Limitations in current Australian regulatory provisions may be identified by demonstrating the effect of different marketing methods on children’s recognition and attitudes toward unhealthy food ...brands.
To investigate how exposure to different marketing techniques from television (TV) and online food advertising affects children’s brand recall, recognition, and attitudinal responses toward brands and brand consumers and children’s desire to eat the advertised products.
Secondary analysis of data from a crossover experimental-control study.
In all, 154 children (7 to 12 years) completed the study, conducted at four 6-day holiday camps from April 2016 to January 2017 in New South Wales, Australia. Children were assigned to a single-media (n=76) or multiple-media (n=78) condition.
All children viewed 10 TV food advertisements in a cartoon on three occasions. For one of the brands, one set of children additionally played online “advergames” featuring the brand.
Children’s recognition and attitudes toward brands and brand consumers and children’s desire to eat the product were reported via a brand recognition and attitude survey pre- and postintervention. Marketing techniques were categorized.
Pre- and postintervention brand recognition and relationships between brand recognition and attitudes by media condition and desire to eat the product were examined using generalized linear mixed models and linear mixed models.
There was a significant increase in the number of brands recognized postexposure by children in both media groups (mean difference=3.8, P<0.0001). The majority of brands appealed to children. Children who reported wanting to eat the advertised products rated brands more positively than children who did not express a desire to eat the products. A larger proportion of children who played the advergames (36%) rated brand consumers as “cool” than children who viewed the TV advertisements only (19%) (P<0.001). Anti-adult themes, fun and humor, and parent pleasing were techniques unique to some of the most recognized and favored advertisements.
The marketing communications increased children’s brand recognition and elicited positive attitudinal responses. These findings indicate a need for policy makers to consider additional regulations to protect children from the persuasive influence of unhealthy food advertising.
Fish is a source of several nutrients that are important for healthy foetal development. Guidelines from Australia, Europe and the USA encourage fish consumption during pregnancy. The potential for ...contamination by heavy metals, as well as risk of listeriosis requires careful consideration of the shaping of dietary messages related to fish intake during pregnancy. This review critically evaluates literature on fish intake in pregnant women, with a focus on the association between neurodevelopmental outcomes in the offspring and maternal fish intake during pregnancy. Peer-reviewed journal articles published between January 2000 and March 2014 were included. Eligible studies included those of healthy pregnant women who had experienced full term births and those that had measured fish or seafood intake and assessed neurodevelopmental outcomes in offspring. Medline, Scopus, Web of Science, ScienceDirect and the Cochrane Library were searched using the search terms: pregnant, neurodevelopment, cognition, fish and seafood. Of 279 papers sourced, eight were included in the final review. Due to heterogeneity in methodology and measured outcomes, a qualitative comparison of study findings was conducted. This review indicates that the benefits of diets providing moderate amounts of fish during pregnancy outweigh potential detrimental effects in regards to offspring neurodevelopment. It is important that the type of fish consumed is low in mercury.
Policies restricting children's exposure to unhealthy food marketing have been impeded by the lack of evidence showing a direct link between food advertising exposure and children's energy intake and ...body weight. Food advertising exposure increases children's immediate food consumption, but whether this increased intake is compensated for at later eating occasions is not known; consequently the sustained effect on diets remains unclear.
We conducted a within-subject, randomised, crossover, counterbalanced study across four, six-day holiday camps in New South Wales, Australia between April 2016 and January 2017. Children (7-12 years, n = 160) were recruited via local schools, email networks and social media. Two gender- and age-balanced groups were formed for each camp (n = 20), randomised to either a multiple- or single- media condition and exposed to food and non-food advertising in an online game and/or a television cartoon. Children's food consumption (kilojoules) was measured at a snack immediately after exposure and then at lunch later in the day. Linear mixed models were conducted to examine relationships between food advertising exposure and dietary intake, taking into account gender, age and weight status.
All children in the multiple-media condition ate more at a snack after exposure to food advertising compared with non-food advertising; this was not compensated for at lunch, leading to additional daily food intake of 194 kJ (95% CI 80-308, p = 0.001, d = 0.2). Exposure to multiple-media food advertising compared with a single-media source increased the effect on snack intake by a difference of 182 kJ (95% CI 46-317, p = 0.009, d = 0.4). Food advertising had an increased effect among children with heavier weight status in both media groups.
