Food Marketing to Children and Youth Threat or Opportunity? (2006) / Chapter Skim
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5 Influence of Marketing on the Diets and Diet- Related Health of Children and Youth
5 Influence of Marketing on the Diets and Diet- Related Health of Children and Youth
Pages 226-318
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From page 226... ...
Chapter 4 reviews the ways in which young people are targeted for food and beverage marketing of both product categories and new product lines. A substantial proportion of such marketing is for high-calorie and low-nutrient foods and beverages.
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From page 227... ...
As a result, systematic evidence reviews sometimes include far fewer studies than traditional narrative reviews, but they also typically include more than just randomized controlled trials. For example, this review includes not only many controlled experimental studies, but also many observational studies -- both cross-sectional and longitudinal -- on the influence of food and beverage marketing on the diets and diet-related health of children and youth.
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From page 228... ...
The systematic evidence review focused on marketing intended for young people ages 18 years and younger rather than on the parents of these young people. At the same time, research was included when it addressed marketing techniques that could engage either or both 1The problems of causal inference are discussed in the section on Causal Inference Validity below.
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From page 229... ...
Diet - Related Marketing Mediators/Precursors Diet Health Outcomes Food & Beverage Product, Place, Short - Term Consumption, Preferences, Beliefs, Adiposity, Other Price, Promotion Usual Dietary Intake Purchase Requests Moderators Age, SES, Gender, Race/Ethnicity FIGURE 5-1 The five-element causal framework used to organize the systematic evidence review.
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From page 230... ...
Thus, it is important to distinguish studies that considered short-term dietary effects from those that attempted to relate marketing to a more comprehensive measure of diet. Experimental studies tended to focus on shortterm consumption following some controlled exposure; cross-sectional and longitudinal studies employed broader measures of usual dietary intake, though they rarely assessed diet comprehensively.
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From page 231... ...
In this domain, the committee identified age, gender, race/ethnicity, socioeconomic status, as well as whether a young person has the opportunity to make independent food purchases, can understand the persuasive intent of advertising, and has accurate nutritional knowledge as a potential moderator. In general, a moderator is a factor that changes the nature of the causal relationship between two other factors.
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From page 232... ...
The analysis of the evidence presented later in this chapter is organized along these lines: evidence for a causal connection between marketing and mediator/precursor factors first, then evidence for a causal connection between marketing and diet, and finally, evidence for a causal connection between marketing and diet-related health. Identification of Research for the Review Unlike narrative reviews, a systematic evidence review includes explicit criteria for which studies to include and which to exclude.
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For the systematic evidence review, the committee established criteria that included all forms of market
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From page 234... ...
For example, some of the studies specify that a measure of television viewing is meant to reflect absence of physical activity. The committee established criteria by which all such studies could be included in the evidence base.
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From page 235... ...
The criteria for a study to be included in the committee's systematic evidence review were therefore as follows: 1. Only peer-reviewed, published research that included a full description of methods and results or that directed the reader to another publicly available report that provided the full description of methods.
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From page 236... ...
Finding the Research Using the guidelines described above and the many possible variables identified with the initial proposed causal framework, extensive and iterative searches for relevant literature were conducted. Briefly, the quest included an online bibliographic search of several databases, outreach to experts in relevant fields, examining published literature reviews, recourse to committee members' personal and university libraries, and pursuing references cited in articles that were being coded for the systematic evidence review.
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From page 237... ...
In the end, the systematic evidence review included 155 research results from 123 studies. To place this collection of evidence in context, it is helpful to compare this systematic evidence review of the effects of food and beverage marketing on children and youth with the previous most extensive effort.
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From page 238... ...
In these cases, the number of items considered in the data tables will be larger than the total number of results in the systematic evidence review table. Each result in the evidence table was identified by author(s)
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From page 239... ...
During assessment of the evidence from the body of research in the systematic evidence review, the cause and effect variables were placed into a small number of conceptual categories, and these were added into the final evidence table. The kind of research study design was coded.
