer-reviewed publications and conference presentations and will contribute to the PhD thesis of the primary author. PROSPERO REGISTRATION NUMBER CRD42023414476.
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Affiliation(s)
- Hao Tang
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Marie Spreckley
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Nuss T, Chen YJM, Scully M, Hickey K, Martin J, Morley B. Australian adults' attitudes towards government actions to protect children from digital marketing of unhealthy food and drink products. Health Promot J Austr 2024; 35:332-339. [PMID: 37286359 DOI: 10.1002/hpja.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
ISSUE ADDRESSED This study assessed Australian adults' attitudes towards government actions to protect children from digital marketing of unhealthy food and drink products. METHODS An online survey was undertaken by Australian adults aged 18-64 recruited via two national panels in December 2019 (N = 2044). RESULTS Most respondents (69%) agreed the Government should protect children from unhealthy food and drink marketing and advertising broadly. Those who agreed most commonly indicated children should be protected up to age 16 (34%) or 18 (24%). There was widespread support for government actions to stop unhealthy food and drink marketing on digital platforms (e.g., internet sites) (68%-69%) and various digital marketing techniques (e.g., advertising by brands on social media) (56%-71%). A total ban on targeting unhealthy food and drink marketing to children online received the highest level of support (76%). Most respondents (81%) disagreed unhealthy food and drink companies should be able to collect children's personal information for marketing purposes. Support for examined actions was generally higher among older adults, more educated adults and more frequent internet users, lower among males, and similar between parents and non-parents. CONCLUSIONS There is public perception that the government is responsible for protecting children, well into adolescence, from unhealthy food and drink marketing broadly. Widespread public support extends to specific actions to reduce children's exposure to digital marketing of unhealthy food and drink products. SO WHAT?: Implementation of policies to protect children from digital marketing of unhealthy food and drink products would be well received by the Australian public.
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Affiliation(s)
- Tegan Nuss
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | | | - Jane Martin
- Food For Health Alliance, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
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Evans R, Christiansen P, Masterson T, Barlow G, Boyland E. Food and non-alcoholic beverage marketing via Fortnite streamers on Twitch: A content analysis. Appetite 2024; 195:107207. [PMID: 38218416 DOI: 10.1016/j.appet.2024.107207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/08/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
Food and non-alcoholic beverage (hereafter: food) marketing is prevalent in digital media and predominantly for foods high in fats, salt and/or sugar (HFSS). However, little is known about food marketing in videogame livestreaming platforms - a hybridisation of social and gaming media where individuals can watch influencers (i.e., streamers) play videogames. No studies have explored food cues within the streamed content or content likely to be viewed by adolescents. The current study analysed the food cues in Twitch (the leading videogame livestreaming platform) videos (n = 52, 52h) uploaded to the platform during October 2020-September 2021 by influencers likely to be popular with adolescents. Food cues (n = 133, 2.56 per hour) were coded for exposure (e.g., display type, healthfulness) and power (e.g., presentation) using a World Health Organization (WHO) protocol and the UK Nutrient Profile Model. The majority (70.7%) of cues were HFSS, with energy drinks being the most featured food category (62.4%). Most cues were branded (80.5%) and featured as either product placement (44.4%) or a looping image (40.6%). Influencers were more likely to consume healthy (88.5%) than HFSS items (33.4%). The mean duration of each food cue was 20 min and 25 s per hour. Only 2.3% of cues had an advertising disclosure. This study provides the first empirical assessment of food cues on Twitch in livestreamed content likely to be popular with adolescents and has implications for digital food marketing policy development.
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Affiliation(s)
- Rebecca Evans
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK.
| | - Paul Christiansen
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK
| | - Travis Masterson
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, 226 Henderson, University Park, PA 16802, USA
| | - Georgia Barlow
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, UK
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Ellithorpe ME, Bleakley A, Hennessy M, Jordan A, Stevens R, Maloney E. Athletes Drink Gatorade: DMA Advertising Expenditures, Ad Recall, and Athletic Identity Influence Energy and Sports Drink Consumption. HEALTH COMMUNICATION 2023; 38:3031-3039. [PMID: 36214773 PMCID: PMC10083192 DOI: 10.1080/10410236.2022.2131971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Understanding why sports and energy drinks remain increasingly popular among adolescents despite declines in other sugar sweetened beverages is critical. This study points to memory for advertising exposure and adolescent athletic identity as two aspects that together help to explain consumption. An online survey of U.S. adolescents aged 14-18 (n = 503) was combined with Nielsen data for television and social media advertising expenditures by sports and energy drink brands in participants' designated market areas (DMAs). Advertisement recall mediates the relationship between social media DMA expenditures and sports and energy drink consumption. Recall for television advertisements is related to consumption but is unrelated to television DMA expenditures. Athletic identity moderated the relationship between recall and consumption such that consumption increased as both recall and athletic identity increased, suggesting a role for motivated memory and motivated processing of ad messages based on athletic identity consistent with the limited capacity model of motivated media message processing. Based on these results, we conclude that effectiveness of expenditures in influencing behavior is dependent upon both ad recall and ad relevance, and that athletic identity is an important factor in ad effectiveness in the context of sports and energy drinks advertising.
