Food Advertising and Marketing Directed at Children and Adolescents in the US
International Journal of Behavioral Nutrition and Physical Activity
Food Advertising and Marketing Directed at Children and Adolescents in the US Mary Story* and Simone French
0 Address: Division of Epidemiology, University of Minnesota , Minneapolis, MN USA
In recent years, the food and beverage industry in the US has viewed children and adolescents as a major market force. As a result, children and adolescents are now the target of intense and specialized food marketing and advertising efforts. Food marketers are interested in youth as consumers because of their spending power, their purchasing influence, and as future adult consumers. Multiple techniques and channels are used to reach youth, beginning when they are toddlers, to foster brand-building and influence food product purchase behavior. These food marketing channels include television advertising, in-school marketing, product placements, kids clubs, the Internet, toys and products with brand logos, and youth-targeted promotions, such as cross-selling and tie-ins. Foods marketed to children are predominantly high in sugar and fat, and as such are inconsistent with national dietary recommendations. The purpose of this article is to examine the food advertising and marketing channels used to target children and adolescents in the US, the impact of food advertising on eating behavior, and current regulation and policies.
Nutrition during childhood and adolescence is essential
for growth and development, health and well-being. [1,2]
Further, eating behaviors established during childhood
track into adulthood and contribute to long-term health
and chronic disease risk. [3,4] Numerous studies have
consistently documented that dietary intake patterns of
American children and adolescents are poor and do not
meet national dietary goals. [5-8] In addition, US food
consumption trend data show a shift over the past few
decades. Children and adolescents are eating more food
away from home, drinking more soft drinks, and snacking
more frequently. [9-11] American children now obtain
over 50% of their calories from fat or added sugar (32%
and 20%, respectively). 
The growing epidemic of childhood overweight and
obesity is a major public health concern. Currently 15% of US
youth are overweight, a prevalence nearly twice as high in
children and three times as high in adolescents compared
to 1980 prevalence rates.  Almost two-thirds (60%) of
overweight children have at least one cardiovascular risk
factor (e.g., hypertension, hyperlipidemia)  and the
prevalence of type 2 diabetes mellitus is increasing in
youth.  These trends may seriously compromise the
future health and productivity of the US population and
add to health care costs.
While multiple factors influence eating behaviors and
food choices of youth, one potent force is food
advertising.  Today's youth live in a media-saturated
environment. Over the past 10 years, US children and adolescents
have increasingly been targeted with intensive and
aggressive forms of food marketing and advertising
practices through a range of channels. [17-22] Marketers are
interested in children and adolescents as consumers
because they spend billions of their own dollars annually,
influence how billions more are spent through household
food purchases, and are future adult consumers. [18,23] It
is estimated that US adolescents spend $140 billion a
year. Children under 12 years of age spend another $25
billion, but may influence another $200 billion of
spending per year. [23,24]
The purpose of this article is to examine the food
advertising and marketing channels used to target US children
and adolescents, the impact of food advertising on eating
behavior of youth, and current regulation and policies.
The emphasis of this article is on food advertising and
marketing practices in the United States.
Advertising is central to the marketing of the US food
supply. Marketing is defined as an activity an organization
engages in to facilitate an exchange between itself and its
customers/clients.  Advertising is one type of
marketing activity.  The US food system is the second largest
advertiser in the American economy (the first being the
automotive industry) and is a leading buyer of television,
newspaper, magazine, billboard, and radio
advertisements.  The reasons that the food advertising market
is so large include the following: 1) food captures 12.5%
of US consumer spending and so there is vigorous
competition, 2) food is a repeat-purchase item and consumers'
views can change quickly, and 3) food is one of the most
highly branded items, which lends itself to major
advertising.  Over 80% of US grocery products are branded.
Advertising expenditures for US food products were $7.3
billion in 1999.  In 1997, the US advertising
expenditures for various foods were: breakfast cereals $792
million; candy and gum $765 million; soft drinks $549
million; and snacks $330 million. Total expenditure for
confectionery and snacks was $1 billion.  In contrast,
during the same year, the US Department of Agriculture
spent $333 million on nutrition education, evaluation,
and demonstrations.  Advertising budgets for specific
brands of foods, beverages, and fast food restaurants are
also revealing (Table 1). It is unclear how much money is
spent on food advertising specifically directed at children
and adolescents, but estimates are available for overall
youth-oriented advertising in the US. It is estimated that
over $1 billion is spent on media advertising to children,
mostly on television.  In addition, over $4.5 billion is
spent on youth-targeted promotions such as premiums,
sampling, coupons, contests, and sweepstakes. About $2
billion is spent on youth-targeted public relations, such as
broadcast and print publicity, event marketing, and
school relations. In addition, roughly $3 billion is spent
on packaging especially designed for children. 
Source: Advertising Age. June 24, 2002.
The heavy marketing directed towards youth, especially
young children, appears to be driven largely by the desire
to develop and build brand awareness/recognition, brand
preference and brand loyalty. Marketers believe that
brand preference begins before purchase behavior does.
 Brand preference in children appears to be related to
two major factors: 1) children's positive experiences with
a brand, and 2) parents liking that brand.  Thus,
marketers are intensifying their efforts to develop brand
relationships with young consumers, beginning when they
are toddlers.  Marketers know that toddlers and
preschool children have considerable purchase influence and
can successfully negotiate purchases through what
marketers term the "nag factor" or "pester power".  A
child's first request for a product occurs at about 24
months of age and 75% of the time this request occurs in
a supermarket. The most requested first in-store request is
breakfast cereal (47%), followed by snacks and beverages
(30%) and toys (21%). Requests are often for the brand
name product.  Isler, et al, examined the location,
types, and frequency of products that children ages 3-11
requested of their mothers over 30 days. Food accounted
for over half (54%) of total requests made by children and
included snack/dessert foods (24%), candy (17%), cereal
(7%), fast foods (4%), and fruit and vegetables (3%). 
Almost two-thirds (65%) of all cereal requests were for
presweetened cereals. Preschool children made more
requests than the older elementary school children.
Parents honored children's requests for food about 50% of
the time, soft drinks (60%), cookies (50%), and candy
(45%).  These findings show that food advertisers
spend large amounts of money targeting children, in an
attempt to build brand loyalty and to persuade them to
desire a particular food product, starting when they are
Central to any discussion on food advertising to children
is the nature of children's comprehension of advertising.
Numerous studies have documented that young children
have little understanding of the persuasive intent of
advertising. [24,31,32] Prior to age 7 or 8 years, children tend
to view advertising as fun, entertaining, and unbiased
information.  An understanding of advertising intent
usually develops by the time most children are 7-8 years
old. Because of their level of cognitive development,
children under 8 years of age are viewed by many child
development researchers as a population vulnerable to
misleading advertising.  The heavy marketing of high
fat, high sugar foods to this age group can be viewed as
exploitative because young children do not understand
that commercials are designed to sell products and they
do not yet possess the cognitive ability to comprehend or
evaluate the advertising. Preteens, from ages 8-10 years,
possess the cognitive ability to process advertisements but
do not necessarily do so.  From early adolescence
(1112 years), children's thinking becomes more
multidimensional, involving abstract as well as concrete thought.
Adolescents still can be persuaded by the emotive
messages of advertising, which play into their developmental
concerns related to appearance, self-identity, belonging,
Food Advertising and Marketing Channels
Multiple channels are used to reach youth to foster
brandbuilding and influence food product purchase behavior.
Youth-oriented marketing channels and techniques
include television advertising, in-school marketing,
product placements, kids clubs, the Internet, toys and products
with brand logos, and youth-targeted promotions, such as
cross-selling and tie-ins. The channels used to market
food and beverages to youth are described below.
The largest single source of media messages about food to
children, especially younger children, is television. Over
75% of US food manufacturers' advertising budgets and
95% of US fast-food restaurant budgets are allocated to
television.  Television viewing starts early, US
children between the ages of 2 and 4 years view 2 hours of
television daily; this increases to over 3.5 hours near the end
of grade school, then drops off to about 2.75 hours in later
adolescence.  US children in low-income families and
minority youth tend to watch more television. [33,34]
Thus they have greater exposure to food ads.
