Keep your children out of the firing line: television food advertising and childhood obesity / overweight

Australia now has one of the highest rates of childhood obesity in the world. There is growing evidence that exposure to TV advertising for foods, is shaping children's food choices and eating habits, and is a contributing factor to the problem of childhood obesity and overweight.

This Fact Sheet is one of three in Young Media Australia (YMA)'s Keep your children out of the firing line series, the development of which has been made possible by the sponsorship from the Telstra Foundation. This Fact Sheet will answer four key questions:

• Is childhood obesity and overweight a problem in Australia?
• Are Australian children exposed to high levels of television food advertising?
• Does this contribute to the problem of childhood obesity and overweight?
• What can parents and health professionals do about television food advertising?

The other two Fact Sheets in the Keep your children out of the firing line series (coming soon) are:

• Body image problems, eating disorders and media messages, and
• Strategies for parents to counter television food advertising.

A brochure for parents entitled Fight childhood obesity: keep your children out of the firing line is also available.

A big problem, many solutions

YMA acknowledges that childhood obesity and overweight is a complex problem, with many causes and requiring a range of solutions. We acknowledge the extremely valuable contributions being made by many other groups in the areas of increasing children's physical activity levels, providing parents with better information about nutrition, training in parenting skills and other strategies.

However, as Australia 's peak body in the field of children and the media, our contribution to the obesity debate is primarily about the impact of the media, and in this instance, of television food advertising, in particular.

Is childhood obesity and overweight a problem in Australia ?

Yes

It is estimated that the prevalence of childhood overweight and obesity in Australia is 27%–30%, that is: more than one in four children are overweight or obese.

Childhood obesity high and increasing

From 1985 to 1995, the prevalence of overweight and obesity in Australian children aged 7–15 years virtually doubled, from about 10% to about 20%. (Magarey AM et al. 2001) A recent study in South Australia found that 20% of children under the age of five were obese or overweight and  the percentages of overweight and obese pre-school children had doubled during the period 1995 to 2004. (Vaska VL and Volkmer R, 2004)

Consequences of childhood obesity

Psycho social consequences. Children who are overweight or obese can suffer from social isolation, poor self esteem and depression.

Related medical problems. These include increased risk of back pain, flat feet, obstructive sleep apnoea, heat intolerance, asthma, shortness of breath and many other related conditions, all of which affect their daily lifestyle and sense of well being, as well as increasing the risks of later life problems.

Dental decay. The frequency and quantity of sugar intake is directly related to rates of dental decay. Consumption of acidic soft drinks is the biggest risk factor for dental erosion in children and adolescents (Rugg-Gunn A, 1997).

Bone health. This may be compromised by consuming soft drinks in place of milk and by the caffeine content of some soft drinks.

Adult overweight or obesity. A child who is overweight or obese has about an 80% chance of being overweight or obese at age 20. (Magarey AM et al, 2003)

Long term disease risks . These include Type 2 diabetes, cardiovascular disease, stroke, hypertension, some types of cancer, musculoskeletal disorders and gall bladder disease (World Health Organisation 1997)

A longitudinal study published in The Lancet in 2004, viz ,“Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study,” has shown that children spending more than two hours a day watching television had a much higher chance of becoming overweight, have a high cholesterol and becoming addicted to cigarettes by their mid-twenties. The study finds the 17% of overweight, 15% of raised serum cholesterol, 17% of smoking, and 15% of poor fitness in 26-year-olds can be attributed to watching more than 2 hours a day of television during childhood and adolescence. (Hancox R et al. 2004)

Are Australian children exposed to high levels of food advertising?

Yes

Levels of food advertising in Australia

A study of 13 OECD countries showed that Australia had the highest number of television food advertisements per hour (higher than the USA and the UK ) (Dibb, 1996).

Average number of food advertisements per hour in 13 OECD countries

(Source: CFAC, 2003)

Amount of advertising children to which children are exposed

Five to 12 year olds watch on average 2½ hours of television daily; which means that with approximately 30 ads every hour, they are watching 75 ads per day, or about 22,000 ads per year. ( ABA , 2002). Eminent US researcher Dale Kunkel, recently estimated that the number of advertisements viewed by children has now risen to more than 40,000 per year. (Kunkel D, 2001)

Types of foods advertised

The vast majority of television food advertisements are for foods that are high in fat, sugar, or salt and of low nutritional value.

In January 2003, the Australian Divisions of General Practice (ADGP) conducted an audit to determine the extent of junk food advertising that Australian children are exposed to on television. The ADGP recorded and analysed 50 hours of child-targeted television on commercial television stations during the January holiday period 2003. This audit included programs scheduled during the early morning, afternoon and on Saturday morning. An equal number of hours from each commercial channel was analysed. The focus of the audit was on programs targeting children aged approximately 5 to 15.

The audit found that during children's television programs there was an average of one junk food advertisement per ad break and in some cases up to three advertisements per ad break for different types of junk food. Over 99% of food advertisements broadcast during children's TV programming were for junk food. T he main categories of foods advertised were (in descending order): fast food (hamburgers, pizza and fried chicken); soft drink; ice cream; and chocolate confectionery.

