Branding and a child's brain: an fMRI study of neural responses to logos

Neural correlates of chocolate brand preference: A functional MRI study

BACKGROUND AND PURPOSE

Preferences can be developed for, or against, specific brands and services. Using two functional magnetic resonance imaging (fMRI) experiments, this study investigated two dissociable aspects of reward processing, craving and liking, in chocolate lovers. The goal was to further delineate the neural basis supporting branding effects using familiar chocolate (FC) and unfamiliar chocolate (UC) brand images.

METHODS

In the first experiment, subjects rated their subjective craving and liking on a scale of 1-5 (weak-strong) for each FC and UC image. In the second experiment, they performed a choice task between FC and UC images.

RESULTS

Both the craving and liking ratings were significantly greater for FC and were differentially correlated with choice behavior. Craving ratings predicted greater preference for UC, and liking ratings predicted greater preference for FC. A contrast of neural activity for UC versus FC choice trials revealed significantly greater activation for UC choices in the bilateral inferior frontal gyrus and right caudate head. Response times for the FC images were faster than UC images; fMRI activity in the ventromedial prefrontal cortex was significantly correlated with response times during FC trials, but not UC trials. These correlations were significantly different from each other at the group level.

CONCLUSIONS

The choices for branded chocolate products are driven by higher subjective reward ratings and lower neural processing demands.

[Consequences of digital media on the health of children and adolescents with a focus on the consumption of unhealthy foods]

Children and adolescents' media time has increased since 2019. Prolonged time spent with media and media multitasking is increasingly being discussed as a health determinant. This narrative review highlights the importance of media time on the development of obesity and metabolic disorders in children and adolescents and discusses in more detail the associations with consumption of unhealthy foods and increased exposure to media food marketing.The prolonged durations that children and adolescents spend with social and digital media in their leisure time are positively related to sensory taste preferences for sweet, fatty, and salty foods as well as to higher snack food and energy intakes. Moreover, prolonged media time is also associated with a long-term increased risk of metabolic syndrome and its single components. The potential of social media for promoting physical activity and healthy eating lies especially in simplifying the inclusion of otherwise hard-to-reach groups. Further, social media may facilitate social support from peers and thus positively influence the well-being of young users.Particularly against the background of the not yet fully developed cognitive abilities of children and adolescents, the article refers to options for action to protect young media users. Exposure to certain social media content appears to negatively relate to children and adolescents' food choices and eating behaviors, supporting the call to regulate advertising directed at young consumers for foods and beverages that do not meet WHO criteria for child-friendly foods in these media.

Food and non-alcoholic beverage marketing in children and adults: A systematic review and activation likelihood estimation meta-analysis of functional magnetic resonance imaging studies

Food marketing impacts the food behaviors of children and adults, but the underpinning neural mechanisms are poorly understood. This systematic review and meta-analysis pooled evidence from neuroimaging studies of exposure to food marketing stimuli (vs. control) on brain activations in children and adults to clarify regions associated with responding. Databases were searched for articles published to March 2022. Inclusion criteria included human functional magnetic resonance imaging (fMRI) studies employing a contrast between a food marketing stimulus and a non-food/non-exposure control, published in English in a peer-reviewed journal, reporting whole brain (not Region of Interest [ROI] only) co-ordinates. Eleven studies met inclusion criteria, of which eight were included in the quantitative synthesis (Activation Likelihood Estimation [ALE] meta-analysis). Food marketing exposures (vs. controls) produced greater activation in two clusters lying across the middle occipital gyrus, lingual gyrus, and cuneus (cluster 1), and the postcentral gyrus, precentral gyrus, and the inferior parietal lobule/supramarginal gyrus (cluster 2). Brain responses to food marketing are most consistently observed in areas relating to visual processing, attention, sensorimotor activity, and emotional processing. Subgroup analyses (e.g., adults vs. children) were not possible because of the paucity of data, and sensitivity analyses highlighted some instability in the clusters; therefore, conclusions remain tentative pending further research.

Powerful promotions: An investigation of the teen-directed marketing power of outdoor food advertisements located near schools in Australia

ISSUE ADDRESSED

Adolescents are heavily exposed to unhealthy outdoor food advertisements near schools, however, the marketing power of these advertisements among adolescents has not yet been explored. This study aimed to investigate the teen-directed marketing features present and quantify the overall marketing power of outdoor food advertisements located near schools to explore any differences by content (ie, alcohol, discretionary, core and miscellaneous foods) school type (ie, primary, secondary, K-12) and area-level socio-economic status (SES; ie, low vs high).

METHODS

This cross-sectional study audited every outdoor food advertisement (n = 1518) within 500m of 64 randomly selected schools in Perth, Western Australia, using a teen-informed coding tool to score the marketing power of each advertisement.

RESULTS

Outdoor alcohol advertisements around schools had the highest average marketing power score and number of advertising features present. Outdoor advertisements for alcohol and discretionary foods scored significantly higher in marketing power than core food advertisements (P < .001). Outdoor alcohol advertisements around secondary schools scored significantly higher in marketing power than around primary and K-12 schools (P < .001); and outdoor advertisements for discretionary foods in low SES areas scored significantly higher in marketing power than those in high SES areas (P < .001).

CONCLUSIONS

This study found outdoor advertisements for unhealthy products, such as alcohol and discretionary foods, were more powerful than advertisements for core foods around schools. SO WHAT?: These findings strengthen the need for policies which restrict outdoor advertisements for non-core foods near schools, to reduce adolescents' exposure to powerful alcohol and discretionary food advertisements.

Binge-Eating Precursors in Children and Adolescents: Neurodevelopment, and the Potential Contribution of Ultra-Processed Foods

Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.