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From page 240... ...
Measure quality was, therefore, also rated, using the same high, medium, low system used for the two relevance ratings, and it also will be explained below. Causal Inference Validity Rating.
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From page 241... ...
Experimental studies on the influence of food and beverage marketing were rated high on causal inference validity if treatment was assigned randomly, dropout was not a factor, and the measures used were valid. In an observational study, that is, a study in which the treatment, or cause variable, was not assigned but rather just passively observed, an association between a putative cause X and a putative effect Y might be explained in three ways: (1)
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From page 242... ...
Also high in ecological validity are studies in which daily television viewing is measured from the use of viewing diaries or program check-off lists. The measure quality may not be high but the ecological validity is high because everyday behavior over a period of time is being measured.
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From page 243... ...
Later reviews of the evidence table suggested that both the recording and rating functions were executed consistently by all coders. Characteristics and Relevance of Research in the Systematic Evidence Review The systematic evidence review is based on results from published original research about the relationship of commercial food and beverage marketing to diet indirectly through mediators (or precursors)
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28 22 58 6 10 33 Teens (1218) Sample Size 049 8 4 1 5099 10 6 6 100499 24 16 21 500999 1 2 11 1,000 or more 2 8 35 Type of Marketing TV ads: experimental treatment 24 9 0 TV ads: observed in natural setting 0 0 2 TV ads: TV viewing only 15 22 56 TV ads: TV campaign 2 1 0 TV ads: TV viewing and 0 2 16 other media use All other marketing 4 2 0 Type of Outcome Preferences 27 0 0 Purchase requests 14 0 0 Beliefs 13 0 0 Short-term consumption 0 9 0 Usual dietary intake 0 27 0 Adiposity 0 0 73 Other 1 0 2 NOTE: Other types of marketing for precursors of diet were print ads, radio ads, multimedia campaign, and price and promotion.
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From page 245... ...
Across all three relationships, no single publication accounted for more than two results in the evidence table. When analyses delved into possible differences by age or by type of outcome, one publication could contribute more than two data points if it involved more than one age group or type of outcome.
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From page 246... ...
This is true particularly in terms of the ability to determine cause and effect relationships (causal inference validity) and to relate research results to phenomena in everyday life (ecological validity)
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From page 247... ...
The main types of outcomes were food and beverage preferences, purchase requests, and beliefs for the precursors of diet; short-term consumption and usual dietary intake for diet; and adiposity for diet-related health. Overall the research included in the systematic evidence review was of sufficient size, diversity, and quality to support the derivation of several findings about the influence of marketing, specifically television advertising, on the precursors of children's and teens' diet, on their current diet, and on their diet-related health.
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From page 248... ...
. A rather large number of results in the systematic evidence review measured everyday television viewing as a means of assessing exposure to food and beverage advertising on television.
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From page 249... ...
Despite these possibilities, broad-based estimates of time spent watching television function reasonably well to identify an individual's relative exposure to commercial messages, as advertising permeates the large majority of television viewed by most individuals, in particular young people. A second important ramification of having included these studies in the systematic evidence review is that the committee must accept the burden of carefully considering alternative explanations for any association found between television advertising, measured by television viewing, and precursors of diet, diet, or diet-related health.
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From page 250... ...
Overall, the research results included in the systematic evidence review were of sufficient quality, diversity, and scope to support certain findings about the influence of marketing, including the overall finding that food and beverage marketing influences the preferences and purchase requests of children, influences consumption at least in the short term, is a likely contributor to less healthful diets, and may contribute to negative diet-related health outcomes and risks. Presentation of the Systematic Evidence Review Analysis The next three sections review in detail the evidence related to each of the three specific relationships.
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From page 251... ...
All significant results show that more exposure to marketing is associated with greater preference or more purchase requests for what was advertised or more beliefs like that presented via marketing. Virtually all studies in the systematic evidence review focused on marketing of high-calorie and low-nutrient foods and beverages, either due to researcher selection for an experiment or due to the predominant marketing of such products in naturalistic studies.
