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International Journal of Obesity (1998) 22, 206±214 ß 1998 Stockton Press All rights reserved 0307±0565/98 $12.00 Food advertising on British children's television: a content analysis and experimental study with nine-year olds MK Lewis and AJ Hill Division of Psychiatry and Behavioural Sciences, University of Leeds, UK OBJECTIVES: The nature and signi®cance of food advertising during children's television was examined in two studies: a content analysis of advertising (Study 1) and an investigation of the impact of food adverts on the selfperception of overweight children (Study 2). PARTICIPANTS: Study 1 monitored 91 h of children's broadcasting on four terrestrial and satellite stations in the UK. In Study 2, 103 children aged 9.75 y viewed two videotaped cartoons containing either food or non-food product advertisements. MEASURES: Study 1 used a detailed record of advertisement style and content. Study 2 included a self-report measure of current state, and measures of self-esteem, dietary restraint, body weight and height. RESULTS: Half of the 828 adverts were for food products, 60% of which were for breakfast cereals and confectionery/ snacks. Food advertisements used signi®cantly more animation, stories, humour and the promotion of fun/happiness/mood alteration. In Study 2, signi®cant interactions between advertisement type and overweight were observed on ratings of perceived health and appetite for sweets. CONCLUSION: While small changes are apparent, advertisements during children's television are still dominated by those for foods of questionable nutritional value, in a manner designed to engage attention and emotional response. That overweight children appeared more in¯uenced by their personal enhancement message, suggests the value of further work identifying who is most in¯uenced and by what features of advertising. Keywords: Food advertisements; television; children; content analysis; overweight; self-esteem; self-perception Introduction The commercialisation of children's television is one of several concerns raised by child health professionals regarding the impact of television on children's well-being.1,2 Advertising to children is viewed as exploitative, coercive and extremely prevalent, with estimates of American children viewing up to 20 000 advertisements per year. Governmental responses have varied. In Sweden, all advertising to children aged under 12 y is banned and advertising around children's programming prohibited.3 However, in both the UK and USA restrictions on children's advertising are extremely limited, subject to market forces and largely voluntary in nature.4±6 Early analysis of the products advertised to children in the USA revealed that over two thirds were foodrelated.7 Doubts about the nutritional quality of these food products have been a strong mandate for continuing to investigate the content of children's food advertising. Recent data from the USA6,8 and the UK9 Correspondence: Dr Andrew J Hill, Division of Psychiatry and Behavioural Sciences, School of Medicine, University of Leeds, 15 Hyde Terrace, Leeds LS2 9LT, UK. Received 17 July 1997; revised 16 October 1997; accepted 21 October 1997 show that food advertisements made up 56±63% of all commercials during peak children's viewing time. Breakfast cereals, and confectionery and other snack foods, were the two most heavily advertised categories of food. Moreover, 80±100% of these adverts were for foods high in fat, sugar or salt. Fatty and sugary foods, that should make up a minority of our diet, accounted for 44±76% of all food advertisements on children's television. A further reason for this attention lies in the proposal that television contributes to obesity in children and adolescents.10 Analysis of large national samples in the USA showed that during adolescence the prevalence of obesity increased by 2% for each additional hour of television viewed.10 A subsequent analysis of a younger cohort aged 10±15 y, revealed that the adjusted odds of being overweight were 5.3 times greater for those watching more than ®ve hours of television per day compared with those watching for 0±2 hours.11 In addition, the proportion of overweight incidence attributable to excess television viewing was estimated at 64%. Food advertising has long been proposed as a candidate for this association, albeit only one of several possible effects of television viewing on food intake, physical activity and metabolic rate.10,12,13 Not only are foods advertised on television of generally poor nutritional quality, they are more Food advertising on children's TV MK Lewis and AJ Hill likely to be chosen by children,14 requested by children and bought by parents.6,15,16 Their popularity and pester power can be explained at two levels: First, children's advertisements contain formats and use methods designed to appeal to