Randomized Exposure to Food Advertisements and Eating in the Absence of Hunger Among Preschoolers

Abstract

BACKGROUND: Preschoolers in the United States are heavily exposed to unhealthy food advertisements. Whether such exposure promotes cued eating has not been documented in this age group. METHODS:Randomized experiment among 60 children, aged 2 to 5 years, recruited in 2015-2016 from New Hampshire and Vermont. Children completed the experiment at a behavioral laboratory. Children were provided with a healthy snack to consume upon arrival then randomized to view a 14-minute TV program embedded with advertisements for either a food or a department store. Children were provided 2 snack foods to consume ad libitum while viewing the TV program; 1 of those snacks was the food advertised. Eating in the absence of hunger (EAH) was operationalized as the kilocalories of snack foods consumed. t tests were used to compare EAH by advertisement condition; linear regression models assessed effect modification by the child's age, sex, BMI percentile, and parental feeding restriction. RESULTS:Mean age was 4.1 (SD 0.9) years, 55% of children were male, 80% were nonHispanic white, and 20% were overweight or obese. There were no differences in child or socioeconomic characteristics by advertisement condition. Child BMI was not related to EAH. Mean kilocalories consumed during the EAH phase was greater among children exposed to the food advertisements (126.8, SD: 58.5) versus those exposed to the nonfood advertisements (97.3, SD: 52.3; P = .04), an effect driven by greater consumption of the advertised food (P < .01). There was no evidence of effect modification. CONCLUSIONS:Findings suggest that food advertisement exposure may encourage obesogeniceating behaviors among the very young.

Household chaos and screen media use among preschool-aged children: a cross-sectional study

“…Parents completed a series of questions regarding their children’s typical screen use in the past three months. First, parents selected which of nine electronic media activities their children engaged with on any media device; screen use activities were selected based on published reports [ 43 ] and the research team’s past experience measuring media use in preschool-age children [ 14 ]. Screen activities included 1) watching shows or movies, 2) playing or engaging with apps, 3) viewing videos or clips other than shows or movies online (e.g., YouTube), 4) video calls such as Facetime or Skype, 5) listening to streaming music, 6) browsing or reading electronic books or magazines, 7) playing video games on the Internet, 8) engaging with social media either by self or with another, or 9) browsing websites.…”

“…Screen use may increase sedentary time and displace physical activity. Screen use may also expose children to advertisements for energy dense foods, which can cue immediate eating [ 14 ], and screen use itself may serve as a cue to eat once children begin to pair screen use with eating snacks or meals [ 15 ]. Repeated advertisement exposure may also have a longer-term effect on shaping dietary preferences towards calorically dense foods [ 16 ].…”

The potential of a human rights approach for accelerating the implementation of comprehensive restrictions on the marketing of unhealthy foods and non-alcoholic beverages to children

“…The rapid increase in the prevalence of overweight and obesity among children in low-and middle-income countries is particularly concerning (Lobstein et al, 2015). Cumulative evidence shows that the marketing of unhealthy food and beverage products to children affects their food and drink preferences, purchasing requests and consumption patterns (Boyland et al, 2016;Cairns, Angus et al, 2013;Emond et al, 2016;Hastings et al, 2006;Longacre et al, 2017), which in turn affect their health and nutritional status.…”

Exposure to Child-Directed TV Advertising and Preschoolers’ Intake of Advertised Cereals

“…Laboratory-based studies 12,13,22,23 have demonstrated that food advertising exposure shapes children's immediate food preferences and requests 22 and cues immediate eating in children as young as age 3-5 years. 12,13 The current study extends those findings and prior crosssectional work 14 by demonstrating a prospective advertising effect on diet in a populationbased study of preschool-age children. A previous longitudinal ecologic study 24 documented prospective associations between soft drink and fast-food TV advertisement exposure and a greater intake of those products over 3 years among fifth graders; however, advertisement exposure was not measured at the individual level.…”

“…1 Experimental studies demonstrate that food advertising exposure affects children's food preferences and requests. 1 TV food advertisement exposure also cues immediate consumption of food, 12,13 and cross-sectional studies indicate significant associations between children's advertisement exposure and intake of advertised foods. 14 However, little is known about the prospective influence of food advertising on preschoolers' dietary intake in natural settings.…”