The Influence of Brand Equity Characters on Children's Food Preferences and Choices

How characters on packaging influence children's choice of a healthy beverage

The present research explores how the use of characters on the packaging of beverages influences children's consumption choices between healthy and less healthy products. Two controlled experiments with a total of 180 children aged between 5 and 11 years old tested how a packaging with character influenced children's choice between a hedonic (apple juice) and a utilitarian product (water). Packaging displaying a character proves particularly effective to influence children behavior, especially when the character is known by the children. Results show that children preferred water over apple juice when the packaging of the water bottle displayed a character, leading to increased water consumption and, consequently, reduced sugar intake.

The impact of characters like Tony the Tiger and other child-targeted techniques used in food and beverage marketing

Introduction

Food marketing's impact is a function of exposure and power, both of which contribute to children's poor diet quality and obesity risk. Children's exposure to food marketing is well documented, however, few studies have assessed the impact of specific persuasive marketing techniques or aspects of 'power' on children.

Methods

This study administered an online survey to 1,341 Canadian children (9-12 years) aiming to determine the impact of: (1) child-targeted vs. adult-targeted marketing, and (2) licensed characters vs. spokes characters on children's food preferences and behavioral intentions. Participants were randomized to a single condition in each survey part and viewed 3 static food advertisements displaying the features of that condition (e.g., child-targeted advertising or licensed characters), and answered 3 Likert-scale (5-point) questions after each exposure. For each condition within each research question, there were four outcome variables related to the impact of marketing on children: food preference, purchase intent, pester power, and total impact. ANOVA tested the difference in impact (Likert scores) between conditions overall and for each outcome, with Bonferroni post-hoc tests where necessary.

Results

A greater average total impact was observed among children exposed to child-targeted ads (mean Likert score 3.36) vs. adult-targeted ads (mean score 2.75; p < 0.001) or no marketing (mean score 2.81; p < 0.001). Children exposed to ads featuring spokes characters had a higher average total impact (mean score 3.98) vs. licensed characters (mean score 3.80; p < 0.001) and the control (i.e., no characters) (mean score 3.19; p < 0.001), and the total impact of licensed characters was greater than that of no characters. Similar trends were observed for all other outcomes.

Discussion

Overall, this study showed that child-targeted ads and those using characters - especially spokes characters - have a strong overall impact on children's food preferences, purchase intents, and pester power, and support the implementation of comprehensive marketing restrictions to protect children.

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

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

Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet

Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this "great plant transition" with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed "plant-based" commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into "plant-based" foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales-of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the "Future of Food", which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources-meat vs. novel soy/pea protein burgers, etc.-the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.

Front-of-package nutrition labeling as a driver for healthier food choices: Lessons learned and future perspectives

This work aims to provide a comprehensive overview of the use of front-of-package nutritional labeling (FOPL), identify and characterize the major existing FOPL systems, examine the impact of FOPL systems on consumer behavior, and discuss future perspectives. The searched databases were PubMed, Scopus, and Web of Science, and papers in English, Portuguese, Spanish, and French were considered. The integrative review method was used, comprising 68 papers. The FOPL system from more than 47 countries from North America, South America, Africa, Europe, Australia, and Asia was included in this study. The two main ways to characterize FOPL are the level of interpretation and the type of information provided. Interpretive schemes (such as warning labels, multiple traffic lights, and Nutri-Score) appear to lead to better consumer understanding and support healthier food purchases. However, due to the differences among the results and the specificity of the contexts in which they are used, it is impossible to define one FOPL interpretation scheme superior to the others. Some potential factors that influence the effectiveness of FOPL on consumer attitudes have been identified, such as food taste, as a major intrinsic factor. Extrinsic factors, such as price, food category, cultural diversity, politics, and economics, were also relevant. The lack of availability of similar alternatives, lack of understanding of the importance of FOPL, and lower levels of income and education were also some cognitive and social aspects impairing FOPL effectiveness. Prospects for the United States, Europe, Brazil, Colombia, and Argentina were discussed.

