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

Unhealthy Food and Beverage Marketing to Children in the Digital Age: Global Research and Policy Challenges and Priorities

Food and nonalcoholic beverage marketing is implicated in poor diet and obesity in children. The rapid growth and proliferation of digital marketing has resulted in dramatic changes to advertising practices and children's exposure. The constantly evolving and data-driven nature of digital food marketing presents substantial challenges for researchers seeking to quantify the impact on children and for policymakers tasked with designing and implementing restrictive policies. We outline the latest evidence on children's experience of the contemporary digital food marketing ecosystem, conceptual frameworks guiding digital food marketing research, the impact of digital food marketing on dietary outcomes, and the methods used to determine impact, and we consider the key research and policy challenges and priorities for the field. Recent methodological and policy developments represent opportunities to apply novel and innovative solutions to address this complex issue, which could drive meaningful improvements in children's dietary health.

The food and beverage cues in digital marketing model: special considerations of social media, gaming, and livestreaming environments for food marketing and eating behavior research

Digital marketing to children, teens, and adults contributes to substantial exposure to cues and persuasive messages that drive the overconsumption of energy dense foods and sugary beverages. Previous food marketing research has focused on traditional media, but less is known about how marketing techniques translate within digital platforms, such as social media, livestreaming, and gaming. Building upon previous theories and models, we propose a new model entitled food and beverage cues in digital marketing (FBCDM). The FBCDM model specifies key marking elements and marketing integration strategies that are common on digital platforms and are hypothesized to enhance the effects of advertising and incentive sensitization process. FBCDM also categorizes measurable outcomes into three domains that include brand, food, and social outcomes. Additionally, repeated marketing exposure and the resulting outcomes are hypothesized to have long term consequences related to consumer markets, consumption behavior, culture, and health. We include a discussion of what is currently known about digital marketing exposure within the outcome domains, and we highlight gaps in research including the long-term consequences of digital marketing exposure. The FBCDM model provides a conceptual framework to guide future research to examine the digital marketing of food and beverages to children and adolescents in order to inform government and industry policies that restrict the aggressive marketing of products associated with obesity and adverse diet related outcomes.

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.

Beverage industry TV advertising shifts after a stepwise mandatory food marketing restriction: achievements and challenges with regulating the food marketing environment

OBJECTIVE

Sugar-sweetened beverages (SSB) are heavily advertised globally, and SSB consumption is linked to increased health risk. To reduce unhealthy food marketing, Chile implemented a regulation for products classified as high in energies, sugar, saturated fat or sodium, starting with a 2016 ban on child-targeted advertising of these products and adding a 06.00-22.00 daytime advertising ban in 2019. This study assesses changes in television advertising prevalence of ready-to-drink beverages, including and beyond SSB, to analyse how the beverage industry shifted its marketing strategies across Chile's implementation phases.

DESIGN

Beverage advertisements were recorded during two randomly constructed weeks in April-May of 2016 (pre-implementation) through 2019 (daytime ban). Ad products were classified as 'high-in' or 'non-high-in' according to regulation nutrient thresholds. Ads were analysed for their programme placement and marketing content.

SETTING

Chile.

RESULTS

From pre-regulation to daytime ban, child-targeted, daytime and total ads decreased by 51·8 percentage points (p.p.), 51·5 p.p. and 61·8 p.p. for high-in products and increased by 62·9 p.p., 54·9 p.p. and 61·8 p.p. for non-high-in products (Ps < 0·001). Additionally, total ready-to-drink beverage ads increased by 5·4 p.p. and brand-only ads (no product shown) by 7 p.p.

CONCLUSIONS

After the regulation implementation, 'high-in' ads fell significantly, but 'non-high-in' ads rose and continued using strategies targeting children and being aired during daytime. Given research showing that advertising one product can increase preferences for a different product from that same brand and product categories, broader food marketing regulation approaches may be needed to protect children from the harmful effects of food marketing.