It is estimated that US children may view between 20,000
40,000 commercials each year  and by the time they
graduate from high school may have been exposed to
360,000 television ads.  Food is the most frequently
advertised product category on US children's television
and food ads account for over 50% of all ads targeting
children. [35-38] Children view an average of one food
commercial every five minutes of television viewing time,
and may see as many as three hours of food commercials
each week.  In a descriptive study that examined US
food advertising during 52.5 hours of Saturday morning
children's programming, 564 food advertisements (57%
of all ads) were shown.  On average, 11 of 19
commercials per hour were for food. Of these ads, 246 (44%)
promoted food from the fats and sweets group, such as
candy, soft drinks, chips, cakes, cookies and pastries.
Fastfood restaurant advertising was also prevalent, comprising
11% of total food advertisements. The most frequently
advertised food product was high sugar breakfast cereal.
There were no advertisements for fruits or vegetables.
Several other studies have documented that the foods
promoted on US children's television are predominantly high
in sugar and fat, with almost no references to fruits or
vegetables. [35,37-43] The food advertised on US children's
Cash or credit rebate programs
Advertisements in school publications
Adapted from: US General Accounting Office. Commercial Activities in Schools, 2000.
television programming is inconsistent with healthy
eating recommendations for children.
An international comparative survey of television
advertising aimed at children was recently conducted by
Consumers International, a non-profit organization
consisting of a federation of consumer organizations. 
Television advertisements were monitored during
approximately 20 hours of children's programming in 13
countries during a 3-month period in 1996. The 13 countries
included Australia, Austria, Belgium, Denmark, Finland,
France, Germany, Greece, Netherlands, Norway, Sweden,
United Kingdom and the USA. The findings showed that
Australia, US and UK had the most food advertisements,
between 10 and 12 an hour or about 200 in a 20 hour
period. This was twice as many advertisements as in
Denmark, Germany and France, and between 6 to 10 times
more than in Austria, Belgium and Sweden. The least
Exclusionary contracts or other arrangements between school districts, or
schools and bottlers to sell soft drinks in schools or on school grounds
Contracts or other arrangements between districts or schools and fast
food companies to sell food in schools or on school grounds
Programs that award cash or equipment to schools in proportion to the
value of store receipts or coupons collected by the schools (e.g., cereal box
tops, food product labels)
Short-term sales of candy, pizza, cookie dough, etc. by parents, students,
or both to benefit a specific student population or club
Teaching materials and nutrition education kits from food corporations
that incorporate the sponsor's products or promote the sponsor's brand
Nutrition information produced by trade associations (e.g., dairy, meat,
egg, sugar association)
Pizza Hut's Book-It program, McDonald's McSpellIt Club
Corporate gifts to schools that generate commercial benefits to the donor
amount of food advertising was in Sweden, which had
almost no food advertisements (<1 ad/hour). Food
products comprised the largest category of all advertisements
to children in virtually all countries. In two-thirds of all
countries food advertisements accounted for more than
40% of total advertisements. Confectionery, breakfast
cereals (mainly sweetened), and fast food restaurants
accounted for over half of all food advertisements.
Confectionery was the largest category accounting for nearly a
fifth of all food advertising. A nutritional analysis
conducted for the advertised foods in the UK found that 95%
of the ads were for foods that were high in fat (62%),
sugar (50%) or salt (61%).  The results from this
study indicate that the advertising of high fat/high sugar
foods to children is an international issue.
During the past decade in the US, use of public schools as
advertising and marketing venues has grown. Reasons for
the increase in in-school marketing to children and
adolescents include the desire to increase sales and generate
product loyalty, the ability to reach large numbers of
children and adolescents in a contained setting, and the
financial vulnerability of schools due to chronic funding
shortages. [19,44] In-school commercial activities related
to food and beverages include 1) product sales; 2) direct
advertising; 3) indirect advertising; and 4) market research
with students. [45,46] Examples of these four types of
marketing practices used in schools are shown in Table 2.
In a recent report by the US General Accounting Office
(GAO), food sales were reported to be the most prevalent
form of commercial activity in schools.  Food sales
involved primarily the sale of soft drinks from vending
machines and short-term fundraising sales. The US
national School Health Policies and Programs Study 2000
(SHPPS) found that students could purchase soft drinks,
sports drinks, or fruit drinks that are not 100% juice in a
vending machine, school store, or snack bar in 58% of
elementary schools, 83% of middle schools, and 94% of
high schools.  In a recent survey of 336 secondary
school principals in Minnesota, US, 98% of the school
principals reported that soft drink vending machines were
available to students, and 77% of the schools had a
contract with a soft drink company.  The GAO report
found that the sale of soft drinks by schools or districts
under exclusive contracts is the fastest growing activity of
all product sales.  Nationally in the US, more than
one-third of elementary schools, half of middle/junior
high schools, and almost three-fourths of senior high
schools have a contract that gives a company rights to sell
soft drinks at schools. Most (92%) of these schools receive
a specified percentage of the soft drink sales revenues and
about 40% receive incentives such as cash awards or
donated equipment once revenues total a specified
amount.  The contract terms vary greatly, but many
are highly lucrative. For example, a beverage contract with
one US school district has the potential to generate up to
$1.5 million per year.  Contracts may also specify
advertising of their products. SHPPS found that in 35% of
school districts with soft drink contracts, the company is
allowed to directly advertise in the school buildings; 43%
allow ads to be placed on school grounds, outside of
school buildings, or on playing fields. 
There is also a growing trend of fast food vendors in
schools. About 20% of US high schools offer brand-name
fast foods, such as Pizza Hut, Taco Bell, or Subway. 
The results from the 2000 California High School Fast
Food Survey conducted in 171 US school districts with
345 public high schools found that 24% of districts with
a fast food or beverage contract gave exclusive advertising
promotion rights to that company, including placement
of the company's name and logo on school equipment
and facilities.  Only 13% of the districts did not allow
advertising on campus.
There are many types of direct advertising in schools, such
as soft drink, fast food, or snack food corporate logos on
athletic scoreboards, sponsorship banners in gyms, ads in
school newspapers and yearbooks, free textbook covers
with ads, and screen-saver ads on school computers for
branded foods and beverages. The US GAO report found
that the most visible and prevalent types of direct
advertising in schools were soft drink advertisements and
corporate names and logos on scoreboards.  Recently, food
marketing to youth in schools has become even more
intense, persuasive, and creative. Some schools are now
selling food advertising space on their athletes' warm-up
suits, as well as inside and outside of school buses. A large
multinational food company tested an advertising
campaign in 2001 that paid ten elementary school teachers in
Minneapolis, MN, US to drive cars to school that
advertised Reese's Puffs, a sweetened cereal.  The cars were
wrapped with a vinyl ad and teachers earned a $250
monthly stipend for their efforts as "freelance brand
managers." The campaign was to last from early August
through the first month of classes in September but was
canceled after 3 weeks due to public protest. 
Food advertisements can also be delivered through
inschool media. About 12,000 schools or about 38% of
middle and high schools in the US are connected to
Channel One, the 12-minute current events program that
carries two minutes of commercials including
advertisements for soft drinks and high fat snack foods. 
Schools receive free video equipment in exchange for
mandatory showing of the program in classrooms. Brand
and Greenberg evaluated the effects of Channel One
inschool advertising on high school students' purchasing
attitudes, intentions, and behaviors. About 70% of the 45
food commercials shown on Channel One during one
month were for food products including fast foods, soft
drinks, chips and candy. In schools where Channel One
was viewed, students had more positive attitudes about
the advertised products, and were more likely to report
intentions to purchase these products compared to
students who did not have Channel One in their classrooms.
However, students who watched Channel One did not
report more frequent purchases of the advertised products
compared with students in schools that did not show
Channel One. 
In the last 10 years, US marketing companies have
developed strategies that focus exclusively on schools. For
example, a US marketing company, Cover Concepts,
Example of Web Site Content*
DUBBLE BUBBLE GUM
KENTUCKY FRIED CHICKEN (KFC)
KOOLAID, KRAFT, OSCAR MAYER, POST
Games, toys, tunes, and other downloads are promoted along side their food items.
There is a special Big Kids Club link on the home page where 412 year olds are
encouraged to become club members.
Downloadable Cap'n Crunch commercials, screen savers, desktop wallpaper, and
cursor icons. An ad for free Air Head candy in specially marked boxes of Cap'n
Crunch appears on the corner of most pages of the site.