children. Animation, pace, and fantasy are common in food advertisements, as are premium offers (free gifts) and statements about product quality.7 In addition, attention grabbing story themes of violence, con¯ict and achievement are commonplace.17 Second, children, especially younger children, are more vulnerable and have the least cognitive defences against television advertising.6 Below the age of six years, for example, children confuse advertisements with regular programmes and have little understanding of their persuasive intent.18 And even though children become more cynical towards advertising by the age of 8±9 y, they continue to be in¯uenced.19 The resulting conceptualisation of the effects of television advertising is of complex interplay between the way advertisements are constructed and presented, and characteristics of the viewing child.20 22 Apart from age (and inferred cognitive development), gender and regularity of viewing, few other characteristics of children have been used to explore their psychological responses to food advertisements. Several lines of evidence suggest that children's overweight or obesity may in¯uence their responses. First, an emphasis on physical attractiveness is a prominent theme in children's television programmes,23 in television commercials generally24 and even in those advertisements broadcast during Saturday morning cartoons.25 The stereotypes of thinness as attractive and desirable, and fatness as neither, are well established by the age of 9 y.26 Second, exposure to media images depicting a thin ideal body shape results in increased body dissatisfaction in women who are pregnant, dieting, have unhealthy eating attitudes or an eating disorder.27±30 Heavier children are both dissatis®ed with their body weight and shape, and viewers of the same ideal images.31 Third, television advertisements that contain stereotypically thin and attractive women32 or promote dieting and diet products,33 disinhibit dietary restraint and lead to overeating. Dietary restraint is greater in overweight children34 and subject to disinhibition in young adolescent girls.35 Fourth, individuals with moderate to low selfesteem may be more susceptible to interpersonal in¯uence36 and are more likely to subscribe to culturally set ideals.37 Feelings of low self-worth, especially in relation to physical appearance, are found in some, but not all, overweight children and adolescents.38,39 It has been observed that food advertisements use emotional appeals, linking products with concepts such as fun, happiness, health and wellbeing, and so marketing personal enhancement.40,41 The strength and immediacy of emotional appeals, coupled with low body esteem, may make overweight children particularly vulnerable to commercials that promote personal enhancement via the consumption of foods. This vulnerability could be shown as increased body dissatisfaction or increased appetite for these products. The aims of the present study were twofold and investigated in two stages. The ®rst study was a content analysis of food advertising on British children's television. This was designed to permit an extension of the period examined by the National Food Alliance,9 to include monitoring of recently available satellite stations in the UK and to enable comparison with data from the USA. In addition, the style of advertising was investigated, with a focus on the use of appeals in food and child-orientated advertising. The second study was an experimental investigation of the impact of food advertising on the selfperception of overweight children. It was hypothesised that exposure to food advertisements would compromise self-perception in the overweight and increase feelings of body dissatisfaction. STUDY 1 Methods Programme monitoring Children's television was videotaped from four commercial stations broadcasting in the UK. These were Carlton TV, Yorkshire TV (both regional Independent Television Network stations), Nickelodeon and the Cartoon channel (both subscriber-only satellite stations). These recordings were made from Children's ITV (weekday afternoons, normally 15.30±17.10 h), ITV weekend morning programmes (07.00±11.00 h), and weekday afternoons and weekend mornings for both satellite stations. Viewing ®gures con®rmed these times as periods where children comprised a large proportion of the audience (for example, ITV: children aged 4±15 y made up 44% of the total audience of CITV and 51% of the weekend audience). A full week was recorded for each station, with days selected randomly over a two week period. All recording was conducted during January and February, 1996. Advert format and content analysis Past research was used as the basis for the development of categories used to describe and analyse the adverts.4,17,40,41 These categories were piloted and re®ned prior to the study proper. One rater viewed and analysed the advertisements, recording the presence of the following components: 1. Format. Evaluation was made of the advertisement frequency (number of times shown), animation 207 Food advertising on children's TV MK Lewis and AJ Hill 208 (full, partial, none) and pace (duration of advert divided by the number of camera shots). 