Exploring global trends and future directions in advertising research: A focus on consumer behavior

This study aims to select the physiological and neurophysiological studies utilized in advertising and to address the fragmented comprehension of consumers' mental responses to advertising held by marketers and advertisers. To fill the gap, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework was employed to select relevant articles, and bibliometric analysis was conducted to determine global trends and advancements in advertising and neuromarketing. The study selected and analyzed forty-one papers from the Web of Science (WoS) database from 2009-2020. The results indicated that Spain, particularly the Complutense University of Madrid, was the most productive country and institution, respectively, with 11 and 3 articles. The journal Frontiers in Psychology was the most prolific, with eight articles. The article "Neuromarketing: The New Science of Consumer Behavior" had the most citations (152 T.Cs). Additionally, the researchers discovered that the inferior frontal and middle temporal gyri were associated with pleasant and unpleasant emotions, respectively, while the right superior temporal and right middle frontal gyrus was connected to high and low arousal. Furthermore, the right prefrontal cortex (PFC) and left PFC were linked to withdrawal and approach behaviors. In terms of the reward system, the ventral striatum played a critical role, while the orbitofrontal cortex and ventromedial PFC were connected to perception. As far as we know, this is the first paper that focused on the global academic trends and developments of neurophysiological and physiological instruments used in advertising in the new millennium, emphasizing the significance of intrinsic and extrinsic emotional processes, endogenous and exogenous attentional processes, memory, reward, motivational attitude, and perception in advertising campaigns.

The Effects of Food Advertisements on Food Intake and Neural Activity: A Systematic Review and Meta-Analysis of Recent Experimental Studies

Food advertisements are ubiquitous in our daily environment. However, the relationships between exposure to food advertising and outcomes related to ingestive behavior require further investigation. The objective was to conduct a systematic review and meta-analysis of behavioral and neural responses to food advertising in experimental studies. PubMed, Web of Science, and Scopus were searched for articles published from January 2014 to November 2021 using a search strategy following PRISMA guidelines. Experimental studies conducted with human participants were included. A random-effects inverse-variance meta-analysis was performed on standardized mean differences (SMD) of food intake (behavioral outcome) between the food advertisement and nonfood advertisement conditions of each study. Subgroup analyses were performed by age, BMI group, study design, and advertising media type. A seed-based d mapping meta-analysis of neuroimaging studies was performed to evaluate neural activity between experimental conditions. Nineteen articles were eligible for inclusion, 13 for food intake (n = 1303) and 6 for neural activity (n = 303). The pooled analysis of food intake revealed small, but statistically significant, effects of increased intake after viewing food advertising compared with the control condition among adults and children (adult SMD: 0.16; 95% CI: 0.03, 0.28; P = 0.01; I² = 0; 95% CI: 0, 95.0%; Children SMD: 0.25; 95% CI: 0.14, 0.37; P < 0.0001; I² = 60.4%; 95% CI: 25.6%, 79.0%). The neuroimaging studies involved children only, and the pooled analysis corrected for multiple comparisons identified one significant cluster, the middle occipital gyrus, with increased activity after food advertising exposure compared with the control condition (peak coordinates: 30, -86, 12; z-value: 6.301, size: 226 voxels; P < 0.001). These findings suggest that acute exposure to food advertising increases food intake among children and adults and that the middle occipital gyrus is an implicated brain region among children. (PROSPERO registration: CRD42022311357).

Differential neural reward reactivity in response to food advertising medium in children

Introduction

Food cues including food advertisements (ads) activate brain regions related to motivation and reward. These responses are known to correlate with eating behaviors and future weight gain. The objective of this study was to compare brain responses to food ads by different types of ad mediums, dynamic (video) and static (images), to better understand how medium type impacts food cue response.

Methods

Children aged 9-12 years old were recruited to complete a functional magnetic resonance imaging (fMRI) paradigm that included both food and non-food dynamic and static ads. Anatomical and functional images were preprocessed using the fMRIPrep pipeline. A whole-brain analysis and a targeted region-of-interest (ROI) analysis for reward regions (nucleus accumbens, orbitofrontal cortex, amygdala, insula, hypothalamus, ventral tegmental area, substantia nigra) were conducted. Individual neural responses to dynamic and static conditions were compared using a paired t-test. Linear mixed-effects models were then constructed to test the differential response by ad condition after controlling for age, sex, BMI-z, physical activity, and % of kcal consumed of a participant's estimated energy expenditure in the pre-load prior to the MRI scan.

Results

A total of 115 children (mean=10.9 years) completed the fMRI paradigm. From the ROI analyses, the right and left hemispheres of the amygdala and insula, and the right hemisphere of the ventral tegmental area and substantia nigra showed significantly higher responses for the dynamic food ad medium after controlling for covariates and a false discovery rate correction. From the whole-brain analysis, 21 clusters showed significant differential responses between food ad medium including the precuneus, middle temporal gyrus, superior temporal gyrus, and inferior frontal gyrus, and all regions remained significant after controlling for covariates.

Discussion

Advertising medium has unique effects on neural response to food cues. Further research is needed to understand how this differential activation by ad medium ultimately affects eating behaviors and weight outcomes.

Neural correlates of food labels on brand, nature, and nutrition: An fMRI meta-analysis

Eating is an essential act of our everyday life, and it involves complicated cognitive appraisal and gustatory evaluation. This study meta-analyzed the functional magnetic resonance imaging (fMRI) studies about food labels on brand, nature and nutrition. Web of Science Core Collection (WoS), Scopus, and PubMed were queried to identify human fMRI studies written in English and published in peer-reviewed journals and used taste or food related labels. Studies were excluded if they reported no results from taste/food related stimuli versus control, no task-based fMRI results, or no results from whole-brain analysis. Nineteen studies entered the analysis. Results for the meta-analysis on food nutrition revealed that the precuneus on the right hemisphere was significantly activated, a brain region related to internal mentation of self-consciousness and nutritional evaluation. Results for the overall analysis on all 19 studies, the analysis on food brand, and the analysis on food nature revealed no significant brain regions. Food nutrition labels were generally processed by brain regions related to internal mentation of self-consciousness and nutritional evaluation. However, the neural correlates of labels of food brand and food nature were inconsistent across studies. More future studies are needed to better understand the cognitive processing of different kinds of food labels in our brain.

Dissecting ultra-processed foods and drinks: Do they have a potential to impact the brain?

Ultra-processed foods and drinks (UPF) are formulation of ingredients, mostly of exclusive industrial use, that result from a series of industrial processes. They usually have a low nutrient but high energy density, with a high content of saturated and trans fats, and added sugars. In addition, they have characteristic organoleptic properties, and usually contain sophisticated additives, including artificial sweeteners, to intensify their sensory qualities and imitate the appearance of minimally processed foods. In addition, recent research has warned about the presence of chemicals (e.g., bisphenol) and neo-formed contaminants in these products. UPF production and consumption growth have been spectacular in the last decades, being specially consumed in children and adolescents. UPF features have been associated with a range of adverse health effects such as overeating, the promotion of inflammatory and oxidative stress processes, gut dysbiosis, and metabolic dysfunction including problems in glucose regulation. The evidence that these UPF-related adverse health effects may have on the neural network implicated in eating behavior are discussed, including the potential impact on serotonergic and dopaminergic neurotransmission, brain integrity and function. We end this review by placing UPF in the context of current food environments, by suggesting that an increased exposure to these products through different channels, such as marketing, may contribute to the automatic recruitment of the brain regions associated with food consumption and choice, with a detrimental effect on inhibitory-related prefrontal cortices. While further research is essential, preliminary evidence point to UPF consumption as a potential detrimental factor for brain health and eating behavior.