Animated site includes games (Gum Ball Drop, Pud's Gum Factory, Bubble Breakout)
contests, cartoons, e-cards, and a virtual tour of a bubble gum or gumball factory.
Homepage displays logos of all of this corporation's food products. Each logo links to
individual product's homepage (i.e., Doritos, Cheetos, Cracker Jack, Fritos, etc.)
These websites contain flashing icons and banners, music, games, e-cards, and special
offers featuring the products and/or its characters, (i.e., Chester Cheeto, the hip
animated character that advertises Cheetos).
You Rule School is the kids' link for this site and features the Trix rabbit and the Lucky
Charms leprechaun leading kids through the Homework Free Zone schoolhouse of
games and activities for kids.
Kids' link from Hershey's homepage that welcomes viewers to the "sweetest place on
the web." There are animated games all promoting the company's brands, i.e., Milk
Duds Trivia, Hershey's Syrup Flavor Farm, Twizzlers Slider Puzzle, Hershey's Kisses Way to
Go, and recipes using Hershey's candy.
Many games and activities all featuring elves and the company's food products. Kids
can meet the individual elves and also send an electronic "elfin greeting card" to
friends. Throughout the website, there is e-billboard with ads for Keebler cookies
Homepage includes a link to Save Our Apple Jacks, an interactive page aimed at kids to
tell them that the taste of Apple Jacks will not be changed: "Great news, NO apple
taste" is the slogan. There is also an interactive Frosted Flakes Hockey Game that
kids can play with Tony the Tiger, replete with the sound of a cheering crowd.
Kids' link features photos of the KFC latest "laptop" meal available at KFC and a link
where kids can send an e-card with a photo of a KFC entre.
Site co-sponsored by KoolAid, Kraft Macaroni and Cheese, Oscar Mayer Lunchables,
and Post cereals. Children can look at child-geared food logos in a number of fun
activities. Many games, the pieces of which involve one of the sponsored products.
For example, there is Quest for Cheese (Kraft Mac 'n Cheese), Lunchables Playground
Panic, Honeycomb Craver Course, Fruity Pebbles Bumper Pool. Puzzles and quizzes include
AlphaBits Word Wizard and KoolAid Maze Craze.
Links at the top of the website provide a variety of games: 15 arcade games, 20 sports
games, 8 action "extreme" sports games, 11 card games/puzzles, 3 trivia games, 6
multiplayer sports games, and a list of 5 prizes you could win if you play certain games
that advertise Lifesavers, including the game pieces.
All games actively involve the M&M's characters and promote its candy. Downloads
include M&M desktop wallpaper, icons, sounds, stationery, and autographed pictures.
E-cards of characters can be sent from this site. In the Colorworks section, you can
play a melody on a keyboard of colorful M&M's and order special M&M's color
combinations of your school's colors.
Main page links to Ronald.com with the slogan "You found the Internet's land for fun.
Ronald.com!" There are many games, puzzles, quizzes, and coloring pages all with
Ronald McDonald and other McDonald's characters, as well as the food entres
available at the restaurant.
Games and downloads of desktop wallpaper, screensavers, as well as current ads and
promotions. You can register to receive a regular newsletter and e-mails of the latest
offers or rewards promoted by the company.
Animated links to 17 arcade games, 16 sports games, 6 card games, and 13 puzzles.
Nabisco snacks (i.e., Chips Ahoy and Oreo cookies, Ritz crackers, Cheese Nips, etc.)
are prominently displayed and are animated in every game and puzzle.
Homepage features links to several interactive sites including Family Fun Park which
includes many games, i.e. Create Lunchables: Design your own fun with toppings and
You're Full of Bologna Trivia.
Postopia Party is an animated site including many different games, all featuring or
promoting Post's sweetened cereals, Honeycomb, Pebbles, Alphabits, Golden Crisp,
Oreo O's, Honey Comb.
"Don't let hunger happen to you" is the slogan of this web site. Games (i.e., Hunger
Attack), jokes, videos, and e-cards all feature and promote Snicker bars.
Loud, animated site where viewers can visit Sunny Spots to download commercials or
go to D-Cards to send e-cards to friends.
"Destination Planet Twinkie." The main page has links to Hall of Fame (gives
biographies of hostess characters, including Twinkie the Kid, Happy Ho Ho and King
Ding Dong), E-card Express that lets viewers send birthday or post cards that feature
the Twinkies characters and products.
* The content on the websites changes frequently
tributes textbook covers, lesson plans, posters,
bookmarks, sampling programs, specialty paks, and lunch
menu posters to participating companies. These products
are branded with the company's name or corporate logo
and then distributed free to students and schools. Cover
Concepts' promotional materials state: "Cover Concepts
places your brand directly into the hands of kids and teens
in a clutter-free environment. We work in tandem with
school administrators to distribute free,
advertiser-sponsored materials to over 30 million students grades K-12
in 43,000 authorized schools nationwide, plus
additional reach in daycare centers throughout the country." A
list of advertisers for Cover Concepts includes
McDonalds, Pepsi, Gatorade, Frito Lay, General Mills, Hershey,
Keebler, Kellogg's, M&M's, Mars, Kraft/Nabisco, Wrigley
and State Fair Corn Dogs. 
Indirect advertising includes corporate-sponsored
educational materials and corporate-sponsored incentives and
contests. Many US elementary school programs promote
a reading incentive program that rewards students with a
free pizza for reading a required number of books. When
students reach their reading goal they are given a
certificate for a free pizza.  McDonald's McSpellit Club
rewards perfect scores on spelling tests with coupons for
free hamburgers, cheeseburgers, or Chicken McNuggets.
 Local McDonald's restaurants provide schools with
coupons redeemable for french fries and soft drinks. 
Food industry-sponsored classroom nutrition education
materials are widely available.  Examples include the
Campbell's Prego Thickness Experiment, Domino's Pizza's
Encounter Math: Count on Dominos, and the National
Potato Board Count Your Chips.
Product placement is increasing in popularity and
becoming more acceptable as a standard marketing channel. It
typically involves incorporating brands in movies in
return for money or promotional support. Fees are
variable depending on the relative prominence of the
placement in movies, and are usually around $50,000 to
$100,000.  The product placement may be placed as a
backdrop "prop" or may be an integral part of the script.
Producers contend that product placement makes sets
look more realistic and that brands help define characters
and settings. In addition, product placement can help
offset production costs. Product placement in the movies
first gained attention in 1982 when it was reported that
sales of the peanut butter candy Hershey's Reese's Pieces
increased by 65% within a month due to its placement
within E.T., The Extra Terrestrial.  It is reported that
Play-Doh Little Debbie snack Cake Kitchen
Kit includes Play-Doh, an oven/cookie table, mold trays to make five kinds of snack cakes, creme/chocolate extruder.
Play-Doh Chuck E. Cheese Pizza Playset
Kit includes mold to make pretend Chuck E. Cheese pizzas.
Play-Doh Lunchables Playset
Play-Doh McDonaldland Happy Meal Playshop
Makes a pretend Happy Meal with hamburger, fires, shake and toys. Comes with Happy Meal box.
McDonald's Play Sets (Creative Design)
Easy-Bake Sets (Hasbro)
placement is being used more in radio, music videos,
books, comic strips, plays, and songs  and that
product placement agencies are increasing in number. 
Several corporations have developed branded kids clubs
as a way to communicate with and maintain an ongoing
relationship with children. The name is a misnomer in
that many kids clubs aren't really clubs, but standard
marketing programs with names that imply they are clubs.
 Kids clubs permit mass marketing on a personalized
basis and club members may receive direct mailing such
as membership cards, birthday cards, holiday greetings,
and newsletters. In addition they can participate in
contests, receive coupons and branded items such as posters,
screensavers, and discounts for items with the club's logo.
 Some examples of kids clubs from corporations
include Burger King, Nickelodeon, Fox, Sega, and Disney.
The Burger King Kids Club has more than 5 million
Online media play an increasingly significant role in the
lives of US children and teenagers. US Census data
indicate that between 1998 and 2001 the proportion of US
adolescents (ages 1417 years) using the Internet
increased from 51% to 75% and the proportion of US
children (ages 1013 years) online increased from 39% to
65%.  Families with children represent one of the
fastest growing segments of the population using the Internet.
 US Census data from 2001 indicate that half (51%)
of US children 1013 years old and 61% of those 1417
years old have Internet access at home.