2. Presenting characters. The presence of main and additional characters was noted. This included whether they were real or animated, human or animal, male or female, and adult or child. 3. Themes. The presence of the following themes was noted: magic, fantasy, violence, humour, story format. 4. Appeals. The presence of the following categories of appeals were recorded: Verbal appeals (a) Assertions: Statements about the potential bene®ts of the product to the user (for example, ``its fun''). (b) Attributed qualities: Statements that represent an opinion about the qualities of the product (for example, ``tastes great''). (c) Product properties: Descriptions of the physical properties of the product which are amenable to demonstration (for example, shape, size, colour, texture). (d) Product composition: Statements about the physical nature of the materials or ingredients. Product appeals (a) Competitive: Presented as better than other brands. (b) Exaggerated/unrealistic: Presented with either exaggerated or unrealistic claims about its use or qualities. (c) Premium offers: Product has associated free gifts or material bene®ts. (d) Value for money: Claims of better product value. Emotional appeals (a) Fun/happiness/mood alterations: Suggests that product consumption will have the immediate effect of enhancing pleasure and enjoyment, by either creating positive feelings or removing negative feelings. (b) Health/nutrition/well-being/beauty: Product usage is associated with an improvement in overall health, well-being or beauty. (c) Action/strength/speed/power: Product consumption will enhance physical performance or energy. (d) Adventure: Product consumption is associated with increased adventure and excitement. (e) Achievement/enablement: Product consumption is linked with being able to obtain a desired goal. (f ) Control of self/environment: The product will assist in achieving control over undesirable aspects of self or the environment. (g) Peer acceptance/superiority: Product consumption is associated with peer acceptance or being better than one's peers. Design and data analysis Reliability of the content analysis was established by three independent raters viewing 10% (21) of all the adverts. Cohen's kappa42 was calculated for the appeal and theme ratings. Only those for humour, assertions, fun/happiness/mood alteration and adventure fell below 0.7, and all achieved a mean kappa or above 0.4, regarded as a minimum acceptable level of reliability.43 A between subject design was used with comparisons of advertisement style and content made between food and non-food advertisements, and for child-orientated products and the rest. Statistical analysis was by Mann-Whitney U test and reported as z scores (correcting for ties). Alpha was set at P < 0.01 to accommodate for the large number of pair-wise comparisons. Results Advertising rates and products A total of 91.33 h of programming during children's peak viewing times was monitored. During this time, 828 advertisements were broadcast: 575 (69.4%) on terrestrial stations and 253 (30.6%) on satellite stations. An average of 16 adverts/h were broadcast on terrestrial stations, but only 5/h on satellite stations. Figure 1 summarises the range of products advertised during children's viewing times, both in the present study and in the NFA studies (averaged over the two monitoring periods in 1994 and 1995). Food was the most heavily advertised product in both studies (49.4 and 62.8%, respectively). The range of products advertised was relatively narrow and three product categories, food, toys and entertainment, accounted for 68 and 76% of all advertisements in these studies. The remaining categories, toiletries, household cleaners, and retail and mail order, are those traditionally targeted at adult women. The types of food product advertised during children's viewing times are summarised in Table 1, which includes data from the NFA studies for comparison over a consecutive three year period. The present study showed that cereals and confectionery/ savoury snacks were the most heavily advertised food categories, amounting to 60% of food advertisements overall. Differences between terrestrial and satellite broadcasting were noted, especially in relation to the proportion of advertisements for cereals and `other foods'. This was the result of the higher relative frequency of advertisements for cereals and confectionery on satellite stations, with one (the Cartoon channel) broadcasting almost exclusively commercials for these products (94% of monitored output). Comparison with the NFA data also revealed changes within the three