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From page 252... ...
Preferences 19 8 Purchase requests 13 1 Beliefs 10 3 Intent and credibility of advertising 1 0 * One result in the evidence table could be about more than one age group or type of precursor.
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From page 253... ...
Fourteen of the results examined the effects of food and beverage marketing on young people's purchase requests. Somewhat more than half were cross-sectional designs; the rest were experiments.
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From page 254... ...
Thirteen studies were of high ecological validity, 19 medium, and 13 low. A closer examination of the distribution of significant and nonsignificant results according to the relevance of the research, specifically the ability to make a clear causal inference and the ecological validity, also revealed no difference in relevance between the studies reporting significant results and those reporting nonsignificant results (see Table 5-5)
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From page 255... ...
255 INFLUENCE OF MARKETING ON DIETS AND DIET-RELATED HEALTH TABLE 5-4 Evaluative Characteristics of Research on the Influence of Commercial Marketing on the Precursors, or Mediators, of Young People's Diets Significant Nonsignificant Characteristic Results Results Total Results 35 10 Quality of Measures High 5 0 Medium 21 6 Low 9 4 Causal Inference Validity High 9 2 Medium 15 5 Low 11 3 Ecological Validity High 11 2 Medium 14 5 Low 10 3 TABLE 5-5 Relevance Ratings of Research on the Influence of Commercial Marketing on Precursors, or Mediators, to Young People's Diets Causal Inference Ecological Significant Nonsignificant Validity Validity Results Results Total Results 35 10 High High 0 0 Medium 5 1 Low 4 1 Medium High 4 0 Medium 5 3 Low 6 2 Low High 7 2 Medium 4 1 Low 0 0 Relationships Between Television Advertising and Precursors of Diet Given the descriptive characteristics of research about the relationship of marketing to the precursors of diet, any findings about this relationship must be findings about the relationship of television advertising to food and beverage preferences, purchase requests, and beliefs among children and teens. To create a dataset that only examined these relationships, four
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From page 256... ...
Tables 5-6, 5-7, and 5-8 present the distribution of significant and nonsignificant findings for the relationships of television advertising to food and beverage preferences, purchase requests, and beliefs, respectively. For each outcome, the distribution is examined according to the age of the TABLE 5-7 Distribution of Significant and Nonsignificant Results by Causal Inference Validity for the Relationship of Television Advertising to the Food and Beverage Purchase Requests of Younger Children, Older Children, and Teens Younger Children Older Children Teens (25 years)
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From page 257... ...
(1218 years) Causal Non- Non- NonInference Significant significant Significant significant Significant significant Validity Results Results Results Results Results Results Total Results 4 1 9 2 1 0 High 0 0 1 0 0 0 Medium 4 1 8 1 1 0 Low 0 0 0 1 0 0 participants and the causal inference validity.
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From page 258... ...
The causal inference validity for younger children is high, medium, and low; for older children, medium and low. Among the significant results are studies measuring the immediate influence of television advertising on purchase requests and studies measuring longer term influence, as well as studies indicating that more exposure to advertising is associated with greater influence and that affected purchase requests are for product types as well as specific brands.
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From page 259... ...
The great majority of the results when television viewing was the measure of exposure to television advertising report a positive relationship between viewing and preferences, purchase requests, or beliefs, the same type of relationship found in studies using other more direct (often experimental) but short-term measures of exposure to television advertising.
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From page 260... ...
What would happen if healthier foods and beverages were advertised instead is an open question. Finding: Given the findings from the systematic evidence review of the influence of marketing on the precursors of diet, and given the evidence from content analyses that the preponderance of television food and bever
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From page 261... ...
In the previous section, results in which the outcome variable was a precursor to diet (e.g., food and beverage preferences, food and beverage purchase requests, or food and beverage beliefs) were considered.