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Affiliation(s)
| | - Amy Bleakley
- Department of Communication, University of Delaware
| | | | - Amy Jordan
- Department of Journalism and Media Studies, Rutgers, the State University of New Jersey
| | - Robin Stevens
- USC Annenberg School for Communication and Journalism, University of Southern California
| | - Erin Maloney
- Department of Communication, University of Delaware
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11
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Alfraidi A, Alafif N, Alsukait R. The Impact of Mandatory Food-Marketing Regulations on Purchase and Exposure: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1277. [PMID: 37628276 PMCID: PMC10453145 DOI: 10.3390/children10081277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
(1) Background: Several governments have enforced a series of actions to improve the local food environment and reduce obesity-related diseases in the population by implementing statutory regulations to reduce or ban the marketing of products that are considered unhealthy based on nutrient profile systems or them being high in fat, sugar, and salt (HFSS); (2) Objective: This narrative review is aiming to provide a comprehensive exploration of the available evidence on the impact of identified mandatory regulations restricting food marketing, including advertisements and packages on the exposure and purchase of HFSS food products, to help justify the need for these regulations; (3) Methods: Articles were retrieved by searching electronic databases, including EBSCO Education, PubMed, Scopus, Web of Science, and Google Scholar from 2012 up to December 2022; (4) Results: A total of 12 articles were included in this review. Almost all mandatory food-marketing regulations have evidence in favor of reducing HFSS food purchases and exposure; (5) Conclusions: Protecting children and adolescents from food and beverage marketing through mandatory regulations is a crucial step toward tackling global childhood and adolescent obesity and securing a healthier environment for future generations.
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Affiliation(s)
- Alanoud Alfraidi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
- Department of Clinical Dietitian, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Nora Alafif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
| | - Reem Alsukait
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (N.A.); (R.A.)
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12
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Rios JM, Berg MK, Gearhardt AN. Evaluating Bidirectional Predictive Pathways between Dietary Restraint and Food Addiction in Adolescents. Nutrients 2023; 15:2977. [PMID: 37447303 DOI: 10.3390/nu15132977] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
The relationship between food addiction, an important emerging construct of excessive eating pathology, and dietary restraint has yet to be fully understood. Eating disorder models commonly posit that dietary restraint exacerbates loss of control eating (e.g., binge episodes) and may also play a causal role in the development of food addiction. However, dietary restraint as a reaction to consequences of food addiction (e.g., uncontrollable eating or weight gain) represents another plausible pathway. Existing studies indicate that the association between food addiction and dietary restraint may be more significant during adolescence than adulthood, but are limited by cross-sectional study designs. A longitudinal study using an adolescent sample is ideal for investigating potential pathways underlying links between food addiction and dietary restraint. This study examined temporal pathways between food addiction and dietary restraint in a sample of one hundred twenty-seven adolescents (M = 14.8, SD = 1.1) at three timepoints spanning two years. This is the first study to examine longitudinal cross-lagged panel associations between food addiction and dietary restraint. In this adolescent sample, food addiction significantly predicted future dietary restraint (b = 0.25, SE = 0.06, p < 0.001), but dietary restraint did not significantly predict future food addiction (b = 0.06, SE = 0.05, p > 0.05). These findings support the theory that dietary restraint may be a reaction to deleterious effects of food addiction during adolescence.