Online ('advergame') advertising combined with TV advertising exerted a stronger influence on children's food consumption than TV advertising alone. The lack of compensation at lunch for children's increased snack intake after food advertising exposure suggests that unhealthy food advertising exposure contributes to a positive energy-gap, which could cumulatively lead to the development of overweight.
Australian New Zealand Clinical Trials Registry, number ACTRN12617001230347 (Retrospectively registered).
Exposure to unhealthy food marketing stimulates children's food consumption. A child's responsiveness is influenced by individual factors, resulting in an increased vulnerability to advertising ...effects among some children. Whether these differential responses may be altered by different parental feeding behaviours is unclear. The purpose of this study was to determine the relationship between parental feeding practices and children's food intake responses to food advertising exposure. A randomised, crossover, counterbalanced, within subject trial was conducted across four, six-day holiday camps in New South Wales, Australia between April 2016 and January 2017 with 160 children (7–12 years, n = 40/camp). Children were randomised to either a multiple media (TV and Internet) or single media (TV) condition and exposed to food (3 days) and non-food (3 days) advertising in an online game and/or a cartoon. Children's food consumption (kilojoules (kJ)) was measured at a snack immediately after advertising exposure and then at lunch later in the day. Parents completed the Child Feeding Questionnaire, and ‘restriction’ and ‘pressure to eat’ subscale scores were calculated. While food advertising affected all children in the multiple media condition, there was an increased effect on snack intake among children whose parents reported pressuring them to eat, with children consuming an additional 356 kJ after food advertising compared with non-food advertising. This was 209 kJ more than children whose parents did not pressure them to eat. In the single media condition, only children whose parents reported restrictive feeding practices ate more at lunch on food advertising days than non-food advertising days (240 kJ). These data highlight an increased susceptibility to food advertising among children whose parents report controlling feeding practices.
Purpose . To investigate patient perceptions of physical rehabilitation received for various adverse physical effects following breast cancer surgery and the content and delivery methods of the ...physical rehabilitation received. Methods . Cross‐sectional study of 509 Australian women living with breast cancer ( n = 178 (35%) (Breast Conserving Surgery (BCS)), n = 168 (33%) (Mastectomy (MAST)), and n = 163 (32%) (Breast Reconstruction Surgery (BRS)). Retrospective, online survey investigated the physical rehabilitation received after surgery/treatment. The survey explored the respondents′ perceptions (open response) and satisfaction levels with the physical rehabilitation received and its content and delivery method (closed responses). Perceptions were analyzed using a thematic analysis; satisfaction levels and delivery methods for each adverse physical effect were tabulated. Results . Major perceptions: (i) unaware of and unprepared for adverse physical effects, (ii) unsuitable information delivery, and (iii) insufficient follow‐up from health professionals. Physical rehabilitation content focused on shoulder issues and lymphedema; less than half of respondents received any information about scars, torso, and donor site issues or physical discomfort disturbing sleep. The proportion that received each delivery method varied for each adverse physical effect. Pamphlets and verbal instruction were the most common delivery methods and sessions with health professionals where issues were physically assessed, checked, or progressed the least common. Satisfaction levels varied for each adverse physical effect; all were less than 50%. Conclusion . Women perceived their physical rehabilitation did not prepare them for the adverse physical effects they experienced, the method and timing of delivery did not meet their needs at various stages of recovery, and the follow‐up was insufficient. Quantitative data on the content and delivery method support these perceptions. Explanations of why these perceptions occurred and recommendations to improve physical rehabilitation through greater use of patient‐related outcome measures and spreading limited physical rehabilitation resources using a three‐level model of care are recommended. Although many women recover from breast cancer, improved physical rehabilitation could enable women to manage any immediate or long‐term side effects of their breast cancer surgery and treatment.