The effect of food packaging elements on children's food choices and intake: A systematic review

Little can be added about the worldwide concern over the exponential increase in obesity and child overweight problems. Much of the unhealthy eating habits occur at the time of food choice. The enormous influence of marketing strategies in general, and packaging in particular, has been highlighted here. In this respect, public policies that tend to direct choices toward healthier options have been developed. However, the usefulness of such policies will depend on evidence of how different packaging elements can influence children. This systematic review (SR) aims to compile the knowledge available to date on the influence of packaging on food choices and eating behaviours in children. Methodologically, the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines have been followed to select papers. We also assessed the risk of bias in the studies analysed using the Newcastle-Ottawa Quality Assessment Scale (NOS). The initial search strategy found 2,627 articles, although only 20 of them met the eligibility criteria. Data from the studies were extracted, categorised, and analysed. The results indicate that most of the packaging elements have some effect on children's food choices or food intake. The use of Cartoon is the element with the most consistent evidence of influence. Despite the number of studies and public initiatives developed to promote this informative and persuasive element, less consistency has been found regarding the effect of Nutrition Labelling. Therefore, the results found should be considered by both governments and organisations when promoting public policies that work for the wellbeing of children.

Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and Health: A Systematic Review and Meta-analysis

IMPORTANCE

There is widespread interest in the effect of food marketing on children; however, the comprehensive global evidence reviews are now dated.

OBJECTIVE

To quantify the association of food and nonalcoholic beverage marketing with behavioral and health outcomes in children and adolescents to inform updated World Health Organization guidelines.

DATA SOURCES

Twenty-two databases were searched (including MEDLINE, CINAHL, Web of Science, Embase, and The Cochrane Library) with a publication date limit from January 2009 through March 2020.

STUDY SELECTION

Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines were followed. Inclusion criteria were primary studies assessing the association of food marketing with specified outcomes in children and adolescents (aged 0-19 years). Exclusion criteria were qualitative studies or those on advertising of infant formula. Of 31 063 articles identified, 96 articles were eligible for inclusion in the systematic review, and 80 articles in the meta-analysis (19 372 participants).

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently extracted data. Random-effects models were used for meta-analyses; meta-regressions, sensitivity analyses, and P curve analyses were also performed. Where appropriate, pooling was conducted using combining P values and vote counting by direction of effect. Grading of Recommendations Assessment, Development, and Evaluation was used to judge certainty of evidence.

MAIN OUTCOMES AND MEASURES

Critical outcomes were intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, and diet-related noncommunicable diseases.

RESULTS

Participants totaled 19 372 from 80 included articles. Food marketing was associated with significant increases in intake (standardized mean difference [SMD], 0.25; 95% CI, 0.15-0.35; P < .001), choice (odds ratio, 1.77; 95% CI, 1.26-2.50; P < .001), and preference (SMD, 0.30; 95% CI, 0.12-0.49; P = .001). Substantial heterogeneity (all >76%) was unexplained by sensitivity or moderator analyses. The combination of P values for purchase requests was significant but no clear evidence was found for an association of marketing with purchasing. Data on dental health and body weight outcomes were scarce. The certainty of evidence was graded as very low to moderate for intake and choice, and very low for preference and purchasing.

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, food marketing was associated with increased intake, choice, preference, and purchase requests in children and adolescents. Implementation of policies to restrict children's exposure is expected to benefit child health.

The impact on dietary outcomes of licensed and brand equity characters in marketing unhealthy foods to children: A systematic review and meta-analysis

Licensed and brand equity characters are used to target children in the marketing of products high in fat, salt, and sugar (HFSS), but the impact of characters on dietary outcomes is unclear. The primary aim of this review was to quantify the impact of both licensed and brand equity characters on children's dietary outcomes given that existing regulations often differentiates between these character types. We systematically searched eight interdisciplinary databases and included studies from 2009 onwards until August 2021, including all countries and languages. Participants were children under 16 years, exposure was marketing for HFSS product with a character, and the outcomes were dietary consumption, preference, or purchasing behaviors of HFSS products. Data allowed for meta-analysis of taste preferences. A total of 16 articles (including 20 studies) met the inclusion criteria, of which five were included in the meta-analysis. Under experimental conditions, the use of characters on HFSS packaging compared with HFSS packaging with no character was found to result in significantly higher taste preference for HFSS products (standardized mean difference on a 5-point scale 0.273; p < 0.001). Narrative findings supported this, with studies reporting impact of both character types on product preferences including food liking and snack choice. There was limited evidence on the impact on purchase behaviors and consumption. These findings are supportive of policies that limit the exposure of HFSS food marketing using characters to children.

Association of Food and Nonalcoholic Beverage Marketing With Children and Adolescents' Eating Behaviors and Health: A Systematic Review and Meta-analysis

IMPORTANCE

There is widespread interest in the effect of food marketing on children; however, the comprehensive global evidence reviews are now dated.

