Role of Media in Childhood Overweight

1
Role of Media in Childhood Overweight Chronic
Disease Risk

• November McGarvey, MPH
• Doctoral Roundtable
• 1/12/07

2
Outline

• Background childhood OW disease
• Theories
• Food marketing facts
• Children as a vulnerable population
• Review of existing data on
• - Obesity/TV
• - Physical Activity/TV
• - Food Content in TV/Movies
• - Food Ads/Food choices
• - Marketing cross promotions
• Findings summarized
• Limitations
• Conclusion
• Review of existing advertising guidelines
• Recommendations
• References

3
Childhood Overweight (OW)

• Prop. of OW children has increased more than 2x
  and 3x for adolescents
• If include at risk of being OW, 30 of children
  ages 6-19 are affected

Proportion of OW Children in the US Source CDC,
Natl Center for Health Statistics, US, 2003,
Table 69
4
Childhood OW Disease

• 10x more likely to become obese adults.
• OW/obese adults have gt risk for CHD, type 2
  diabetes, some cancers, osteoarthritis.
• Development of typically adult-type diseases.
• Higher frequency of type 2 diabetes, high blood
  lipids pressure, early maturation, orthopedic
  problems.
• In addition to health problems, there are also
  high social economic costs related to obesity.

5
Theories on Medias Contribution to Child OW

• Displacement of Physical Activity (PA)
• Unhealthy ad influence on food choices
• Cross-promotions encourage buying consumption
  of high calorie foods

6
Theories on Medias Contribution to Child OW

• Excessive snacking when using media eat less
  healthy meals in front of the TV
• Watching TV videos lowers metabolic rates
  (below even that for sleeping)
• Media depictions of nutrition body weight
  encourage development of less healthy diets

7
Child Food Marketing Facts

• 40,000 TV ads/yr on TV (Kunkel, 2001)
• 1 food commercial every 5 minutes (Kotz Story,
  1994)
• Majority of child-targeted ads for food (Kunkel,
  2001)
• Candy (32)
• Cereal (31)
• Fast Food (9)
• Food marketing aimed at children increased from
  6.9 billion (1992) to 15 billion (2002) (Spake,
  2003)

8
Vulnerable Population

• Under age 6 cannot distinguish between program
  content ads
• Under age 8 most do not understand purpose of
  advertising is to sell a product
• Age 8-10 may understand nature of advertising,
  but may not always discern the persuasive intent
  or understand disclaimer wording
• (Kunkel et al. 2002)

9
Vulnerable Population

• After reviewing the research, the American
  Academy of Pediatrics concluded that
• advertising directed toward children is
  inherently deceptive exploits children lt 8 yrs
  of age

10
Child OW TV watching

• Avg. 5 ½ hrs/day using media (Roberts Foehr,
  2004)
• 12-17 yr olds obesity prevalence inc. by 2/hr
  of TV (Dietz Gortmaker, 1985)
• High school students gt2hrs TV/ day related to
  being OW (Lowry et al., 2002)
• Longitudinal - preschool children through early
  adolescence TV watching is a risk factor for
  change in body fat (Proctor et al., 2003)

11
Child PA TV watching

• Mixed results some found a weak statistically
  significant relationship between hours of TV
  levels of PA while others have found no
  relationship
• 8-12 yr olds TV viewing decreased metabolic
  rates even more than resting or sleeping (Klesges
  et al., 1993)

12
Food Content in TV/Movies

• Content analysis food references in all shows
  sampled
• Highest rated programs among 2-5 year olds had
  food reference in every episode 1/3 had gt/ 16
  references
• 1/3 references for empty calorie foods high in
  fat, sugar, salt another ¼ for nutrient rich
  foods also high in fat, sugar, salt
• (Borzekowski 2001)

13
Effect of TV Food Ads on Childrens Food Choices

• 500 adolescent students for each hr of TV/day,
  daily servings of FAV decreased
• (Boynton-Jarrett et al., 2003)
• Amount of TV time watched predicts how often they
  request products (up to 3/4)
• (Galst White, 1976)
• Headstart 2-6 yr olds viewers of cartoons
  embedded w/food ads significantly more likely to
  choose product preference was gt for those
  advertised 2x
• (Borzekowski Robinson, 2001)

14
Marketing Cross Promotions

• of food products being marketed to children
  through x-promotions with popular TV/Movie
  characters has increased
• - McDonalds Disney Happy Meals
• - Burger King Rugrats, Shrek, Pokemon,
  Spongebob
• - 45 fruit snacks have licensing agreements in
  2003 (only 10 in 1996)
• - 1/6 (16.9) of food commercials offer a free
  toy
• (Kotz Story, 1994)

15
Findings Summarized

• Most x-sectional longitudinal studies indicate
  children who spend more time with media are more
  likely to be OW.
• While several regional studies have not agreed,
  experimental interventions indicate that media
  reduction can reduce childrens body weight.

