Trends in the Nutritional Content of TV Food Advertisements Seen by Children in the US

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Trends in the Nutritional Content of TV Food Advertisements Seen by Children in the US Lisa M. Powell, PhD, Rebecca M. Schermbeck, MPH, MS, Glen Szczypka BA, Frank J. Chaloupka PhD, and Carol Braunschweig PhD Presented by Lisa M. Powell, PhD CSPI Food Marketing Workgroup April 6 th, 211

Presentation Outline Overview of Advertising Data Nutritional Measures Advertising Content Nutritional Content Policy Implications 2

Overview of Advertising Data Nielsen Media Research Ratings Data

Advertising Data Targeted Ratings Points (TRPs) data on exposure to ads seen on TV obtained from Nielsen Media Research Ratings cover all programming seen by children Ratings points measure the reach and frequency of advertising. For example, a commercial with 8 TRPs for 2-5 year olds per month is estimated to have been seen an average of one time by 8% of children 2-5 over the defined period Ratings by: Year: 23, 25, 27, and 29 Age Groups: 2-5y, 6-11y, and 12-17y Race: All children, separately by white and black. Study does not include separate ratings for Hispanic children nor does it cover Spanish Language TV Food-related advertising categorized as: Cereal, Sweets, Snacks, Beverages, Fast Food Restaurants, Full-service Restaurants, and Other 4

Advertising Content

Number of Food-Related Ads Per Day, By Year and Age Food-Related 23 25 27 29 % Change 23-29 Children Age 2-5 13.3 12.1 11.5 1.9-17.9% Children Age 6-11 13.6 13.5 13.1 12.7-6.9% Adolescents Ages 12-17 13.1 13.4 13.6 14.5 1.4% Food & Bev Products 23 25 27 29 % Change 23-29 Children Age 2-5 1.1 8.7 7.9 6.8-32.5% Children Age 6-11 1.1 9.7 8.9 7.9-21.7% Adolescents Ages 12-17 8.8 8.5 8.2 8.4-4.4% Fast Food 23 25 27 29 % Change 23-29 Children Age 2-5 3.2 3.3 3.6 4.1 28.7% Children Age 6-11 3.5 3.8 4.2 4.8 35.4% Adolescents Ages 12-17 4.4 4.9 5.5 6.1 4.4% 6

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 Children Ages 2-5 Years 2.5 2 1.5 1.5 23 25 27 29 7

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 Children Ages 2-5 Years 2.5 2 1.5 1 Beverage Ads.5 23 25 27 29 8

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 Children Ages 2-5 Years 2.5 2 1.5 1.5 23 25 27 29 Cereal Ads Beverage Ads 9

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 Children Ages 2-5 Years 2.5 2 1.5 1.5 23 25 27 29 Cereal Ads Beverage Ads Snack Ads 1

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 Children Ages 2-5 Years 2.5 2 1.5 1.5 23 25 27 29 Cereal Ads Sweets Ads Beverage Ads Snack Ads 11

Ads Per Day Exposure to Food Advertisements per Day for Children by Year 3 2.5 Children Ages 2-5 Years Fast Food Restaurant Ads 2 1.5 1.5 23 25 27 29 Cereal Ads Sweets Ads Beverage Ads Snack Ads 12

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 2.5 2 1.5 1.5 23 25 27 29 13

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 2.5 2 1.5 1 Beverage Ads.5 23 25 27 29 14

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 2.5 2 Cereal Ads 1.5 1 Beverage Ads.5 23 25 27 29 15

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 2.5 2 Cereal Ads 1.5 1.5 23 25 27 29 Beverage Ads Snack Ads 16

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 2.5 2 1.5 1.5 23 25 27 29 Cereal Ads Sweets Ads Beverage Ads Snack Ads 17

Axis Title Exposure to Food Advertisements per Day for Children by Year 4 Children Ages 6-11 Years 3.5 3 Fast Food Restaurant Ads 2.5 2 1.5 1.5 23 25 27 29 Cereal Ads Sweets Ads Beverage Ads Snack Ads 18