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Affiliation(s)
- Julia M Rios
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - Martha K Berg
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
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13
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Evans R, Christiansen P, Masterson T, Pollack C, Albadri S, Boyland E. Recall of food marketing on videogame livestreaming platforms: Associations with adolescent diet-related behaviours and health. Appetite 2023; 186:106584. [PMID: 37127245 DOI: 10.1016/j.appet.2023.106584] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/24/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023]
Abstract
Digital media has become an integral part of adolescents' lives. Mirroring this trend, food and non-alcoholic beverage (hereafter: food) brands increasingly promote products in digital media to maximise reach with young consumers. Videogame livestreaming platforms, where individuals can broadcast or watch streamed videogame footage, are a growing form of digital media. The top three platforms (market share by hours watched) are Twitch (72%), YouTube Gaming (13%), and Facebook Gaming Live (9%), with a combined 34.6 billion hours watched in 2021. These platforms represent a hybridisation of two popular digital trends amongst teenagers: viewing online video content and playing videogames. On these platforms, gaming influencers promote food brands and products, with energy drinks and fast-food restaurants representing the most frequently promoted categories. Evidence suggests that food marketing via Twitch is associated with food craving, purchasing and consumption in adults. Yet, despite the evident teenage appeal and prevalence of food marketing on these platforms, research is yet to explore its associations with adolescent eating behaviour. Adolescents (n = 490, Mage = 16.81, 30.2% female) completed an online cross-sectional questionnaire exploring their recall of food marketing on the top three videogame livestreaming platforms, and relevant behavioural (purchase, consumption) and health (Body Mass Index) outcomes. Structural equation modelling was used to explore hierarchical relationships between the key variables. Results showed that recall of unhealthy food marketing on these platforms was significantly associated with purchase and consumption of marketed food categories. Attitudes towards unhealthy foods mediated this relationship. Findings are the first to demonstrate the relationships between unhealthy food marketing via videogame livestreaming platforms and adolescent eating behaviours, which has implications for the design of policies to restrict digital food marketing to young people.
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Affiliation(s)
- Rebecca Evans
- Department of Psychology, The University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Paul Christiansen
- Department of Psychology, The University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
| | - Travis Masterson
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, 226 Henderson, University Park, PA, 16802, USA
| | - Catherine Pollack
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, 1 Medical Center Drive, Lebanon, NH, 03756, USA
| | - Sondos Albadri
- School of Dentistry, The University of Liverpool, Pembroke Place, Liverpool, L3 5PS, UK
| | - Emma Boyland
- Department of Psychology, The University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK
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14
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Thomas S, van Schalkwyk MCI, Daube M, Pitt H, McGee D, McKee M. Protecting children and young people from contemporary marketing for gambling. Health Promot Int 2023; 38:7080461. [PMID: 36932993 PMCID: PMC10024482 DOI: 10.1093/heapro/daac194] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
Around the world, children are being exposed to intensive marketing for gambling products. This normalizes perceptions that gambling is essentially a harmless form of entertainment, despite mounting evidence of the harms it causes. Young people and their parents are supportive of strategies to protect children from being exposed to gambling marketing. Yet existing regulatory efforts are inconsistent and inadequate, and have not protected children from exposure to the many forms of marketing now being developed and exploited by the gambling industry. We outline existing knowledge about strategies used by the gambling industry to market its products, with a specific focus on the potential impact of gambling marketing on young people. We provide a definition of gambling marketing and outline the different forms of promotion that are currently used to market gambling, current regulatory responses, and the impact of marketing on children and young people. We then argue that a comprehensive public health approach to gambling is urgently required, which must include effective action to limit the influence of marketing for gambling products, while recognizing that it is never possible to insulate children entirely from their reach.
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Affiliation(s)
| | - May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Hannah Pitt
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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15
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Potvin Kent M, Pauzé E, Bagnato M, Guimarães JS, Pinto A, Remedios L, Pritchard M, L'Abbé M, Mulligan C, Vergeer L, Weippert M. Advertising expenditures across media on food and beverage products heavily advertised on youth-appealing television stations in Canada. Appl Physiol Nutr Metab 2023; 48:27-37. [PMID: 36174233 DOI: 10.1139/apnm-2022-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This research estimated and characterized advertising expenditures on food products heavily advertised on youth-appealing television stations in Canada in 2019 overall, by media, by food category, and compared expenditures in two policy environments (Quebec and the rest of Canada, excluding the territories) and on "healthier" versus "less healthy" products. Advertising expenditure estimates for 57 selected food categories promoted on television, radio, out-of-home media, print media, and popular websites were licensed from Numerator. Sixty-one products or brands were identified as heavily advertised on youth-appealing stations and classified as "healthier" or "less healthy" based on a nutrient profile model proposed by Health Canada. Total expenditures and expenditures per adolescent capita were calculated. Approximately, $110.9 million was spent advertising food products heavily advertised to adolescents in Canada in 2019, with television accounting for 77% of total expenditures and fast food restaurants accounting for 51%. Most expenditures (77%; $80.6 million) were devoted to advertising "less healthy" products. In Quebec, advertising expenditures on examined products were 23% lower per capita ($45.15/capita) compared to the rest of Canada ($58.44/capita). Advertising expenditures in Quebec were lower for energy drinks (-47%; -$0.80/capita) and candy and chocolate (-41%; -$1.00/capita) and higher for yogurt (+85%; +$1.22/capita) and portable snacks (+25%; +$0.15/capita). Quebec's restriction of commercial advertising directed to children under 13 may explain lower per capita advertising expenditures on some "less healthy" foods heavily advertised to adolescents in Quebec. Nevertheless, this spending remains high in Quebec and nationally. Continued monitoring of these expenditures is warranted.