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From page 262... ...
7 3 Sample Size 049 4 0 5099 6 0 100499 13 3 500999 1 1 1,000 or more 6 2 Type of Marketing TV ads: experimental treatment 6 3 TV ads: TV viewing only 29 3 TV ads: TV campaign 1 0 TV ads: TV viewing and other 2 0 media use Product placement in film 1 0 Price and promotion 1 0 Type of Diet Outcome Short-term consumption 7 2 Usual dietary intake 23 4 * One result in the evidence table could be about more than one age group or type of diet outcome.
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From page 263... ...
was generally very good. Twenty-four results were of high ecological validity (the bulk of them cross-sectional studies using overall television viewing as the measure of exposure to advertising)
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From page 264... ...
those concerned with the influence on usual dietary intake. TABLE 5-11 Relevance Ratings of Research on the Influence of Television Advertising on Young People's Short-Term Consumption Causal Inference Ecological Significant Nonsignificant Validity Validity Results Results Total Results 6 2 High High 1 0 Medium 4 1 Low 1 0 Medium High 0 0 Medium 0 1 Low 0 0 Low High 0 0 Medium 0 0 Low 0 0
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From page 265... ...
Although 15 of 16 results with low causal inference validity found a significant statistical association between exposure to television advertising and usual dietary intake these results provide little support for interpreting the association as causal. The great bulk of them are from cross-sectional studies in which television viewing and dietary habits are measured by diary or survey, both of which involve measurement difficulties, and in most of these studies little effort TABLE 5-12 Relevance Ratings of Research on the Influence of Television Advertising on Young People's Usual Dietary Intake Causal Inference Ecological Significant Nonsignificant Validity Validity Results Results Total Results 22 4 High High 0 2 Medium 0 0 Low 0 0 Medium High 5 1 Medium 2 0 Low 0 0 Low High 13 1 Medium 1 0 Low 1 0
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From page 266... ...
Finding: There is strong evidence that television advertising influences the short-term consumption of children ages 211 years. There is insufficient TABLE 5-13 Distribution of Significant and Nonsignificant Results by Causal Inference Validity for the Relationship of Television Advertising to the Short-Term Consumption of Younger Children, Older Children, and Teens Younger Children Older Children Teens (25 years)
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From page 267... ...
In contrast, Hitchings and Moynihan (1998) measured the relationship between recall of advertisements for seven targeted food groups and items TABLE 5-14 Distribution of Significant and Nonsignificant Results by Causal Inference Validity for the Relationship of Television Advertising to the Usual Dietary Intake of Younger Children, Older Children, and Teens Where a Direct Measure of Television Advertising Was Included Younger Children Older Children Teens (25 years)
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From page 268... ...
Tables 5-14 and 5-15 present the results on usual dietary intake, broken down by age. Table 5-14 presents the results that involve a direct measure of television advertising, and Table 5-15 presents results in which exposure to advertising was measured solely by overall television viewing.
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From page 269... ...
This study on the effects of price is persuasive and methodologically sound, and rates high on causal inference validity. However, it is the only study in the systematic evidence review that examines the effect of price on diet, and the committee was unwilling to come to any finding based on a single study.
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From page 270... ...
The committee's systematic evidence review found strong evidence that food and beverage marketing does influence the preferences and purchase requests of children. Of 22 results on the effect of marketing on food or beverage preferences, 15 found an effect.
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. In children ages 8 13 years, preference for the taste of carbonated soft drinks was the strongest predictor of carbonated soft drink consumption (both measures selfreported)
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From page 272... ...
Nearly all employed various statistical controls to better elucidate the underlying causal mechanisms accounting for any significant association of television viewing and dietrelated health. After careful consideration, the committee judged that it was reasonable to include these studies in the systematic evidence review for the rela
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From page 273... ...
and employed similar correlational designs had already been included in the systematic evidence review for the relationship of marketing to precursors of diet and for the relationship of marketing to diet. Moreover, television viewing is well related to exposure to food and beverage advertising because, as explicated in Chapter 4, food and beverage marketing messages are common across the television landscape, particularly in programming with the highest concentrations of youth in the audience.