Testing a conceptual Hierarchy of Effects model of food marketing exposure and associations with children and adolescents' diet-related outcomes

OBJECTIVE

Children's exposure to unhealthy food marketing contributes to poor diets by influencing the foods that children like, request, buy and consume. This study aimed to use confirmatory mediational analyses to test a hypothetical model of marketing effects, to better understand the mechanisms behind food marketing's impacts on children.

DESIGN

Children responded to a cross-sectional online survey about their attitudes towards, and purchase and consumption behaviours of, ten frequently promoted food/beverage brands and their media use. Structural equation modelling tested a priori potential pathways for the effects of food marketing exposure on children's diets.

PARTICIPANTS

10-16-year-old children (n 400).

SETTING

Australia.

RESULTS

There was a significant positive correlation between children's commercial screen media use and their attitudes towards brands (related to perceived social norms) and their brand purchasing behaviours, including their own purchases and requests to parents. The use of strategies to avoid advertising in commercial screen media reduced but did not remove the association between media use and brand purchases. Other brand exposures (on clothing, outdoor advertising, sponsorships) had a positive association with children's perceived social norms about brands and their brand purchases and requests. Non-commercial screen media use was not associated with any brand-related outcomes.

CONCLUSIONS

Commercial screen media use and other brand exposures were strongly positively associated with children's perceptions and purchasing behaviours of frequently marketed food/beverages. Regulations to restrict children's exposures to food marketing on-screen and through other media are required to reduce the effect of marketing exposure on children's food purchasing behaviours.

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).

Can new healthy luxury food products accelerate short food supply chain formation via social media marketing in high-income countries?

Social media marketing is a promising tool for successful product placement of new healthy luxury food products, a subcategory of superfoods. Despite its growing popularity, no studies have investigated how social media marketing affects consumers' quality perception process for such superfoods and whether this provides opportunities for farmers to gain a competitive advantage in direct marketing channels. Therefore, we integrate media richness theory into the food quality guidance model, compile a data set of 697 German fruit consumers from May to June 2020, and analyze this sample via partial least square analysis. Results show that social media marketing is a viable tool for new healthy luxury food products if media content is highly experience providing. Furthermore, it offers opportunities for the formation of shorter food supply chains as farmers could, through the provision of engaging social media marketing content, sell new healthy luxury food products directly to the final consumer. This research provides implications to farmers, retailers and policy makers to exploit the social media marketing potential of new healthy luxury food products.

Adults' Exposure to Unhealthy Food and Beverage Marketing: A Multi-Country Study in Australia, Canada, Mexico, the United Kingdom, and the United States

BACKGROUND

Food marketing increases product appeal, purchasing, and consumption, using diverse strategies and locations to reach consumers.

OBJECTIVES

The aim of this study was to examine differences in adults' self-reported exposure to various marketing strategies (brand and licensed characters, celebrities, and sponsorship of sports and cultural events) and locations (television, radio, and digital media) across 5 countries: Australia, Canada, Mexico, the United Kingdom, and the United States.

METHODS

We analyzed cross-sectional survey data on self-reported exposure to food marketing strategies and locations collected in 2018 by the International Food Policy Study. Participants (n = 21,678) aged ≥18 years completed an online survey. Exposures to unhealthy food marketing strategies and locations in the prior 30 days were self-reported. Regression models examined differences in marketing exposure and locations across countries.

RESULTS

The average number of unhealthy food marketing strategies to which participants reported being exposed ranged from 0.5 in the United Kingdom to 2.3 in Mexico. Self-reported exposure to strategies across all countries was highest for brand characters (32%), followed by licensed characters (22%). In total, the reported mean exposure of marketing locations was 1.6 in the prior month. Television was the most prevalent location (44%), followed by digital marketing (32%). Adjusted models indicated that the odds of reporting exposure to marketing strategies and marketing locations were higher for Mexico compared to the rest of the countries.

CONCLUSIONS

Adults report a variety of exposures to unhealthy food marketing in all countries, but exposure was highest in Mexico. Special attention should be paid to regulating marketing strategies, such as brand characters and licensed characters, and locations, such as television and digital marketing.

