Marketing Unhealthy Foods to Children: History
View Latest Version
Please note this is an old version of this entry, which may differ significantly from the current revision.
Subjects: Health Policy & Services
Contributor:
Jessica Packer

HFSS food marketing featuring celebrities or influencers increases children’s food consumption, although this was from a limited number of studies. These findings suggest that limiting exposure of children to HFSS marketing including all celebrity types may have beneficial impacts upon dietary consumption. Further research on the impact of child characteristics such as SES, long-term impacts, and real-world studies would be beneficial to further inform the thinking of policy makers.

  • child and adolescent health
  • food marketing
  • obesity
  • policy research

1. Introduction

Increased exposure to high in fat, sugar, and salt (HFSS) marketing is occurring simultaneously with the global childhood obesity epidemic [1]. The marketing of unhealthy foods is ubiquitous and is particularly impactful for children and young people (the term ‘marketing’ includes both advertising and packaging) [2]. Children are exposed to marketing throughout the food environment, including via television and other broadcast media, in shops and supermarkets, on the street, and, increasingly, online [3]. The majority of food marketing is for HFSS products, some of which is directly targeted at children [4][5]. Evidence suggests that children from ethnic minority and lower socioeconomic groups are disproportionately exposed to, and influenced by, food marketing [6]. Children with higher body weight have also been found to be disproportionately affected by screen advertising for HFSS products [7].
The need for enhanced regulations of commercial marketing is a priority on the global health and policy agenda, as highlighted in a recent WHO–UNICEF–Lancet child health Commission [8]. This follows on from the 2010 WHO recommendations, for policies to limit the effectiveness of HFSS food marketing to children by limiting its exposure and power (the creative content, design, and execution of the marketing message/impacted by techniques used) [9]. In the accompanying WHO implementation guidance, restricting the use of celebrities in HFSS product marketing was used as a specific example of how to reduce the power of marketing [10]. Celebrity endorsements, across a broad array of categories, including HFSS food products, have been shown to increase sales, bring about more positive attitudes to brand and product, and increase purchase intentions [11][12][13][14].
Celebrity endorsements are thought to work through the process of evaluative conditioning, where liking of a stimulus is the result of its pairing with other positive stimuli [15]. This process is mediated by the parasocial relationships children can form with celebrities (one-sided relationships between media users and celebrities), especially through social media interaction [16]. A cross-disciplinary review examining how celebrities influence patients’ health-related behaviors found that they can help distinguish products and elicit herd behavior (economics); transfer positive characteristics to the endorsed products (marketing); activate brain regions associated with trust, creating positive associations and encoding memories (neuroscience); and cause positive reactions (psychology) [17]. This results in the possibility of celebrities having a substantial influence on people’s health-related behaviors.
Current restrictions on the use of celebrities in marketing of HFSS products to children have been identified as an area of concern [18][19][20]. Whilst the UK, Ireland, Chile, Australia, Netherlands, Portugal, Spain, and Brazil restrict the use of celebrities in HFSS advertising to children, loopholes exist in the interpretation of defining celebrities and audience thresholds, and the implementation of regulations [19][21][22][23][24]. In the UK, for example, the use of celebrities ‘popular with children’ is restricted in broadcast and non-broadcast HFSS advertisements targeting pre- and primary school children (under 12 years) but no definition of what constitutes a celebrity ‘popular with children’ is provided [25][26]. Additionally, the regulation of restrictions varies between self-regulated or statutory legislation. Evidence has shown that self-regulation is broadly ineffective at limiting HFSS marketing to children [19][27][28][29]. An example of voluntary and self-regulated restrictions is the Spanish Publicidad, Actividad, Obesidad, Salud (PAOS) Code for food and drinks marketing to children, which prevents the participation, appearance, and exploitation of well-known and famous persons [30]. The scope of restrictions is mainly focused on broadcast marketing, with packaging, sponsorship, cinema, and in-store promotions commonly neglected [18][19]. Restrictions frequently apply only to pre-digital media and need to be updated to react to changes in marketing and media consumption, with digital marketing now accounting for the majority of UK advertising spend [18][31]. Children as young as 3–4 years old are increasingly switching their preference and usage from TV to online (e.g., YouTube), and YouTube is growing as the preferred platform [3]. This has led to a new type of celebrity, the ‘influencer’ (or YouTuber), defined as gaining fame by successfully branding themselves as experts on social media platforms [32], which has been identified as a new marketing source targeting children [33]. Experiments have shown that influencer marketing leads to greater purchase intentions due to participants identifying, relating to and trusting influencers more than other celebrities [32]. Evidence suggests that the integration of ‘real-life’ scenarios into social media marketing (use of advertised product in their daily lives) leads to greater positive brand effects (brand attitude, purchase intention, willingness to pay for a product, and feeling connected to the brand) compared to traditional commercial celebrity-endorsed advertising [34]. Sports celebrities are also of interest in our review, with research showing that their association with high-sugar products can foster beliefs in children that they are healthy and improve sports performance [35].