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 19

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 Beverage Ads 2

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 Beverage Ads Cereal Ads 21

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 Beverage Ads Cereal Ads Snack Ads 22

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 Sweets Ads Beverage Ads Cereal Ads Snack Ads 23

Ads Per Day Exposure to Food Advertisements per Day for Adolescents by Year 5 4.5 4 3.5 3 2.5 2 1.5 1.5 Adolescents Ages 12-17 Years 23 25 27 29 Fast Food Restaurant Ads Sweets Ads Beverage Ads Cereal Ads Snack Ads 24

Nutritional Content

Nutritional Content Analysis Food and beverage advertisements were assessed on the basis of: Saturated Fat (% Kcal): High >1% Kcal from saturated fat Sugar (%Kcal): High >25% Kcal from sugar Sodium (mg per 5g portion): High >2mg of sodium per 5g portion Fiber (g per 5g portion): Low <1.15g of fiber per 5g portion Nutritional Content was weighted by the ratings data to provide estimates of exposure to nutritional content 26

Nutritional Content : Mean of Selected Measures All Food Ads Seen by Children and Adolescents % Kcal Saturated Fat % Kcal Sugar Sodium (mg) per 5 g Fiber (g) per 5 g 23 29 23 29 23 29 23 29 Ages 2-5 7.3 6.8 43.4 36.7 193.8 222.1.8 1.4 Ages 6-11 7.3 6.9 44.1 36.7 19.6 222.3.8 1.3 Ages 12-17 7.7 7.9 44.2 34.3 181.1 215.1.8 1.2 27

Percent Food Ads High in Saturated Fat Children Ages 6-11 Years Old 1 8 6 4 2 Cereal Sweets Snacks Beverages Other 23 29 28

Percent Food Ads High in Sugar Children Ages 6-11 Years Old 1 8 6 4 2 Cereal Sweets Snacks Beverages Other 23 29 29

Percent Food Ads High in Sodium Children Ages 6-11 Years Old 1 8 6 4 2 Cereal Sweets Snacks Beverages Other 23 29 3

Percent Food Ads Low in Fiber Children Ages 6-11 Years Old 1 8 6 4 2 Cereal Sweets Snacks Beverages Other 23 29 31

Percent Food Ads High in Saturated Fat, Sugar or Sodium Children Ages 2-5 Years 1 8 6 4 2 All Foods Cereal Sweets Snacks Beverages Other 23 29 32

Percent Food Ads High in Saturated Fat, Sugar or Sodium Children Ages 6-11 Years 1 8 6 4 2 All Foods Cereal Sweets Snacks Beverages Other 23 29 33

Percent Food Ads High in Saturated Fat, Sugar or Sodium Adolescents Ages 12-17 Years 1 8 6 4 2 All Foods Cereal Sweets Snacks Beverages Other 23 29 34

Exposure to Beverage Advertisements, by Type and Year Children Ages 2-5 Years 23 29 % Change 7-9 % Change 3-9 High Sugar Beverage Ads 1.16.52-31.% -55.6% Regular Soft Drinks.28.9 4.5% -67.2% Fruit Drinks.39.19 1.7% -51.9% Bottled Water (Sugar Added).1.6-49.7% 425.8% Drinks - Isotonic.13.5-51.7% -62.7% Other High Sugar Beverage.36.13-62.1% -62.7% Low Sugar Beverage Ads.19.31 19.3% 58.% Diet Soft Drinks.3.3-37.1% 8.1% Fruit Juices (1%).1.11 8.3% 12.7% Bottled Water.2.2 19.4% 15.2% Milk (Unflavored)..3 127.2% 1425.5% Other Low Sugar Beverage.5.11 51.8% 135.9% 35

