Children see less and less advertising for unhealthy food on television, but still a lot

Study: Trends in children’s exposure to food and beverage advertising on television. Photo credit: MIA Studio / Shutterstock.com

Since 2013, the number of children exposed to food advertisements on television has declined significantly. However, they still see over 1,000 predominantly unhealthy commercials each year, suggesting that government regulation is needed.

A recently published study JAMA network opened compares trends among children watching television advertisements for food and beverages in the United States between 2013 and 2022.

What impact does advertising for unhealthy food have on children’s health?

The World Health Organization (WHO) has advocated for government-mandated rules to limit the advertising of harmful foods to children. However, few countries have enacted such laws. The food industry has introduced self-regulatory programs such as the United States Voluntary Children Food and Beverage Advertising Initiative (CFBAI), which promotes healthier products in programs aimed at children.

However, children between the ages of two and 11 are exposed to nearly 4,000 food advertisements each year that promote the consumption of foods containing excessive amounts of trans fats, saturated fats, salt and sugar. Therefore, research is needed to examine the impact of unhealthy food advertising on children, particularly children from ethnic or racial minority groups with lower socioeconomic status.

About the study

Researchers examined changes in food and beverage advertising for products in the “nutrients that should be limited” (NTL) category based on the Interagency Working Group (IWG) principle, including trans fat, saturated fat, salt, and total sugars. They also identified changes in the proportion of food, beverage, and restaurant product advertising that exceeded recommended NTL levels following implementation of the updated CFBAI nutritional criteria in 2020.

The primary research exposure included CFBAI changes between 2014 and 2020. The primary study outcome measures were the number of FB-related ads viewed annually and the proportion of NTL-rich food advertisements in children’s and non-children’s programming. Children’s programming was defined as programs with a child audience share of 35% or more, and Spanish-language programming was excluded.

Nielsen’s household- and individual-level television ratings were also calculated based on advertising exposure between 2013 and 2015 and 2018 and 2022, with those ratings stratified by race. Ratings information included exposure by cable networks, broadcast networks, syndicated television commercials, and spot advertisements seen exclusively in local broadcast areas.

Nutritional and calorie content data for marketed items were obtained from manufacturers’ websites, while nutritional information on the products was obtained from grocery store labels and in person, the Minnesota Nutrition Data System, and the U.S. Department of Agriculture (USDA) Food Data Central. The nutrient composition of each FB product was determined using nutritional criteria issued by the U.S. Centers for Disease Control and Prevention (CDC), Federal Trade Commission (FTC), Food and Drug Administration (FDA), and U.S. Department of Agriculture (USDA).

Sensitivity analyses examined exposure to programs with different child audience shares of 30%, 25% and 20%.

Products were considered high in saturated fat if they contained one or more grams per reference intake usually consumed (RACC) or if more than 15% of calories came from saturated fat. Foods high in salt contained more than 210 mg sodium/RACC for individual products or more than 450 mg/serving for main dishes and meals.

Study results

During the study period, annual advertising audiences fell by 78% among children aged two to five and by 79% among children aged six to eleven. Annual advertising audiences for children’s programmes fell by 95% among children aged two to five and by 97% among children aged six to eleven.

Regardless of the definition of children’s programming, non-children’s programming contributed 80-90% of exposure through 2022. Advertising for high-NTL items declined but remained high: 69% for all-inclusive programs, 64% for two- to five-year-olds, 68% for all, and 61% for six- to 11-year-olds. Over 50% of CFBAI participating members’ food-related commercials in children’s programming were for high-NTL foods.

Black children watched food and beverage advertisements more frequently than their white peers. Among two- to five-year-olds and six- to 11-year-olds, the frequency was 58% and 72% higher, respectively. In 2022, this gap narrowed from 85% to 58% among children between the ages of two and five, while the share of children between the ages of six and 11 who watched these programs increased from 60% to 72%. However, the share of advertisements for high-NTL food products remained consistent across all races.

Conclusions

The number of children shown food and drink advertisements fell dramatically from 2013 to 2022, from 5,000 to 1,000. By 2022, non-pediatric programming accounted for over 90% of advertising, but most commercials continued to focus on unhealthy foods.

Government restrictions on broadcast time rather than type of programming can minimize nutrition-related health disparities among minority children by reducing their exposure to advertisements for dangerous foods.