Oral Sensory Sensitivity Influences Attentional Bias to Food Logo Images in Children: A Preliminary Investigation

Background

Children's sensory processing patterns are linked with their eating habits; children with increased sensory sensitivity are often picky eaters. Research suggests that children's eating habits are also partially influenced by attention to food and beverage advertising. However, the extent to which sensory processing influences children's attention to food cues remains unknown. Therefore, we examined the attentional bias patterns to food vs. non-food logos among children 4-12 years with and without increased oral sensory sensitivity.

Design

Children were categorized into high (n = 8) vs. typical (n = 36) oral sensory sensitivity by the Sensory Profile-2. We used eye-tracking to examine orientation and attentional bias to food vs. non-food logos among children with high vs. typical oral sensory sensitivity. We used a mixed model regression to test the influence of oral sensory sensitivity to attentional biases to food vs. non-food logos among children.

Results

Results showed that children with high oral sensory sensitivity showed attentional biases toward non-food logos; specifically, children with high oral sensory sensitivity oriented more quickly to non-food logos as compared to food logos (p < 0.05), as well as spent more time looking at non-food logos as compared to food logos (p < 0.05). Findings were in the opposite direction for children with typical oral sensory sensitivity.

Conclusion

Sensory sensitivity may be an individual characteristic that serves as a protective mechanism against susceptibility to food and beverage advertising in young children.

An EEG-Based Neuromarketing Approach for Analyzing the Preference of an Electric Car

This study evaluates consumer preference from the perspective of neuroscience when a choice is made among a number of cars, one of which is an electric car. Consumer neuroscience contributes to a systematic understanding of the underlying information processing and cognitions involved in choosing or preferring a product. This study aims to evaluate whether neural measures, which were implicitly extracted from brain activities, can be reliable or consistent with self-reported measures such as preference or liking. In an EEG-based experiment, the participants viewed images of automobiles and their specifications. Emotional and attentional stimuli and the participants' responses, in the form of decisions made, were meticulously distinguished and analyzed via signal processing techniques, statistical tests, and brain mapping tools. Long-range temporal correlations (LRTCs) were also calculated to investigate whether the preference of a product could affect the dynamic of neuronal fluctuations. Statistically significant spatiotemporal dynamical differences were then evaluated between those who select an electric car (which seemingly demands specific memory and long-term attention) and participants who choose other cars. The results showed increased PSD and central-parietal and central-frontal coherences at the alpha frequency band for those who selected the electric car. In addition, the findings showed the emergence of LRTCs or the ability of this group to integrate information over extended periods. Furthermore, the result of clustering subjects into two groups, using statistically significant discriminative EEG measures, was associated with the self-report data. The obtained results highlighted the promising role of intrinsically extracted measures on consumers' buying behavior.

Neuroimaging Techniques in Advertising Research: Main Applications, Development, and Brain Regions and Processes

Despite the advancement in neuroimaging tools, studies about using neuroimaging tools to study the impact of advertising on brain regions and processes are scant and remain unclear in academic literature. In this article, we have followed a literature review methodology and a bibliometric analysis to select empirical and review papers that employed neuroimaging tools in advertising campaigns and to understand the global research trends in the neuromarketing domain. We extracted and analyzed sixty-three articles from the Web of Science database to answer our study questions. We found four common neuroimaging techniques employed in advertising research. We also found that the orbitofrontal cortex (OFC), the ventromedial prefrontal cortex, and the dorsolateral prefrontal cortex play a vital role in decision-making processes. The OFC is linked to positive valence, and the lateral OFC and left dorsal anterior insula related in negative valence. In addition, the thalamus and primary visual area associated with the bottom-up attention system, whereas the top-down attention system connected to the dorsolateral prefrontal cortex, parietal cortex, and primary visual areas. For memory, the hippocampus is responsible for generating and processing memories. We hope that this study provides valuable insights about the main brain regions and processes of interest for advertising.

Promoting Resilience to Food Commercials Decreases Susceptibility to Unhealthy Food Decision-Making

Children are vulnerable to adverse effects of food advertising. Food commercials are known to increase hedonic, taste-oriented, and unhealthy food decisions. The current study examined how promoting resilience to food commercials impacted susceptibility to unhealthy food decision-making in children. To promote resilience to food commercials, we utilized the food advertising literacy intervention intended to enhance cognitive skepticism and critical thinking, and decrease positive attitudes toward commercials. Thirty-six children aged 8–12 years were randomly assigned to the food advertising literacy intervention or the control condition. Eighteen children received four brief intervention sessions via video over 1 week period. In each session, children watched six food commercials with interspersed embedded intervention narratives. While watching food commercials and narratives, children were encouraged to speak their thoughts out loud spontaneously (“think-aloud”), which provided children's attitudes toward commercials. Eighteen children in the control condition had four control sessions over 1 week, and watched the same food commercials without intervention narratives while thinking aloud. The first and last sessions were held in the laboratory, and the second and third sessions were held at the children's homes. Susceptibility to unhealthy food decision-making was indicated by the decision weights of taste attributes, taste perception, food choices, ad libitum snacking, and cognitive and affective attitudes toward food commercials. As hypothesized, the intervention successfully decreased susceptibility to unhealthy food decision-making evidenced by reduced decision weights of the taste in food decisions, decreased tasty perception of unhealthy foods, and increased cognitive skepticism and critical thinking toward food commercials. In addition, as children's opinions assimilated to intervention narratives, their cognitive skepticism and critical thinking toward commercials increased. The aforementioned results were not shown in the control condition. However, this brief intervention was not enough to change actual food choices or food consumption. Results of this study suggest that promoting resilience to food commercials by enhancing cognitive skepticism and critical thinking effectively reduced children's susceptibility to unhealthy food-decision making.

