Advertising Obesity? TV Marketing, Food Promotion, Diet and Body Weight in Children.
Submitting InstitutionUniversity of Liverpool
Unit of AssessmentPsychology, Psychiatry and Neuroscience
Summary Impact TypePolitical
Research Subject Area(s)
Medical and Health Sciences: Nutrition and Dietetics, Public Health and Health Services
Summary of the impact
Research conducted by the University of Liverpool (UoL) has convincingly
shown that there are strong links between the exposure of children to food
advertising, brand recognition and being overweight or obese. This work
consistently informs the policies of regulators and health agencies,
nationally and internationally. In this specific example, work by Halford
and Boyland to characterize the effects of food advertising on children's
diet, food preferences, intake and body weight has had a direct effect on
UK and overseas policy development. Notably this includes informing WHO
guidelines to national governments on introducing effective regulatory
frameworks and for monitoring their effectiveness.
The impact of television viewing and food advertising on children's diet
and health is an increasingly concerning, but controversial, issue for
health agencies worldwide. There is a growing realisation that advertising
contributes significantly to the increased prevalence of obesity and early
onset diabetes — evidenced principally by a body of University of
Liverpool (UoL) research begun in 2003 by Halford (Lecturer, Department of
Psychological Sciences). Governments and health systems express concerns
about this issue and mobilise resources and legislation to address it.
However, their actions meet considerable opposition from the food and
advertising industries. This research programme has definitively
demonstrated that the relationship between TV viewing and childhood
obesity cannot simply be attributed to a sedentary lifestyle and
specifically implicates food advertising as a cause of overconsumption and
Initially in 2003, Halford et al. examined the ability of lean,
overweight and obese children (aged 9-11) to recognize food and non-food
adverts, and how advert viewing influenced their subsequent snack
consumption. Obese children recognized more food adverts than lean
children, and recognition level correlated significantly with the amount
of food eaten (especially sweet, high fat snacks). However, while clearly
indicating heightened alertness to food-related cues in obese children,
the study showed that acute exposure to food adverts can increase food
intake in all children . The immediate reception of this work within
academia, policy circles, and international media stimulated a series of
UoL follow up studies with larger cohorts and age ranges that have
consolidated and expanded those findings; confirming by 2008 the critical
contribution of advertising to children's dietary choices, energy intake
and body weight [2,3].
Research by Halford and Boyland at UoL from 2006 showed that in 5-7 year
old children, food advert exposure markedly increased food intake in all
children, and that recognition of food adverts is directly related to body
mass index (BMI). Exposure to food advertisements thus promotes
over-consumption in younger children generally, but a particular awareness
in overweight/obese children of unhealthy snack food brands suggests that
obese and overweight children are more responsive to food promotions, and
so at greater risk of negative health consequences . Indeed, a further
study demonstrated that obese and overweight children show a greater
preference for branded foods than do normal weight children . Further,
children with higher habitual levels of television viewing were more
responsive to food promotion messages, displaying a greater magnitude of
preference shift towards branded foods after viewing food commercials .
The UoL research went on to show that despite the 2009 Ofcom regulations
on advertising to children, children in the UK are exposed to more TV
advertising for unhealthy than healthy food items — even at peak
children's viewing times, with advertisers targeting programming popular
with children and adults alike, and directing children to
celebrity-endorsed websites where current regulations do not apply .
UoL's involvement in an international collaboration to examine the impact
of the regulatory environments of different countries on TV food
advertising to children showed a similar pattern worldwide .
References to the research
1. Halford JCG, Gillespie J, Brown V, Pontin EE, Dovey TM (2004)
The effect of television (TV) food advertisements / commercials on food
consumption in children. Appetite, 42 (2): 221-225.
doi:10.1016/j.appet.2003.11.006. Citations: 145 Impact Factor: 2.541
2. Halford JCG, Boyland E, Hughes G, Stacey L, McKean S, Dovey TM.
(2008) Beyond-brand effect of television food advertisements on food
choice in children: the effects of weight status. Public Health Nutrition.
11 (9); 897-904 DOI: 10.1017/S1368980007001231.
Citations: 47 Impact Factor: 2.250
3. Halford JCG, Boyland E, Cooper GD, Dovey TM, Smith CJ, Williams N,
Lawton CL, Blundell JE (2008). Children's preferences: Effects of weight
status and television food advertisements (commercials). International J.
Paediatric Obesity. 3; 31-38. DOI: 10.1080/17477160701645152.
Citations: 21 Impact Factor: 2.276
4. Boyland EJ, Harrold JA, Kirkham TC, Dovey TM, Lawton CL,
Blundell JE, Halford JCG (2011). Television food advertisements
(commercials) increase preference for energy-dense foods, particularly in
high TV viewing children. Pediatrics 128 (1) E93-E100 —
doi:10.1542/peds.2010-1859. Citations: Impact Factor: 5.119
5. Boyland EJ, Harrold JA, Kirkham TC, Halford JCG. (2011). The
extent of food advertising to children on UK television in 2008.
International Journal of Pediatric Obesity 6 (5-6) 455-461
doi:10.3109/17477166.2011.608801. Citations: 16 Impact Factor: 2.276
6. Kelly B, Halford JCG, Boyland EJ, Chapman K, Bauitisa-Castaño,
Berg C, Carolu M, Cook B, Coutinho JG, Effertz T, Grammatikaki E, Keller
K, Leung R, Manios Y, Monterio R, Pedley C, Prell H, Raine K, Recine E,
Serra-Majem L, Singh S, Summerbell C. (2010). Television food advertising
to children: a global perspective. American Journal of Public Health. 100
(9); 1730-1736. doi: 10.2105/AJPH.2009.179267. Citations: 38
Impact Factor: 3.930
Details of the impact
The World Health Organisation estimated that in 2010 42m children under
the age of 5 years were obese, of which nearly 35m were living in
developing countries. They describe childhood obesity as one of the most
serious public health challenges. A majority of obese children become
obese adults, and obesity leads to 30,000 premature deaths per year in the
UK alone and a cost of £1b to the NHS.
