Frans Folkvord

The effect of playing advergames that promote energy-dense snacks or fruit on actual food intake among children

BACKGROUND Previous studies have focused on the effects of television advertising on the energy intake of children. However, the rapidly changing food-marketing landscape requires research to measure the effects of nontraditional forms of marketing on the health-related behaviors of children. OBJECTIVES The main aim of this study was to examine the effect of advergames that promote energy-dense snacks or fruit on childrens ad libitum snack and fruit consumption and to examine whether this consumption differed according to brand and product type (energy-dense snacks and fruit). The second aim was to examine whether advergames can stimulate fruit intake. DESIGN We used a randomized between-subject design with 270 children (age: 8-10 y) who played an advergame that promoted energy-dense snacks (n = 69), fruit (n = 67), or nonfood products (n = 65) or were in the control condition (n = 69). Subsequently, we measured the free intake of energy-dense snacks and fruit. The children then completed questionnaire measures, and we weighed and measured them. RESULTS The main finding was that playing an advergame containing food cues increased general energy intake, regardless of the advertised brand or product type (energy-dense snacks or fruit), and this activity particularly increased the intake of energy-dense snack foods. Children who played the fruit version of the advergame did not eat significantly more fruit than did those in the other groups. CONCLUSION The findings suggest that playing advergames that promote food, including either energy-dense snacks or fruit, increases energy intake in children.

Impulsivity, “Advergames,” and Food Intake

BACKGROUND AND OBJECTIVES: Previous studies have focused on the effect of food advertisements on the caloric intake of children. However, the role of individual susceptibility in this effect is unclear. The aim of this study was to examine the role of impulsivity in the effect of advergames that promote energy-dense snacks on children’s snack intake. METHODS: First, impulsivity scores were assessed with a computer task. Then a randomized between-subject design was conducted with 261 children aged 7 to 10 years who played an advergame promoting either energy-dense snacks or nonfood products. As an extra manipulation, half of the children in each condition were rewarded for refraining from eating, the other half were not. Children could eat freely while playing the game. Food intake was measured. The children then completed questionnaire measures, and were weighed and measured. RESULTS: Overall, playing an advergame containing food cues increased general caloric intake. Furthermore, rewarding children to refrain from eating decreased their caloric intake. Finally, rewarding impulsive children to refrain from eating had no influence when they were playing an advergame promoting energy-dense snacks, whereas it did lead to reduced intake among low impulsive children and children who played nonfood advergames. CONCLUSIONS: Playing an advergame promoting energy-dense snacks contributes to increased caloric intake in children. The advergame promoting energy-dense snacks overruled the inhibition task to refrain from eating among impulsive children, making it more difficult for them to refrain from eating. The findings suggest that impulsivity plays an important role in susceptibility to food advertisements.

The role of attentional bias in the effect of food advertising on actual food intake among children

This study examined the potential moderating role of attentional bias (i.e., gaze duration, number of fixations, latency of initial fixation) in the effect of advergames promoting energy-dense snacks on childrens snack intake. A randomized between-subject design was conducted with 92 children who played an advergame that promoted either energy-dense snacks or nonfood products. Eye movements and reaction times to food and nonfood cues were recorded to assess attentional bias during playtime using eye-tracking methods. Children could eat freely after playing the game. The results showed that playing an advergame containing food cues increased total intake. Furthermore, children with a higher gaze duration for the food cues ate more of the advertised snacks. In addition, children with a faster latency of initial fixation to the food cues ate more in total and ate more of the advertised snacks. The number of fixations on the food cues did not increase actual snack intake. Food advertisements are designed to grab attention, and this study shows that the extent to which a childs attention is directed to a food cue increases the effect of the advertisement.