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Affiliation(s)
- Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Elise Pauzé
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Julia Soares Guimarães
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Adena Pinto
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Lauren Remedios
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Meghan Pritchard
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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16
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Amson A, Pauzé E, Remedios L, Pritchard M, Potvin Kent M. Adolescent exposure to food and beverage marketing on social media by gender: a pilot study. Public Health Nutr 2023; 26:33-45. [PMID: 36321517 PMCID: PMC11077454 DOI: 10.1017/s1368980022002312] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/24/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this research was to determine if, based on gender, adolescents were exposed to different marketing techniques that promoted food and beverages over social media. DESIGN A secondary analysis of adolescent boy (n 26) and girl (n 36) exposures (n 139) to food and beverage marketing was conducted. Mann-Whitney U and Fisher's exact tests were conducted to compare the number, healthfulness and the marketing techniques of exposures viewed by boys and girls. SETTING Ottawa, Ontario, Canada. PARTICIPANTS Sixty-two adolescents aged 12-16 years. RESULTS Boys and girls were exposed to similar volumes of food marketing instances (median = 2 for both boys and girls, Mann-Whitney U = 237, P = 0·51) per 10-min period of social media use. More girls viewed products that were excessive in total fat compared to boys (67 % v. 35 %, P = 0·02). Boys were more likely to view instances of food marketing featuring a male as the dominant user (50 % v. 22 %, P = 0·03), appeals to achievement (42 % v. 17 %, P = 0·04), an influencer (42 % v. 14 %, P = 0·02) and appeals to athleticism (35 % v. 11 %, P = 0·03), whereas girls were more likely to view instances of food marketing featuring quizzes, surveys or polls (25 % v. 0 %, P = 0·01). CONCLUSIONS Food and beverage companies utilise marketing techniques that differ based on gender. More research examining the relationship between digital food and beverage marketing and gender is required to inform the development of gender-sensitive policies aimed at protecting adolescents from unhealthy food marketing.
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Affiliation(s)
- Ashley Amson
- University of Ottawa, Interdisciplinary School of Health Sciences, Ottawa, ON, Canada
| | - Elise Pauzé
- University of Ottawa, Interdisciplinary School of Health Sciences, Ottawa, ON, Canada
| | - Lauren Remedios
- University of Ottawa, School of Epidemiology and Public Health, 600 Peter Morand, Room 301J, Ottawa, ONK1N 7K4, Canada
| | - Meghan Pritchard
- University of Ottawa, School of Epidemiology and Public Health, 600 Peter Morand, Room 301J, Ottawa, ONK1N 7K4, Canada
| | - Monique Potvin Kent
- University of Ottawa, School of Epidemiology and Public Health, 600 Peter Morand, Room 301J, Ottawa, ONK1N 7K4, Canada
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17
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Packer J, Croker H, Goddings AL, Boyland EJ, Stansfield C, Russell SJ, Viner RM. Advertising and Young People's Critical Reasoning Abilities: Systematic Review and Meta-analysis. Pediatrics 2022; 150:e2022057780. [PMID: 36377381 PMCID: PMC9724173 DOI: 10.1542/peds.2022-057780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Young people are exposed to an abundance of advertising for unhealthy products (eg, unhealthy foods, tobacco, alcohol). Because of their developing cognition, children may not be able to understand the intent of advertising. However, advertising restrictions often assume that adolescents have critical reasoning capacity and can resist the effects of advertising. This review seeks to assess whether the evidence supports this assumption. METHODS Ten databases were searched in December 2020. Inclusion criteria were participants aged 6 to 17 years, any advertising exposure, objectively measured understanding or attitudinal outcome, a comparison, control, and between-group comparison. This study included all languages and excluded studies published pre-2010. Two reviewers independently extracted data and assessed study quality. RESULTS Thirty-eight articles were included. Meta-analysis of 9 studies with attitudinal outcomes indicated that unhealthy product advertising generated more positive brand or product attitudes compared with neutral or no advertising control in all ages. There were significant effects for digital and nondigital advertising formats. We found greater understanding did not protect against the impact of advertising on brand or product attitudes. Limitations include the inability to meta-analyze the impact of advertising on understanding or the influence of age. CONCLUSIONS Evidence shows that the attitudes of young people were influenced by advertising. Critical reasoning abilities did not appear to be fully developed during adolescence and not found to be protective against the impact of advertising. Policymakers should ensure regulations to restrict marketing of unhealthy commodities protects adolescents as well as younger children.