Impact of Pediatric Mobile Game Play on Healthy Eating Behavior: Randomized Controlled Trial

BACKGROUND

Video and mobile games have been shown to have a positive impact on behavior change in children. However, the potential impact of game play patterns on outcomes of interest are yet to be understood, especially for games with implicit learning components.

OBJECTIVE

This study investigates the immediate impact of fooya!, a pediatric dietary mobile game with implicit learning components, on food choices. It also quantifies children's heterogeneous game play patterns using game telemetry and determines the effects of these patterns on players' food choices.

METHODS

We analyzed data from a randomized controlled trial (RCT) involving 104 children, aged 10 to 11 years, randomly assigned to the treatment group (played fooya!, a dietary mobile game developed by one of the authors) or the control group (played Uno, a board game without dietary education). Children played the game for 20 minutes each in two sessions. After playing the game in each session, the children were asked to choose 2 out of 6 food items (3 healthy and 3 unhealthy choices). The number of healthy choices in both sessions was used as the major outcome. We first compared the choice and identification of healthy foods between treatment and control groups using statistical tests. Next, using game telemetry, we determined the variability in game play patterns by quantifying game play measures and modeled the process of game playing at any level across all students as a Markov chain. Finally, correlation tests and regression models were used to establish the relationship between game play measures and actual food choices.

RESULTS

We saw a significant main effect of the mobile game on number of healthy foods actually chosen (treatment 2.48, control 1.10; P<.001; Cohen d=1.25) and identified (treatment 7.3, control 6.94; P=.048; Cohen d=.25). A large variation was observed in children's game play patterns. Children played an average of 15 game levels in 2 sessions, with a range of 2 to 23 levels. The greatest variation was noted in the proportion of scoring activities that were highly rewarded, with an average of 0.17, ranging from 0.003 to 0.98. Healthy food choice was negatively associated with the number of unhealthy food facts that children read in the game (Kendall τ=-.32, P=.04), even after controlling for baseline food preference.

CONCLUSIONS

A mobile video game embedded with implicit learning components showed a strong positive impact on children's food choices immediately following the game. Game telemetry captured children's different play patterns and was associated with behavioral outcomes. These results have implications for the design and use of mobile games as an intervention to improve health behaviors, such as the display of unhealthy food facts during game play. Longitudinal RCTs are needed to assess long-term impact.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04082195; https://clinicaltrials.gov/ct2/show/NCT04082195, registered retrospectively.

Data Triangulation in Consumer Neuroscience: Integrating Functional Neuroimaging With Meta-Analyses, Psychometrics, and Behavioral Data

This article reviews a wide range of functional magnetic resonance imaging (fMRI) studies conducted in the field of consumer neuroscience to (1) highlight common interpretative approaches of neuroimaging data (i.e., forward inference and reverse inference), (2) discuss potential interpretative issues associated with these approaches, and (3) provide a framework that employs a multi-method approach aimed to possibly raise the explanatory power and, thus, the validity of functional neuroimaging research in consumer neuroscience. Based on this framework, we argue that the validity of fMRI studies can be improved by the triangulation of (1) careful design of neuroimaging studies and analyses of data, (2) meta-analyses, and (3) the integration of psychometric and behavioral data with neuroimaging data. Guidelines on when and how to employ triangulation methods on neuroimaging data are included. Moreover, we also included discussions on practices and research directions that validate fMRI studies in consumer neuroscience beyond data triangulation.

Neural response to fast food commercials in adolescents predicts intake

BACKGROUND

Food advertising is a major contributor to obesity, and fast food (FF) restaurants are top advertisers. Research on the impact of food advertising in adolescents is lacking and no prior research has investigated neural predictors of food intake in adolescents. Neural systems implicated in reward could be key to understanding how food advertising drives food intake.

OBJECTIVES

To investigate how neural responses to both unhealthy and healthier FF commercials predict food intake in adolescents.

METHODS

A cross-sectional sample of 171 adolescents (aged 13-16 y) who ranged from normal weight to obese completed an fMRI paradigm where they viewed unhealthy and healthier FF and nonfood commercials. Adolescents then consumed a meal in a simulated FF restaurant where foods of varying nutritional profiles (unhealthy compared with healthier) were available.

RESULTS

Greater neural activation in reward-related regions (nucleus accumbens, r = 0.29; caudate nucleus, r = 0.27) to unhealthy FF commercials predicted greater total food intake. Greater responses to healthier FF relative to nonfood commercials in regions associated with reward (i.e., nucleus accumbens, r = 0.24), memory (i.e., hippocampus, r = 0.32), and sensorimotor processes (i.e., anterior cerebellum, r = 0.33) predicted greater total food and unhealthier food intake, but not healthier food intake. Lower activation in neural regions associated with visual attention and salience (e.g., precuneus, r = -0.35) to unhealthy relative to healthier FF commercials predicted healthier food intake.

CONCLUSIONS

These findings suggest that FF commercials contribute to overeating in adolescents through reward mechanisms. The addition of healthier commercials from FF restaurants is unlikely to encourage healthier food intake, but interventions that reduce the ability of unhealthy FF commercials to capture attention could be beneficial. However, an overall reduction in the amount of FF commercials exposure for adolescents is likely to be the most effective approach.

A Neurobiological Model of Alcohol Marketing Effects on Underage Drinking

OBJECTIVE

Although an association between exposure to alcohol advertising and underage drinking is well documented, the underlying neurobiological contributions to this association remain largely unexplored. From an epidemiological perspective, identifying the neurobiological plausibility of this exposure-outcome association is a crucial step toward establishing marketing as a contributor to youth drinking and informing public policy interventions to decrease this influence.

METHOD

We conducted a critical review of the literature on neurobiological risk factors and adolescent brain development, social influences on drinking, and neural contributions to reward sensitization and risk taking. By drawing from these separate areas of research, we propose a unified, neurobiological model of alcohol marketing effects on underage drinking.

RESULTS

We discuss and extend the literature to suggest that responses in prefrontal-reward circuitry help establish alcohol advertisements as reward-predictive cues that may reinforce consumption upon exposure. We focus on adolescence as a sensitive window of development during which youth are particularly susceptible to social and reward cues, which are defining characteristics of many alcohol advertisements. As a result, alcohol marketing may promote positive associations early in life that motivate social drinking, and corresponding neurobiological changes may contribute to later patterns of alcohol abuse.