Nutrition and health claims can promote healthier food choices but may lead to consumer confusion if misused. Regular monitoring of claims is therefore required. This study aimed to explore the ...prevalence of nutrition and health claims carried on breakfast cereals in supermarkets, and to assess claim compliance with regulations. Nutrition and health claims on breakfast cereal products across five supermarkets in the Illawarra region of New South Wales, Australia, were recorded in a cross-sectional audit. Prevalence of claim type and claim compliance was determined. Claims were compared across categories of breakfast cereal. Almost all (95.7%) products audited carried at least one nutrition or health claim; nutrition content (
= 1096) was more prevalent than health claims (
= 213). Most claims (91.6%) were compliant with regulations. Additionally, claim prevalence and type differed according to breakfast cereal category, with the highest proportion of claims appearing on 'health and wellbeing' and 'muesli' products. There is a high prevalence of nutrition and health claims on breakfast cereals, with most claims compliant with regulations. Research should investigate consumer interpretation of claims and the impact of applying nutrient profiling for all claims to assist consumers to make informed health choices.
The prevention of overweight in childhood is paramount to long-term heart health. Food marketing predominately promotes unhealthy products which, if over-consumed, will lead to overweight. ...International health expert calls for further restriction of children’s exposure to food marketing remain relatively unheeded, with a lack of evidence showing a causal link between food marketing and children’s dietary behaviours and obesity an oft-cited reason for this policy inertia. This direct link is difficult to measure and quantify with a multiplicity of determinants contributing to dietary intake and the development of overweight. The Bradford Hill Criteria provide a credible framework by which epidemiological studies may be examined to consider whether a causal interpretation of an observed association is valid. This paper draws upon current evidence that examines the relationship between food marketing, across a range of different media, and children’s food behaviours, and appraises these studies against Bradford Hill’s causality framework.
Health and nutrition claims are used by consumers to guide purchasing decisions. In consequence, monitoring and evaluation of such claims to ensure they are accurate and transparent is required. The ...aim of this study was to investigate the use of nutrition and health claims on dairy-yoghurt products within select Australian supermarkets and assess their compliance with the revised Food Standards Code (FSC). Nutrition, health, and related claims on yoghurt products were assessed in a cross-sectional audit of five supermarkets in the Illawarra region of New South Wales. Claim prevalence, type, and compliance were assessed and products were compared against current rating measures. A total of n = 340 dairy yoghurt products were identified. Most products (97.9%) carried at least one nutrition and/or health claim, with nutrition-content claims (93.9%) the most prevalent. Most products (n = 277) met the nutrient profiling scoring criterion; while 87.9% of products did not carry the health star rating. Almost all claims surveyed (97.4%) were compliant with the FSC. Health and nutrition claims are highly prevalent across yoghurt categories, with the majority of these compliant with regulations. The ambiguity surrounding the wording and context of claims challenges researchers to investigate consumers’ interpretations of health messaging within the food environment.
There is a paucity of literature about the nutritional status and energy and protein intakes of Meals on Wheels (MOW) clients. The current study aimed to determine the nutritional status and the ...adequacy of energy and protein intakes of MOW clients. Forty-two clients were recruited from two MOW services in the Illawarra region of Australia for assessment of their nutritional status, using the Mini Nutritional Assessment (MNA®). Estimated energy and protein intakes for a MOW day were compared to a non-MOW day and average daily energy and protein intakes were assessed against estimated daily requirements. A single dietitian performed all assessments and home based interviews to explore the client's perception of the service. Mean daily energy intake (7593 (±2012) kJ) was not significantly different to estimated requirements (7720 (±975) kJ) (P = 0.480), while mean daily protein intake was higher (78.7 (±23.4) g) than calculated requirements (68.4 (±10.8) g; P = 0.009). However 16 clients were identified as at risk of malnutrition and 2 were malnourished; consuming 2072 kJ (P = 0.000) less energy and 20.4 g less protein (P = 0.004) per day compared to well-nourished clients. MOW clients are at risk of being poorly nourished and meals delivered by the service provide an important contribution to overall intakes. These findings support the need for regular nutrition screening and dietary monitoring in this high risk group, to identify those for whom additional strategies may be indicated.
•Meals on Wheels clients are a nutritionally at risk group, with 38% at risk and 5% malnourished in the current study.•The malnourished and ‘at risk’ clients were consuming 2072 kJ and 20.4 g less protein than the well-nourished clients.•There is a need for further research on targeted interventions to assist dietary intakes by community living older adults.
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