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Affiliation(s)
- Jessica Packer
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Helen Croker
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Anne-Lise Goddings
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Emma J. Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Claire Stansfield
- EPPI-Centre, UCL Social Research Institute, University College London, United Kingdom
| | - Simon J. Russell
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Russell M. Viner
- Population, Policy, and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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18
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Grossman ER, Greenthal E, Marx K, Ruffin M, Lucas S, Benjamin-Neelon SE. Are Students Paid to Market Sugar-Sweetened Beverages to Peers? A Review of University Pouring Rights Contracts. Child Obes 2022; 18:533-539. [PMID: 35325554 DOI: 10.1089/chi.2021.0267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Many university students regularly consume sugar-sweetened beverages (SSBs), which are associated with obesity and related chronic diseases. Moreover, students are strongly influenced by both their peers and product marketing. Our exploratory study examined pouring rights contracts between universities and beverage companies, focusing on provisions establishing campus/brand ambassador positions and marketing/merchandising manager positions whose jobs are to market SSBs on campus. Methods: For this cross-sectional study conducted in late 2020, two independent coders reviewed 131 pouring rights contracts between Coca-Cola or Pepsi and 124 unique public universities with 20,000 or more students enrolled. Contracts were active in 2018 or 2019. Results: Twenty-six contracts (20%) contained provisions specifically establishing either campus/brand ambassador positions (n = 16), marketing/merchandising manager positions (n = 7), both (n = 1), or unclear language related to these positions (n = 2). Thirteen contracts (10%) required that the position be filled by a current student. The objectives for both types of positions included increasing revenue and driving beverage sales. When stated in the contracts (n = 5), the payments allocated for these positions ranged between $5,000 and $10,000 per year. Conclusions: Given the association between SSBs and obesity and other related health outcomes, combined with the influence that peers and product marketing may have on adolescents' and young adults' attitudes toward consumption of these beverages, universities should be more transparent when these provisions are included in their pouring rights contracts and should carefully consider whether it is appropriate for these contracts to include funding for students to market SSBs.
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Affiliation(s)
- Elyse R Grossman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eva Greenthal
- Center for Science in the Public Interest, Washington, DC, USA
| | - Katherine Marx
- Center for Science in the Public Interest, Washington, DC, USA
| | - Martha Ruffin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephanie Lucas
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Pollack CC, Emond JA, Masterson TD. Associations between adolescent and young adult External Food Cue Responsiveness (EFCR) and brand recall, product craving and product purchasing in the livestreaming food marketing environment. Public Health Nutr 2022; 25:3036-3043. [PMID: 35920082 PMCID: PMC9991748 DOI: 10.1017/s1368980022001628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 05/04/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the utility of three validated food responsiveness scales in measuring recall of, and responsiveness to, food marketing exposure on social media. DESIGN Cross-sectional survey among adolescents and adults who used the social media platform Twitch.tv (Twitch). Responsiveness to food marketing was self-reported as craving or purchasing any brands participants observed on Twitch. Participants completed three validated scales of food responsiveness: the revised 18-question Three Factor Eating Questionnaire (TFEQ), the external eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ) and the External Food Cue Responsiveness (EFCR) scale. Adjusted linear regression models assessed the predictive ability of each scale on recall and responsiveness outcomes. SETTING Online survey. PARTICIPANTS Five hundred and sixty-eight Twitch users (90·1 % male, 60·6 % White, 43·7 % aged 18-24, 25·9 % under 18). RESULTS In separate adjusted linear regression models, scores on the TFEQ were not related to any outcome, while DEBQ scores related to product cravings (OR: 1·10, 95 % CI 1·01, 1·19, P = 0·02). In contrast, scores on the EFCR scale were significantly associated with higher brand recall (incident rate ratio: 1·42, 95 % CI 1·20, 1·68, P < 0·001), product craving (OR: 3·93, 95 % CI 2·22, 7·17, P < 0·001) and purchasing behaviour (OR: 3·97, 95 % CI 1·99, 8·26, P < 0·001). A subset of three EFCR scale items related to influencer marketing were similarly associated with each outcome with greater precision in the point estimates than the overall EFCR. CONCLUSIONS The EFCR scale predicted recall of and responsiveness to food marketing via Twitch, suggesting its utility in monitoring the effects of food marketing on social media.