CONCLUSIONS

The neurobiological model proposed here, which considers neurodevelopmental risk factors, social influences, and reward sensitization to alcohol cues, suggests that exposure to alcohol marketing could plausibly influence underage drinking by sensitizing prefrontal-reward circuitry.

Brain response to food brands correlates with increased intake from branded meals in children: an fMRI study

Food branding is ubiquitous, however, not all children are equally susceptible to its effects. The objectives of this study were to 1) determine whether food brands evoke differential response than non-food brands in brain areas related to motivation and inhibitory control using blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) and 2) determine the association between brain response and energy intake at test-meals presented with or without brands. Twenty-eight 7-10 year-old children completed four visits as part of a within-subjects design where they consumed three multi-item test-meals presented with familiar food brands, novel food brand, and no brand. On the fourth visit an fMRI was performed where children passively viewed food brands, non-food brands and control images. A whole-brain analysis was conducted to compare BOLD response between conditions. Pearson's correlations were calculated to determine the association between brain response and meal intake. Relative to non-food brands, food brand images were associated with increased activity in the right lingual gyrus. Relative to control, food and non-food brand images were associated with greater response in bilateral fusiform gyri and decreased response in the cuneus, precuneus, lingual gyrus, and supramarginal gyrus. Less activation in the bilateral fusiform gyrus to both food and non-food brands was associated with greater energy intake of the branded vs unbranded meal. These findings may help explain differences in the susceptibility to the intake-promoting effects of food advertising in children.

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.

Measurement of external food cue responsiveness in preschool-age children: Preliminary evidence for the use of the external food cue responsiveness scale

BACKGROUND

Conditioned eating in response to external food cues may contribute to obesity risk in young children.

OBJECTIVES

To develop a brief, parent-reported scale to measure external food cue responsiveness for preschool-age children.

METHODS

Focus groups with parents of preschool-age children were conducted to create an initial pool of items reflecting children's behavioral responses to external food cues. Items were included in a nationally-distributed online survey of parents of preschool-age children (n = 456). Factor analysis was used to reduce the initial item pool, the scale's psychometric properties were assessed, and scores were correlated with reported snacking behaviors.

RESULTS

Nine items met inclusion criteria in the final scale, which had high internal consistency (alpha = 0.86). Final scores were the mean across the nine items. External food cue responsiveness was greater among children with, versus without, usual TV advertisement exposure. Furthermore, greater external food cue responsiveness mediated the relationship between children's usual TV advertisement exposure and snacking during TV viewing. Findings remained statistically significant when adjusted for food responsiveness as measured with the Child Eating Behavior Questionnaire.

CONCLUSIONS

Findings provide preliminary evidence that external food cue responsiveness is measurable by parental report in preschool-age children.

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

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

Sparking interest in restaurant dishes? Cognitive and affective processes underlying dish design and ecological origin. An fMRI study

This papers aims to verify to what extent the presentation of a restaurant dish and the origin of its food provoke reactions in the consumer's brain during the visualization and the decision-making process, from an exploratory approach. The two independent variables singled out for study were whether the presentation was well or poorly presented and if the ingredients were ecological or non-ecological. The results applying the functional magnetic resonance image (fMRI) methodology reveal that well-presented dishes activate areas in the brain linked to the network of emotions indicating that the visualization in restaurant menus is not a purely cognitive and self-reflexive process but retains a strong affective component. Furthermore, the presence of this component is kept at the moment of choosing a dish, as observed by the activation of the cingulate gyrus, region linked to the regulatory processes of emotions. Hence, research ratifies the existence of an emotional factor during the entire process of decision-making carried out in a restaurant. Yet it is true that exposure to an ecological menu provokes activation of the medial frontal cortex, a region connected to higher reasoning and attention, suggesting that stimuli from well-presented dishes of ecological origin trigger neuronal responses related to high-level cognitive processes. The practical implications derived, along with its limitations and the future research opportunities, are interesting for both developing theory and also practice. Therefore, scholars are encouraged to further test some research proposals (e.g. moderating role of salubrity or simultaneously eye tracking method).

Sustained impact of energy-dense TV and online food advertising on children's dietary intake: a within-subject, randomised, crossover, counter-balanced trial

Background

Policies restricting children’s exposure to unhealthy food marketing have been impeded by the lack of evidence showing a direct link between food advertising exposure and children’s energy intake and body weight. Food advertising exposure increases children’s immediate food consumption, but whether this increased intake is compensated for at later eating occasions is not known; consequently the sustained effect on diets remains unclear.

Methods

We conducted a within-subject, randomised, crossover, counterbalanced study across four, six-day holiday camps in New South Wales, Australia between April 2016 and January 2017. Children (7–12 years, n = 160) were recruited via local schools, email networks and social media. Two gender- and age-balanced groups were formed for each camp (n = 20), randomised to either a multiple- or single- media condition and exposed to food and non-food advertising in an online game and/or a television cartoon. Children’s food consumption (kilojoules) was measured at a snack immediately after exposure and then at lunch later in the day. Linear mixed models were conducted to examine relationships between food advertising exposure and dietary intake, taking into account gender, age and weight status.

Results

All children in the multiple-media condition ate more at a snack after exposure to food advertising compared with non-food advertising; this was not compensated for at lunch, leading to additional daily food intake of 194 kJ (95% CI 80–308, p = 0.001, d = 0.2). Exposure to multiple-media food advertising compared with a single-media source increased the effect on snack intake by a difference of 182 kJ (95% CI 46–317, p = 0.009, d = 0.4). Food advertising had an increased effect among children with heavier weight status in both media groups.

Conclusion

Online (‘advergame’) advertising combined with TV advertising exerted a stronger influence on children’s food consumption than TV advertising alone. The lack of compensation at lunch for children’s increased snack intake after food advertising exposure suggests that unhealthy food advertising exposure contributes to a positive energy-gap, which could cumulatively lead to the development of overweight.

Trial registration

Australian New Zealand Clinical Trials Registry, number ACTRN12617001230347 (Retrospectively registered).