Advertisers and marketers have begun to target the rapidly
growing number of US children online with a variety of
new interactive advertising and marketing techniques.
 The forms of advertising and marketing on the Web
differ significantly from television commercials. Utilizing
the unique features of the Internet, companies can
seamlessly integrate advertising and Web site content. 
Almost all of the major companies that advertise and
market to children have created their own websites,
designed as "branded environments" for children. [56,58]
This electronic advertising "environment" and on-line
infomercials is evident with food companies, which offer
multiple entertaining, animated and interactive areas
developed specifically for preschoolers and children
around their food products. These sites include games,
word-find puzzles, contests, quizzes, riddles, music,
email cards, clips of commercials, sweepstakes,
downloadable recipes, desktop wallpaper and screensavers that
feature their products, and on-line stores that sell licensed
merchandise. Children can also sign up to receive
electronic newsletters with news about products and
promotions. The sites often feature popular product
spokescharacters and animated cartoon characters, such as Tony
the Tiger, Chester Cheetah, Toucan Sam, and Snap!
Crackle! And Pop! The integration of products into games
is commonplace. The company's website is frequently
featured on ads or product packaging. Examples of food
branded environments for children on food company
websites are shown in Table 3.
In addition to food company sites, there are also several
other commercial sites that advertise food products to
children. Internet sites aimed at preschoolers have
proliferated in recent years.  Popular sites include
Disney.com, NickJr.com from cable television network and
Nickelodeon, and FoxKids.com from the Fox Kids cable
channel. All of these websites are supported by
advertising. It is reported that more than two-thirds of all Internet
sites designed for children and adolescents use advertising
as their primary revenue stream.  Content analyses
studies to document television food advertising have not
yet been conducted with the Internet sites oriented to
children. Due to criticisms from consumer advocacy groups,
many children's websites and food company web pages
for children now put "ad bugs" or the word
"advertisement" next to a sponsor's hotlink.  However, these
can be easily missed, especially by young children.
Toys and products with brand logos
There has been a recent trend among food companies to
market toys and products with brand logos to
preschoolers and young children to develop an early and positive
relationship with the child and thereby promote brand
awareness and preference. The food industry has
partnered with toy manufacturers to create toys that advertise
food. General Mills last year partnered with Target stores
to create a line of children's loungewear based on iconic
cereal brands like Trix and Lucky Charms.  The M&M's
candy company offers a catalog of items including toys
and clothing. Examples of toys with brand logos are
shown in Table 4.
Several companies sell counting and reading books for
preschoolers and young children for brand-name foods.
For example, Kellogg's Foot Loops! Counting Fun Book, The
M&M's Brand Counting Book, and the Oreo Cookie Counting
Book. There are numerous math books for children such as
Reese's Math Fun: Addition 1 to 9, Skittles Riddles Math, and
the Hershey's Kisses Addition Book. On the Amazon.com
website there are over 40 children's brand food name
counting and reading books available for purchase (see
Table 5). These books are being promoted as teaching
tools but are clever advertising ploys.
Promotions are a commonly used marketing method for
reaching children and adolescents and include
cross-selling, tie-ins, premiums, and sweepstakes prizes.
Cross-selling and tie-ins combine promotional efforts to sell a
product. In the US, the food industry has forged
promotional links with Hollywood and Network studios,
toy companies, and sports leagues. Burger King has
formed a linkage with Nickelodeon, and McDonald's with
the Fox Kids Network. Burger King has sold chicken
nuggets shaped like Teletubbies.  Disney has launched
cross-selling campaigns and tie-ins worth millions of
dollars to promote its films and characters. In 1996, Disney
signed a ten-year global marketing agreement with
McDonald's.  In 2001, Coca-Cola and Disney
partnered to build Disney character-branded children's
beverages. Kellogg's also has an agreement with Disney to
extend the Disney characters to cereals, Keebler cookies
and Eggo waffles.  McDonald's has formed
partnerships with the National Basketball Association. Pizza Hut,
Taco Bell and Wendy's have linked with the National
Collegiate Athletic Association.
Premiums and sweepstakes prizes have increased recently
 and are often used to appeal to children's and
adolescent's tastes and desires.  Premiums provide
something free with a purchase, whereas sweepstakes and
contests promise opportunities to win free products. 
Fast food restaurants typically use premiums in children's
Hershey's Kisses: Counting Board Book; The Hershey's Kisses Addition Book; The Hershey's Kisses Subtraction Book; The Hershey's Milk Chocolate
Multiplication Book; The Hershey's Milk Chocolate Bar Fractions Book; Hershey Milk Chocolate Weights and Measures
The M&M's Brand Chocolate Candies Counting Board Book; The M&M's Brand Counting Book; More M&M's Brand Chocolate Candies Math; The M&M's
Brand Count to One Hundred Book; The M&M's Brand Color Pattern Book; The M&M's Brand Birthday Book; The M&M's Brand Easter Egg Hunt; The
M&M's All-American Parade Book; The M&M's Halloween Treat Book; The M&M's Brand Valentine Book; The M&M's Thanksgiving Feast; The M&M's
Christmas Gift Book
Kellogg's Froot Loops!
Reese's Pieces Candies
Kellogg's Froot Loops! Counting Fun Book; Kellogg's Froot Loops! Color Fun Book;
Reese's Pieces Peanut Butter: Counting Board Book; Reese's Pieces Math Fun: Addition 1 to 9; Reese's Pieces Count by Fives
The Cheerios Counting Book: 1, 2, 3; The Cheerios Play Book; The Cheerios Animal Play Book; The Cheerios Halloween Play Book: Fill in the Missing
Cheerios; The Cheerios Christmas Play Book
Necco Sweethearts Be My Valentine Book; Have a Heart: Book of Friendship (Necco Sweethearts); Math Magic (Necco Sweethearts); Christmas Buttons
(Necco Candy Button Series); Easter Buttons (Necco Candy Button Series)
Twizzlers: Shapes and Patterns; Twizzlers Percentages Book
Pepperidge Farms Goldfish Crackers
Pepperidge Farm Goldfish Counting Board Book; Pepperidge Farm Goldfish Counting Fun Book; Pepperidge Farm Goldfish Fun Book
Oreos Cookies Counting Book; Skittles Riddles Math; Sun Maid Raisins Play Book
Source: Amazon.com <<http://www.amazon.com/exec/obidos/tg/guides/guide-display 2003>>
meals, giving away simple toys. Sweetened cereals also
commonly give premiums in the form of toys, cards or
games. Premiums can increase short-term sales since
children may desire the item over the food, but they also can
help elevate the image of that brand in children's minds.
 In one study in which preschool and school-age
children and parents were unobtrusively observed while
grocery shopping, almost half of the children who made
cereal purchase requests were influenced by premium
The Influence of Food Advertising on Children's
Food Preferences and Eating Behavior
Of critical importance is whether youth-targeted
marketing and advertising of food products has any impact on
children's food behaviors or body weight. Almost all of
the studies on the impact of food advertising on children's
food preferences and behaviors were conducted in the
mid 1970s and the 1980s. These studies focused on the
relationship between children's exposure to television
advertising and their food preferences, food choices, food
intake or purchase requests. A recent review  on the
effects of television food advertising on preschool and
school-age children's food behavior concluded that: 1)
studies of food preferences using experimental designs
have consistently shown that children exposed to
advertising will choose advertised food products at significantly
higher rates than children who were not exposed; 2)
findings from food purchase request studies based on
surveys, diaries, experimental trials, and direct observation of
mother-child pairs shopping have consistently shown
that children's exposure to food television advertising
increases the number of attempts children make to
influence food purchases their parents buy; 3) purchase
requests for specific brands or categories of food products
also reflect product advertising frequencies; and 4) fewer
studies have been conducted on food advertising effects
on actual food intake, in part due to difficulty in
controlling children's exposure to advertising or to foods
outside experimental settings. 
A variety of study designs have been used to study the
effects of food advertising on children's food behavior
and food preferences but most are field experiments or
survey research/ cross-sectional correlational studies. A
strength of correlational studies is that external validity
can be high given the broad range of potential influences
that can be studied. A major weakness is that causality
cannot be established. Longitudinal studies that
prospectively link exposure to food advertising to children's food
intake or behavior have not been done. There also have
not been any meta-analyses review studies conducted in
which effect-size estimates from multiple studies are
combined. Further, the studies to date have focused almost
exclusively on television food advertising. However,
considering all the evidence to date, the weight of the
scientific studies suggests that television food advertising is
associated with more favorable attitudes, preferences and
behaviors towards the advertised product. [37,66] The
research evidence is strong showing that preschoolers and
grade school children's food preferences and food
purchase requests for high sugar and high fat foods are
influenced by television exposure to food advertising.