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Affiliation(s)
- Catherine C Pollack
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Jennifer A Emond
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
- Department of Pediatrics, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Travis D Masterson
- Department of Nutritional Sciences, The Pennsylvania State University, 119C Chandlee Laboratory, University Park, PA16802, USA
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20
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Winzer E, Naderer B, Klein S, Lercher L, Wakolbinger M. Promotion of Food and Beverages by German-Speaking Influencers Popular with Adolescents on TikTok, YouTube and Instagram. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710911. [PMID: 36078625 PMCID: PMC9518047 DOI: 10.3390/ijerph191710911] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/15/2022] [Accepted: 08/26/2022] [Indexed: 06/01/2023]
Abstract
The promotion of nutritionally poor food and beverages (F&B) has a proven effect on children's eating preferences and, therefore, plays a significant role in today's childhood obesity epidemic. This study's objective was to assess the prevalence (exposure) and context (power) of the F&B cues in influencer content across three platforms: TikTok, YouTube, and Instagram. The selected influencers were popular with adolescents, with a combined total of more than 34 million followers/subscribers. We employed the YouTube Influencer Marketing Protocol from the World Health Organization (WHO) as our basis for coding. We analysed a total of 360 videos/posts and, of these, 24% contained F&B cues, which is equivalent to 18.1 F&B cues/hour. In total, 77% of the cues were not permitted for children's advertising, according to WHO criteria, and this was stable across all platforms, with chocolate and sugary confectionery (23%) as the most frequently featured products. Not-permitted F&B had a four-times higher chance of being branded, a five-times higher chance of being described positively, and received significantly more 'likes'. In 62% of the analysed presentations, the branded product was mentioned, yet only 6% of the content was labelled as advertising. The present analysis delivers further grounds for discussion for policies and regulations of influencer marketing.
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Affiliation(s)
- Eva Winzer
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Brigitte Naderer
- Department of Media & Communication, Ludwig-Maximilians University of Munich, 80539 Munich, Germany
| | - Simeon Klein
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Leah Lercher
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Maria Wakolbinger
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
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21
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Demers-Potvin É, White M, Potvin Kent M, Nieto C, White CM, Zheng X, Hammond D, Vanderlee L. Adolescents' media usage and self-reported exposure to advertising across six countries: implications for less healthy food and beverage marketing. BMJ Open 2022; 12:e058913. [PMID: 35589343 PMCID: PMC9121490 DOI: 10.1136/bmjopen-2021-058913] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES The study objectives were to examine: (1) adolescents' media viewing habits, (2) associations with media viewing and self-reported exposure to unhealthy food and beverage advertising and (3) differences in trends among younger and older adolescents in six high and upper middle-income countries. DESIGN Repeat cross-sectional online survey. SETTING Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States of America (USA). PARTICIPANTS Respondents to the International Food Policy Study who provided information on all variables of interest in November-December 2019 aged 10-17 years (n=9171). OUTCOME MEASURES Self-reported exposure to screen-based media (screen time by media channel), use of social media platforms and self-reported location and frequency of exposure to unhealthy food and beverage advertising. RESULTS The average amount of time spent in front of various screens ranged from 7.6 hours to 10.2 hours across countries per week day, which may include possible viewing of multiple media channels simultaneously. Overall, Instagram was the most popular social media platform (52%-68% by country), followed by Facebook (42%-79%) and Snapchat (28%-52%). The percentage of respondents who self-reported having seen unhealthy food advertisements in the past 30 days was highest on television (43%-69%), followed by digital media (27%-60%) and gaming applications (10%-17%). Self-reported daily exposure to advertising varied between countries for sugary drinks (10%-43%) and fast food (19%-44%) and was positively associated with self-reported screen time. Self-reported exposure to screen-based media and social media platforms differed by sociodemographic characteristics and was higher among older adolescents than younger adolescents. CONCLUSIONS The important amount of time spent on screen-based media reported by adolescents and large percentage of adolescents reporting social media usage, coupled with high rates of self-reported advertising exposure, support the need for policies to restrict marketing of unhealthy food and beverages appealing to adolescents on screen-based media.