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From page 274... ...
First, because exposure to television advertising is not measured directly, measurement strength will always be rated low or medium, even for exceptionally good measurement of television viewing per se. As a corollary, in the relevance rating system, causal inference validity will always be rated medium or low due to the relatively weak measurement of exposure to advertising, the target causal variable in this systematic evidence review.
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From page 275... ...
For these two characteristics the column totals can be more than the number of results. This body of research almost exclusively provides evidence about the relationship of television advertising exposure to adiposity.
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From page 276... ...
Although marketing is frequently part of all media and technology, only for television is there enough good evidence about the nature and extent of food and beverage marketing to instill confidence that amount of television viewing is a reasonable measure of exposure to advertising for foods and beverages, the majority of which promote high-calorie and low-nutrient products (see Chapter 4)
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From page 277... ...
For this reason, they were included in the systematic evidence review. Table 5-17 presents the evaluative characteristics of the 74 results, and Table 5-18 identifies the relevance of the results to the committee's goals when both causal inference validity and ecological validity are considered TABLE 5-18 Relevance Ratings of Research on the Influence of Commercial Marketing on Young People's Diet-Related Health Causal Inference Ecological Significant Nonsignificant Validity Validity Results Results Total Results 51 23 High High 1 0 Medium 0 0 Low 0 0 Medium High 12 4 Medium 1 1 Low 0 0 Low High 31 15 Medium 5 2 Low 1 1
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From page 278... ...
compared to 22 percent of the nonsignificant results, and for ecological validity, 86 percent of the significant results were rated high compared to 83 percent of the nonsignificant results. This general pattern did not change when causal inference validity and ecological validity were considered together (see Table 5-18)
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From page 279... ...
One causal inference validity rating is high, not medium. Clearly, the descriptive and evaluative characteristics of the evidence base about the relationship between television advertising exposure and adiposity remain nearly the same as for the entire sample.
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From page 280... ...
Whether Advertising Exposure Predicts Adiposity or Vice Versa If the significant association found between advertising exposure and adiposity represents a causal relationship, then the question becomes which influences the other. Because advertising exposure was measured by television viewing, the obtained association could logically be explained as "adiposity influences exposure to television advertising (as measured by television viewing)
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From page 281... ...
Based on the 1 result of the experimental study and the 15 results of the longitudinal studies, it is unlikely that any causal relationship that might be found between advertising exposure, as measured by television viewing, and adiposity would be explained primarily by the fact that heavier young people watch more television. The committee interprets the evidence as ruling out any reverse causation explanation.
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From page 282... ...
The descriptive characteristics of the 12 significant and 5 nonsignificant results are presented in Table 5-20 and the evaluative characteristics are in Table 5-21. Overall, the characteristics are similar to TABLE 5-20 Descriptive Characteristics of Cross-Sectional and Longitudinal Research on the Influence of Exposure to Television Advertising on Young People's Adiposity, for Results with Medium Causal Inference Validity Significant Nonsignificant Characteristic Results Results Total Results*
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From page 283... ...
To pursue further the question of whether television advertising influences adiposity, the variables other than television viewing that were included in the 16 studies (17 results) with medium causal inference validity were identified.
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From page 284... ...
None of the 17 results that tested enough variables to receive a medium causal inference validity rating covered all seven plausible explanations using measures other than television viewing. Not one included direct measures of satiety cues, metabolic rate, consumption depictions, or television advertising.
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From page 285... ...
Existing evidence about the relationship of age, gender, race/ethnicity, and socioeconomic status to television viewing and to adiposity suggests that only some of the four are likely third variables. Nonetheless, they should each be examined in order to see whether the positive association between television viewing and adiposity exists when potential third variable explanations have been taken into account.