Targeting implicit approach reactions to snack food in children: Effects on intake

OBJECTIVE Implicit approach reactions to energy-dense snack food can facilitate unhealthy eating in children. Therefore, an experiment was conducted to test whether modifying implicit reactions to snack food by means of a go/no-go task can reduce consumption of this food. The effectiveness of this intervention on actual snack intake after exposure to a food or a control advertisement was tested. METHOD Children (133; age range = 7-10 years) played an advergame promoting either energy-dense food or nonfood products. Subsequently, children conducted either a go/no-go food task in which the advertised food was consistently associated with no-go cues, or a go/no-go control task in which colored circles were consistently associated with no-go cues. Afterward, they could eat the advertised food and a new food. Candy intake was weighed and caloric intake was determined. RESULTS Results show that children who performed the go/no-go food task consumed significantly and considerably fewer calories (34%) than the children who carried out the control task. No main effect of type of advertisement was found. Furthermore, the effect of the go/no-go food task was similar after each type of advertisement, similar for advertised and new foods, and was significant for both girls and boys. CONCLUSION Targeting implicit reactions to high-energy snacks proved effective in decreasing intake of snacks in children. Furthermore, the previously reported stimulating effect of food promoting advergames on intake may disappear when a short cognitive task is presented directly after the game. Future work should evaluate the clinical implications of these findings. (PsycINFO Database Record

Food advertising and eating behavior in children

Systematic research reviews have repeatedly shown that food advertising affects childrens eating behavior. Given that most food advertising promotes unhealthy, palatable, and rewarding food products, it is considered to be a significant contributor to the current obesity epidemic. This review describes recent studies that have tested the effect of contemporary food advertisements on childrens eating behavior, including newly emerging data showing marketing effects on subconscious cognitive processes and studies illuminating the mechanistic underpinnings of these effects. In addition, this review presents an integration of empirical findings in a new theoretical framework that increases the understanding of the effects of food advertising on eating behavior and might be used for future research in this area.

The effect of playing advergames promoting healthy or unhealthy foods on actual food intake among children

This experimental study investigates whether playing advergames promoting healthy or unhealthy food influences food intake among children. Three hundred children aged 8–10 played an advergame and afterwards free intake of healthy and unhealthy foods was measured. Children in the experimental conditions either played a healthy food, unhealthy food or a neutral version of a branded memory game for 5 min before eating. Afterwards, they completed questionnaire measures. Children in the control group ate before completing the questionnaire, without playing a game. Preliminary results show that playing an advergame containing (either healthy or unhealthy) food cues leads to higher caloric intake of unhealthy and healthy food. Children who played the healthier version of the advergame did not eat significantly more healthy food than did those who played the less healthy version. Children who played the unhealthy version of the advergame did not eat significantly more unhealthy food than did those who played the healthier version. These findings suggest that playing advergames promoting food, regardless of the food being healthy or unhealthy, might increase the (caloric) amount of food intake in children.

The association between BMI development among young children and (un)healthy food choices in response to food advertisements: a longitudinal study

BackgroundPrevious studies have focused on the acute effects of food advertisements on the caloric intake of children; however, the long-term effects of this food cue reactivity on weight gain have not been examined. The main aim of this study was to explore if reactivity to food cues in an advertisement was associated with weight status two years later.MethodsChildren wo had previously taken part in an experiment investigating the impact of advergames on food intake had their height and weight re-measured two years later, for assessment of body mass index (BMI). A within-subject design was used to test the associations between food choices and BMI over time. In the previous experiment, children played an advergame that promoted energy-dense snacks, fruit, or nonfood products, or did not play an advergame (control condition). After playing the game, the free intake of energy-dense snacks and fruits was measured.ResultsChildren who ate more apple after playing an advergame promoting energy-dense snacks had a lower BMI two years later. Consumption of energy-dense snacks after playing an advergame promoting energy-dense snacks was not associated with BMI two years later. In other condition, no association was found between food intake and BMI after two years .ConclusionsThe findings suggest that coping with environmental cues that trigger unhealthy eating behavior is associated with the body mass index of young children two years later. This might imply that learning to respond to food cues by choosing healthy options might prevent children from excessive weight gain.This trial was registered at as ISRCTN17013832.

