Children's self-regulation of eating provides no defense against television and online food marketing

Abstract

Exposure to unhealthy food marketing stimulates children's food consumption. A child's responsiveness is influenced by individual factors, resulting in an increased vulnerability to advertising effects among some children. Whether these differential responses may be altered by different parental feeding behaviours is unclear. The purpose of this study was to determine the relationship between parental feeding practices and children's food intake responses to food advertising exposure. A randomised, crossover, counterbalanced, within subject trial was conducted across four, six-day holiday camps in New South Wales, Australia between April 2016 and January 2017 with 160 children (7-12 years, n = 40/camp). Children were randomised to either a multiple media (TV and Internet) or single media (TV) condition and exposed to food (3 days) and non-food (3 days) advertising in an online game and/or a cartoon. Children's food consumption (kilojoules (kJ)) was measured at a snack immediately after advertising exposure and then at lunch later in the day. Parents completed the Child Feeding Questionnaire, and 'restriction' and 'pressure to eat' subscale scores were calculated. While food advertising affected all children in the multiple media condition, there was an increased effect on snack intake among children whose parents reported pressuring them to eat, with children consuming an additional 356 kJ after food advertising compared with non-food advertising. This was 209 kJ more than children whose parents did not pressure them to eat. In the single media condition, only children whose parents reported restrictive feeding practices ate more at lunch on food advertising days than non-food advertising days (240 kJ). These data highlight an increased susceptibility to food advertising among children whose parents report controlling feeding practices.

Maternal attitudes, beliefs and practices related to the feeding and nutritional status of schoolchildren

“…Even though this association was not significant in the multivariate analysis, it echoes findings of previous studies [23,25]. Although well-intentioned, restrictive dietary practices may incur opposite consequences, and are associated with child weight gain, a higher attraction, preference and consumption of restricted foods, and the habit of eating even in the absence of hunger [9][10][11]21,23,26,27]. The use of restriction as a practice of control is usually chronic and continuous, and leads the child to lose the ability to regulate the innate sensations of hunger and satiety, resulting in the increased consumption of restricted foods when they are available [8,25,27].…”

“…On the other hand, pressuring a child to eat can mask their internal signs of hunger and satiety, which leads children to regulate their eating habits through external stimulation, such as predetermined times for meals and fixed size of portions [7,8,11].…”

The effect of screen advertising on children's dietary intake: A systematic review and meta‐analysis

“…Healthy food adverts were not found to increase children's consumption of fruit or vegetables . Parental behaviour, such as perceived encouragement to be thin or controlling feeding practices, was reported to affect susceptibility to the effects of television advertising on dietary intake . Two studies conducted in Georgia and Mexico found no association between television advertising and energy intake …”

The Devil Is in the Detail: Challenging the UK Government’s 2019 Impact Assessment of the Extent of Online Marketing of Unhealthy Foods to Children

“…Childhood obesity has become a global issue in the 21st century, with children worldwide affected by the “double burden” of malnutrition and associated consequences for children’s health and well-being [ 1 , 2 , 3 ]. Marketing for unhealthy, ultra-processed foods and beverages (usually conceptualised as those high in saturated fat, sugar or salt; henceforth, “unhealthy food”) is well evidenced as a factor in children’s food preferences, purchases and eating [ 3 , 4 , 5 , 6 , 7 ]. Marketing exposure prompts the eating of extra items, raising calorie intake that is not compensated for later, and this has a sustained impact over time [ 5 , 6 ].…”