Child-focused advertising restrictions for unhealthy foods & beverages

Child-focused advertising restrictions for unhealthy foods and beverages minimize corporate appeals to children and adolescents who may not be aware of persuasive intent. Restrictions can prohibit unhealthy food and beverage advertising during children’s television programming, incentivize healthy food advertising, or ban product placement of unhealthy foods and beverages in children’s movies (LHC-Rockeymoore 2014). Restrictions can also be implemented through school wellness policies, or be legislated at the local, state, or federal level. In 2017, children viewed on average approximately 10 television ads per day for foods, beverages, and restaurants. Such advertisements were mostly for foods of little or no nutritional value (Rudd-Harris 2019, Rudd-Dembek 2014).

Expected Beneficial Outcomes (Rated)

  • Improved dietary habits

  • Reduced unhealthy food consumption

Other Potential Beneficial Outcomes

  • Reduced obesity rates

Evidence of Effectiveness

There is some evidence that child-focused advertising restrictions for unhealthy foods and beverages improve children’s dietary habits and decrease unhealthy food consumption (Boyland 2012*, NBER-Grossman 2012, IOM-Food marketing 2006*, Veerman 2009, AHA-Mozaffarian 2012). Additional evidence is needed to confirm effects.

Children’s food preferences, choices, and short-term consumption are negatively affected by unhealthy food advertising (Folkvord 2018, Boyland 2016, Sadeghirad 2016*, Boyland 2012*, IOM-Food marketing 2006*), including the use of familiar cartoon media characters (Kraak 2015*, Smits 2015*). In one study, adolescents’ body fat percentage increases with exposure to fast food restaurant advertising on television (NBER-Grossman 2012). For preschool-aged children, exposure to advertising for high-sugar breakfast cereals is associated with increased consumption (Longacre 2017). Another study suggests reduced advertising of unhealthy foods decreases average body mass index (BMI) for 6- to 12-year-olds (Veerman 2009).

Unhealthy food advertising bans that cover an entire area can affect families’ purchasing decisions (Dhar 2011). Removing advertisements of one brand of bubble gum for all age groups is associated with reduced household purchases (Huang 2013b*). Living in a census tract with more outdoor advertisements for food and beverages is associated with greater odds of obesity (Lesser 2013). Some researchers recommend that schools eliminate all food marketing (McKenna 2010), while others recommend marketing only healthy options (McKenna 2010, Dixon 2007*, Story 2008*). School districts appear more likely to restrict advertisements for unhealthy foods if state-level policy guidance is provided (Merlo 2018).

Child development experts suggest social media-based advertising for unhealthy foods may be harder for children and youth to recognize than other types of advertising (Powell 2013b). Successful advertising restrictions may need to include stricter regulations to protect children from new forms of marketing techniques that promote unhealthy foods (Folkvord 2018, Dietz 2013). Studies suggest voluntary regulations adopted by the food and beverage industry do not significantly improve the nutritional quality of foods marketed to children (Kunkel 2015*) or reduce children’s exposure to unhealthy food advertising (Galbraith-Emami 2013). Although many companies restrict marketing to children younger than six, preschool-aged children are still exposed to food-related advertisements during programming for older children (Harris 2018*).

Advertising restrictions may be an opportunity to reduce disparities in food marketing aimed at youth of color (Rudd-Harris 2015). One school district survey suggests that large urban school districts serving mostly minority populations are more likely to restrict advertisements for sugar-sweetened beverages (SSBs) than small or medium-sized, suburban or rural, and majority white districts (Merlo 2016). Reports suggest that black and Hispanic youth are exposed to more advertising for unhealthy foods and beverages than white, non-Hispanic youth; black children on average viewed approximately 16 television ads per day and black teens viewed approximately 17 ads per day, substantially more than white youth (Rudd-Harris 2019, Rudd-Harris 2015). A study of children’s television programming suggests that foods advertised on Spanish-language channels are less healthy than those advertised on English-language channels (Kunkel 2013*). Additionally, there is more child-directed marketing at fast food restaurants located in rural areas than urban areas, in middle-income than high-income areas, and majority black than majority white communities (Ohri-Vachaspati 2015*).