A content analysis of the aims, strategies, and effects of food and nonalcoholic drink advertising based on advertising industry case studies

Background

Placing limitations on advertising of food and nonalcoholic drinks to children is an effective strategy in addressing childhood obesity. The industry maintains that further restrictions are unnecessary.

Aims

To ascertain whether the advertising campaigns were successful according to the industry evaluations and more specifically the effects of marketing on children.

Materials & Methods

A total of 117 case studies (1980-2016) published by the advertising industry which evaluate the effects of advertising campaigns were reviewed. This industry data source had been previously used to analyze the effects of alcohol advertising campaigns. The nutrition profile of the products was assessed by applying the World Health Organisation Nutrition Profile model designed to restrict the marketing of foods and beverages to children.

Results

The food and drink industry advertising campaigns target specific consumers including children, use several persuasive marketing techniques (utilizing celebrities and gamification), often position unhealthy products as healthy, and lead to increased sales of the advertised product with good returns on investment. The health-related claims made, and aspects of the campaigns related to the marketing of the products to children are summarized.

Discussion

Our analysis of food and non-alcoholic drinks case studies aligns with similar analyses of tobacco and alcohol advertising.

Conclusion

This analysis, based on internal industry data, presents important evidence on the effects of advertising on consumption-related outcomes and the mechanisms by which they are achieved.

Regulatory focus and junk food avoidance: The influence of health consciousness, perceived risk and message framing

The purpose of this research is to examine: (1) the health-related factors namely perceived health consciousness and perceived risk that motivate a person's intention to avoid junk food consumption, and (2) the influence of regulatory focus (promotion vs prevention foci) on a person's intention to avoid junk food consumption under the conditions of gain-framing vs loss-framing health communication and messages. A set of hypotheses are tested across three studies. Study 1 (n = 148) shows that regulatory focus influences the consumers' intention to avoid junk food. Also, health consciousness mediates the relationship between regulatory focus and junk food avoidance intention. Study 2 (n = 132) finds that perceived risk amplifies the relationship between regulatory focus and health consciousness. Study 3 (n = 168) demonstrates that message framing combined with the appropriate regulatory focus positively influences the consumers' intention to avoid junk food. The findings validate and extend the current theoretical framework in relation to unhealthy eating behaviours (e.g., junk food consumption). Based on the findings of this research, the practitioners can utilise the correct type of health information or claims for the appropriate consumer segment (whether prevention or promotion foci) to effectively implement campaigns and programs.

Awareness of marketing for high fat, salt or sugar foods, and the association with higher weekly consumption among adolescents: a rejoinder to the UK government's consultations on marketing regulation

OBJECTIVE

Exposure to marketing for foods high in fat, salt or sugar (HFSS) reportedly influences consumption, nutritional knowledge and diet-related health among adolescents. In 2018/2019, the UK government held two consultations about introducing new restrictions on marketing for HFSS foods. To reinforce why these restrictions are needed, we examined adolescents' awareness of marketing for HFSS foods, and the association between past month awareness and weekly HFSS food consumption.

DESIGN

Cross-sectional survey that measured past month awareness of ten marketing activities for HFSS foods (1 = everyday; 6 = not in last month). Frequencies were converted into aggregate past month awareness across marketing activities and grouped into three categories (low/medium/high). Consumption was self-reported for fifteen foods (twelve HFSS) (1 = few times/d; 9 = never). For each food, frequency was divided into higher/lower weekly consumption.

SETTING

United Kingdom.

PARTICIPANTS

11-19-year-olds (n 3348).

RESULTS

Most adolescents (90·8 %) reported awareness of a least one marketing activity for HFSS foods, and at least half reported seeing ≥70 instances in the past month. Television, social media and price offers were the marketing activities most frequently reported. Awareness was associated with higher weekly consumption for ten of the twelve HFSS foods. For example, those reporting medium marketing awareness were 1·5 times more likely to report higher weekly consumption of cakes/biscuits compared with those reporting low awareness (AOR = 1·51, P = 0·012). The likelihood of higher weekly HFSS food consumption increased relative to the level of marketing awareness.

CONCLUSIONS

Assuming there is a causal relationship between marketing awareness and consumption, the restrictions proposed by the UK government are likely to help reduce HFSS consumption.