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From page 286... ...
(n = 5) Television-Related Nonadvertising Variables Physical activity 3 1 4 2 7 3 Mild or sedentary activity 0 0 3 0 3 0 Other media use 1 0 1 1 2 1 Snacking context 1 0 1 0 2 0 Diet 3 1 4 1 7 2 Third Variables Age 4 2 4 3 8 5 Gender 4*
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From page 287... ...
Cross-Sectional Methods Longitudinal Methods Total for Both Methods Non- Non- Non Significant significant Significant significant Significant significant Results Results Results Results Results Results Variables (n = 4)
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From page 288... ...
For other media use, which could indicate mild or sedentary activity preference, time taken away from physical activity, or exposure to some uncertain amount of food and beverage marketing or consumption depiction, the association between television viewing and adiposity was significant for 67 percent of the results. Overall, then, for the television-related nonadvertising variable interpretations of the television viewing measure that can be assessed, there is some evidence that the positive association between advertising exposure, as measured by television viewing, and adiposity remains when these alternatives are taken into account.
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From page 289... ...
Two other adiposity-related variables were included in enough analyses that it is possible to assess whether the television advertisingadiposity relationship exists when they are taken into account. For parental adiposity, which is known to be associated with child adiposity, the number of significant results for the television viewing measure of advertising exposure is still large compared to the number of nonsignificant results.
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From page 290... ...
In summary, the 17 results from cross-sectional and longitudinal studies with medium causal inference validity provided useful -- but not conclusive -- information about the likelihood that the positive association reflected a causal relationship of exposure to television advertising on adiposity. The majority of studies that provided evidence about plausible alternative explanations of the statistically significant positive association between exposure to television advertising and adiposity did not convincingly demonstrate that this association was explained by these alternative variables and not explained by exposure to television advertising.
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From page 291... ...
It is difficult to measure dietary intake, physical activity, and other factors that are plausible alternative explanations for the connection between television viewing and adiposity, and such measurement is rarely done with high validity, precision, and reliability. Thus, even though the association between exposure to television advertising and adiposity continued to be significant in the majority of studies that statistically adjusted for alternative or third variables, it is still possible that this is due to measurement error and not due to the association reflecting a causal influence of television advertising on adiposity.
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From page 292... ...
Most of the research about television advertising and adiposity has not focused explicitly on exposure to television advertising as the causal variable, but it is amenable to use for the committee's purposes because it measures television viewing, which is well correlated with exposure to television advertising (Chapter 4)
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From page 293... ...
MODERATORS OF MARKETING INFLUENCE The systematic evidence review indicates that television advertising is related to the precursors of diet (e.g., food preferences) , diet, and dietrelated health (particularly adiposity)
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From page 294... ...
Of four studies that tested age as a moderator from younger to older children and that involved experimental use of television advertising or product placement, none found that age was a significant moderator, although all found the advertising and product placement to influence food and beverage choices. Two studies examined diet in relation to amount of television viewing as a measure of advertising exposure, one using teens and one using older children.
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From page 295... ...
. In other words, although there is a consistent relationship indicating that advertising exposure, as measured by amount of television viewing, is associated with adiposity in children, there is no evidence that this relationship is consistently moderated by age.
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From page 296... ...
Older children and adults recognize this concept and often use it to "discount" self-interested claims and appeals included in commercial messages. In contrast, young children do not yet comprehend the persuasive intent of advertising and hence may be more susceptible to its influence.
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From page 297... ...
In summary, children who have developed a mature ability to recognize persuasive intent in advertising recognize the inherent bias, exaggeration, and self-interest of commercial messages, and can apply that knowledge in shaping their reactions to advertising. The ability to recognize persuasive intent in advertising clearly requires the child to take the perspective of another into account.
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From page 298... ...
When amount of television viewing was the measure of advertising exposure in relation to diet, six studies tested gender effects. Two found gender to be not significant as a moderator, two found effects to be larger in boys, and two found effects to be larger in girls.