Content analyses show that food marketing featuring celebrities is particularly prominent for HFSS products [36][37][38][39]. This was consistent across television advertisements in the UK [36] and musician [37], athlete [38], and YouTube influencer endorsements in the US [39]. Celebrities are also used on HFSS product packaging [40]. Analysis of social media advertising exposure in children aged 7–16 years found that during 10 min of social media use, 72% were exposed to food advertising, primarily for HFSS products, of which 17% was embedded in celebrity generated content [41]. Embedded content is not explicitly advertising, adding to the difficulty children already face in recognizing online advertising and impacting their ability to understand the intent of advertising [42][43]. A longitudinal study, looking at the association between self-reported vlog (i.e., video weblogs) viewing and consumption of HFSS beverages or snacks at three time points, found a significant association between exposure and consumption of HFSS beverages 24 months later [44].
Despite the widespread use of celebrities in the marketing of HFSS products and given the evidence of their impact on dietary outcomes, there have been no systematic reviews to date examining their impact on preference, purchasing, and consumption outcomes in children. Reviews have reported that celebrities are a popular marketing tactic for promoting HFSS foods to children but impacts on outcomes have rarely been assessed [45][46]. One review examined the impact of food marketing tactics on children’s attitudes, preferences, and consumption and included the use of endorsers but found only limited evidence relating to advertising with celebrities [47]. Another review found evidence that celebrity endorsements positively impact brand attitudes and purchase intentions but included only one study in adolescents [11]. Due to these gaps in the literature, we undertook a review to better understand how celebrities used in HFSS food marketing (advertising and packaging) impact on children’s food preferences, purchasing behaviors, and consumption. Our secondary aims were to assess the differential impact of the type of celebrity (sports, YouTubers/influencers, or other), child characteristics (age and socio-economic status), format of advertisement (content within advertisements versus on packaging), and length of any effects (short- or long-term).

2. Current Insights

Evidence was found that marketing HFSS products with celebrities’ influences children’s calorie consumption. The meta-analysis showed that HFSS advertisements with a celebrity endorser, compared to a non-food advertisement, resulted in significantly greater calorie intake in children under experimental conditions. There was limited evidence that celebrities impact purchase intentions and mixed evidence that they impact preference outcomes. The findings from our review extend the findings of previous reviews, which have indicated that celebrities are persuasive HFSS marketing tools [11][45][46][47]. Our previous work showed that, following exposure to screen advertising for food, children consumed an additional 57 kcals [7] when compared to non-food advertisement exposure, which is consistent with the finding here of an additional 56.4 kcals. The impacts of advertising may be modest but over time can accrue to have substantial impacts on energy balance, body weight, and associated morbidities [48][49].
There was limited evidence that age did not impact on consumption outcomes but only one study examined the impact of SES and found no evidence. A review recently found that children from ethnic minority and low SES backgrounds are exposed to more HFSS advertising than children from higher SES and non-ethnic minority backgrounds [6]. This emphasizes the need for policy actions that addresses these inequalities.
