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

• Published in: American journal of preventive medicine Vol. 56; no. 2; pp. e35 - e43
• Main Authors: Emond, Jennifer A., Longacre, Meghan R., Drake, Keith M., Titus, Linda J., Hendricks, Kristy, MacKenzie, Todd, Harris, Jennifer L., Carroll, Jennifer E., Cleveland, Lauren P., Langeloh, Gail, Dalton, Madeline A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-02-2019
• Subjects: Breakfast - psychology; Child Behavior - psychology; Child, Preschool; Dietary Sugars - administration & dosage; Dietary Sugars - economics; Direct-to-Consumer Advertising - statistics & numerical data; Edible Grain - economics; Feeding Behavior - psychology; Female; Follow-Up Studies; Humans; Male; Parents; Prospective Studies; Surveys and Questionnaires - statistics & numerical data; Television - statistics & numerical data
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2018.09.015

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.
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.
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.
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.