Adolescents' behavioral and neural responses to e-cigarette advertising

Although adolescents are a group heavily targeted by the e-cigarette industry, research in cue-reactivity has not previously examined adolescents' behavioral and neural responses to e-cigarette advertising. This study addressed this gap through two experiments. In Experiment One, adult traditional cigarette smokers (n = 41) and non-smokers (n = 41) answered questions about e-cigarette and neutral advertising images. The 40 e-cigarette advertising images that most increased desire to use the product were matched to 40 neutral advertising images with similar content. In Experiment Two, the 80 advertising images selected in Experiment One were presented to adolescents (n = 30) during an functional magnetic resonance imaging brain scan. There was a range of traditional cigarette smoking across the sample with some adolescents engaging in daily smoking and others who had never smoked. Adolescents self-reported that viewing the e-cigarette advertising images increased their desire to smoke. Additionally, all participants regardless of smoking statuses showed significantly greater brain activation to e-cigarette advertisements in areas associated with cognitive control (left middle frontal gyrus), reward (right medial frontal gyrus), visual processing/attention (left lingual gyrus/fusiform gyrus, right inferior parietal lobule, left posterior cingulate, left angular gyrus) and memory (right parahippocampus, left insula). Further, an exploratory analysis showed that compared with age-matched non-smokers (n = 7), adolescent smokers (n = 7) displayed significantly greater neural activation to e-cigarette advertising images in the left inferior temporal gyrus/fusiform gyrus, compared with their responses to neutral advertising images. Overall, participants' brain responses to e-cigarette advertisements suggest a need to further investigate the long-run impact of e-cigarette advertising on adolescents.

Branding a School-Based Campaign Combining Healthy Eating and Eco-friendliness

OBJECTIVE

To develop a branding strategy for a campaign to improve the quality of foods children bring from home to school, using a combined healthy eating and eco-friendly approach and for a control campaign focusing solely on nutrition.

METHODS

Formative research was conducted with third- and fourth-grade students in lower- and middle-income schools in Greater Boston and their parents. Phase I included concept development focus groups. Phase II included concept testing focus groups. A thematic analysis approach was used to identify key themes.

RESULTS

In phase I, the combined nutrition and eco-friendly messages resonated; child preference emerged as a key factor affecting food from home. In phase II, key themes included fun with food and an element of mystery. Themes were translated into a concept featuring food face characters.

CONCLUSIONS AND IMPLICATIONS

Iterative formative research provided information necessary to create a brand that appealed to a specified target audience.

Adolescent and Young Adult Perceptions on Cigar Packaging: A Qualitative Study

OBJECTIVE

To identify the appealing components of cigar packaging among youth.

METHODS

We conducted 8 focus groups among cigar users, separated by sex and age group (ie, adolescents, young adults) in Connecticut between February and July, 2016. Participants were shown cigar packages and instructed to circle aspects of the images on the packages that appealed to them independently and a group discussion followed.

RESULTS

The appealing components identified were flavors (46.8%), price promotions (28.8%), branding (21.2%), marketing claims (17.2%, eg, "natural"), product features (15.2%, eg, the word "cigarillo"), number of cigars (8.0%), color (4.4%), re-sealable features (2.8%), and other (6.0%; eg "limited offer," geographic region). Relative to female participants, male participants were more likely to find flavors and price promotions appealing, and less likely to find colors as appealing (ps < .05). Relative to young adults, adolescents were more likely to find price promotions, branding, marketing claims and number of cigars appealing, and less likely to find colors as appealing (ps < .05).

CONCLUSIONS

In order to reduce the appeal of cigars to youth, regulatory agencies should consider prohibiting flavors, appealing colors, price promotions, misleading marketing claims, and logos/trademarks on cigar packaging.

Food portion size and energy density evoke different patterns of brain activation in children

BACKGROUND

Large portions of food promote intake, but the mechanisms that drive this effect are unclear. Previous neuroimaging studies have identified the brain-reward and decision-making systems that are involved in the response to the energy density (ED) (kilocalories per gram) of foods, but few studies have examined the brain response to the food portion size (PS).

OBJECTIVE

We used functional MRI (fMRI) to determine the brain response to food images that differed in PSs (large and small) and ED (high and low).

DESIGN

Block-design fMRI was used to assess the blood oxygen level-dependent (BOLD) response to images in 36 children (7-10 y old; girls: 50%), which was tested after a 2-h fast. Pre-fMRI fullness and liking were rated on visual analog scales. A whole-brain cluster-corrected analysis was used to compare BOLD activation for main effects of the PS, ED, and their interaction. Secondary analyses were used to associate BOLD contrast values with appetitive traits and laboratory intake from meals for which the portions of all foods were increased.

RESULTS

Compared with small-PS cues, large-PS cues were associated with decreased activation in the inferior frontal gyrus (P < 0.01). Compared with low-ED cues, high-ED cues were associated with increased activation in multiple regions (e.g., in the caudate, cingulate, and precentral gyrus) and decreased activation in the insula and superior temporal gyrus (P < 0.01 for all). A PS × ED interaction was shown in the superior temporal gyrus (P < 0.01). BOLD contrast values for high-ED cues compared with low-ED cues in the insula, declive, and precentral gyrus were negatively related to appetitive traits (P < 0.05). There were no associations between the brain response to the PS and either appetitive traits or intake.

CONCLUSIONS

Cues regarding food PS may be processed in the lateral prefrontal cortex, which is a region that is implicated in cognitive control, whereas ED activates multiple areas involved in sensory and reward processing. Possible implications include the development of interventions that target decision-making and reward systems differently to moderate overeating.

Independent functional connectivity networks underpin food and monetary reward sensitivity in excess weight

Overvaluation of palatable food is a primary driver of obesity, and is associated with brain regions of the reward system. However, it remains unclear if this network is specialized in food reward, or generally involved in reward processing. We used functional magnetic resonance imaging (fMRI) to characterize functional connectivity during processing of food and monetary rewards. Thirty-nine adults with excess weight and 37 adults with normal weight performed the Willingness to Pay for Food task and the Monetary Incentive Delay task in the fMRI scanner. A data-driven graph approach was applied to compare whole-brain, task-related functional connectivity between groups. Excess weight was associated with decreased functional connectivity during the processing of food rewards in a network involving primarily frontal and striatal areas, and increased functional connectivity during the processing of monetary rewards in a network involving principally frontal and parietal areas. These two networks were topologically and anatomically distinct, and were independently associated with BMI. The processing of food and monetary rewards involve segregated neural networks, and both are altered in individuals with excess weight.

Salient nutrition labels increase the integration of health attributes in food decision-making

Every day, people struggle to make healthy eating decisions. Nutrition labels have been used to help people properly balance the tradeoff between healthiness and taste, but research suggests that these labels vary in their effectiveness. Here, we investigated the cognitive mechanism underlying value-based decisions with nutrition labels as modulators of value.

