Kids' exposure to unhealthy food ads on TV drops, but remains high

By Pooja Toshniwal PahariaReviewed by Benedette Cuffari, M.Sc.Aug 26 2024

Study: Trends in Children's Exposure to Food and Beverage Advertising on Television. Image Credit: MIA Studio / Shutterstock.com

Children's exposure to food-related ads on television has significantly decreased since 2013, but they still see over 1,000 mostly unhealthy ads annually, indicating a need for government regulation.

A recent study published in JAMA Network Open compares trends in children watching food and beverage television commercials in the United States between 2013 and 2022.

How do unhealthy food advertisements affect child health?

The World Health Organization (WHO) has advocated for government-mandated rules to limit harmful food marketing to children; however, few nations have enacted these types of laws. The food industry has implemented self-regulatory programs, such as the United States Voluntary Children Food and Beverage Advertising Initiative (CFBAI), which promotes healthier goods in child-directed programming.

However, children between two and 11 years of age are continuously exposed to nearly 4,000 food-related advertisements each year that encourage the consumption of food products with excessive quantities of trans fat, saturated fat, salt, and total sugar. Thus, research is needed to assess the effects of unhealthy food promotion on children, particularly those from minority ethnic or racial groups with lower socioeconomic positions.

About the study

The researchers examined changes in food and beverage advertising for products in the nutrients to limit (NTL)-high category based on the Interagency Working Group (IWG) principle, including trans-fat, saturated fat, salt, and total sugars. Alterations in the fraction of food, beverage, and restaurant product marketing that exceeded suggested NTL levels after the 2020 updated CFBAI nutrition criteria implementation were also determined.

The primary research exposure included CFBAI modifications between 2014 and 2020. The primary study outcome measures were the amount of FB-related advertisements viewed each year and the proportion of NTL-high food commercials in child and non-child programming. Pediatric programming was defined as having a 35% or more child audience share, and Spanish-language programming was excluded.

Nielsen company household- and individual-level television ratings on advertisement exposure were also determined between 2013 and 2015, as well as in 2018 and 2022, with these ratings stratified by race. The ratings information included exposure from cable networks, broadcast networks, syndicated television commercials, and spot advertising exclusively observed in local broadcast areas.

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

Sensitivity analyses examined exposure from programming with varying child-audience proportions of 30%, 25%, and 20%.

Products were considered high in saturated fats if they contained one or more grams for every reference quantity usually eaten (RACC) or over 15% of calories were derived from saturated fatty acids. Foods with a high salt content contained over 210 mg of sodium/RACC for individual products or over 450 mg/serving for major dishes and meals.

Study findings

Throughout the study period, the annual viewership of advertisements decreased by 78% for children between two and five years of age and 79% for those between six and eleven years of age. Annual advertising on pediatric programming declined by 95% and 97% for two—to five-year-olds and six—to eleven-year-olds, respectively.

Regardless of the definition of children's programming, non-children's programming contributed to 80-90% of exposure by 2022. NTL-high items advertising decreased but remained high: 69% for all-inclusive programming, 64% for two-to-five-year-olds, 68% for all, and 61% for six-to-11-year-old children. Over 50% of CFBAI-participating member food-related commercials on pediatric programming pertained to high-NTL foods.

Black children watched food and beverage commercials more frequently than their White counterparts, with 58% and 72% higher frequency reported for two- to five-year-olds and six- to eleven-year-olds, respectively. In 2022, this discrepancy was reduced from 85% to 58% for children between two and five years of age, whereas the proportion of children between six and 11 years watching these programs increased from 60% to 72%. However, the fraction of NTL-high food product advertisements remained consistent across races.

Conclusions

Pediatric exposure to food and beverage commercials reduced dramatically from 5,000 to 1,000 from 2013 to 2022, respectively. By 2022, non-pediatric programming accounted for over 90% of the exposure; however, most commercials continued to be for unhealthy foods.

Government restrictions based on the daytime period, rather than the type of programming, may minimize diet-related health disparities among minority children by reducing their exposure to hazardous food commercials.