OBJECTIVE

To quantify the association of food and nonalcoholic beverage marketing with behavioral and health outcomes in children and adolescents to inform updated World Health Organization guidelines.

DATA SOURCES

Twenty-two databases were searched (including MEDLINE, CINAHL, Web of Science, Embase, and The Cochrane Library) with a publication date limit from January 2009 through March 2020.

STUDY SELECTION

Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines were followed. Inclusion criteria were primary studies assessing the association of food marketing with specified outcomes in children and adolescents (aged 0-19 years). Exclusion criteria were qualitative studies or those on advertising of infant formula. Of 31 063 articles identified, 96 articles were eligible for inclusion in the systematic review, and 80 articles in the meta-analysis (19 372 participants).

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently extracted data. Random-effects models were used for meta-analyses; meta-regressions, sensitivity analyses, and P curve analyses were also performed. Where appropriate, pooling was conducted using combining P values and vote counting by direction of effect. Grading of Recommendations Assessment, Development, and Evaluation was used to judge certainty of evidence.

MAIN OUTCOMES AND MEASURES

Critical outcomes were intake, choice, preference, and purchasing. Important outcomes were purchase requests, dental caries, body weight, and diet-related noncommunicable diseases.

RESULTS

Participants totaled 19 372 from 80 included articles. Food marketing was associated with significant increases in intake (standardized mean difference [SMD], 0.25; 95% CI, 0.15-0.35; P < .001), choice (odds ratio, 1.77; 95% CI, 1.26-2.50; P < .001), and preference (SMD, 0.30; 95% CI, 0.12-0.49; P = .001). Substantial heterogeneity (all >76%) was unexplained by sensitivity or moderator analyses. The combination of P values for purchase requests was significant but no clear evidence was found for an association of marketing with purchasing. Data on dental health and body weight outcomes were scarce. The certainty of evidence was graded as very low to moderate for intake and choice, and very low for preference and purchasing.

CONCLUSIONS AND RELEVANCE

In this systematic review and meta-analysis, food marketing was associated with increased intake, choice, preference, and purchase requests in children and adolescents. Implementation of policies to restrict children's exposure is expected to benefit child health.

Parents' Perceptions of Children's Exposure to Unhealthy Food Marketing: a Narrative Review of the Literature

Purpose of Review

A key driver of unhealthy diets in children is the marketing of unhealthy foods and beverages. Attempts to regulate children’s exposure to unhealthy food marketing through government-led policies are challenged by commercial interests. Parents shoulder the responsibility of counteracting the effects of omnipresent unhealthy food marketing that children are exposed to within the food environment. In this narrative review we aimed to synthesise the evidence over the last 10 years on parents' perceptions of children’s exposure to unhealthy food marketing and parents support for policies to restrict this marketing.

Recent Findings

The evidence indicates that unhealthy food marketing leads parents to feel undermined in their ability to provide healthy foods to their children. Despite this concern, parents tend to underestimate the levels of exposure to, and impacts of, unhealthy food marketing to their children, especially in the digital ecosystem.

Summary

The voices and support of parents represent a significant opportunity to accelerate policy action on food marketing. Increasing awareness among parents and caregivers to the high levels and harmful impacts of children’s exposure to unhealthy food marketing, focusing on their right not to be undermined by such action, may drive support for policy change. Further research is needed to understand parents’ attitudes and perceptions related to their children’s exposure to contemporary unhealthy food marketing, specifically in digital environments, and the perspectives of fathers and parents from low and middle-income countries. 

Prevalence of low-calorie sweeteners and related front-of-package claims in the Brazilian packaged food supply

BACKGROUND

Low-calorie sweeteners (LCS) are increasingly being used worldwide, including in foods and beverages commonly consumed by children.

OBJECTIVE

To examine the prevalence of LCS in packaged foods and beverages sold in Brazil, whether LCS are added to products with advertising directed to children, and whether foods and beverages with LCS include front-of-package (FoP) LCS-related health and nutrition claims.

DESIGN

Cross-sectional study.

SETTING

A sample (n = 11,434) of packaged foods and beverages sold by the top five largest Brazilian food retailers was examined to identify LCS and added sugars and a subsample (n = 3,491) was examined to determine the presence of advertising directed to children and FoP LCS-related claims in foods and beverages with LCS.

MAIN OUTCOME AND MEASURES

The prevalence of foods and beverages with different types of LCS in the Brazilian food supply, among ultra-processed foods and beverages and among foods and beverages with added sugars were measured. Foods and beverages with advertising directed to children were checked to see if these products had LCS, and how many products with LCS had FoP labels with LCS-related claims.