years of monitoring. In particular, there was an increase in advertisements Food advertising on children's TV MK Lewis and AJ Hill 209 Figure 1 Products advertised during children's viewing times on British television (1994±1996) Table 1 Advertised food products on British children's television Present study (1996) Cereals Confectionery/ savoury snacks Other food Fast food outlets NFA Terrestrial Satellite (Combined) 1995 1994 23.6 29.3 44.6 31.2 (30.1) (29.8) 21.4 39.5 28.5 47.0 40.4 6.7 20.6 3.6 (34.3) (5.8) 30.6 8.5 11.4 13.3 for foods other than cereals and confectionery. This was largely attributable to the increase in adverts for pre-prepared foods, sauces and spreads. These included ready meals, frozen foods, tinned foods, sauces and savoury spreads. This `convenience food' category was not present in the 1994 survey, accounted for 7.8% of adverts in 1995 and 21.2% in 1996 (present study). This increase would appear to coincide with a decrease in advertising for fast food outlets, which fell from 13.3% in 1994, to 5.9% in 1996. and central characters (main and additional), together with the themes of magic and fantasy. Consistent with this, the emotional appeals for child-oriented products were those of fun, action, adventure and achievement. In addition, child-oriented product advertisements were more likely to emphasise the physical properties of the product (shape, size, etc) and to be presented as better than market competitors. Discussion Advertising content The differences in style and content of food and nonfood products advertised during children's viewing times are summarised in Table 2. Food adverts were signi®cantly more likely to use animation, a story format, humour and to contain the emotional appeal of fun/happiness/mood alteration. Advertisements for non-food products contained signi®cantly more claims of value for money. Focusing speci®cally on those products that were child-orientated, the advertisement categories, cereals, confectionery and toys were combined and contrasted with all other advertisements. Table 2 shows marked differences in the style and content of these commercials. Those for child-oriented products were signi®cantly more frequently repeated, used animation, pace Food advertisements continue to be the largest single category of products advertised during British children's television, and are themselves dominated by those for breakfast cereals and confectionery/snack foods. Comparisons with surveys conducted by the National Food Alliance9 revealed some changes in the pattern of advertising between 1994 and 1996. While the rate of advertisements broadcast remained steady (16±17 h on terrestrial television), the advertising of pre-prepared `convenience foods' increased at the expense of advertising for fast food outlets and confectionery/snack foods. One possibility is that these differences were artefacts of seasonal variations in product promotion, the 1994 monitoring taking place during the summer and both 1995 and 1996 earlier in Food advertising on children's TV MK Lewis and AJ Hill 210 Table 2 Style and content differences (z scores and signi®cance) between food and non-food advertisements, and between those for child-oriented products and the rest Food advertisements Format Frequency Animation Pace Main characters Present Animated Child Additional characters Present Animated Child Themes Magic Fantasy Violence Humour Story Verbal appeals Assertions Attributed qualities Product properties Product composition Product appeals Competitive Exaggerated/unrealistic Premium offers Value for money Emotional appeals Fun/happiness/mood Health/well-being Action/strength/speed Adventure Achievement/enablement Control Peer acceptance/superiority Child-orientated products 1.12 2.72* Food > Non-food 0.30 4.23** Child > Rest 3.59** Child > Rest 3.95** Child > Rest 1.32 4.00** Food > Non-food 0.05 2.67* Child > Rest 3.43** Child > Rest 3.78** Child > Rest 1.77 1.01 0.55 2.59* Child > Rest 2.73* Child > Rest 3.78** Child > Rest 1.30 2.28 1.26 6.08** Food > Non-food 4.29** Food > Non-food 4.65** Child > Rest 5.77** Child > Rest 1.25 0.09 0.93 1.26 0.43 1.63 1.31 0.43 0.17 3.41** Child > Rest 0.25 1.94 1.01 0.20 4.51** Food < Non-food 2.81* Child > Rest 1.82 1.51 2.01 2.58* Food > Non-food 1.42 0.59 0.02 0.57 1.01 1.69 7.60** 1.59 3.98** 3.86** 2.63* 2.21 2.00 Child > Rest Child > Rest Child > Rest Child > Rest *P < 0.01. **P < 0.001. the year. However, more likely is a true diversi®cation in product advertising. It is notable that many of the advertisements for pre-prepared meals and sauces were broadcast before or during the tea-time meal, and contained assertions that the food products were easy to prepare, highly palatable to children and enjoyable to eat. Time pressures created by changes in family structure (for example, single parents, absence of additional family support) and working habits (both parents working) are