Summary of Junk Food Advertising by Food Category

(Source: ADGP, 2003)

Does television food advertising contribute to the problem of childhood obesity and overweight?

Yes

There is no single cause for the childhood obesity epidemic. At its simplest, there is an energy imbalance “…a relative increase in energy intake (food intake) together with a decrease in energy expenditure (decreased physical activity and increased sedentary behaviour.)” (Waters EB and Baur LA, 2003). However, food advertising has been shown by a growing body of research to be a contributing cause to both sides of this equation. While children are engaged in the very sedentary pursuit of watching television, they are bombarded with advertising designed to persuade them to want foods of low nutritional value.

Advertising to children works

Advertising agencies employ people with knowledge of child development principles to make ads that will engage and convince children. Various techniques are used such as:

• Premium offers such as give-aways, competitions and prizes
• Jingles and cartoon characters
• Emphasis on fun, happiness and excitement
• Implying the product makes them special or superior.

Food companies spend millions of dollars on marketing and advertising. The following table shows the increased annual expenditure on advertising in the last 20 years.

(Source: CFAC, 2003)

A recent UK report found that for every $1 spent by the World Health Organization on preventing the diseases caused by western diets, more than $500 is spent by the food industry promoting these diets.

Children are a vulnerable target

Children are a naïve and vulnerable audience who do not fully comprehend the purpose of advertising, and whose food preferences are being shaped in a way that has adverse impacts on their health.

The American Academy of Pediatrics Committee on Communications (1995) cites the numerous studies documenting that children under the age of 8 years are not able to discern the persuasive intent of ads. They state “The American Academy of Pediatrics believes advertising directed toward children is inherently deceptive and exploits children under 8 years of age.” (AAP 1995)

Advertising increases children's requests for advertised products and this undermines parents' attempts to provide a healthy diet for their children. “A key aim of marketing aimed at children is to get children to nag their parents to purchase certain foods. Marketers call this ‘pester power' or ‘the nag factor' “ (CSPI 2003). Even though parents may be concerned about the low nutritional value of the food their children are asking for, marketers count on the fact that children can wear their parents down if they nag enough.

In November 2002, Adbrief , a newsletter of the advertising industry commented on Coalition on Food Advertising to Children (CFAC)'s call for a complete ban on food advertising to children, drawing parallels with the cigarette advertising debate in the 1970s. They posed the rhetorical question, whether at future conferences “ they will they include replays of McDonald's happy meal ads to the stunned astonishment of the assembled creatives? Will they mutter ‘did we really make ads like that for kids?' ”( Adbrief 2002)

Link between television viewing and childhood obesity

Susan Linn (2004) in her book Consuming Kids lists these disturbing research findings which link television viewing and childhood obesity:

• The incidence of obesity is highest among children who watch four or more hours of television a day and lowest among children watching an hour or less a day (Crespo C et al, 2001)
• Preschoolers who have televisions in their rooms are more likely to have weight problems than those who don't (Dennison BA, Erb TA and Jenkins PL 2002)
• More than 60 percent of the incidence of being overweight in children aged ten to fifteen may be due to excessive television viewing (Gortmacher SL et al. 1996)
• Among teenagers, the incidence of obesity increases by 2 percent for every additional hour of television watched (Dietz WH, 1990)
• For many children, reducing television viewing reduces weight. (Robinson TN, 1999)

Link between television food advertising and childhood obesity

For some time, the marketing industry have been well aware of the effectiveness of advertising directed at children. Scientific studies in the public realm are now confirming the link between television food advertising and childhood obesity. Many reputable sources have now reviewed the evidence and formed conclusions such as:

Hastings G, et al (2003) reporting for the UK Food Standards Agency

Reviewed more than 50 studies and concluded: “Food promotion is having an effect, particularly on children's food preferences, purchase behaviour and consumption. This effect is independent of other factors and operates at both a brand and category level.”

American Psychological Association (APA) (2004)

“…commercials for candy, snacks, and fast food are mainstays of the advertising targeting children. It is well documented that such ads are typically effective in persuading children to like and request the product”

Kaiser Family Foundation (2004)

Reviewed more than 40 studies. Contrary to common assumptions, most research reviewed for the Kaiser report did not find that children's media use displaces more vigorous physical activities.

“…there may be other factors that are contributing to weight gain. In particular, children's exposure to billions of dollars worth of food advertising and marketing in the media may be a key mechanism through which media contributes to childhood obesity.”

Major health organisations which find this evidence convincing, are members of CFAC, and as such support a ban on food advertising to children:

• Royal Australasian College of Physicians (RACP) Paediatric Branch
• Royal Australian College of General Practitioners (RACGP)
• Australasian Society for the Study of Obesity (ASSO)
• Cancer Council of Victoria
• Australian Consumers Association
• Public Health Association of Australia
• Nutrition Australia

What can parents and health professionals do about television food advertising?

One solution … reduce commercial TV viewing!

Childhood obesity and overweight is a problem with many causes; no single action will solve the problem.