Impact on Disparities

No impact on disparities likely

Implementation Examples

As of 2017, the United States Department of Agriculture (USDA) requires that in-school food and beverage advertisements meet the national Smart Snacks in School nutrition standards (ChangeLab-Food marketing 2017). State legislation also supports school wellness policies and obesity prevention programs, which can include advertising restriction guidelines (NCSL Winterfeld 2014a). Maine, for example, bans advertising of junk food at school (Whatley-Blum 2011). Canada, Norway, Sweden, and the United Kingdom regulate advertising to children and adolescents, especially for unhealthy foods and beverages (WHO-Marketing framework 2012).

In 2013, beverage companies spent $866 million advertising sugar-sweetened beverages to children and teens (Rudd-Harris 2014); from 2013-2017, spending increased from $217 million to $333 million to increase the number of advertisements shown during programs with a high percentage of black youth viewers (Rudd-Harris 2019). In 2009, 48 companies spent $9.65 billion on food advertising, with $1.79 billion directed to children and teens. Overall TV advertising expenditures declined from 2006 to 2009; however, this appears to be partially due to reductions in costs for 30-second TV ads and budget shifts to new media marketing expenditures, which increased by 50 percent (FTC-Food marketing 2012).   

Implementation Resources

ChangeLab-School wellness policies - ChangeLab Solutions. Food & beverage marketing in school wellness policies: Model policy language for limiting unhealthy marketing to students.

ChangeLab-Food marketing 2017 - ChangeLab Solutions. Restricting food and beverage marketing in schools. 2017.

PHLC-Food marketing - Public Health Law Center (PHLC). Food marketing to kids.

AHA-VFHK toolkits - American Heart Association (AHA), Robert Wood Johnson Foundation (RWJF). Voices for healthy kids (VFHK): Toolkits to make the healthy choice the easy choice in the places where children live, learn and play.

LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural Childhood Obesity Prevention Toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation. 2014.

Citations - Evidence

* Journal subscription may be required for access.

Boyland 2012* - Boyland EJ, Halford JCG. Regulation of food advertising to children on television: Is it necessary and does it work? CAB Reviews. 2012;7(65):1–10.

NBER-Grossman 2012 - Grossman M, Tekin E, Wada R. Fast-food restaurant advertising on television and its influence on youth body composition. National Bureau of Economic Research (NBER). 2012: Working Paper 18640.

IOM-Food marketing 2006* - Food and Nutrition Board; Board on Children, Youth and Families. Food marketing to children and youth: Threat or opportunity? (McGinnis JM, Gootman JA, Kraak VI, eds.). Washington, DC: Institute of Medicine (IOM); 2006.

Veerman 2009 - Veerman JL, Van Beeck EF, Barendregt JJ, Mackenbach JP. By how much would limiting TV food advertising reduce childhood obesity? European Journal of Public Health. 2009;19(4):365–9.

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63.

Folkvord 2018 - Folkvord F, van’t Riet, J. The persuasive effect of advergames promoting unhealthy foods among children: A meta-analysis. Appetite. 2018;129(1):245-251.

Boyland 2016 - Boyland EJ, Nolan S, Kelly B, et al. Advertising as a cue to consume: A systematic review and meta-analysis of the effects of acute exposure to unhealthy food and nonalcoholic beverage advertising on intake in children and adults. The American Journal of Clinical Nutrition. 2016;103(2):519-533.

Sadeghirad 2016* - Sadeghirad B, Duhaney T, Motaghipisheh S, et al. Influence of unhealthy food and beverage marketing on children's dietary intake and preference: A systematic review and meta-analysis of randomized trials. Obesity Reviews. 2016;17(10):945-959.

Kraak 2015* - Kraak VI, Story M. Influence of food companies' brand mascots and entertainment companies' cartoon media characters on children's diet and health: A systematic review and research needs. Obesity Reviews. 2015;16(2):107-126.

Smits 2015* - Smits T, Vandebosch H, Neyens E, et al. The persuasiveness of child-targeted endorsement strategies: A systematic review. Annals of the International Communication Association. 2015;39(1):311-337.

Longacre 2017 - Longacre MR, Drake KM, Titus LJ, et al. Child-targeted TV advertising and preschoolers’ consumption of high-sugar breakfast cereals. Appetite. 2017;108:295-302.

Dhar 2011 - Dhar T, Baylis K. Fast-food consumption and the ban on advertising targeting children: The Quebec experience. Journal of Marketing Research. 2011;48(5):799-813.

Huang 2013b* - Huang R, Yang M. Buy what is advertised on television? Evidence from bans on child-directed food advertising. Journal of Public Policy & Marketing. 2013;32(2):207-222.