[30,37,66-68] Only a few studies have been done on food
advertising and the effects on children's actual food
intake. [69,70] Gorn and Goldberg  conducted a
novel, well-designed experimental field study which
randomly assigned children ages 58 years old attending a
summer camp to one of four conditions to examine
television exposure of snack food commercials to actual food
consumption. Daily for two weeks, children watched 30
minutes of a television cartoon with about 5 minutes of
advertising embedded. The four experimental conditions
differed in the type of food advertising included with the
cartoon: ads for candy and Kool-Aid; ads for fruit and fruit
juice; control (no ads); and public service ad
announcements for healthy foods. Each day after the television
exposure, the children were given a selection of fruits,
juices, candy, or Kool-Aid to choose to eat. Children in the
candy/Kool-Aid commercials condition selected the most
candy/Kool-Aid and the least fruit and juice. For example,
those in the candy commercial condition selected
significantly less fruit (25%) than those in the fruit
commercial condition (45%).
A new WHO/FAO consultation report on diet and
prevention of chronic diseases examined the strength of evidence
linking dietary and lifestyle factors to the risk of
developing obesity.  Diet and lifestyle factors were categorized
based on the strength of scientific evidence according to
four levels of evidence: convincing, probable, possible
and insufficient. The report concluded that while the
evidence that the heavy marketing of fast food outlets and
energy-dense, micronutrient-poor food and beverages to
children causes obesity is equivocal, sufficient indirect
evidence exists to place this practice in the "probable"
category for increasing risk of obesity.  For comparative
purposes, other factors placed in the "probable" category
were: high intake of sugar-sweetened soft drinks and fruit
juices; and adverse socioeconomic conditions (in
developed countries, especially for women). Clearly, additional
research is needed to examine possible links between
exposure to food ads, food consumption patterns and
Regulations on Advertising to Children
It is evident that food advertising targeting children is
well-funded and saturates their environment from
multiple channels. Furthermore, much of the non-television
advertising, such as the food companies' web sites, toys,
in-school marketing, is indirect and subtle (e.g., is it a toy
or an ad?). Finally, available evidence suggests that food
ads on television have an influence on children's food
choices. As children have become an increasingly
important target market for the food industry, consumer and
child advocate organizations have become increasingly
concerned that adequate safeguards exist to protect
children from exploitative commercial gain. [72-74]
Concerns over the effects of advertising to children have raised
issues about the need for tighter controls on food
advertising to children. This section reviews US regulations
related to food advertising to children.
In the US, there are currently few policies or standards for
food advertising and marketing aimed at children. The
advertising industry maintains self-regulatory policies
established by the Children's Advertising Review Unit
(CARU) of the National Council of Better Business
Bureaus.  CARU's guidelines apply to all forms of
children's advertising, but it has no legal authority over
advertisers and can only seek voluntary compliance. CARU has
a group of about 20 advisors and 35 supporters, many of
National Association of Broadcasters' first adopted self-regulatory toy TV advertising guidelines.
Action for Children's Television (ACT), a children's advocacy group calls on FCC and FTC to prohibit or limit TV
advertising directed at children.
FCC adopts first federal policies restricting TV advertising. These include:
1. limits on overall amount of advertising allowed during children's programming (12 min/hr on weekdays and 9.5 min/hr
2. clear separation between program content and commercial messages (no host selling)
3. clear delineation when a program is interrupted by a commercial
Children's Advertising Review Unit (CARU) of the National Council of Better Business Bureau's is established by the
advertising industry to self-regulate advertising policies. The group was created in response to legislation to restrict or
ban advertising to children.
ACT ad the Center for Science in the public interest (CSPI) file petitions to FTC to ban TV advertising of highly sugared
FTC formally proposes a rule that would ban or severely restrict all TV advertising to children. FTC presents a review
of the scientific evidence and argues that all advertising directed to young children is inherently unfair and deceptive.
The proposal provokes intense opposition from the broadcasting, advertising and food and toy industries and an
aggressive campaign to oppose the ban based on First Amendment Protection.
In response to corporate pressure, Congress refuses to approve FTC's operating budget and passed legislation "FTC
Improvements Act of 1980" which removes the agency's authority to restrict advertising. The Act prohibits any further
action to adopt proposed children's advertising rules.
Deregulation of Television occurs during the Reagan administration. FCC deregulates all limits on the amount of
advertising times, and the restriction on program-length commercials.
Children's advocacy and consumer groups pushed Congress t pass the Children's Television Act which directed the
FCC to require educational programming for children and to limit the amount of commercial time during children's
programming to 10.5 min/hr on weekends and 12 min/hr on weekdays. FCC reinstates the policy on program length
commercials but redefines them.
In response to advocacy groups and an FTC report, Congress passes the Children's Online Privacy Protection Act
(COPPA) that directs the FTC to develop rules restricting certain data collection practices and requiring parental
permission for collection of personal information for children under 13 years of age.
whom are from the food industry, such as Burger King,
Frito-Lay, McDonald's, General Mills, Nabisco and
Hershey. The CARU voluntary guidelines list seven basic
principles, which address areas such as product presentation
and claims, endorsement and promotion by program
characters, sales pressures, disclosures and disclaimers
and safety concerns.  It is questionable how well an
organization like CARU, comprised primarily of
interested food marketers, can self-regulate the food
advertising behavior of its members.
At a federal level, the Federal Communications
Commission (FCC) and the Federal Trade Commission (FTC)
share authority for regulating advertising, although each
agency has a different emphasis.  The FCC has the
responsibility of establishing public interest obligations
for television broadcasters, while FTC's responsibility is to
regulate advertising deemed unfair or deceptive. 
Concerns about advertising on children's television were
first raised in the early 1970s by the children's advocacy
group, Action for Children's Television (ACT) which
urged the FCC and the FTC to prohibit or limit advertising
directed at children.  In 1974, the FCC required
specific limitations on the overall amount of advertising
allowed during children's programs (12 minutes/hour on
weekdays and 9.5 minutes/hour on weekends) and clear
separation between program content and commercial
messages. This involved policies against "host selling," the
use of a program host or other program personality to
promote products on the program.  The FCC also
required clear delineation when a program is interrupted
by a commercial to help young children distinguish
program content from commercial messages. As a result it
became common for television stations to air "bumpers,"
In 1978, the FTC formally proposed a rule that would ban
or severely restrict all television advertising to children.
[31,78] The FTC presented a comprehensive review of the
scientific literature and argued that all advertising directed
to young children was inherently unfair and deceptive.
 The proposal provoked intense opposition from the
food, toy, broadcasting and advertising industries, who
initiated an aggressive campaign to oppose the ban. A key
argument was First Amendment protection for the right to
provide information about products to consumers. 
Responding to corporate pressure, Congress refused to
approve the FTC's operating budget and passed legislation
titled the FTC Improvements Act of 1980 that removed
the agency's authority to restrict television advertising.
The act specifically prohibited any further action to adopt
the proposed children's advertising rules. 
In 1990, children's advocacy groups persuaded Congress
to pass the Children's Television Act that included
limiting the amount of commercial time during children's
programming to 10.5 minutes per hour on weekends and 12
minutes per hour on weekdays. These time limits remain
in effect today. A chronology of key events in the
regulation of food advertising to children is shown in Table 6.
Advertising and marketing aimed at children is rapidly
becoming a pervasive presence on the Internet, with new
techniques constantly being developed, yet advertising on
the Web is virtually unrestricted.  Advertising and
content for children are often seamlessly interwoven in
online "infomercials," interactive forms of product
placement, and branded environments on food company
websites. In 1997, CARU revised its Children's Advertising
Guidelines to include a new section addressing the
Internet.  However, the CARU guidelines regarding online
and Internet advertising are considerably weaker than
those applied to television. For example, one of CARU's
guidelines for television is that products derived from or
associated with program content primarily directed to
children should not be advertised during or adjacent to
that program. Yet, this does not apply to websites or the
In the mid 1990s, children's media advocacy groups
documented a number of exploitative data collection
marketing practices on children's websites used to gather
personal information from children and learn about their
preferences and interests. These included interactive
surveys with animated characters or spokespersons, guest
books, registrations, incentives, contests, and prizes for
filling out surveys. This information permitted companies
to conduct market research which then could be used to
and create personalized marketing and sales appeals to
children. [57,77] In 1998, Congress passed the Children's
Online Privacy Protection Act (COPPA), which directed
the FTC to develop rules restricting certain data collection
practices and requiring parental permission for collection
of personal information for children under 13.  This
law went into effect in 2000.