STATISTICAL ANALYSES

Mean and 95% confidence intervals were used to determine the overall prevalence of foods and beverages with LCS and in the different assessed stratifications.

RESULTS

The prevalence of LCS was 9.3% (95% CI 8.8, 9.9) in Brazilian packaged foods and beverages, 14.6% (95% CI 13.8, 15.4) in ultra-processed products alone, and 5.7% (95% CI 4.2, 7.7) in foods and beverages with advertising directed to children. About 83% of food and beverage with LCS were also sweetened with added sugars. LCS were most frequently added to nonalcoholic sweetened beverages, breakfast cereals, and granola bars. Forty percent of foods and beverages with LCS did not present any front-of-package LCS-related claim.

CONCLUSION

This study shows that LCS are present in 15% of ultra-processed foods and beverages in Brazil, largely used in combination with added sugars, and are found in foods and beverages with advertising directed to children. Clearer FoP information regarding the presence of LCS, in particular in products with advertising directed to children, can help consumers make more informed choices regarding LCS consumption.

Invited review: Maintaining and growing fluid milk consumption by children in school lunch programs in the United States

Fluid milk consumption among children has declined for decades. Adequate consumption of milk and dairy products, especially during childhood, has beneficial health outcomes for growth, development, and reduced risk of osteoporosis, hypertension, obesity, and cancer during adulthood. Satisfaction with milk flavor, perceived health benefits derived from milk, and habit are primary drivers of lifelong milk consumption. Child preferences and attitudes for milk may differ from those of adults, and as such, understanding and fulfilling the needs of children is crucial to reverse the decline in milk consumption. School meal programs make fluid milk accessible to millions of children each day; however, regulations and school lunch procurement systems in the United States sometimes make it difficult to provide novel or value-added milk products in these programs. Total consumption of all milk types in US schools declined by 14.2% from 2008 to 2017, and the percentage of children participating in the school lunch program has also declined. This decline has also been driven by declining average daily participation in the school meal program and may also reflect children's dissatisfaction with the sensory characteristics and the form of milk offered in schools. The change in form of milk offered in schools to lower fat and lower added sugar content in the United States has been driven by government-mandated school lunch calorie and fat requirements. This review describes the current milk consumption trends among children; the structure and basic requirements of the school lunch program in total and for milk; and the intrinsic, extrinsic, and environmental factors that influence child perception, preference, and consumption of fluid milk in the US school system.

Advertising Unhealthy Food to Children: on the Importance of Regulations, Parenting Styles, and Media Literacy

Purpose of Review

Childhood obesity is a global health concern. And a number of studies have indicated that food promotions affect children’s food attitudes, preferences, and food choices for foods high in fat and sugar, which potentially impacts children’s body weight development. This review showcases how children are affected by food promotions, why companies even target children with their promotional efforts, and what makes children so susceptible to promotion of unhealthy food. In addition, this review discusses how regulations, parental styles, and individual media literacy skills can help to contain the potential detrimental effects of food promotions on children’s health.

Recent Findings

The recent findings indicate that children are affected by food promotions in their preference for unhealthy food and beverages in selection tasks shortly conducted after exposure. Furthermore, results indicate significant effects of food marketing, including enhanced attitudes, preferences, and increased consumption of marketed (predominantly unhealthy) foods connected with a wide range of marketing strategies. Children are particularly vulnerable to promotional efforts and react to it strongly due to their still developing cognitive and social skills as well as their lack in inhibitory control.

Summary

This review proposes an applied focus that discusses pathways for regulators, parents, and educators. In the light of the discussed results, a large number of studies on food promotion indicate that there is need to react. In all these measures, however, it is of relevance to consider children’s developmental stages to effectively counteract and respond to the potential detrimental effects of food promotions on children’s long-term weight development.

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.

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

PURPOSE OF REVIEW

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

RECENT FINDINGS

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

The Power of Packaging: A Scoping Review and Assessment of Child-Targeted Food Packaging

Child-targeted food marketing is a significant public health concern, prompting calls for its regulation. Product packaging is a powerful form of food marketing aimed at children, yet no published studies examine the range of literature on the topic or the "power" of its marketing techniques. This study attempts such a task. Providing a systematic scoping review of the literature on child-targeted food packaging, we assesses the nutritional profile of these foods, the types of foods examined, and the creative strategies used to attract children. Fifty-seven full text articles were reviewed. Results identify high level trends in methodological approaches (content analysis, 38%), outcomes measured (exposure, 44%) and with respect to age. Studies examining the nutritional profile of child-targeted packaged foods use various models, classifying from anywhere from 41% to 97% of products as unhealthy. Content analyses track the prevalence of child-targeted techniques (cartoon characters as the most frequently measured), while other studies assess their effectiveness. Overall, this scoping review offers important insights into the differences between techniques tracked and those measured for effectiveness in existing literature, and identifies gaps for future research around the question of persuasive power-particularly when it comes to children's age and the specific types of techniques examined.

