Beyond-brand effect of television food advertisements on food choice in children: the effects of weight status

Objective: To investigate the effect of television food advertising on children's food intake, specifically whether childhood obesity is related to a greater susceptibility to food promotion. Design: The study was a within-subject, counterbalanced design. The children were tested on two occasions separated by two weeks. One condition involved the children viewing food advertisements followed by a cartoon, in the other condition the children viewed non-food adverts followed by the same cartoon. Following the cartoon, their food intake and choice was assessed in a standard paradigm. Setting: The study was conducted in Liverpool, UK. Subjects: Fifty-nine children (32 male, 27 female) aged 9-11 years were recruited from a UK school to participate in the study. Thirty-three children were normal-weight (NW), 15 overweight (OW) and 11 obese (OB). Results: Exposure to food adverts produced substantial and significant increases in energy intake in all children (P<0.001). The increase in intake was largest in the obese children (P=0.04). All children increased their consumption of high-fat and/or sweet energy-dense snacks in response to the adverts (P<0.001). In the food advert condition, total intake and the intake of these specific snack items correlated with the children's modified age- and gender-specific body mass index score. Conclusions: These data suggest that obese and overweight children and indeed more responsive to food promotion, which specifically stimulates the intake of energy-dense snacks.