Exposure to Beverage Advertisements, by Type and Year Children Ages 6-11 Years 23 29 % Change 7-9 % Change 3-9 High Sugar Beverage Ads 1.34.63-28.4% -52.8% Regular Soft Drinks.37.12 3.5% -68.5% Fruit Drinks.42.24 18.9% -43.5% Bottled Water (Sugar Added).1.7-54.4% 369.7% Drinks - Isotonic.15.6-54.% -59.8% Other High Sugar Beverage.38.15-6.3% -61.% Low Sugar Beverage Ads.23.35 27.3% 57.% Diet Soft Drinks.3.4-33.9% 2.8% Fruit Juices (1%).12.12 18.% 4.% Bottled Water.2.2 36.2% 15.7% Milk (Unflavored)..4 161.5% 1318.9% Other Low Sugar Beverage.5.13 59.8% 151.% 36

Exposure to Beverage Advertisements, by Type and Year Adolescents Ages 12-17 Years 23 29 % Change 7-9 % Change 3-9 High Sugar Beverage Ads 1.61.84-23.% -48.% Regular Soft Drinks.67.24 8.2% -63.8% Fruit Drinks.32.18 38.7% -45.3% Bottled Water (Sugar Added).3.9-47.% 242.% Drinks - Isotonic.22.15-35.9% -33.1% Other High Sugar Beverage.36.18-46.5% -5.9% Low Sugar Beverage Ads.33.56 35.5% 66.8% Diet Soft Drinks.6.7-39.8% 24.2% Fruit Juices (1%).16.17 31.% 6.3% Bottled Water.4.3 11.7% -16.1% Milk (Unflavored)..4 65.9% 817.4% Other Low Sugar Beverage.7.24 123.% 234.% 37

Number of Ads Seen and Nutritional Content (%) of Ads for Companies in the CFBAI Children Ages 2-5 Years # of Ads per Day % of Ads High in SFSUSO 23 29 % Change 3-9 23 29 % Change 3-9 Burger King.4.4 6.6% NA NA NA Cadbury.1.1 9.9%.% 17.2% -- Campbell.3.3 4.1% 88.2% 7.7% -19.8% Coca-Cola.2.1-57.1% 93.9% 41.4% -56.% ConAgra.3.3 7.% 63.9% 63.1% -1.2% Dannon.2.2 21.% 1.% 99.9% -.1% General Mills 2.4 2. -16.2% 97.2% 97.4%.2% Hershey.3.2-32.7% 81.5% 1.% 22.7% Kellogg 1.5.7-51.1% 98.8% 89.2% -9.8% Kraft 1.3.6-51.5% 97.7% 94.3% -3.5% Mars.7.2-64.7% 95.5% 75.1% -21.4% McDonalds.8.8 4.% NA NA NA Nestle.4.3-37.% 91.% 72.3% -2.5% Pepsi.6.2-7.9% 91.7% 81.6% -11.% Post.4.2-46.5% 95.2% 96.7% 1.5% Unilever.2.1-66.4% 95.1% 92.2% -3.% 38

Number of Ads Seen and Nutritional Content (%) of Ads for Companies in the CFBAI Children Ages 6-11 Years # of Ads per Day % of Ads High in SFSUSO 23 29 % Change 3-9 23 29 % Change 3-9 Burger King.4.5 24.5% NA NA NA Cadbury.1.1 4.8%.% 24.3% -- Campbell.3.3 17.1% 88.5% 69.6% -21.4% Coca-Cola.2.1-57.3% 94.5% 44.8% -52.6% ConAgra.2.3 22.8% 66.2% 62.8% -5.2% Dannon.2.2 29.2% 1.% 99.9% -.1% General Mills 2.2 2.3 6.4% 96.6% 97.3%.7% Hershey.3.2-18.3% 79.6% 1.% 25.7% Kellogg 1.4.9-37.1% 98.7% 88.7% -1.1% Kraft 1.3.8-41.% 97.5% 94.9% -2.7% Mars.7.3-56.5% 95.3% 74.% -22.3% McDonalds.8 1. 29.7% NA NA NA Nestle.4.3-33.8% 92.6% 73.7% -2.5% Pepsi.6.2-67.6% 9.8% 82.4% -9.3% Post.4.3-33.% 94.7% 96.9% 2.3% Unilever.2.1-57.7% 96.8% 91.7% -5.2% 39