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Affiliation(s)
- Élisabeth Demers-Potvin
- École de nutrition, Centre NUTRISS - Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels, Université Laval, Quebec City, Quebec, Canada
| | - Martin White
- Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Claudia Nieto
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Christine M White
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Xueying Zheng
- Health Education East of England, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, Merseyside, UK
| | - David Hammond
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Lana Vanderlee
- École de nutrition, Centre NUTRISS - Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels, Université Laval, Quebec City, Quebec, Canada
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22
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Chiong R, Figueroa R. Food Insecurity and the Association between Perceptions and Trust of Food Advertisements and Consumption of Ultra-Processed Foods among U.S. Parents and Adolescents. Nutrients 2022; 14:1964. [PMID: 35565932 PMCID: PMC9099781 DOI: 10.3390/nu14091964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/25/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
Adolescents exposed to food and beverage advertisements (FBAs) typically low in nutrient density can be influenced in their food choices, eating behaviors, and health. This study examines the association between perceptions and trust of FBAs (key predictor) and the outcome of daily consumption of ultra-processed foods (UPFs) in parent-adolescent dyads, with risk of food insecurity as a potential moderator. Cross-sectional data from the Family, Life, Activity, Sun, Health and Eating (FLASHE) study was used to test actor and partner effects using structural equation modeling. The final model was adjusted for parent sex and education level, and effects were compared between dyads at risk of food insecurity (n = 605) and dyads not at risk (n = 1008). In the unadjusted model, actor effects (parent: b = 0.23, p = 0.001; adolescent b = 0.12, p = 0.001) and parent-partner effects were found (b = 0.08, p = 0.004). The final comparative model produced similar results for dyads not at risk of food insecurity (parent actor: b = 0.27, p = 0.001; parent partner: b = 0.10, p = 0.01; adolescent actor: b = 0.11, p = 0.003). For dyads at risk of food insecurity, only actor effects were significant (parent: b = 0.22, p = 0.001; adolescent: b = 0.11, p = 0.013). These findings suggest that parents' favorability towards FBAs influence parent-adolescent unhealthy food consumption, and that this association is different when accounting for risk of food insecurity.
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Affiliation(s)
- Reah Chiong
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA;
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23
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Coleman PC, Hanson P, van Rens T, Oyebode O. A rapid review of the evidence for children’s TV and online advertisement restrictions to fight obesity. Prev Med Rep 2022; 26:101717. [PMID: 35141122 PMCID: PMC8814640 DOI: 10.1016/j.pmedr.2022.101717] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 01/11/2022] [Accepted: 01/23/2022] [Indexed: 12/31/2022] Open
Abstract
The relationship between obesity and exposure to food advertising meets all criteria commonly used to demonstrate the presence of a causal relationship in epidemiology. Younger children (≤8 years of age) are more susceptible to the impacts of food marketing, in terms of quantity and quality of calories consumed, than older children and adults, although emerging evidence suggests that adolescents (10–19 years) may be most susceptible to the impacts of online advertisements. Children from socio-economically disadvantaged and ethnic minority backgrounds are disproportionately exposed to unhealthy food advertisements. Statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy. However, advertising restrictions must be accompanied by community-based interventions that address other causes of poor diet and sedentary behaviour; this is because online and TV advertisements represent one small dimension in the wider obesogenic environment. Voluntary bans are ineffective. Exposure to unhealthy food advertising is similar before and after the introduction of voluntary food advertisements.
The World Health Organisation has urged all governments to address rising rates of obesity by implementing population-based interventions, such as restrictions on the marketing to children of unhealthy food and beverage items. However, the relationship between unhealthy food advertisements and childhood obesity is disputed by industry-sponsored reports, which recommend promoting physical activity and weight loss campaigns rather than policies to limit exposure to advertisements. We aimed to elucidate this debate by providing a narrative review of the evidence on the relationship between unhealthy TV and online food advertisements, short-term food consumption and childhood obesity. We also examined the impact of unhealthy food advertisements on vulnerable groups and identified which policy interventions are supported by current evidence. We conducted a rapid overview of reviews published since 2006. From a synthesis of 18 reviews meeting the inclusion criteria, we conclude that exposure to unhealthy TV and online food advertising is a contributing factor to childhood obesity. Evidence of a relationship between exposure to unhealthy food advertisements and childhood obesity was evident at all stages of the causal pathway, including a clear dose-response relationship. The evidence base was particularly strong for children aged 3–12 years of age and for children from socio-economically disadvantaged and minority ethnic backgrounds. The introduction of statutory regulation is a potentially cost-effective policy option, in terms of healthcare savings outweighing the costs of implementing the policy, although voluntary codes were shown to be ineffective, with exposure to unhealthy food advertisements similar in countries before and after their introduction. Food advertising, however, is just one factor in the wider obesogenic environment and further advertising restrictions must be implemented alongside population-based interventions that aim to address systemic causes of poor diet.