More specifically, we used a binary decision task between products along with two different nutrition labels to examine how salient, color-coded labels, compared to purely information-based labels, alter the choice process. Using drift-diffusion modeling, we investigated whether color-coded labels alter the valuation process, or whether they induce a simple stimulus-response association consistent with the traffic-light colors irrespective of the features of the item, which would manifest in a starting point bias in the model. We show that color-coded labels significantly increased healthy choices by increasing the rate of preference formation (drift rate) towards healthier options without altering the starting point. Salient labels increased the sensitivity to health and decreased the weight on taste, indicating that the integration of health and taste attributes during the choice process is sensitive to how information is displayed. Salient labels proved to be more effective in altering the valuation process towards healthier, goal-directed decisions.

The child brain computes and utilizes internalized maternal choices

As children grow, they gradually learn how to make decisions independently. However, decisions like choosing healthy but less-tasty foods can be challenging for children whose self-regulation and executive cognitive functions are still maturing. We propose a computational decision-making process in which children estimate their mother's choices for them as well as their individual food preferences. By employing functional magnetic resonance imaging during real food choices, we find that the ventromedial prefrontal cortex (vmPFC) encodes children's own preferences and the left dorsolateral prefrontal cortex (dlPFC) encodes the projected mom's choices for them at the time of children's choice. Also, the left dlPFC region shows an inhibitory functional connectivity with the vmPFC at the time of children's own choice. Our study suggests that in part, children utilize their perceived caregiver's choices when making choices for themselves, which may serve as an external regulator of decision-making, leading to optimal healthy decisions.

Mothers advocate eating healthy foods while children like to eat tasty foods. Lim and colleagues demonstrate that children incorporate their mothers' food choices while deciding what to eat as well as provide the neural correlates of this decision making process.

Is it the picture or is it the frame? An fMRI study on the neurobiology of framing effects

Using functional magnetic resonance imaging (fMRI) we investigated whether a culturally defined context modulates the neurocognitive processing of artworks. We presented subjects with paintings from the Museum of Modern Art (MoMA) in New York, and labeled them as being either from the MoMA or from an adult education center. Irrespective of aesthetic appreciation, we found higher neural activation in the left precuneus, superior and inferior parietal cortex for the MoMA condition compared to the control label condition. When taking the aesthetic preference for a painting into account, the MoMA condition elicited higher involvement of right precuneus, bilateral anterior cingulate cortex (ACC), and temporoparietal junction (TPJ). Our findings indicate that mental frames, in particular labels of social value, modulate both cognitive and affective aspects of sensory processing.

Food packaging cues influence taste perception and increase effort provision for a recommended snack product in children

Food marketing research shows that child-directed marketing cues have pronounced effects on food preferences and consumption, but are most often placed on products with low nutritional quality. Effects of child-directed marketing strategies for healthy food products remain to be studied in more detail. Previous research suggests that effort provision explains additional variance in food choice. This study investigated the effects of packaging cues on explicit preferences and effort provision for healthy food items in elementary school children. Each of 179 children rated three, objectively identical, recommended yogurt-cereal-fruit snacks presented with different packaging cues. Packaging cues included a plain label, a label focusing on health aspects of the product, and a label that additionally included unknown cartoon characters. The children were asked to state the subjective taste-pleasantness of the respective food items. We also used a novel approach to measure effort provision for food items in children, namely handgrip strength. Results show that packaging cues significantly induce a taste-placebo effect in 88% of the children, i.e., differences in taste ratings for objectively identical products. Taste ratings were highest for the child-directed product that included cartoon characters. Also, applied effort to receive the child-directed product was significantly higher. Our results confirm the positive effect of child-directed marketing strategies also for healthy snack food products. Using handgrip strength as a measure to determine the amount of effort children are willing to provide for a product may explain additional variance in food choice and might prove to be a promising additional research tool for field studies and the assessment of public policy interventions.

Resting-state brain connectivity after surgical and behavioral weight loss

OBJECTIVE

Changes in food-cue neural reactivity associated with behavioral and surgical weight loss interventions have been reported. Resting functional connectivity represents tonic neural activity that may contribute to weight loss success. This study explores whether intervention type is associated with differences in functional connectivity after weight loss.

METHODS

Fifteen participants with obesity were recruited prior to adjustable gastric banding surgery. Thirteen demographically matched participants with obesity were selected from a separate behavioral diet intervention. Resting-state functional magnetic resonance imaging was collected 3 months after surgery/behavioral intervention. ANOVA was used to examine post-weight loss differences between the two groups in connectivity to seed regions previously identified as showing differential cue-reactivity after weight loss.

RESULTS

Following weight loss, behavioral dieters exhibited increased connectivity between left precuneus/superior parietal lobule (SPL) and bilateral insula pre- to postmeal and bariatric patients exhibited decreased connectivity between these regions pre- to postmeal (P(corrected) <0.05).

CONCLUSIONS

Behavioral dieters showed increased connectivity pre- to postmeal between a region associated with processing of self-referent information (precuneus/SPL) and a region associated with interoception (insula) whereas bariatric patients showed decreased connectivity between these regions. This may reflect increased attention to hunger signals following surgical procedures and increased attention to satiety signals following behavioral diet interventions.

Can neural activation in dorsolateral prefrontal cortex predict responsiveness to information? An application to egg production systems and campaign advertising

Consumers prefer to pay low prices and increase animal welfare; however consumers are typically forced to make tradeoffs between price and animal welfare. Campaign advertising (i.e., advertising used during the 2008 vote on Proposition 2 in California) may affect how consumers make tradeoffs between price and animal welfare. Neuroimaging data was used to determine the effects of brain activation in dorsolateral prefrontal cortex (dlPFC) on choices making a tradeoff between price and animal welfare and responsiveness to campaign advertising. Results indicated that activation in the dlPFC was greater when making choices that forced a tradeoff between price and animal welfare, compared to choices that varied only by price or animal welfare. Furthermore, greater activation differences in right dlPFC between choices that forced a tradeoff and choices that did not, indicated greater responsiveness to campaign advertising.