The data suggest there is potential for population-level interventions, including policy action such as enhanced regulations, to have an impact on HFSS consumption by children, even if effects are modest at an individual level. The use of celebrities in HFSS marketing is often not restricted or subject to weak regulations, and greater policy action has been recommended by WHO. The quantifiable impact of celebrities on children’s dietary outcomes has not been previously evidenced in the literature [18][19]. Our findings suggest that tightening policies regulating HFSS marketing directed at children that contain celebrities may be effective in reducing children’s calorie intake. Celebrity-endorsed HFSS brand advertising is frequently omitted from regulations, due to complexities in identifying advertised products and assessing if restrictions are applicable [50]. An additional concern with using celebrities in HFSS marketing is the knock-on effect of exposure to them in contexts outside of HFSS advertisements. This has been shown to increase consumption of the HFSS food (seeing Gary Lineker in Match of the Day led to children eating more Walkers crisps) [20]. Chile has implemented policies that comprehensively restrict use of celebrities, and these have been shown to be effective at reducing HFSS food marketing to children [19][50][51]. The UK government announced plans to introduce a pre-watershed ban on HFSS advertisements across television and on-demand program services, and a restriction on paid-for less healthy food and drink advertising online, which could be effective at overcoming some gaps and limiting exposure of celebrities in HFSS marketing to children [50][51]. These policies touch on areas where regulations could be strengthened including a standardization of approaches to achieve a consistent definition of celebrities, scope (programs and medias), audience thresholds (approved composition of the audience i.e., proportion of children), and enforcement. In the UK, only celebrities ‘popular with children’ are restricted (but this is not defined), allowing free use of celebrities with general appeal, such as Gary Lineker, and unrestricted endorsement opportunities for influencers [18][19]. Certain regulations (e.g., Ireland, UK, and the EU pledge) only apply if children make up between 20–50% of the viewing audience, but quantifying the audience demographics for broadcast and non-broadcast media is difficult to accurately assess [18]. This is especially true online, where user age restrictions on social media platforms are rarely followed by site users and children often use their parents’ account or devices [3]. Restrictions specific to children’s programs, mean that family programs popular with children and broadcast during peak children viewing times (6–9 p.m. in the UK) are out of scope in many jurisdictions but could be overcome by total bans on HFSS advertising, such as the proposed pre-watershed ban in the UK [3][29].

This entry is adapted from the peer-reviewed paper 10.3390/nu14030434

References

  1. Sahoo, K.; Sahoo, B.; Choudhury, A.K.; Sofi, N.Y.; Kumar, R.; Bhadoria, A.S. Childhood obesity: Causes and consequences. J. Fam. Med. Prim. Care 2015, 4, 187–192.
  2. Lapierre, M.A.; Fleming-Milici, F.; Rozendaal, E.; McAlister, A.R.; Castonguay, J. The Effect of Advertising on Children and Adolescents. Pediatrics 2017, 140, S152.
  3. Ofcom. Children and Parents: Media Use and Attitudes Report 2018. 2019. Available online: https://www.ofcom.org.uk/__data/assets/pdf_file/0024/134907/children-and-parents-media-use-and-attitudes-2018.pdf (accessed on 9 December 2021).
  4. Griffith, R.; O’Connell, M.; Smith, K.; Stroud, R. Children’s Exposure to TV Advertising of Food and Drink; The Institute for Fiscal Studies: London, UK, 2018; Available online: https://www.ifs.org.uk/uploads/publications/bns/BN238.pdf (accessed on 9 December 2021).
  5. Boyland, E.J.; Whalen, R. Food advertising to children and its effects on diet: Review of recent prevalence and impact data. Pediatric Diabetes 2015, 16, 331–337.