coinciding with children eating at separate times to their parents, and having different preferences and menus.44 The formulation and marketing of convenience foods during children's peak viewing times is therefore understandable. Whether these products meet criteria of nutritional adequacy is another matter. Recent diversi®cation of advertising is also apparent in data from the USA. A comparative analysis by Taras and Gage6 indicates that the category `other foods' (that is, other than cereals, confectionery, etc) rose from 1.2% in 1978, to 9.5% in 1988, and to 21.3% in 1995. From a nutritional perspective they viewed this change as ``irrelevant'' since the proportion of advertised foods that were high in fat, sugar and salt had barely changed since 1978. From a social and skills perspective this change may be revealing. One possibility is that children have the opportunity, using these products, to prepare their own meals, something particularly likely if parents are still at work. But while convenient, this form of meal preparation hardly quali®es as a culinary skill. The very low rate of advertising on the satellite channels monitored was unexpected. Not only were fewer commercials broadcast (5/h), a considerably smaller range of products was represented. Access to satellite broadcasting is a relatively recent event in the UK and, being subscriber-only, still limited in comparison with terrestrial channels, thus attracting fewer advertisers. Satellite broadcasting to children was not monitored in the NFA samples so no comparable British data are available. But ®gures from the USA, where multi-channel access and pay-TV are well established, show high rates of advertising (21/h) that account for 16% of children's total viewing time.6 The investigation of advertisement style and content supported many of the observations in previous research,17,40,41 the statistical analysis con®rming the greater use in food advertising of animation, stories, humour and the promotion of fun/happiness/mood alteration. Animation has been linked to greater atten- Food advertising on children's TV MK Lewis and AJ Hill tion in children.40 Furthermore, a story format makes the advert familiar, easier to follow, more enjoyable (especially if it uses humour), and increases children's emotional response.17 The extent of the differences in commercials aimed primarily at children and those aimed at adults is apparent in the analysis of child-orientated products (Table 2). The latter were signi®cantly more likely to include people (animated or otherwise), pace, animation, magic and fantasy, together with a wide range of emotional appeals. Moreover, these advertisements were shown repeatedly. That the contrast between food and non-food commercials revealed fewer differences in style, is a reminder that food advertisements are not made exclusively for a child audience. Audience composition ®gures for the period of current monitoring showed that more than 50% of those viewing children's television were over 16 y. Indeed, marketing a product while children and parents are watching together may be an excellent way of in¯uencing parental purchasing decisions. A question that remains is whether certain children are more in¯uenced than others by the techniques in child-orientated food commercials. As outlined earlier, Study 2 examined the impact of food advertising on the self-perception of overweight children. in Study 1, and matched (where possible) for duration, characters (adults/children, human/non human), and major themes (for example, magic, fantasy). In addition to the type of product analysed, the other main difference was that the food advertisements used more self-concept appeals. Ratings of current state (``I Feel''). A self-report measure, comprising a series of 12 rating scales, was developed to evaluate self-perception before and after the videotape recordings. Statements represented four domains: body satisfaction (I feel thin, I feel fat, I feel healthy), self-esteem (I feel liked by my friends, I feel good looking, I feel clever), mood (I feel happy, I feel sad, I feel worried) and appetite (I feel like eating a lot, I feel like eating sweets, I feel hungry). Each statement was rated on a nine-point scale that ranged from ``Not at all'' to ``Very very''. A pictorial scale was used, with nine circles of increasing shading representing the degree of agreement. Pilot work showed this to be both understood and well accepted by children of this age. STUDY 2 Other assessments. In addition to measuring the children's body weight and height, they also completed a pictorial scale assessing body shape preferences, the Self-Perception Pro®le for Children,45 and the Dutch Eating Behaviour Questionnaire.46 Details and descriptions of their use can be found in Hill et al34 and Hill and Pallin.47 Methods Procedure Participants One hundred and three children with a mean age of 