Exposure to ‘healthy’ fast food meal bundles in television advertisements promotes liking for fast food but not healthier choices in children

Due to regulatory changes, fast food companies often depict healthy foods in their television advertisements to children. The present study examined how exposure to advertising for ‘healthy’ meal bundles to children influenced the selection of food in children. A total of fifty-nine children (thirty-seven males) aged 7–10 years (8·8 (sd0·9) years) took part in the present study. The within-participant, counterbalanced design had two conditions: control (exposure to ten toy adverts across two breaks of five adverts each) and experimental (the middle advert in each break replaced with one for a McDonald's Happy Meal®depicting the meal bundle as consisting of fish fingers, a fruit bag and a bottle of mineral water). Following viewing of the adverts embedded in a cartoon, children completed a hypothetical menu task that reported liking for McDonald's food and fast food, in general. Nutritional knowledge, height and weight of the children were measured. There was no significant difference between the two advert conditions for the nutritional content of the meal bundles selected. However, children's liking for fast food, in general, increased after exposure to the food adverts relative to control (P= 0·004). Compared to children with high nutritional knowledge, those with low scores selected meals of greater energy content (305 kJ) after viewing the food adverts (P= 0·016). Exposure to adverts for ‘healthy’ meal bundles did not drive healthier choices in children, but did promote liking for fast food. These findings contribute to debates about food advertising to children and the effectiveness of related policies.

A qualitative study of children's snack food packaging perceptions and preferences

Background

Food marketing is pervasive in high- and low/middle-income countries and is recognized as a significant risk factor for childhood obesity. Although food packaging is one of the most important marketing tools to persuade consumers at the point-of-sale, scant research has examined how it influences children’s perceptions. This study was conducted in Guatemala and aimed to understand which snack foods are the most frequently purchased by children and how aspects of food packaging influence their product perceptions.

Methods

Six activity-based focus groups were conducted in two elementary public schools with thirty-seven children (Grades 1 through 6, age range 7–12 years old). During each focus group, children participated in three activities: 1) list their most frequently purchased food products; 2) select the picture of their favorite product, the packaging they liked best, and the product they thought was the healthiest from eight choices; and 3) draw the package of a new snack.

Results

Children reported purchasing salty snacks most frequently. Most children chose their favorite product based on taste perceptions, which can be influenced by food packaging. Visual elements influenced children’s selection of favorite packaging (i.e., characters, colors) and healthiest product (i.e., images), and persuaded some children to incorrectly think certain foods contained healthy ingredients. When children generated their own drawings of a new product, the most frequently included packaging elements in the drawings were product name, price, product image and characters, suggesting those aspects of the food packaging were most significant to them.

Conclusions

Policies regulating package content and design are required to discourage consumption of unhealthy snacks. This might be another public health strategy that can aid to halt the obesity epidemic.

Food and Beverage Marketing to Youth

After nearly a decade of concern over the role of food and beverage marketing to youth in the childhood obesity epidemic, American children and adolescents - especially those from communities of color - are still immersed in advertising and marketing environments that primarily promote unhealthy foods and beverages. Despite some positive steps, the evidence shows that the food and beverage industry self-regulation alone is not likely to significantly reduce marketing of unhealthy foods and beverages to youth. A variety of research is needed to monitor industry marketing of unhealthy products to young people, and identify the most promising approaches to improve children's food marketing environments. The continued presence of unhealthy marketing toward children despite years of industry self-regulation suggests it is time for stronger action by policymakers to protect young people from harmful marketing practices.

Mechanisms of the portion size effect. What is known and where do we go from here?

Childhood obesity is a persistent problem worldwide, and of particular concern in the United States. Clarifying the role of the food environment in promoting overeating is an important step toward reducing the prevalence of obesity. One potential contributor to the obesity epidemic is the increased portion sizes of foods commonly served. Portion sizes of foods served both at home and away from home have dramatically increased over the past 40 years. Consistently, short-term studies have demonstrated that increasing portion size leads to increased food intake in adults and children, a phenomenon known as the portion size effect. However, the mechanisms underlying this effect are poorly understood. Understanding these mechanisms could assist in clarifying the relationship between portion size and weight status and help inform the development of effective obesity interventions. First, we review the role of visual cues, such as plate size, unit, and utensil size as a potential moderator of the portion size effect. In addition, we discuss meal microstructure components including bite size, rate, and frequency, as these may be altered in response to different portion sizes. We also review theories that implicate post-ingestive, flavor-nutrient learning as a key moderator of the portion size effect. Furthermore, we present preliminary data from an ongoing study that is applying neuroimaging to better understand these mechanisms and identify modifiable child characteristics that could be targeted in obesity interventions. Our tentative findings suggest that individual differences in cognitive (e.g. loss of control eating) and neural responses to food cues may be critical in understanding the mechanisms of the portion size effect. To advance this research area, studies that integrate measures of individual subject-level differences with assessment of food-related characteristics are needed.

The association between smokers' perceived importance of the appearance of cigarettes/cigarette packs and smoking sensory experience: a structural equation model

OBJECTIVE

We assessed the reliability of a measure of the latent construct "smoking sensory experience." We further measured the relationship between "smoking sensory experience" and smokers' rating of the importance of the appearance of cigarettes/cigarette packs in brand choice and smoking dependence.

METHODS

Analyses involved a national sample of smokers (n = 633) who participated in the 2010 South African Social Attitudes Survey (N = 3,112). Smokers ranked on a scale of 1-5, the importance of the following attributes in choosing their cigarette brand: health concerns, cost, packaging, taste, satisfaction, and flavor/strength. Using structural equation modeling, an a priori model was specified based on the hypothesis that taste, satisfaction, and flavor/strength are measures of a construct of "smoking sensory experience" and that cigarette packaging would be positively related to "smoking sensory experience." Furthermore, "smoking sensory experience" would be positively related to cigarettes smoked per day.

RESULTS

The latent construct--"smoking sensory experience" was considered reliable (Cronbach's α = 0.75). The structural equation model confirmed that the specified model fitted the data well (goodness of fit index = 0.993; normed fit index = 0.978; root mean square error of approximation = 0.031). Higher "smoking sensory experience" was positively associated with increasing cigarettes smoked per day (β = 0.12). Higher rating of the cigarette package in brand choice positively covaried with both "smoking sensory experience" (β = 0.29), and higher rating of health considerations (β = 0.42).

CONCLUSIONS

These findings support the regulation of the appearance of cigarettes/cigarette packs to reduce cigarettes' appeal and abuse liability in line with Article 11 of WHO's Framework Convention on Tobacco Control.