Lesser 2013 - Lesser LI, Zimmerman FJ, Cohen DA. Outdoor advertising, obesity, and soda consumption: a cross-sectional study. BMC Public Health. 2013;13:20.

McKenna 2010 - McKenna ML. Policy options to support healthy eating in schools. Canadian Journal of Public Health. Revue Canadienne de Santé Publique. 2010;101(8 Suppl 2):S14-7.

Dixon 2007* - Dixon HG, Scully ML, Wakefield MA, White VM, Crawford DA. The effects of television advertisements for junk food versus nutritious food on children’s food attitudes and preferences. Social Science & Medicine. 2007;65(7):1311-23.

Story 2008* - Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health. 2008;29:253-72.

Merlo 2018 - Merlo CL, Michael S, Brener ND, et al. State-level guidance and district-level policies and practices for food marketing in US school districts. Preventing Chronic Disease. 2018;15:E74.

Powell 2013b - Powell LM, Harris JL, Fox T. Food marketing expenditures aimed at youth putting the numbers in context. American Journal of Preventive Medicine. 2013;45(4):453-461.

Dietz 2013 - Dietz W. New strategies to improve food marketing to children. Health Affairs. 2013;32(9):1652-1658.

Kunkel 2015* - Kunkel DL, Castonguay JS, Filer CR. Evaluating industry self-regulation of food marketing to children. American Journal of Preventive Medicine. 2015; 49(2):181-187.

Galbraith-Emami 2013 - Galbraith-Emami S, Lobstein T. The impact of initiatives to limit the advertising of food and beverage products to children: A systematic review. Obesity Reviews. 2013;14(2):960-974.

Harris 2018* - Harris JL, Kalnova, SS. Food and beverage TV advertising to young children: Measuring exposure and potential impact. Appetite. 2018;123:49-55.

Rudd-Harris 2015 - Harris JL, Shehan C, Gross R, et al. Food advertising targeted to Hispanic and Black youth: Contributing to health disparities. Hartford: Rudd Center for Food Policy & Obesity; 2015.

Merlo 2016 - Merlo CL, Michael S, Brener ND, et al. Differences in food and beverage marketing policies and practices in US school districts, by demographic characteristics of school districts, 2012. Preventing Chronic Disease. 2016;13:E169.

Rudd-Harris 2019 - Harris JL, Frazier W, Kumanyika S, et al. Increasing disparities in unhealthy food advertising targeted to Hispanic and Black youth. University of Connecticut Rudd Center For Food Policy And Obesity. 2019.

Kunkel 2013* - Kunkel D, Mastro D, Ortiz M, et al. Food marketing to children on US Spanish-language television. Journal of Health Communication. 2013;18(9):1084-1096.

Ohri-Vachaspati 2015* - Ohri-Vachaspati P, Isgor Z, Rimkus L, et al. Child-directed marketing inside and on the exterior of fast food restaurants. American Journal of Preventive Medicine. 2015;48(1):22-30.

Citations - Implementation Examples

* Journal subscription may be required for access.

ChangeLab-Food marketing 2017 - ChangeLab Solutions. Restricting food and beverage marketing in schools. 2017.

NCSL Winterfeld 2014a - Winterfeld A. State actions to reduce and prevent childhood obesity in schools and communities: Summary and analysis of trends in legislation. National Conference of State Legislators (NCSL); 2014.

Whatley-Blum 2011 - Whatley-Blum JE, Beaudoin CM, O’Brien LM, et al. Impact of Maine’s statewide nutrition policy on high school food environments. Preventing Chronic Disease. 2011;8(1):A19.

WHO-Marketing framework 2012 - World Health Organization (WHO). A framework for implementing the set of recommendations on the marketing of foods and non-alcoholic beverages to children. Geneva, CH: World Health Organization (WHO); 2012.

Rudd-Harris 2014 - Harris JL, Schwartz MB, LoDolce M, et al. Sugary drink FACTS 2014 (Food advertising to children and teens score): Sugary drink marketing to youth: Some progress but much room to improve. Hartford: Rudd Center for Food Policy & Obesity; 2014.

Rudd-Harris 2019 - Harris JL, Frazier W, Kumanyika S, et al. Increasing disparities in unhealthy food advertising targeted to Hispanic and Black youth. University of Connecticut Rudd Center For Food Policy And Obesity. 2019.

FTC-Food marketing 2012 - Federal Trade Commission (FTC). A review of food marketing to children and adolescents. 2012.

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