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Food marketing to teenagers: An exploratory study examining the ‘Power’ and platforms of food and beverage marketing in Canada. Appetite 2022; 173:105999. [DOI: 10.1016/j.appet.2022.105999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 11/21/2022]
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25
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A content analysis of sports and energy drink advertising. Appetite 2022; 174:106010. [DOI: 10.1016/j.appet.2022.106010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/23/2022] [Accepted: 03/17/2022] [Indexed: 11/20/2022]
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26
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Folkvord F, Naderer B, Coates A, Boyland E. Promoting Fruit and Vegetable Consumption for Childhood Obesity Prevention. Nutrients 2021; 14:nu14010157. [PMID: 35011032 PMCID: PMC8746926 DOI: 10.3390/nu14010157] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/21/2022] Open
Abstract
Currently, food marketing for unhealthy foods is omnipresent. Foods high in fat, salt, and sugar (HFSS) are advertised intensively on several media platforms, including digital platforms that are increasingly used by children, such as social media, and can be bought almost everywhere. This could contribute to the obesity epidemic that we are facing. As the majority of children and adolescents do not eat the recommended amount of fruits and vegetables (F&V), which leads to chronic diseases, we need to change the obesogenic environment to a healthogenic environment. Reducing the marketing of energy-dense snacks to children and increasing the promotion of healthier foods, such as fruits and vegetables, may be an effective and necessary instrument to improve the dietary intake of children and reduce the risk of their experiencing some chronic diseases later in life. With this focused narrative review, we provide an overview of how children and adolescents react to food promotions and how food promotional efforts might be a useful tool to increase the attractiveness of fruit and vegetables. This review therefore contributes to the question of how changing the advertising and media environment of children and adolescents could help create a world where the healthy choice is the easier choice, which would reduce childhood obesity and improve children’s health, as well as to make the food system more sustainable.
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Affiliation(s)
- Frans Folkvord
- Tilburg School of Humanities and Digital Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands
- Open Evidence Research, Open Evidence, 08005 Barcelona, Spain
- Correspondence:
| | - Brigitte Naderer
- Department of Media & Communication, LMU Munich, 80539 Munich, Germany;
| | - Anna Coates
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK; (A.C.); (E.B.)
| | - Emma Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, UK; (A.C.); (E.B.)
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Social media's influence on adolescents' food choices: A mixed studies systematic literature review. Appetite 2021; 168:105765. [PMID: 34687823 DOI: 10.1016/j.appet.2021.105765] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 09/27/2021] [Accepted: 10/18/2021] [Indexed: 11/23/2022]
Abstract
Over 90% of adolescents have at least one social media account, and their presence on social media continues to grow. Food and beverage brands capitalize on this trend by marketing their products on social media to adolescents. Depending on the nutrition value of the products being marketed, social media advertisements' influence may contribute to the risk of developing unfavorable health outcomes such as obesity, hypertension, and type 2 diabetes. This review aimed to investigate social media's food and beverage advertisements' role in influencing adolescents' food choices by appraising published literature. A systematic literature review was conducted reporting on social media's role in adolescents' food choices. Articles were searched through CINAHL and PubMed from scholarly journals between 2015 and 2020, using the search terms: social media use, food advertisements, adolescents, and food choices. Eligible articles were selected based on inclusion criteria. PRISMA guidelines were followed, and study quality was assessed using the Mixed Methods Appraisal Tool. The analysis was conducted using narrative analysis to identify key findings. Of the 234 records, six articles met inclusion criteria. The studies revealed two major findings: adolescents were more likely to recall unhealthy food and celebrity influence was a common component of the advertisements. This review suggests that food and beverage companies use social media for marketing their products by targeting the adolescent population. The use of celebrities and influencers and the promotion of "unhealthy" products appear to be commonly used tactics. With these findings, healthcare professionals should consider screening adolescents routinely for social media use and current eating habits and educating the adolescents, parents, and families about health risk. Additionally, implementing legislation and policies may be beneficial in preventing this exposure.
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28
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Abstract
Poor diets are responsible for more of the global burden of disease than sex, drugs, alcohol, and tobacco combined. Without good health, food security, and nutrition, development is unsustainable. How food is grown, distributed, processed, marketed, and sold determines which foods are available, affordable, and acceptable within the local cultural context. These factors guide food choices, influencing the quality of people’s diets, and hence they play a vital part in health. The food system is complex and is neither nutrition nor health driven. Good nutrition and human health are not seen as important supply chain outcomes, diminishing between the different processes and actors in the chain. This is in contrast to the environmental and labour concerns now also perceived as supply chain issues. Although food loss and waste is now appreciated as key to sustainable food supply chains, the critical role on nutrition security remains obscure. In a free market dispensation, the trade-offs between agricultural production and income generation versus nutrient delivery from farm to fork needs to be addressed. Investment and incentivised initiatives are needed to foster diverse food production, preservation, distribution and influence consumers’ behaviour and consumption. The decisions made at any stage of the food supply chain have implications on consumer choices, dietary patterns, and nutritional outcomes. Leveraging the entire food system is an underused policy response to the growing problem of unhealthy diets.
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