Soft Drinks and Sugar-Sweetened Beverages Advertising in Spain: Correlation between Nutritional Values and Advertising Discursive Strategies

Spain ranks fifth among European countries for childhood obesity. Sugar-sweetened beverages (SSBs) and soft drinks (SDs) are consumed by 81% of the Spanish children weekly. Advertising is one of the factors that contributes to an obesogenic environment. This study correlated longitudinally the nutritional values of SSBs and SDs and advertising discursive strategies between 2013 and 2018 for all media. A mixed-methods approach was applied that included a quantitative analysis of advertising spend data, a content analysis and a study of the discursive strategies used in advertisements. In addition, the Nutri-score system was used in order to determine the nutritional quality of the beverages. The results were analyzed applying the Spanish advertising regulatory framework for obesity prevention. The main findings indicate an association between low nutritional value beverage advertisements and a discourse based on hedonistic elements. In order to prevent childhood obesity in Spain, a stricter regulation of advertising is necessary, especially in aspects such as the language used to present products and celebrity endorsements.

Nutritional Content, Labelling and Marketing of Breakfast Cereals on the Belgian Market and Their Reformulation in Anticipation of the Implementation of the Nutri-Score Front-Of-Pack Labelling System

Objective: Breakfast cereals are frequently consumed in Belgium, especially among children. We investigated the nutritional content, labelling and marketing of breakfast cereals and the changes in nutrient content and reformulation in anticipation of the implementation of the Nutri-Score front-of-pack label. Design: Pictures were taken of cereal packages. The WHO-Europe nutrient profiling tool was used to classify cereals into ‘permitted’/‘not-permitted’ to be marketed to children, while the nutritional quality was assessed using Nutri-Score. The proportion of cereals with nutrition and health claims and/or promotional characters on the front-of-pack was compared between permitted and not-permitted cereals and between different Nutriscore categories using Chi-squared tests. The average nutrient contents per 100g were compared between 2017 and 2018 using paired t-tests. Setting: Belgium. Participants: All breakfast cereals in the major supermarkets (n = 7) in 2017 and 2018. Results: Overall, 330 cereals were included. About 77.2% of cereals were not permitted to be marketed to children but, of those, 22.0% displayed promotional characters. More claims (68.9% of all claims) were found on ‘not-permitted’ compared with ‘permitted’ cereals, particularly nutrition claims. Most claims were displayed on cereals with the allocated Nutri-Score A (42.0%) and C (37.0%). A significant reformulation of cereals was found between 2017 and 2018, with reductions in total sugar (−5%) (p < 0.001) and sodium (−20%) (p = 0.002) and increases in fibre (+3%) (p = 0.012) and proteins (+2%) (p = 0.002). Conclusion: Breakfast cereals on the Belgian market are predominantly unhealthy and frequently carry claims and promotional characters. Minimal reformulation occurred over one year. Policy recommendations include restrictions on claims and marketing for not-permitted cereals.

Adolescents' Reactions to Adverts for Fast-Food and Confectionery Brands That are High in Fat, Salt, and/or Sugar (HFSS), and Possible Implications for Future Research and Regulation: Findings from a Cross-Sectional Survey of 11-19 Year Olds in the United Kingdom

The influence that marketing for foods high in fat, salt, and/or sugar (HFSS) has on adolescents extends beyond a dose-response relationship between exposure and consumption. It is also important to explore how marketing shapes or reinforces product/brand attitudes, and whether this varies by demography and Body Mass Index (BMI). To examine this, a cross-sectional survey was conducted with 11-19 year olds in the United Kingdom (n = 3348). Participants watched 30 s video adverts for a fast-food and confectionery brand. For each advert, participants reported reactions on eight measures (e.g., 1 = Makes [product] seem unpopular choice-5 = Makes [product] seem popular choice), which were binary coded based on whether a positive reaction was reported (Yes/No). At least half of adolescents had positive reactions to both adverts for 5/8 measures. Positive reactions had associations with age, gender and, to a lesser extent, BMI. For example, 11-15 year olds were more likely than 16-19 year olds to report appeal to their age group for the fast-food (OR = 1.33, 95% CI: 1.13-1.58) and confectionery advert (OR= 1.79, 95% CI: 1.51-2.11). If these reactions are typical of other HFSS products, future research and regulatory change should examine whether additional controls on the content of HFSS marketing, for example mandated health or nutritional information and revised definitions of youth appeal, offer additional protection to young people.