The majority of US schools and states do not have any
policies about commercial marketing activities in schools.
The US GAO report found that only 19 states currently
have statutes or regulations that address school-related
commercial activities.  This includes some state
statutes to encourage commercial activities (e.g., New
Mexico's only statute allows advertising in and on school
buses). Only five states were reported to have more
comprehensive policies covering various activities related to
product sales, and direct or indirect advertising.  New
York and California have adopted laws prohibiting or
restricting many types of commercial promotional
activities in public schools.  In most states, local school
boards have the authority to make policy decisions about
commercial activities. 
Several national organizations and youth advocacy
groups are concerned about the growing influx of
inschool marketing and advertising and have advocated
limiting commercial activities in schools, arguing that
children's health is not an acceptable "trade off" for
increased revenues. [19,44] The Consumers Union
Education has urged that parents and educators unite to make
schools ad-free zones, where young people can pursue
learning free of commercial influences and pressures. 
Recently, there have been successful local initiatives to
eliminate soft drink vending machines and advertising
from schools. Several school districts across the country
have refused to enter into agreements with soft drink
companies after protests by parents, students and school
officials.  In 2002, Oakland, California school district
banned all school sales of soda and candy. The same year,
the Los Angeles unified school district, which includes
677 schools and 736,000 students, voted to ban the sales
of soft drinks in vending machines.  These initiatives
demonstrate the effectiveness of local efforts to regulate
commercial activities in schools.
Regulations in Other Countries
Concerns about the effects of television advertising on
children are shared by a number of European countries
and Australia. [19,74,80,81] The Nordic countries are at
the forefront of protecting children from the effects of
advertising.  Sweden has the strictest controls in
Europe and in 1991 instituted a ban on television and
radio advertising targeted at children under the age of 12.
 The Swedish government views advertising to
children as morally and ethically unacceptable, since children
have difficulty distinguishing between the purpose of
advertising and other modes of communication.  In
Belgium, it is forbidden to broadcast commercials during
children's programs as well as during the 5 minutes before
and after them. Australia does not allow ads during
television programming for preschoolers.  Data are needed
regarding whether more stringent regulation of television
food advertising to children results in more healthful food
choices and eating behaviors.
Summary and Conclusions
In recent years, the food and beverage industry has viewed
children and adolescents as a major market force. As a
result, children and adolescents are targeted aggressively
by food advertisers, and are exposed to a growing and
unprecedented amount of advertising, marketing, and
commercialism through a wide range of channels. The
principal goal of food advertising and marketing aimed at
children is to influence brand awareness, brand
preference, brand loyalty, and food purchases among youth.
A wide range of food advertising techniques and channels
are used to reach children and adolescents to foster brand
awareness to encourage product sales.  Marketing
channels include television advertising, in-school
marketing, product placements, kids clubs, the Internet, toys and
products with brand logos, and youth-targeted
promotions. The strong similarities between the marketing and
promotional activities used by food companies to
advertise unhealthy foods to children and those used by the
tobacco industry to market cigarettes to children are
striking.  For example, at one time tobacco companies
were providing schools with free sports programs,
scoreboards, and book covers featuring school logos on the
front and cigarette ads on the back.  Young children
were targeted with the sale of candy and bubble gum in
packages that resembled those of actual cigarette brands.
 Ads for cigarette brands popular with youth were
selectively placed in magazines with large youth
readerships. Promotional materials (caps, sports bags, lighters
with cigarette brand logos), sweepstakes, and premiums
were commonly used. The "Marlboro Man," with his
image of independence and autonomy, struck a
responsive chord among adolescent males. Studies of the use of
the cartoon character Joe Camel to promote Camel
cigarettes showed that 30% of 3-year olds and over 80% of
6year olds could make the association between Joe Camel
and a pack of cigarettes.  In the three years after the
introduction of the cartoon camel character, preference
for Camel cigarettes increased from 0.5 to 32% among
adolescent smokers. 
Collectively, the advertising techniques and promotional
campaigns targeting youth were highly successful in
encouraging underage smoking. [85,86] A time-series
study concluded that adolescents are three times as
responsive to cigarette brand advertising as adults. 
Several cross-sectional and longitudinal studies have
clearly and strongly shown that exposure and receptivity
to tobacco advertising and promotional activities is
related to adolescent tobacco use. [86,88-90] Similar
studies need to be conducted with food advertising and
relationships to consumption of high fat, high sugar foods,
Numerous studies have shown that foods heavily
marketed to preschool and grade school children are
predominantly high in sugar and fat, [36,40,41] which is the
antithesis of healthful eating recommendations for
children. Experimental studies have consistently shown that
children exposed to food advertising prefer and choose
advertised food products more frequently than those not
exposed to such ads.  Purchase request studies with
children under age 11 have also found strong associations
between number of hours of television watched by
children and number of children's requests to parents for
those foods, as well as availability of those food items in
the home.  Of concern is that African American and
Hispanic children watch more television compared to
white children. [33,34] Thus, they are exposed to more
food ads. African American and Hispanic children also
have a higher prevalence of obesity than white children.
 Several studies have documented associations
between the number of hours of television watched and
the prevalence of obesity among children.  Research is
needed to examine possible relationships between
exposure to food advertising, eating behaviors and obesity.
Because marketing to children and adolescents has
become so pervasive, many child advocates and media
experts believe that such marketing constitutes an
escalating public health problem.  Children, especially
young children, are more susceptible to the effects of
marketing than adults. Numerous studies have documented
that children under 8 years of age are developmentally
unable to understand the intent of advertisements and
accept advertising claims as factual.  The intense
marketing of high fat, high sugar foods to young children can
be viewed as exploitation because they do not understand
that commercials are designed to sell products and do not
have the ability to comprehend or evaluate advertising.
The purpose of advertising is to persuade, and young
children have few defenses against such advertising. Older
children and teens can be manipulated by the strong
emotive messages in advertisements.  It can be argued that
children, especially young children, are a vulnerable
group that should be protected from commercial
influ Develop federal, state, or local policies to designate schools as food advertising-free zones, where children and adolescents can pursue learning
free of commercial influences and pressures. Children's health should never be an acceptable "trade-off," no matter how severe the budgetary
constraints in schools or communities.  If American public schools were adequately funded, in-school commercialism would be subjected to
greater scrutiny, and schools would be less likely to enter into corporate agreements without more public debate. 
Develop federal or state school policies that promote a healthful eating environment in schools. The sale of soft drinks and other high calorie, low
nutrition foods should be prohibited during the school day in public schools.
Congressional action to eliminate food advertising aimed at young children on children's television programs, such as morning, after-school, and
weekend children's programs. Since the climate has not been favorable for regulation, interim means could be explored such as having stricter
limitations on the amount of advertising permitted on children's television (e.g., no more than 5-6 commercial minutes per hour on programming
which would reduce the current limits by about 50%), or by placing a monetary surcharge on advertising for high-calorie, low-nutrition foods
targeted at youth. These funds could be used to develop nutrition and physical activity media campaigns and promotion programs to be overseen by
a non-profit or governmental organization. As an interim step, guidelines for responsible food advertising and marketing aimed at children could be
Establish federal regulations to protect children from manipulative, invasive, and deceptive food advertising on the Internet. The FTC would be the
most appropriate federal agency to develop such rules.
Convene a White House or Surgeon General's Conference on food marketing and advertising aimed at children and adolescents and its effects on
their health, and develop recommendations on this issue.
Develop and disseminate school-based curricula that teach children and adolescents media literacy and give them life skills to be informed
consumers of media.
Build public support by increasing awareness among parents, educators, and consumers on the nature and extent of food advertising and
marketing to children, especially young children.
ences that may adversely impact their health, and that as
a society that values children, there should be greater
social responsibility for their present and future health.