  6. Backholer, K.; Gupta, A.; Zorbas, C.; Bennett, R.; Huse, O.; Chung, A.; Isaacs, A.; Golds, G.; Kelly, B.; Peeters, A. Differential exposure to, and potential impact of, unhealthy advertising to children by socio-economic and ethnic groups: A systematic review of the evidence. Obes. Rev. 2020, 22, e13144.
  7. Russell, S.J.; Croker, H.; Viner, R.M. The effect of screen advertising on children’s dietary intake: A systematic review and meta-analysis. Obes. Rev. 2019, 20, 554–568.
  8. Clark, H.; Coll-Seck, A.M.; Banerjee, A.; Peterson, S.; Dalglish, S.L.; Ameratunga, S.; Balabanova, D.; Bhan, M.K.; Bhutta, Z.A.; Borrazzo, J.; et al. A future for the world’s children? A WHO-UNICEF-Lancet Commission. Lancet 2020, 395, 605–658.
  9. WHO. Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children; World Health Organization: Geneva, Switzerland, 2010; Available online: https://apps.who.int/iris/bitstream/handle/10665/44416/9789241500210_eng.pdf (accessed on 9 December 2021).
  10. WHO. A Framework for Implementing the Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children; World Health Organization: Geneva, Switzerland, 2012; Available online: https://www.who.int/dietphysicalactivity/MarketingFramework2012.pdf (accessed on 9 December 2021).
  11. Bergkvist, L.; Zhou, K.Q. Celebrity endorsements: A literature review and research agenda. Int. J. Advert. 2016, 35, 642–663.
  12. Cuomo, M.T.; Foroudi, P.; Tortora, D.; Hussain, S.; Melewar, T.C. Celebrity Endorsement and the Attitude Towards Luxury Brands for Sustainable Consumption. Sustainability 2019, 11, 6791.
  13. Elberse, A.; Verleun, J. The Economic Value of Celebrity Endorsements. J. Advert. Res. 2012, 52, 149.
  14. Knoll, J.; Matthes, J. The effectiveness of celebrity endorsements: A meta-analysis. J. Acad. Mark. Sci. 2017, 45, 55–75.
  15. De Houwer, J.; Thomas, S.; Baeyens, F. Associative learning of likes and dislikes: A review of 25 years of research on human evaluative conditioning. Psychol. Bull. 2001, 127, 853–869.
  16. Aw, E.C.-X.; Labrecque, L.I. Celebrity endorsement in social media contexts: Understanding the role of parasocial interactions and the need to belong. J. Consum. Mark. 2020, 37, 895–908.
  17. Hoffman, S.J.; Tan, C. Biological, psychological and social processes that explain celebrities’ influence on patients’ health-related behaviors. Arch. Public Health 2015, 73, 3.
  18. WHO. Evaluating Implementation of the WHO Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children; World Health Organization: Geneva, Switzerland, 2018; Available online: https://www.euro.who.int/__data/assets/pdf_file/0003/384015/food-marketing-kids-eng.pdf (accessed on 9 December 2021).
  19. Taillie, L.S.; Busey, E.; Stoltze, F.M.; Dillman Carpentier, F.R. Governmental policies to reduce unhealthy food marketing to children. Nutr. Rev. 2019, 77, 787–816.
  20. Boyland, E.J.; Harrold, J.A.; Dovey, T.M.; Allison, M.; Dobson, S.; Jacobs, M.C.; Halford, J.C. Food choice and overconsumption: Effect of a premium sports celebrity endorser. J. Pediatr. 2013, 163, 339–343.
  21. WCRF. Restrict Food Advertising and Other Forms of Commercial Promotion; WCRF: London, UK, 2019; Available online: https://policydatabase.wcrf.org/level_one?page=nourishing-level-one#step2=3 (accessed on 9 December 2021).
  22. Hawkes, C. Marketing Food to Children: Changes in the Global Regulatory Environment 2004–2006; World Health Organization: Geneva, Switzerland, 2007; Available online: https://www.who.int/dietphysicalactivity/regulatory_environment_CHawkes07.pdf (accessed on 9 December 2021).