"It's Just Addictive People That Make Addictive Videos": Children's Understanding of and Attitudes Towards Influencer Marketing of Food and Beverages by YouTube Video Bloggers

Exposure to influencer marketing of foods and beverages high in fat, sugar, and/or salt (HFSS) increases children's immediate intake. This study qualitatively explored children's understanding of, and attitudes towards, this marketing, to elucidate potential mechanisms through which exposure affects behavior. In six focus groups (n = 4) children (10-11 years) were shown a YouTube video featuring influencer marketing of an HFSS product. Inductive thematic analysis identified six themes from children's discussions of this marketing: (1) YouTubers fill a gap in children's lives, (2) the accessibility of YouTubers increases children's understanding of their actions, (3) influencer marketing impacts all-the influencer, the brand, and the viewer, (4) attitudes towards influencer marketing are most affected by a YouTuber's familiarity, (5) YouTuber influencer marketing is effective because they are not 'strangers', (6) children feel able to resist influencer marketing of HFSS products. Children had an understanding of the persuasive intent of this marketing, and although most were sceptical, familiar YouTubers elicited particularly sympathetic attitudes. Children felt affected by influencer marketing of HFSS products, but believed they were able to resist it. Beyond theoretical insight, this study adds to the growing body of evidence to suggest children's exposure to HFSS influencer marketing should be reduced.

Investigating the Effects of Non-Branded Foods Placed in Cartoons on Children's Food Choices through Type of Food, Modality and Age

Cartoons are among the most consumed media products by children, especially those at a young age. While branded food placements are not allowed in animated series, non-branded food placements are prevalent. However, little is known about the effects that these food placements might have on children's eating preferences. In an experimental study with 124 children (51.6% girls, age range: 7-11, M_age = 9.24, and SD = 1.19), 62 children in the experimental condition were exposed to 16 food placements in cartoons, whereas children in the control condition were exposed to cartoon scenes without foods. The healthiness of the placed foods (low nutritional value foods versus high nutritional value foods) as well as the modality of food placements (unimodal versus bimodal) were manipulated. After watching the cartoon scenes, children completed a choice task where each placed food appeared on a separate choice card. Our results indicate that non-branded low nutritional value foods placed in cartoons are an effective strategy in modifying children's food choices when children are under age 9. We suggest that policy makers, particularly those involved in the content design of cartoons, take these results into account when placing low nutritional value foods in cartoons, especially for an animated series that targets young child audiences.

Food Advertising and Prevention of Childhood Obesity in Spain: Analysis of the Nutritional Value of the Products and Discursive Strategies Used in the Ads Most Viewed by Children from 2016 to 2018

In Spain, 40% of children are overweight or obese. Television advertising is a widely acknowledged factor contributing to high-calorie food intake. This study longitudinally correlates some variables involved in childhood obesity prevention strategies in Spain. A mixed-methods approach was used. A quantitative analysis of audience data was conducted to determine the advertising campaigns most viewed by Spanish children from 2016 to 2018. The Nutri-score system was applied to determine the nutritional quality of the food advertised. A content analysis and a study of the discursive strategies used as an advertising ploy was undertaken. The results were examined in relation to the regulatory framework of the Spanish PAOS Code for the co-regulation of food advertising aimed at children. The study shows that Spanish advertising aimed at children mostly advertises very low nutritional value products. Moreover, these campaigns violate the PAOS Code in terms of the use of language in relation to the product, its benefits, and the appearance of popular characters. Our findings suggest a direct association between low nutritional value food ads and discursive strategies based on the intangible and extrinsic characteristics of these products. There remains the need for stricter legislation that takes into consideration the nutritional value of advertised foods and the language used in their hedonistic advertising.