Skin Conductance Responses Indicate Children are Physiologically Aroused by Their Favourite Branded Food and Drink Products

Children's favourite food and beverage brands use various tactics to foster positive associations and loyalty. This brand-consumer dynamic is frequently influenced by the use of implicit techniques and emotional appeals. Few studies have used physiological methods to examine the connections that brands build with children and the influence this has on their automatic responses. These techniques are potentially less prone to bias than behavioural or cognitive methods. This is the first study to explore the implicit response that children have to images of their favourite food and beverage brands using skin conductance responses as a marker of arousal. Australian children aged 8-11 years (n = 48) were recruited. Images of the participants' favourite branded food and beverage products, alongside images of the same products unpackaged, their family and friends, and neutral objects were presented in a randomised order with a standard timed interval between images. Children were significantly more aroused by branded images of their favourite food and beverage products than by their unpackaged counterparts (p < 0.042, d = 0.4). The physiological response to the branded products was similar to the response to the children's family and friends (p = 0.900, d = -0.02). These findings suggest that children may have an implicit connection to their favourite branded products.

Identifying food marketing to teenagers: a scoping review

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Tracking Kids' Food: Comparing the Nutritional Value and Marketing Appeals of Child-Targeted Supermarket Products Over Time

Marketing unhealthy foods negatively impacts children’s food preferences, dietary habits and health, prompting calls for regulations that will help to create an “enabling” food environment for children. One powerful food marketing technique is product packaging, but little is known about the nature or quality of child-targeted food products over time. This study assesses how child-targeted supermarket foods in Canada have transformed with respect to nutritional profile and types of marketing appeals (that is, the power of such marketing). Products from 2009 (n = 354) and from 2017 (n = 374) were first evaluated and compared in light of two established nutritional criteria, and then compared in terms of marketing techniques on packages. Overall, child-targeted supermarket foods did not improve nutritionally over time: 88% of child-targeted products (across both datasets) would not be permitted to be marketed to children, according to the World Health Organization (WHO) criteria, and sugar levels remained consistently high. Despite this poor nutritional quality, the use of nutrition claims increased significantly over time, as did the use of cartoon characters and appealing fonts to attract children’s attention. Character licensing—using characters from entertainment companies—remained consistent. The findings reveal the critical need to consider packaging as part of the strategy for protecting children from unhealthy food marketing. Given the poor nutritional quality and appealing nature of child-oriented supermarket foods, food product packaging needs to be included in the WHO’s call to improve the restrictions on unhealthy food marketing to children.

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

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

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

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

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.

Transforming Life: A Broad View of the Developmental Origins of Health and Disease Concept from an Ecological Justice Perspective

The influential scientist Rene J. Dubos (1901–1982) conducted groundbreaking studies concerning early-life environmental exposures (e.g., diet, social interactions, commensal microbiota, housing conditions) and adult disease. However, Dubos looked beyond the scientific focus on disease, arguing that “mere survival is not enough”. He defined mental health as fulfilling human potential, and expressed concerns about urbanization occurring in tandem with disappearing access to natural environments (and elements found within them); thus modernity could interfere with health via “missing exposures”. With the advantage of emerging research involving green space, the microbiome, biodiversity and positive psychology, we discuss ecological justice in the dysbiosphere and the forces—financial inequity, voids in public policy, marketing and otherwise—that interfere with the fundamental rights of children to thrive in a healthy urban ecosystem and learn respect for the natural environment. We emphasize health within the developmental origins of health and disease (DOHaD) rubric and suggest that greater focus on positive exposures might uncover mechanisms of resiliency that contribute to maximizing human potential. We will entrain our perspective to socioeconomic disadvantage in developed nations and what we have described as “grey space”; this is a mental as much as a physical environment, a space that serves to insidiously reinforce unhealthy behavior, compromise positive psychological outlook and, ultimately, trans-generational health. It is a dwelling place that cannot be fixed with encephalobiotics or the drug-class known as psychobiotics.