  23. Australian Communications and Media Authority. Guide to the Children’s Television Standards 2009. Available online: https://www.acma.gov.au/sites/default/files/2019-06/Previous-guide-to-the-Childrens-Television-Standards-2009.pdf (accessed on 9 December 2021).
  24. WHO. Marketing of Foods High in Fat, Salt and Sugar to Children: Update 2012–2013; WHO Regional Office: Copenhagen, Denmark, 2013; Available online: http://www.euro.who.int/__data/assets/pdf_file/0019/191125/e96859.pdf (accessed on 9 December 2021).
  25. Advertising Standards Authority. The BCAP Code—The UK Code of Broadcast Advertising; The Advertising Standards Authority: London, UK, 2018; Available online: https://www.asa.org.uk/static/846f25eb-f474-47c1-ab3ff571e3db5910/BCAP-Code-full.pdf (accessed on 9 December 2021).
  26. Advertising Standards Authority. The CAP Code—The UK Code of Non-Broadcast Advertising and Direct & Promotional Marketing; The Advertising Standards Authority: London, UK, 2018; Available online: https://www.asa.org.uk/static/47eb51e7-028d-4509-ab3c0f4822c9a3c4/bbca4ed3-9b41-4c6b-8d13299664f119be/The-Cap-code.pdf (accessed on 9 December 2021).
  27. Boyland, E.J.; Harris, J.L. Regulation of food marketing to children: Are statutory or industry self-governed systems effective? Public Health Nutr. 2017, 20, 761–764.
  28. Zhou, M.; Rincón-Gallardo Patiño, S.; Hedrick, V.E.; Kraak, V.I. An accountability evaluation for the responsible use of celebrity endorsement by the food and beverage industry to promote healthy food environments for young Americans: A narrative review to inform obesity prevention policy. Obes. Rev. 2020, 21, e13094.
  29. Department of Health and Social Care. Introducing Further Advertising Restrictions on TV and Online for Products High in Fat, Sugar and Salt (HFSS). Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/807378/hfss-advertising-consultation-10-april-2019.pdf (accessed on 9 December 2021).
  30. León-Flández, K.; Rico-Gómez, A.; Moya-Geromin, M.; Romero-Fernández, M.; Bosqued-Estefania, M.J.; Damián, J.; López-Jurado, L.; Royo-Bordonada, M. Evaluation of compliance with the Spanish Code of self-regulation of food and drinks advertising directed at children under the age of 12 years in Spain, 2012. Public Health 2017, 150, 121–129.
  31. House of Lords. UK Advertising in a Digital Age; Authority of the House of Lords: London, UK, 2018; Available online: https://publications.parliament.uk/pa/ld201719/ldselect/ldcomuni/116/116.pdf (accessed on 9 December 2021).
  32. Schouten, A.P.; Janssen, L.; Verspaget, M. Celebrity vs. Influencer endorsements in advertising: The role of identification, credibility, and Product-Endorser fit. Int. J. Advert. 2020, 39, 258–281.
  33. De Veirman, M.; Hudders, L.; Nelson, M.R. What Is Influencer Marketing and How Does It Target Children? A Review and Direction for Future Research. Front. Psychol. 2019, 10, 2685.
  34. Russell, C.A.; Rasolofoarison, D. Uncovering the power of natural endorsements: A comparison with celebrity-endorsed advertising and product placements. Int. J. Advert. 2017, 36, 761–778.
  35. Phillipson, L.J.; Jones, S.C. I eat Milo to make me run faster: How the use of sport in food marketing may influence the food beliefs of young Australians. Proc. Aust. N. Z. Mark. Acad. Conf. 2008, 1–7. Available online: https://ro.uow.edu.au/cgi/viewcontent.cgi?article=3332&context=hbspapers (accessed on 9 December 2021).
  36. Boyland, E.J.; Harrold, J.A.; Kirkham, T.C.; Halford, J.C. Persuasive techniques used in television advertisements to market foods to UK children. Appetite 2012, 58, 658–664.