Attentional bias for food cues in advertising among overweight and hungry children

Attentional bias theory suggests that an increased motivation to receive or avoid a rewarding substance elevates automatic selective attention toward cues that are related to that specific substance. Until now, no study has examined attentional bias toward food cues in food advertisements, even though these are designed to grab the attention of possible consumers and induce craving and eating behavior. This study aims to examine if overweight and hungry children have an attentional bias for food cues when exposed to food advertising. A randomized between-subject design was used with 95 children (age: 7- 10 years) who played an advergame that promoted either energy-dense snacks or nonfood products. While playing, eye-movements to food or nonfood cues were recorded to assess attentional bias. We found that overweight children had a higher gaze duration for the food cues (P < 0.05, Cohens d = 0.72) compared to normal weight children. We found no effects of overweight for number of fixations and latency of initial fixation for the food cues. No effects were found of overweight on the attentional bias measurements for the nonfood cues. Furthermore, hungrier children had a higher gaze duration (P < 0.05, Cohen’s f2 = 0.18), a higher number of fixations (P < 0.05, Cohens f2 = 0.19), and a faster latency of initial fixation on the food cues than less hungry children (P < 0.05, Cohens f2 = 0.15), whilewe found the opposite results for the nonfood cues. Food cues trigger attention to a larger extent among overweight and hungrier children. The findings largely confirm our expectations, adding important knowledge to existing literature about attentional bias theory.

A systematic review of mHealth interventions for the support of eating disorders

OBJECTIVE To systematically review the existing evidence of mobile health (mHealth) tools for the treatment of eating disorders (ED). METHOD Electronic databases (Pubmed, PsycInfo, and SCOPUS) were searched, and PRISMA guidelines were followed. Selected studies were divided into three categories according to the intended purpose of the mHealth tools used: (a) sole means of support, (b) complementary to standard face-to-face treatment, and (c) for relapse prevention. Additionally, studies were assessed on efficacy, qualitative information, and methodological quality. RESULTS Fifteen studies were identified. Most studies using mHealth as a sole means of intervention or adjunct to traditional therapy showed no effects, although an improvement at postassessment was present in vodcast, smartphone application, and text-messaging interventions. Between group effects were only found for a text-messaging intervention for relapse prevention. Qualitative analyses showed that most mHealth interventions were considered as acceptable, supporting, and motivating by patients and therapists, although different important problems were observed in individual studies. CONCLUSIONS Limited effects were found for mHealth interventions to reduce ED-related symptoms. A common evaluation framework for ED mHealth interventions should be proposed to assess the validity of interventions before implementing them on a larger scale in clinical practice.

Cognitive Therapy for Dementia Patients: A Systematic Review

Background: Cognitive therapy is a well-established intervention for treating elderly suffering from dementia. In particular, reality orientation and skills training seem to be effective interventions for reversing cognitive impairment among elderly, although findings are inconclusive. Therefore, a systematic update of the existing evidence of cognitive therapy for people suffering from dementia is needed. Aim: To review existing scientific evidence regarding the efficacy of cognitive therapies for elderly suffering from dementia. Methods: Studies were retrieved from several bibliographic databases (January 2009 to December 2017) with prespecified selection criteria, data extraction, and methodological quality assessment. Results: In total, 10 reality orientation, 25 skills training, and 12 mixed trials were identified as meeting the inclusion criteria and were systematically reviewed. Results from reality orientation trials showed minor effects for cognitive assessments, while skills training trials and mixed trials showed contradicting effects on cognition. Effects on other outcomes (e.g., daily functioning, depression, language) were limited or not found. Conclusions: Skills training trials and mixed trials seem to affect cognitive impairment in a positive way, although the results are inconclusive. Comparison between studies was difficult due to differences in form of intervention. Because findings are inconclusive, more structuralized and comparable randomized controlled trials are needed.