9.75 y took part in the study. All were in National Curriculum Year 5 and were drawn from two state Junior schools in in the north of England. The majority (82%) were white Caucasians and all children came from a low to middle class social background. These 51 girls and 52 boys represented 90% of the school registers for that school group. Of those who did not take part, all were absent on one or more of the research days, with no cases of refused parental consent. In addition to seeking parental consent, full approval for the study was given by the participating schools. Measures Videotapes. Two 15 min recordings were made on videotapes, each of an episode of a popular children's cartoon (Rugrats) with a segment of advertisements edited in, roughly halfway through. One group of ®ve advertisements were for food products (breakfast cereal, confectionery (3), sauce/savoury spread), the other for non-food products (toiletries, household cleaner, retail and mail order, publishing, pet products). The adverts were selected from those analysed The children were divided into groups of 12±15 and watched the videotapes in a viewing area away from the classroom. Children watched both videotapes on two separate days, 3±7 d apart. The presentation order was counterbalanced and the sessions held at the same time of day on each occasion. The children completed the series of ratings of current state (``I Feel'') immediately before and again after watching the videos. They were told the scales did not represent a test and emphasis was placed on not looking at what others had written. The remaining questionnaires and physical measurements were made during a third session at the end of the study. Design and data analysis In order to examine the effect of the adverts on the self-perception of overweight children a Body Mass Index (BMI, kg/m2) was calculated for each child and used to identify two groups. The top 10% in BMI (the 10 heaviest children) were the overweight group. As a group, their mean BMI was above the 97th percentile by British age-standardised norms.48 A comparison group of normal weight children was formed by taking the quartile (25 children) whose BMI was at or around the median. A repeated measures design was used with participants taking part in both experimental conditions 211 Food advertising on children's TV MK Lewis and AJ Hill 212 (food vs non-food advertisements). Accordingly, the effects of the two videotapes were analysed by ANOVA: the between subjects factor was weight (overweight vs normal weight), and within subjects factors advertisement type (food vs non-food) and time (pre vs post-advert). Results Participant characteristics Table 3 shows that the overweight group of children were both heavier and taller (t(33) 2.31, P < 0.05) than the comparison group. Using BMI as an indicator of their relative overweight, they were 132% heavier than their age-standardised normative weight.48 There were also more boys than girls in the overweight group (7 vs 3; comparison group, 13 vs 12). The other group comparisons showed the overweight children had a stronger preference to be thinner (t(33) 4.09, P < 0.001) and scored signi®cantly lower than the comparison children on satisfaction with physical appearance (t(33) 3.01, P < 0.01). While they also tended to have lower self-esteem and higher dietary restraint, these differences did not reach statistical signi®cance. Advert effects Analysis of the ratings of current state revealed only one main effect of children's weight. Those in the overweight group felt signi®cantly more fat than those in the normal weight group (F1,33) 26.83, Table 3 Mean (s.e.m.) weight, height and scores on the measures of self-perception of the overweight and comparison children Comparison group (n 25) Weight (kg) Height (m) BMI (kg/m2) Body shape preference Dietary restraint Global self-worth Scholastic competence Social acceptance Athletic competence Physical appearance Behavioural conduct *P < 0.05. **P < 0.01. ***P < 0.001. BMI body mass index. 30.7 (2.1) 1.38 (0.01) 16.1 (0.1) 70.04 (0.12) 2.24 (0.13) 3.12 (0.14) 2.85 (0.13) 2.83 (0.15) 2.83 (0.16) 3.20 (0.10) 2.91 (0.13) Overweight group (n 10) 44.0*** (2.1) 1.42* (0.02) 21.6*** (0.4) 71.10*** (0.28) 2.53 (0.29) 2.85 (0.21) 2.68 (0.27) 2.83 (0.29) 2.67 (0.26) 2.62** (0.17) 2.85 (0.24) P < 0.001). There were also both general effects of viewing the videotapes and speci®c effects of the type of advertisement. Signi®cant main effects of time were found on ratings of feeling worried (F(1,33) 4.32, P < 0.05) and feeling sad (F(1,33) 4.83, P < 0.05), with improvements in mood in both cases. Furthermore, children rated themselves as more liked by their friends after the videos (F(1,33) 5.22, P < 0.05), showing that they enjoyed their participation in the study. While there were no main effects of advert type, there were signi®cant interactions on two rating scales, feeling