Apples or candy? Internal and external influences on children's food choices

Examining Chile's unique food marketing policy: TV advertising and dietary intake in preschool children, a pre- and post- policy study

BACKGROUND

The Chilean government implemented the first phase of a comprehensive marketing policy in 2016, restricting child-directed marketing of products high in energy, total sugars, sodium or saturated fat (hereafter "high-in").

OBJECTIVES

To examine the role that high-in TV food advertising had in the effect of the policy on consumption of high-in products between 2016 and 2017.

METHODS

Dietary data were obtained from 24-hour diet recall measured in 2016 (n = 940) and 2017 (n = 853), pre- and post-policy, from a cohort of 4 to 6 years children. Television use was linked to analyses of food advertisements to derive individual-level estimates of exposure to advertising. A multilevel mediation analysis examined direct and indirect effects of the policy through advertising exposure.

RESULTS

Children's high-in food consumption and advertising exposure declined significantly from 2016 to 2017 (P < .01). Consumption changes were not significantly mediated by changes in advertising exposure, which might suggest other elements of the Chilean Law potentially driving decreases in consumption to a greater extent than TV ads.

CONCLUSIONS

Preschoolers' exposure to high-in advertising and consumption of high-in products decreased post-policy. Further research is needed to understand how marketing changes will relate to dietary changes after full implementation of the law and in the long term.

Neural Mechanisms of Food Decision-Making in Children

PURPOSE OF REVIEW

The goal of the current paper is to review the literature on the neural and behavioral factors involved in food decision-making in youth.

RECENT FINDINGS

Recent neuroimaging studies that employ passive viewing paradigms have found that exposure to food-related cues activate reward, motor planning, and attentional salience signals in children. Greater activations of reward signals and/or lower activations of control signals are associated with overeating and weight gain. Neuroimaging studies with decision-making paradigms have found the reward network in the brain activates during food choices, while control network activates less strongly. Findings suggest that exposure to food cues activates reward/valuation network, but activation of control network tends to be relatively weaker in children. Hedonic aspects of foods are predominantly considered in children's food choices, and their dietary self-control is not matured yet. The increased activation in reward network and the decreased activation in control network are associated with risk of developing obesity.

Food Marketing as a Special Ingredient in Consumer Choices: The Main Insights from Existing Literature

The choices and preferences of food consumers are influenced by several factors, from those related to the socioeconomic, cultural, and health dimensions to marketing strategies. In fact, marketing is a determinant ingredient in the choices related to food consumption. Nonetheless, for an effective implementation of any marketing approach, the brands play a crucial role. Creating new brands in the food sector is not always easy, considering the relevant amount of these goods produced within the agricultural sector and in small food industries. The small dimension of the production units in these sectors hinders both brand creation and respective branding. In this context, it would seem important to analyse the relationships between food marketing and consumer choice, highlighting the role of brands in these frameworks. For this purpose, a literature review was carried out considering 147 documents from Scopus database for the topics of search “food marketing” and “choices” (search performed on 16 October 2020). As main insights, it is worth highlighting that the main issues addressed by the literature, concerning food marketing and consumer choices, are the following: economic theory; label and packaging; marketing strategies; agriculture and food industry; market segments; social dimensions; brand and branding. In turn, food marketing heavily conditions consumer choices; however, these related instruments are better manipulated by larger companies. In addition, this review highlights that bigger companies have dominant positions in these markets which are not always beneficial to the consumers’ objectives.

The effect of gendered presentation on children's food choice

Children at the peak age of cognitive gender rigidity (age 3-6 years) demonstrate preference for gender-typed activities, toys, and peers. This study explores whether this preference extends to gender-typed food. A total of 212 Virginia preschool and elementary school children performed a card sort of food images and chose between snacks with gender-consistent and gender-inconsistent packaging. Chi-squared analyses revealed that children were more likely to choose a snack in gender-consistent packaging, even when a tastier snack in gender-inconsistent packaging was available. Further, children consistently sorted pink-frosted cupcakes for girls and blue-frosted cupcakes for boys; and a subset of children who imposed gender onto other foods did so consistently (e.g., hamburgers for boys). Consistent with other evidence of children's gender rigidity, these findings support cognitive developmental theories of gender and add a gender-based explanation of children's food choice.

Food Advertising Literacy Training Reduces the Importance of Taste in Children's Food Decision-Making: A Pilot Study

Television food advertising influences children’s food choices. The attribute of “taste” drives children’s food choices, and exposure to food commercials can increase the importance of “taste” when children make food decisions. The current pilot study explored whether food advertising literacy training influences children’s food choices. In particular, whether the training would change the way children weigh the importance of taste attributes in their food decisions. Thirty-nine children ages 8–13 were recruited. Twenty-three of those children had four sessions of food advertising literacy training (1 week): children watched four videos of food commercials embedded with factual narratives (i.e., building cognitive defenses; e.g., “commercials want to sell products”) and evaluative narratives (i.e., changing affective responses toward commercials; e.g., “these foods don’t make you happy”). The first and last sessions were held in the laboratory, and the second and third sessions were at home. During the training, children were encouraged to think aloud while watching commercials and provided narratives to encourage active information processing. At baseline and post-training, children made binary eating choices for 60 foods and rated each food item on health and taste. We fitted linear regression models to examine whether taste and health attributes predicted unique variance in each child’s food choices. The results showed that taste attributes in children’s food choices was significantly decreased after completing the training. This finding suggested that improving food advertising literacy could be helpful for reducing the influence of taste attributes in the food decision-making process. Also, the cognitive literacy training increased children’s critical thoughts toward commercials during thinking aloud. These findings suggest that food advertising literacy training was helpful for reducing the importance of “taste” in children’s food decisions. In contrast, 16 children in the control condition (i.e., watching four videos of food commercials without narratives in 1 week) did not show any significant change in their food choices. Future research should investigate the utility of food advertising literacy training for the promotion of healthy eating and the prevention of childhood obesity.

Obesogenic Behavior and Weight-Based Stigma in Popular Children's Movies, 2012 to 2015

BACKGROUND

Obesity-promoting content and weight-stigmatizing messages are common in child-directed television programming and advertisements, and 1 study found similar trends in G- and PG-rated movies from 2006 to 2010. Our objective was to examine the prevalence of such content in more recent popular children's movies.

METHODS

Raters examined 31 top-grossing G- and PG-rated movies released from 2012 to 2015. For each 10-minute segment (N = 302) and for movies as units, raters documented the presence of eating-, activity-, and weight-related content observed on-screen. To assess interrater reliability, 10 movies (32%) were coded by more than 1 rater.

RESULTS

The result of Cohen's κ test of agreement among 3 raters was 0.65 for binary responses (good agreement). All 31 movies included obesity-promoting content; most common were unhealthy foods (87% of movies, 42% of segments), exaggerated portion sizes (71%, 29%), screen use (68%, 38%), and sugar-sweetened beverages (61%, 24%). Weight-based stigma, such as a verbal insult about body size or weight, was observed in 84% of movies and 30% of segments.

CONCLUSIONS

Children's movies include much obesogenic and weight-stigmatizing content. These messages are not shown in isolated incidences; rather, they often appear on-screen multiple times throughout the entire movie. Future research should explore these trends over time, and their effects.

Healthy eating decisions require efficient dietary self-control in children: A mouse-tracking food decision study

Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions.