Exposure to Child-Directed TV Advertising and Preschoolers' Intake of Advertised Cereals.

Jennifer A Emond, Meghan R Longacre, Keith M Drake, Linda J Titus, Kristy Hendricks, Todd MacKenzie, Jennifer L Harris, Jennifer E Carroll, Lauren P Cleveland, Gail Langeloh, Madeline A Dalton

Journal: American journal of preventive medicine 2020;56(2):e35-e43

PMID: 30573338

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Abstract

INTRODUCTION

Child-directed TV advertising is believed to influence children's diets, yet prospective studies in naturalistic settings are absent. This study examined if child-directed TV advertisement exposure for ten brands of high-sugar breakfast cereals was associated with children's intake of those brands prospectively.

METHODS

Observational study of 624 preschool-age children and their parents conducted in New Hampshire, 2014-2015. Over 1 year, parents completed a baseline and six online follow-up surveys, one every 8 weeks. Children's exposure to high-sugar breakfast cereal TV advertisements was based on the network-specific TV programs children watched in the 7 days prior to each follow-up assessment, and parents reported children's intake of each advertised high-sugar breakfast cereal brand during that same 7-day period. Data were analyzed in 2017-2018.

RESULTS

In the fully adjusted Poisson regression model accounting for repeated measures and brand-specific effects, children with high-sugar breakfast cereal advertisement exposure in the past 7 days (i.e., recent exposure; RR=1.34, 95% CI=1.04, 1.72), at any assessment in the past (RR=1.23, 95% CI=1.06, 1.42), or recent and past exposure (RR=1.37, 95% CI=1.15, 1.63) combined had an increased risk of brand-specific high-sugar breakfast cereal intake. Absolute risk difference of children's high-sugar breakfast cereal intake because of high-sugar breakfast cereal TV advertisement exposure varied by brand.

CONCLUSIONS

This naturalistic study demonstrates that child-directed high-sugar breakfast cereal TV advertising was prospectively associated with brand-specific high-sugar breakfast cereal intake among preschoolers. Findings indicate that child-directed advertising influences begin earlier and last longer than previously demonstrated, highlighting limitations of current industry guidelines regarding the marketing of high-sugar foods to children under age 6 years.

Address: Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. Electronic address: [email protected].; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Greylock McKinnon Associates, Cambridge, Massachusetts.; Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.; Rudd Center for Food Policy and Obesity, University of Connecticut, Storrs, Connecticut.; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard School of Medicine, Boston, Massachusetts.

DOI: 10.1016/j.amepre.2018.09.015

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MeSH Terms: Breakfast, Child Behavior, Child, Preschool, Dietary Sugars, Direct-to-Consumer Advertising, Edible Grain, Feeding Behavior, Female, Follow-Up Studies, Humans, Male, Parents, Prospective Studies, Surveys and Questionnaires, Television