healthy and feeling like eating sweets. In both cases these were three-way interactions between advertisement type, time and weight group. Table 4 shows that the overweight children felt more healthy after watching the food adverts, in contrast with the opposite effect in both the comparison children and their own response to the non-food adverts (three-way interaction: F(1,33) 11.26, P < 0.01). This same interaction was seen in their relative decrease in desire to eat sweets (F(1,33) 5.80, P < 0.05) following the food advertisements. Discussion As hypothesised, the self-perception of overweight children was in¯uenced by viewing food advertisements, and in a different manner to their normal weight peers. And as anticipated, this effect was seen in an interaction between the three experimental variables. However, the small improvement in feeling healthy and decrease in appetite for sweets that occurred in response to the food advertisements was in the opposite direction to that expected. Rather than expressing their vulnerability to food advertising in a negative way, these overweight children, unlike their normal weight peers, appeared to accept and re¯ect the personal enhancement messages that pervaded these commercials. It would not be appropriate to speculate deeply either on the mechanism of these effects, or their likely long-term or behavioural consequence. These were weak and complex effects, resulting from a single exposure to familiar advertising (it was apparent that most of the children had seen many of the adverts many times), and derived from a relatively small sample size. The commercials used as stimuli differed both in the type of product promoted and in their use of emotional appeals (higher in the food adverts), with additional minor differences also likely. Furthermore, an excess of adipose tissue will not in itself produce this outcome. There must be mediating psychological factors. Heavier children have higher body dissatisfaction, frequently lower self-worth, and are more likely to diet, associations that are in¯uenced by gender and age.34,38 Exactly which of these psy- Food advertising on children's TV MK Lewis and AJ Hill Table 4 Mean (s.e.m.) ratings made before and after viewing the food and non-food advertisements Non-food adverts Feel healthy Overweight Comparison Feel like eating sweets Overweight Comparison Feel fat Overweight Comparison Food adverts Pre- Post- Pre- 8.20 (0.39) 7.52 (0.41) 6.70 (0.80) 7.76 (0.38) 5.70 (1.00) 7.48 (0.42) 6.80 A6T6W** (0.80) A6T* 7.24 (0.48) 6.60 (1.07) 7.44 (0.45) 7.00 (1.04) 7.20 (0.47) 7.20 (1.00) 7.20 (0.50) 6.80 A6T6W* (1.13) 7.64 (0.44) 3.60 (0.85) 1.36 (0.14) 3.90 (0.80) 1.32 (0.15) 4.30 (0.87) 1.40 (0.15) 3.50 W*** (0.83) 1.56 (0.23) W main effect of weight group; A6T advertisement by A6T6W advertisement by time by weight group interaction. *P < 0.05. **P < 0.01. ***P < 0.001. chological features affected the present outcome was not possible to determine from our limited sample. There is a clear need to replicate and extend these ®ndings. But the importance of this study lies in the simple demonstration of an interaction between the type of advert shown and some feature of the viewer. Finding that this interplay occurred between overweight viewers of food commercials, in a community sample of children viewing broadcast television, should be an incentive to further this line of investigation. Post- time interaction; of advertised foods,6,8 and epidemiological evidence has con®rmed the association between viewing time and childhood obesity,10,11 we know rather less about who is most in¯uenced and by what features of advertising. It is reasonable to assume that academic and therefore public understanding of this falls far short of that of advertisers themselves. It is important that this imbalance is remedied and that health promotion for all has as high a priority as commercial gain. Acknowledgements Conclusions Food advertising is a small part of the in¯uence of the media on children's lives, not all of which should be regarded as negative. Nonetheless, food advertising is an example of directed and coercive in¯uence that is of little bene®t to its audience. As the AAP Committee on Communication1 concluded, ``advertising food products to children promotes pro®t rather than health.'' This criticism is compounded by poor nutritional quality, advertiser's consistent use of slim participants, the association between television viewing time and obesity, and the con¯ict between television viewing and physical activity. The regular and continued monitoring of advertising output in different countries across available stations is necessary to inform and update recommendations to parents, health bodies, government and the media themselves. The present study is a small contribution to this process. Research in this area needs to progress. 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