Number of Ads Seen and Nutritional Content (%) of Ads for CFBAI vs. Non CFBAI Companies # of Ads per Day % of Ads High in SFSUSO 23 29 % Change 3-9 23 29 % Change 3-9 CFBAI Companies Food and Beverage Products Subtotal Non CFBAI Companies Food and Beverage Products Subtotal CFBAI Fast Food Companies Subtotal Non CFBAI Fast Food Companies Subtotals CFBAI Companies Food and Beverage Products Subtotal Non CFBAI Companies Food and Beverage Products Subtotal CFBAI Fast Food Companies Subtotal Non CFBAI Fast Food Companies Subtotals Age 2-5 8.7 5.4-37.5% 94.% 88.2% -6.2% 1.4 1.4-1.3% 93.3% 79.% -15.3% 1.2 1.3 4.9% NA NA NA 1.1 1.5 38.8% NA NA NA Age 6-11 8.6 6.4-25.2% 93.6% 88.2% -5.8% 1.6 1.5-2.2% 93.6% 79.4% -15.2% 1.2 1.5 27.9% NA NA NA 1.5 1.9 33.1% NA NA NA 4

Summary: Results of CFBAI Companies General Mills remains the largest advertiser; moderate reduction in ads seen by 2-5y (-16%) and an increase for 6-11y (6%). 97% of ads seen are for unhealthy products. Kellogg and Kraft ads are both down by about 4-5% for children, but about 9/1 ads still seen are for unhealthy products. Coke ads are down substantially (-57%), only company other than Cadbury with less than 5% of ads for unhealthy products. Pepsi ads down substantially (-7%), although 82% remain for unhealthy products. Overall, there were significantly fewer food and beverage product ads seen by children from CFBAI companies (-38%) compared to the 1% reduction in non- CFBAI food companies. But that the vast majority of the CFBAI company ads (88%) seen, in 29, continued to be for products that were high in either saturated fat, sugar or sodium. 41

Summary and Policy Implications

General Summary of Trends in Ad Content Positive reductions in exposure to food and beverage ads from 23-9: -33%, -22% and -4% for 2-5y, 6-11y and 12-17y olds, respectively Cereal: -3% for 2-5y; -11% for 6-11y Sweets: -55% for 2-5y; -44% for 6-11y Snacks: -43% for 2-5y; -32% % for 6-11y Beverages: -43% for 2-5y; -41% for 6-11y But fast food ad exposure up substantially between 23 and 29: +21%, +31% and +37% for 2-5y, 6-11y and 12-17y olds, respectively The vast majority of ads seen in 29 continue to be for products that are either high in saturated fat, sugar, or sodium: 86%, 87% and 81% of ads seen by 2-5y, 6-11y and 12-17y olds, respectively 43

Policy Implications of Trends in Ad Content Children, on average, continue to see more than 1 food-related ads on TV every day (teens see almost 15 ads per day) Children and teens continue to be exposed mainly to food and beverage ads for products that are high in saturated fat, sugar or sodium Study results suggest that industry self-regulation is limited in its effectiveness to substantially improve food-related advertising seen by children on TV Key issues of concern for policymakers regarding CFBAI self-regulation: No uniform nutritional standards No uniform definition of child audiences Does not address reach of ads in non-child programming Does not apply to children age 12 and over 44

Institute for Health Research and Policy, UIC http://www.ihrp.uic.edu ImpacTeen http://www.impacteen.org Bridging the Gap http:// Study funded by The Robert Wood Johnson Foundation Bridging the Gap ImpacTeen Project 45