Social and environmental structures can actively support
and promote healthy food choices for children.  Table
7 provides examples of potential environmental strategies
and policy recommendations for food advertising and
marketing aimed at children and adolescents. There is a
need for national discussion and dialogue on these issues.
The growing epidemic of childhood obesity has focused
attention on the possible role that food and beverage
advertising and marketing may play in influencing child
and adolescent eating behaviors and body weight. More
research is needed to examine whether food advertising is
a causal factor for increased risk of obesity. Experimental
and epidemiologic research, including longitudinal
designs, is needed to study the effect of food advertising
on children's food choices, eating behaviors and body
weight. Studies need to include the various marketing
channels used to reach youth, such as television, schools,
and the Internet, as well as different age periods, such as
early childhood, middle childhood and adolescence. This
article focused on marketing practices and research
conducted primarily in the US. However, a number of studies
in other countries, such as Australia and the UK, have
found that television advertising to children for high sugar
and high fat foods is prevalent. [39-41,72,74,81]
Comparative international studies could help shed light on the
prevalence and impact of food marketing and advertising
2ndth edition . Arlington, VA, National Center for Education in Maternal and Child Health ; 2002 .
Dietz William H. , Stern Loraine , American Academy of Pediatrics.: American Academy of Pediatrics Guide to Your Child's Nutrition: Feeding Children of All Ages . 1stth edition . New York, Villard Books ; 1999 :xiii, 234.
Centers for Disease Control and Prevention: Guidelines for school health programs to promote lifelong healthy eating . Morbidity and Mortality Weekly Report 1996 , 45 : 1 - 37 .
Perry CL , Story M , Lytle LA : Promoting healthy dietary behaviors . Healthy Children 2010 : Enhancing Children's Wellness Volume 8.
Edited by: Weissberg RP, Gullotta TP , Hampton RL , Ryan BA and Adams GR. Thousand Oaks, CA, Sage; 1997 : 214 - 249 .
Cavadini C , Siega-Riz AM , Popkin BM : US adolescent food intake trends from 1965 to 1996 . West J Med 2000 , 173 : 378 - 383 .
Nicklas TA , Elkasabany A , Srinivasan SR , Berenson G : Trends in nutrient intake of 10-year-old children over two decades (1973-1994): the Bogalusa Heart Study . Am J Epidemiol 2001 , 153 : 969 - 977 .
Neumark-Sztainer D , Story M , Hannan PJ , Croll J : Overweight status and eating patterns among adolescents: where do youths stand in comparison with the healthy people 2010 objectives? Am J Public Health 2002 , 92 : 844 - 851 .
Munoz KA , Krebs-Smith SM , Ballard-Barbash R , Cleveland LE : Food intakes of US children and adolescents compared with recommendations . Pediatrics 1997 , 100 : 323 - 329 .
9. Jahns L , Siega-Riz AM , Popkin BM : The increasing prevalence of snacking among US children from 1977 to 1996 . J Pediatr 2001 , 138 : 493 - 498 .
10. Gleason Phil , Suitor Carol , US Food and Nutrition Service.: Children's diets in the mid-1990s: dietary intake and its relationship with school meal participation . Special nutrition programs; report no . CN-01-CD1 Alexandria , VA, US Dept of Agriculture, Food and Nutrition Service; 2001 : 1 v. (various pagings).
11. Lin BH , Guthrie JF , Frazao E : American children's diets not making the grade . FoodReview 2001 , 24 : 8 - 17 .
12. Gleason P , Suitor C : Food for thought: children's diets in the 1990s . Princeton, NJ, Mathematica Policy Research, Inc.; 2001 .
13. US Department of Health and Human Services: The Surgeon General's call to action to prevent and decrease overweight and obesity . Rockville, MD, US Department of Health and Human Services , Public Health Service, Office of the Surgeon General; 2001 .
14. Freedman DS , Dietz WH , Srinivasan SR , Berenson GS : The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study . Pediatrics 1999 , 103 : 1175 - 1182 .
15. American Diabetes Association : Type 2 diabetes in children and adolescents . Pediatrics 2000 , 105 : 671 - 680 .
16. Story M , Neumark-Sztainer D , French S : Individual and environmental influences on adolescent eating behaviors . J Am Diet Assoc 2002 , 102 : S40 - 51 .
17. Kraak V , Pelletier DL : The influence of commercialism on the food purchasing behavior of children and teenage youth . Family Economics and Nutrition Review 1998 , 11 : 15 - 24 .
18. Kraak V , Pelletier DL : How marketers reach young consumers: Implications for nutrition education and health promotion campaigns . Family Economics and Nutrition Review 1998 , 11 : 31 - 41 .
19. Consumers Union Education Services: Captive Kids: Commercial Pressures on Kids at School . Yonkers, NY, Consumers Union of United States; 1995 .
20. Strasburger VC , Donnerstein E : Children, adolescents, and the media: issues and solutions . Pediatrics 1999 , 103 : 129 - 139 .
21. Valkenburg PM : Media and youth consumerism . J Adolesc Health 2000 , 27 : 52 - 56 .
22. American Academy of Pediatrics: Children, adolescents, and advertising. Committee on Communications, American Academy of Pediatrics. Pediatrics 1995 , 95 : 295 - 297 .
23. McNeal J : Tapping the three kids' markets . American Demographics 1998 , 20 : 37 - 41 .
24. Strasburger VC : Children and TV advertising: nowhere to run, nowhere to hide . J Dev Behav Pediatr 2001 , 22 : 185 - 187 .
25. McCall KL : What's the Big Dif'?: Differences Between Marketing and Advertising . 2003 , 2003 : [http://www.marketing profs.com/print.asp?source=%2F2%2Fmccall5%2Easp]. MarketingProfs .com
26. Gallo AE : Food Advertising in the United States . America's Eating Habits: Changes and Consequences Edited by: USDA/Economic Research Service. Washington, DC, USDA; 1999 : 173 - 180 .
27. Harris JM , Kaufman P , Martinez S , Price C : The US Food Marketing System , 2002 . 2002 , 2003 : [http://www.ers.usda.gov/publica tions/aer811]. USDA
28. McNeal J : The Kids Market: Myth and Realities . Ithaca, NY, Paramount Market Publishing ; 1999 .
29. Zollo P : Wise Up To Teens: Insight into Marketing and Advertising to Teenagers, 2nd edition. Ithaca, NY, New Strategist Publications, Inc.; 1999 .
30. Isler L , Popper HT , Ward S : Children's purchase requests and parental responses: results from a diary study . Journal of Advertising Research 1987 , 27 : 28 - 39 .
31. Kunkel D , Gantz W : Assessing compliance with industry selfregulation of television advertising to children . Applied Communication Research 1993 , 148 : 151 +.
32. John DR : Consumer socialization of children: A retrospective look at twenty-five years of research . Journal of Consumer Research 1999 , 26 : 183 - 213 .
33. Roberts DF , Foehr UG , Rideont VJ , Brodie M : Kids, Media and the New Millenium . A Kaiser Family Foundation Report , Menlo Park, CA, J Kaiser Family Foundation; 1999 .
34. Gentile DA , Walsh DA : A normative study of family media habits . Applied Developmental Psychology 2002 , 23 : 157 - 178 .
35. Gamble M , Cotunga N : A quarter century of TV food advertising targeted at children . American Journal of Health Behavior 1999 , 23 : 261 - 267 .
36. Kotz K , Story M : Food advertisements during children's Saturday morning television programming: Are they consistent with dietary recommendations ? J Am Diet Assoc 1994 , 94 : 1296 - 1300 .
37. Coon KA , Tucker KL : Television and children's consumption patterns. A review of the literature . Minerva Pediatr 2002 , 54 : 423 - 436 .
38. Taras HL , Gage M : Advertised foods on children's television . Arch Pediatr Adolesc Med 1995 , 149 : 649 - 652 .
39. Morton H : The television advertising of food to children: a South Australian study . Journal of Food Nutrition 1984 , 41 : 170 - 175 .
40. Dibb S , Harris L : A spoonful of sugar. Television food advertising aimed at children: an international comparative study . London, UK, Consumers International ; 1996 .
41. Lewis MK , Hill AJ : Food advertising on British children's television: a content analysis and experimental study with nineyear olds . Int J Obes Relat Metab Disord 1998 , 22 : 206 - 214 .