  37. Bragg, M.A.; Miller, A.N.; Elizee, J.; Dighe, S.; Elbel, B.D. Popular Music Celebrity Endorsements in Food and Nonalcoholic Beverage Marketing. Pediatrics 2016, 138, e20153977.
  38. Bragg, M.A.; Yanamadala, S.; Roberto, C.A.; Harris, J.L.; Brownell, K.D. Athlete endorsements in food marketing. Pediatrics 2013, 132, 805–810.
  39. Alruwaily, A.; Mangold, C.; Greene, T.; Arshonsky, J.; Cassidy, O.; Pomeranz, J.L.; Bragg, M. Child Social Media Influencers and Unhealthy Food Product Placement. Pediatrics 2020, 146, e20194057.
  40. Hebden, L.; King, L.; Kelly, B.; Chapman, K.; Innes-Hughes, C. A menagerie of promotional characters: Promoting food to children through food packaging. J. Nutr. Educ. Behav. 2011, 43, 349–355.
  41. Potvin Kent, M.; Pauzé, E.; Roy, E.A.; de Billy, N.; Czoli, C. Children and adolescents’ exposure to food and beverage marketing in social media apps. Pediatr. Obes. 2019, 14, e12508.
  42. Blades, M.; Oates, C.; Li, S. Children’s recognition of advertisements on television and on Web pages. Appetite 2013, 62, 190–193.
  43. Rozendaal, E.; Buijzen, M.; Valkenburg, P. Comparing Children’s and Adults’ Cognitive Advertising Competences in the Netherlands. J. Child. Media 2010, 4, 77–89.
  44. Smit, C.R.; Buijs, L.; van Woudenberg, T.J.; Bevelander, K.E.; Buijzen, M. The Impact of Social Media Influencers on Children’s Dietary Behaviors. Front. Psychol. 2020, 10, 2975.
  45. Jenkin, G.; Madhvani, N.; Signal, L.; Bowers, S. A systematic review of persuasive marketing techniques to promote food to children on television. Obes. Rev. 2014, 15, 281–293.
  46. Cairns, G.; Angus, K.; Hastings, G.; Caraher, M. Systematic reviews of the evidence on the nature, extent and effects of food marketing to children. A retrospective summary. Appetite 2013, 62, 209–215.
  47. Smith, R.; Kelly, B.; Yeatman, H.; Boyland, E. Food Marketing Influences Children’s Attitudes, Preferences and Consumption: A Systematic Critical Review. Nutrients 2019, 11, 875.
  48. Public Health England. Calorie Reduction: The Scope and Ambition for Action; Public Health England: London, UK, 2018. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/800675/Calories_Evidence_Document.pdf (accessed on 9 December 2021).
  49. Mytton, O.T.; Boyland, E.; Adams, J.; Collins, B.; O’Connell, M.; Russell, S.J.; Smith, K.; Stroud, R.; Viner, R.M.; Cobiac, L.J. The potential health impact of restricting less-healthy food and beverage advertising on UK television between 05.30 and 21.00 hours: A modelling study. PLoS Med. 2020, 17, e1003212.
  50. Department of Health and Social Care. New Advertising Rules to Help Tackle Childhood Obesity. 2021. Available online: https://www.gov.uk/government/news/new-advertising-rules-to-help-tackle-childhood-obesity (accessed on 9 December 2021).
  51. Department of Health and Social Care. Introducing Further Advertising Restrictions on TV and Online for Products High in Fat, Salt and Sugar: Government Response-Consultation Outcome. Available online: https://www.gov.uk/government/consultations/further-advertising-restrictions-for-products-high-in-fat-salt-and-sugar/outcome/introducing-further-advertising-restrictions-on-tv-and-online-for-products-high-in-fat-salt-and-sugar-government-response (accessed on 9 December 2021).
More
© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.
This entry is offline, you can click here to edit this entry!
ScholarVision Creations
Feedback