The UoL research into the impact of advertising on the food preferences
and intake of children is extensively used as an evidence base and source
of recommendations by regulators and policymakers throughout the world as
they grapple with the adverse consequences of increased childhood obesity
and associated childhood and life-long diseases such as diabetes. The
research also informs the public directly, enabling them to act and apply
political pressure. The following impacts have occurred since 2008 and
stem from the UoL research.
The UoL research, particularly that pre-dating current regulation on
advertising to children, definitively demonstrated links between branded
advertisements and increased preference for, and intake of, unhealthy,
obesity-inducing foods — especially amongst overweight and obese children
and those exposed to the most television. Consequently, the UoL has
pro-actively engaged in a programme of outreach to communicate these
findings to policymakers, health organisations and the general public in
the UK and internationally through interviews with UK and international
broadcast and print media with the objective of influencing policy debates
The research has strongly influenced policymakers
internationally. Since 2008, the UoL studies have been widely used by key
agencies to substantiate and promote their policy positions, including the
International Obesity Taskforce of the International Association for the
Study of Obesity, the British Heart Forum and US Institute of Medicine, as
well as the European strata of the World Health Organisation.
In 2008, the UoL was invited by the Department of Health to bring
together key policy stakeholders to report on the impact of new media on
the marketing of food and beverages to children. The initial UoL studies
were presented to the WHO via the European Network for the Reduction of
Marketing to Children, an organisation of European Health Ministries
constituted to coordinate national contributions to the formulation and
implementation of WHO recommendations on the marketing of foods and
non-alcoholic beverages to children. Two extensive, systematic literature
reviews formed the basis for the WHO recommendations, with the UoL body of
work informing the key report on the extent, nature and effects of food
promotion to children [8, 9]. In 2011, due to the strength of UoL research
and the body of evidence built up, the WHO (represented by Dr Joao Breda,
Programme Manager, Nutrition, Physical Activity and Obesity) entered into
an agreement with the UoL to develop a European WHO-collaborating centre
examining the marketing of food and non-alcoholic beverages to children
. The UoL has contributed directly to WHO reviews and policy
documents; the UoL's Halford and Boyland were the sole academic
consultants in the preparation of the WHO report, Marketing of foods
high in fat, salt and sugar to children .
The public dissemination programme driven by the UoL research and its
citation by others generated political pressure to act. In 2009, Ofcom
fully implemented regulations on the promotion of high fat, salt and sugar
(HFSS) foods to children on television and in 2010 they reported that
there was a ~37% reduction in such advertising. Regulators have
benefited from being able to act on sound evidence and the general
public have benefited from increased understanding  .The UK
example of regulation was not the first, but it is often cited
internationally so other regulators are taking a keen interest in the
impact of the UoL research when formulating their policies.
Broadcast media are only a part of the advertising problem; there is
increasing use of internet and mobile telephone applications to direct
marketing at children, so it is now recognised that broader action has to
be taken. In this context, the UoL's recognized expertise and research on
advertising has informed the UK Department of Health (2008-), the European
Network on Reducing Marketing Pressure on Children (2010-) , the
EU-funded StanMark project for improved marketing standards (2010-11)
, and WHO (European region) [9,10,11,14] as they seek to tackle all
avenues of food advertising.
These findings on the failure to control food promotion to children along
with more recent experimental data on advert exposure on children's food
preferences are regularly presented to WHO, European and international
health agencies, where they continue to inform the development of
recommendations for regulatory regimes.
Sources to corroborate the impact
Each source listed below provides evidence for the corresponding numbered
claim made in section 4 (details of the impact).
- Boyland interview on Radio 4's `All in the Mind' programme (broadcast
8th June 2011) http://www.bbc.co.uk/programmes/b011p6yv
- Cairns G, Angus K, Hastings G. The extent, nature and effects of
food promotion to children: a review of the evidence to December 2008.
Geneva, WHO, 2009 (http://www.who.int/dietphysicalactivity/Evidence_Update_2009.pdf
- WHO (2010) Set of recommendations on the marketing of foods and
non-alcoholic beverages to children.
- Letter: Nutrition, Physical Activity and Obesity, WHO Europe. (Able to
corroborate UoL's international standing in the field of food marketing
research, contribution to WHO policy documents (as authors and the
inclusion of UoL research findings as key evidence) and our progression
towards achieving WHO Collaborating Centre status for the Department of
- WHO 2013. Marketing of foods high in fat, salt and sugar to children:
update 2012-2013. ISBN 978 92 890 009 3.
- European Marketing Network on reducing marketing pressure on children
— report from the 7th meeting (Copenhagen 2012). http://www.helsedirektoratet.no/english/topics/food-marketing-children/Documents/Final%20report%20seventh%20meeting%20in%20European%20Network.pdf
- IASO (2012) The 2012 report of the StanMark project on standards for
marketing food and beverages to children in Europe. http://www.iaso.org/site_media/uploads/A_Junk-free_Childhood_2012.pdf
- WHO (2012) A framework for implementing the set of recommendations on
the marketing of foods and non-alcoholic beverages to children (2012).