42. Chestnutt IG , Ashraf FJ : Television advertising of foodstuffs potentially detrimental to oral health -- a content analysis and comparison of children's and primetime broadcasts . Community Dental Health 2002 , 19 : 86 - 89 .
43. Byrd-Bredbenner C , Grasso D : What is television trying to make children swallow?: content analysis of the nutrition information in prime-time advertisements . Journal of Nutrition Education 2000 , 32 : 187 - 195 .
44. Levine J : Food industry marketing in elementary schools: implications for school health professionals . J Sch Health 1999 , 69 : 290 - 291 .
45. Nestle M : Food Politics: How the Food Industry Influences Nutrition and Health . Los Angeles, University of California Press; 2002 .
46. US General Accounting Office: Public education: Commercial activities in schools. Report to congressional requesters . GAO/HEHS-00-156. US General Accounting Office ; 2000 .
47. Wechsler H , Brener ND , Kuester S , Miller C : Food service and foods and beverages available at school: results from the School Health Policies and Programs Study 2000 . J Sch Health 2001 , 71 : 313 - 324 .
48. French SA , Story M , Fulkerson JA : School food policies and practices: a state-wide survey of secondary school principals . J Am Diet Assoc 2002 , 102 : 1785 - 1789 .
49. Craypo L , Purcell A , Samuels SE , Agron P , Bell E , Takada E : Fast food sales on high school campuses: results from the 2000 California high school fast food survey . J Sch Health 2002 , 72 : 78 - 82 .
50. Tevlin J : General Mills ad campaign turns sour after protest . Star Tribune Minneapolis , MN ; 2001 :1D.
51. Brand JE , Greenberg Bq . S.: Commercials in the classroom: the impact of Channel One advertising . Journal of Advertising Research 1994 , 34 : 18 - 27 .
52. Cover Concepts: Cover Concepts . 2003 , 2003 : [http://www.cov erconcepts.com]. Primedia Resource Group
53. Gupta PB , Gould SJ : Consumers' perceptions of the ethics and acceptability of product placement in movies: product category and individual differences . Journal of Current Issues and Research in Advertising 1997 , 19 : 37 - 50 .
54. Mortimer R : Box office brand bonanzas . Brand Strategy 2002 , 166 : 25 .
55. Kaiser Family Foundation : Teens Online. Menlo Park, CA, Henry J. Kaiser Family Foundation ; 2002 .
56. Montgomery KC : Children's media culture in the new millenium: mapping the digital landscape . The Future of Children 2000 , 10 : 145 - 167 .
57. Montgomery D , Pasnik S : Web of Deception. Washington, DC, Center for Media Education; 1996 .
58. Montgomery KC : Digital kids: the new online children's consumer culture . Handbook of Children and the Media Edited by: Singer D G and Singer J L . Thousand Oaks, CA, Sage Publications ; 2001 : 635 - 650 .
59. Tarpley T : Children, the Internet, and other new technologies . Handbook of Children and the Media Edited by: Singer D G and Singer J L . Thousand Oaks, CA, Sage Publications ; 2001 : 547 - 556 .
60. Montgomery K : TeenSites.com: A field guide to the new digital landscape . Washington, DC, Center for Media Education; 2001 .
61. Reyes S : What will become of the box? Brandweek 2003 , 44 : 24 - 27 .
62. Schlosser Eric : Fast Food Nation: The Dark Side of the AllAmerican Meal . New York, HarperCollins ; 2002 .
63. Thompson SH : Disney food tie-in efforts go sour: cereal and beverage brands fail to hit targets . 2002 , 2003 : [http:// www.adage.com/news.cms?newsId=35707]. Advertising Age
64. CARU: Sweepstakes directed to children . 2003 , 2003 : [http:// www.caru.org/caruwhite/sweepstakes.asp]. National Council of Better Business Bureaus
65. Atkin C : Observation of parent-child interaction in supermarket decision-making . Journal of Marketing 1978 , 42 : 41 - 45 .
66. Horgan KB , Choate M , Brownell KD : Television food advertising . Handbook of Children and Media Edited by: Singer D G and Singer J L . Thousand Oaks, CA, Sage Publications ; 2001 : 447 - 461 .
67. Taras HL , Sallis JF , Patterson TL , Nader PR , Nelson JA : Television's influence on children's diet and physical activity . J Dev Behav Pediatr 1989 , 10 : 176 - 180 .
68. Borzekowski DL , Robinson TN : The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers . J Am Diet Assoc 2001 , 101 : 42 - 46 .
69. Gorn GJ , Goldberg ME : Behavioral evidence of the effects of televised food messages on children . Journal of Consumer Research 1982 , 9 : 200 - 205 .
70. Jeffrey DB , McLellarn RW , Fox DT : The development of children's eating habits: the role of television commercials . Health Educ Q 1982 , 9 : 174 - 189 .
71. World Health Organization: Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic Disease . Geneva, World Health Organization ; 2003 .
72. Linn S : Marketing to children harmful: experts urge candidates to lead nation in setting limits . 2000 , 2003 : [http:// www.cme.org/press/001018pr.html]. Center for Media Education
73. Sustain : The Alliance for Better Food and Farming: TV Dinners: What's being served up by the advertisers . London; 2001 : 1 - 31 .
74. National Council of Better Business: Children's Advertising Review Unit . 2003 , 2003 : [http://www.caru.org].
75. Campbell AJ : Self-regulation and the media . Federal Communications Law Journal 1999 , 51 : 711 +.
76. Campbell AJ : Ads2Kids.com: should government regulate advertising to children on the world wide web? Gonzaga Law Review 1997 , 33 : 311 +.
77. Dietz WH , Strasburger VC : Children, adolescents, and television. Curr Probl Pediatr 1991 , 21 : 8 - 31 .
78. Fried EJ , Nestle M : The growing political movement against soft drinks in schools . JAMA 2002 , 288 : 2181 .
79. Public Health Association of Australia: Television food advertising during children's viewing times . 2002 , 2003 : [http:// www.phaa. net.au/policy/TVfoodAdvertisingF .htm]. PHAA
80. Nutrition Australia : Nutrition Australia position statement: Food advertising directed at children . 2002 , 2003 : [http:// www.nutritionaustralia.org/News_in_Nutrition/Postition_Papers/ food_advertising_at_children.asp]. Nutrition Australia
81. US Department of Health and Human Services: The role of advertising and promotion in the marketing of tobacco products. Preventing Tobacco Use Among Young People: A Report of the Surgeon General Edited by: US Department of Health and Human Services Public Health Service Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Office of Smoking and Health . Washington, DC, US Government Printing Office ; 1994 : 159 - 179 .
82. Fischer PM , Schwartz MP , Richards J. W. , Jr., Goldstein AO , Rojas TH : Brand logo recognition by children aged 3 to 6 years. Mickey Mouse and Old Joe the Camel . Jama 1991 , 266 : 3145 - 3148 .
83. DiFranza JR , Tye JB : Who profits from tobacco sales to children? Jama 1990 , 263 : 2784 - 2787 .
84. Perry CL : The tobacco industry and underage youth smoking: Tobacco industry documents from the Minnesota litigation . Arch Pediatr Adolesc Med 1999 , 153 : 935 - 941 .
85. Perry CL : The relationship between "share of voice" and "share of market" and implications for youth health promotion . Health Education 1998 , 29 : 206 - 212 .
86. Holak SL , Tang YE : Advertising's effect on the product evolutionary cycle . Journal of Marketing 1990 , 54 : 16 - 29 .
87. Biener L , Siegel M : Tobacco marketing and adolescent smoking: more support for a causal inference . Am J Public Health 2000 , 90 : 407 - 411 .
88. Altman DG , Levine DW , Coeytaux R , Slade J , Jaffe R : Tobacco promotion and susceptibility to tobacco use among adolescents aged 12 through 17 years in a nationally representative sample . Am J Public Health 1996 , 86 : 1590 - 1593 .
89. Pierce JP , Choi WS , Gilpin EA , Farkas AJ , Berry CC : Tobacco industry promotion of cigarettes and adolescent smoking . Jama 1998 , 279 : 511 - 515 .
90. Nestle M : Soft drink "pouring rights": marketing empty calories to children . Public Health Rep 2000 , 115 : 308 - 319 .