16
Limitations

• Some studies
• - Lack replication of findings
• - Have small sample sizes
• - Have very specific sample populations
• - Lack of good dietary/physical assessment for
  children in studies

17
Conclusions

• Medias effects on children are significant for
  the most part negative in terms of increasing
  risk for OW obesity
• As media is increasingly targeting children for
  unhealthy food products, media regulation or
  reduction is needed to protect this vulnerable
  population

18
Current Childrens Advertising Guidelines

• FCC Regulations
• - Bumpers to signal beginning end of commercial
  break
• Prohibit ads w/character endorsements from
  running directly before/after characters show
• 1990 Childrens Television Act
• Mandates advertising limits for children under 12
  to 10.5min/hr on weekends 12min/hr on weekdays
• Childrens Advertising Review Unit (CARU)
  self-regulatory policies
• - Ads should 1) not mislead about nutritional
  benefits 2) depict appropriate amounts for a
  product 3) depict product w/ a view toward
  development of good nutritional practices 4)
  refrain from portraying snacks as meal
  substitutes 5) show meals in context of
  balanced diet

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Recommendations

• Ban advertising to preschoolers
• Ban advertising of junk food to very young
  children
• FTC investigation into marketing of junk food
  to children
• Ban of food product placement in childrens
  programming
• Provision of equal time for messages on
  nutrition/fitness to counteract food ads

20
Recommendations

• Parental warnings about nutritional value of
  advertised foods
• Repeal of the tax deduction for company expenses
  associated w/advertising junk food to children
• Ban of food advertising in school based TV prog.
  (e.g. Channel 1)
• Disclosure of food-related product placement
  deals in TV/movies viewed by children

21
Recommendations

• Eliminating/limiting x-promotions between popular
  childrens media characters unhealthy food
  products
• Increase use of popular media characters
  celebrities to promote healthy food alternatives
• Prohibition of marketing and sale of junk food
  on school property
• Develop school-based curricula to teach children
  adolescents media literacy.

22
References

• American Academy of Pediatrics. Policy statement
  Children, adolescents, and advertising.
  Pediatrics295-97, 1995.
• Borzekowski D. Watching what they eat A content
  analysis of televised food references reaching
  preschool children. Unpublished manuscript, 2001
  (as cited in Strasberg Wilson, 2002)
• Borzekowski DL, Robinson TN. The 30-second
  effect An experiment revealing the impact of
  television commercials on food preferences of
  preschoolers. J Am Diet Assoc, 101(1)42-6, 2001.
• Boynton-Jarrett R, Thomas TN, Peterson KE,
  Wiecha, J, Sobol A, Gortmaker SL. Impact of
  television viewing patterns on fruit and
  vegetable consumption among adolescents.
  Pediatrics, 112(6)1321-26, 2003.
• Centers for Disease Control Prevention.
  Overweight among US children and adolescents.
  National Health Nutrition Examination Survey.
  Accessed from http//www.cdc.gov/nchs/data/nhanes/
  databriefs/overwght.pdf on 12/10/2004.
• Dietz W, Gortmaker S. Do we fatten our children
  at the TV set? Obesity and television viewing in
  children and adolescents. Pediatrics, 75807-12,
  1985.
• Galst J, White M. The unhealthy persuader The
  reinforcing value of television and childens
  purchase influence attempts at the supermarket.
  Child Development, 471089-1096, 1976.
• Henry J Kaiser Family Foundation. The role of
  media in childhood obesity, 2004.
• Kennedy K. Examining television as an influence
  on childrens health behaviors. J of Pediatric
  Nursing, 15(5)272-81, 2000.
• Klesges R, Shelton M, Klesges L. Effects of
  television on metabolic rate Potential
  implications for childhood obesity. Pediatrics,
  91(2)281-6, 1993.

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References

• Kotz K, Story M. Food advertisements during
  childrens Saturday morning television
  programming Are they consistent with dietary
  recommendations? J Am Diet Assoc,
  94(11)1296-1300, 1994.
• Kunkel D. Children and television advertising.
  Handbook of children the media, eds. Singer D
  Singer J. Thousand Oaks, CA Sage Publications,
  375-93, 2001.
• Kunkel D, Strasberg V, Wilson B. Eating and
  eating disorders. Children, adolescents the
  media. Thousand Oaks, CA Sage Publications,
  237-70, 2002.
• Levine J. Food industry marketing in elementary
  schools Implications for school health
  professionals. J of School Health, 69(7)290,
  1999.
• Lobstein T, Dibbs S. Evidence of a possible link
  between obesogenic food advertising and child
  overweight. Obesity Reviews, 6203-8, 2005.
• Proctor M, Moore L, Gao D, Cupples L, Bradlee M,
  Hood M, Ellison R. Television viewing and change
  in body fat from preschool to early adolescence
  The Framingham Childrens Study. Intl J of
  Obesity, 27827-33, 2003.
• Roberts D, Foehr U. Kids media in America.
  Cambridge, MAUniversity Press, 2004.
• Spake A. Hey, kids! Weve got sugar and toys. US
  News World Report, 0041-5537, 135(17), 2003.
• Story M, French S. Food advertising and marketing
  directed at children and adolescents in the US.
  Intl J of Behav Nutrition Physical Activity,
  13-19, 2004.
• Strasberg V, Wilson B. Eating and eating
  disorders. Children, adolescents, and the media.
  Thousand Oaks, CA Sage Publications237-70,
  2002.
• Taras HL, Gage M. Advertised foods on childrens
  television. Arch Pediatric Adolescent Medicine,
  149(6)649-52, 1995.

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Contact Information

• Comments questions can be sent to November
  McGarvey at november_at_ucla.edu.
• THANK YOU!