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From page 299... ...
. With respect to the relationship between amount of television advertising exposure, as measured by overall television viewing, and adiposity, seven studies examined race and ethnicity with two finding nonsignificant moderator effects.
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From page 300... ...
. Two studies examined amount of advertising exposure, with a television viewing measure in relation to diet, with one study of young children finding socioeconomic status to be a nonsignificant moderator (Borzekowski and Poussaint, 1998)
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From page 301... ...
And third, they all agree (ones that address this topic) that children under age 8 years have limited ability to recognize persuasive intent in commercials, leading to the expectation that food advertising to young children may be particularly effective (Hastings et al., 2003; Ofcom, 2004; WHO and FAO, 2003)
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From page 302... ...
There were some differences between the two, in scope, in depth, and in the nature of the evidence base. For example, our committee chose not to undertake a separate systematic evidence review of the nature and extent of food advertising to children, relying instead on the extensive information and consensus from work done elsewhere.
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From page 303... ...
found that an intervention that reduced the amount of television viewing, video watching, and game playing resulted in a significant decrease in obesity, but he also found that, as measured, there was no decrease in high-fat food intake, moderate to vigorous physical activity, consumption of highly advertised foods, or cardio respiratory fitness. Likewise, data on dietary intake trends for children over the past 30 years are inconsistent, yielding different findings from different measures and yielding findings that are often difficult to interpret (see Chapter 2)
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From page 304... ...
Measurement · Improved measurement There should be research focused on understanding, reducing, and quantifying measurement error for dietary intake, physical activity, exposure to marketing, and other factors crucial to this research. Intervention Research · Healthful diet promotion Research should be conducted on intervention strategies promoting healthful diets that incorporate the most effective and powerful techniques employed by food and beverage marketers.
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From page 305... ...
If marketing has an influence, then reducing television viewing should have more of an influence than reducing video game playing or video watching, as the latter involve less marketing and often no marketing of foods and beverages. More research is needed on teasing apart effects from just participating in media and effects from the marketing occurring in that media.
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From page 306... ...
An explicit selection process identified studies to be included in the review. Using a causal framework and a systematic evidence review process, the committee assessed the available evidence on the influence of food and beverage marketing on young people's diets and diet-related health.
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From page 307... ...
The research results included in the systematic evidence review were of sufficient quality, diversity, and scope to support several findings about the influence of marketing. The overall finding from the research was that food and beverage marketing influences the preferences and purchase requests of children, influences consumption at least in the short term, is a likely contributor to less healthful diets, and may contribute to negative diet-related health outcomes and risks.
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From page 308... ...
With respect to the specific influence of food and beverage marketing on young people's diet-related health, a systematic evidence review relied on research investigating the relation between amount of television viewing, among other variables, and diet-related health. Amount of television viewing is highly correlated with amount of exposure to television advertising and is frequently used as a measure of advertising exposure.
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From page 309... ...
1998. Children's television viewing, body fat, and physical fitness.
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From page 310... ...
2003. Impact of television viewing patterns on fruit and vegetable consumption among adoles cents.
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From page 311... ...
Obesity and television viewing in children and adolescents. Pediatrics 75(5)
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From page 312... ...
2003. Parental weight status and girls' television viewing, snacking, and body mass indexes.
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From page 313... ...
2002. Fatness, physical activity, and television viewing in children during the adiposity rebound period: the Iowa Bone Development Study.
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From page 314... ...
2004. Children's food con sumption during television viewing.
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From page 315... ...
1990. A survey of the television viewing habits, food behaviours, and percep tion of food advertisements among south Australian year 8 high school students.
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From page 316... ...
1995. Ethnic and gender differences in the relationships between television viewing and obesity, physical activity, and dietary fat intake.
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From page 317... ...
1986. The relationship of television viewing to physical fitness and obesity.
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From page 318... ...
1992. Television viewing and pediatric hypercholesterolemia.
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