However, because television food advertising has been shown to be one of the contributory factors, there are at least some steps that parents and concerned professionals can take to make a difference. First and foremost, it is recommended that parents limit children's exposure to commercial TV. There is much attractive content on the ABC TV, and it's free of food commercials. Alternatively build your own library of videos and / or DVDs or borrow them from your local library.

Other media related strategies are to:

• moderate TV viewing overall, or even switch the TV off altogether.
• take the TV out of your child's bedroom.
• from the age of about 7 or 8 years, start talking to children about the purpose of advertising. Teach them to spot the tricks and talk about what the consequences really are of eating the foods that are advertised.
• write to your local MP and tell them that action must be taken to encourage more responsible behaviour on the part of advertising and food companies.
• if you think television food advertising should be banned, join the Friends of CFAC and find out how you can work through them to make a difference.

For more detail about these strategies, see related Fact Sheet, Keep your children out of the firing line: strategies for parents to counter television food advertising .

YMA gratefully acknowledges the sponsorship of the Telstra Foundation which has facilitated the development of the Keep your children out of the firing line Fact Sheet series.

References

The American Academy of Pediatrics (Committee on Communications) (1995) “Children, Adolescents and Advertising” Pediatrics Vol. 95 No. 2 February 1995

American Psychological Association (APA) (2004) Report of the APA Taskforce on Advertising and Children [viewed 24 May 2005 ] http://www.apa.org/releases/childrenads.pdf

Australian Divisions of General Practice (2003) What are we feeding our children: a junk food advertising audit . [viewed 21 March 2005 ] http://www.adgp.com.au/client_images/1743.pdf

Coalition on Food Advertising to Children (CFAC) (2003) Children's Health or Corporate Wealth? The case for banning television food advertising to children (A Briefing Paper) (CFAC: Australia )

Coalition on Food Advertising to Children (CFAC) (2004) TV advertising Promotes JUNK FOOD to Children (CFAC: Australia )

Crespo, CJ et al. (2001) “Television Watching, Energy Intake, and Obesity in US Children: Results from the Third National Health and Nutrition Examination Survey, 1988–1994” Archives of Pediatric and Adolescent Medicine 155 (3) (2001): 360–365

Dennison BA, Erb TA and Jenkins PL (2002) “Television Viewing and Television in Bedroom Associated with Overweight Risk Among Low Income Preschool Children, Pediatrics 109 (2002): 1028–1035

Dibb S, (1996) A spoonful of sugar: television food advertising aimed at children: An international comparative survey (Consumers International: UK )

Dietz WH (1990) “You Are What You Eat—What You Eat Is What You Are” Journal of Adolescent Health Care 11 (1990): 76–81

Food Commission on behalf of The International Association of Consumer Food Organisations (IACFO) (2003). Broadcasting Bad Health. Why food marketing to children needs to be controlled: Report to WHO [viewed 21 March 2005 ] http://www.foodcomm.org.uk

Gortmacher SL et al (1996) “Television Viewing as a Cause of Increasing Obesity Among Children in the United States, 1986–1990 Archives of Pediatric Adolescent Medicine 150 (1996): 356–362

Hancox, R, Milne, B, and Poulton, R (2004) “Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study” Lancet , 17 July 2004 : 364: 257–262

Hastings G, et al (2003) Review of the research on the effect of food promotion to children . (Centre for Social Marketing: Glasgow )

Kaiser Family Foundation (2004) The role of the media in childhood obesity (US: Kaiser Family Foundation)

Kunkel, D (2001) “Children and Television Advertising” in Singer D and Singer J (eds.) (2001) Handbook of Children and the Media ( Thousand Oaks , CA : Sage Publications)

Linn, S (2004) Consuming Kids: the hostile takeover of childhood (US: New Press)

Magarey AM, Daniels LA, and Boulton TJ (2001) “Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against standard international definitions” MJA 2001: 174 (11), p 561–4

Magarey AM, Daniels LA, Boulton TJ and Cocking ton RA (2003) “Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord 2003: 27 (4), p 505–13

Morton H, Stanton R, Zuppa J, Mehta K "Food advertising and broadcasting legislation—a case of system failure?” Nutrition & Dietetics , Vol 62, No 1, March 2005, p26–32

Pestering parents: How food companies market obesity to children . Centre for Science in the Public Interest. Washington . US [viewed 23 March 2005 ] http:// www.cspinet.org/pesteringparents

Rugg-Gunn A (1997), “Nutrition, dietary guidelines and food policy in oral health” in Community Oral Health , Pine CM (ed) (1997) (Reed Educational and Professional Publishing Ltd: Great Britain )

Vaska VL and Volkmer R (2004) “Increasing prevalence of obesity in South Australian four year olds: 1995–2002” Journal of Paediatrics and Child Health , 2004, Vol 40, pages 353–355

Waters LA and Baur LA (2003) “Childhood obesity: modernity's scourge” MJA Vol 178 5 May 2003

World Health Organisation (1997) Global Database on Child Growth and Malnutrition (World Health Organisation: Geneva )