Margo G. Wootan

Nine out of 10 Food Advertisements Shown During Saturday Morning Children’s Television Programming Are for Foods High in Fat, Sodium, or Added Sugars, or Low in Nutrients

A 2005 review by the Institute of Medicine of the National Academies concluded that food marketing influences childrens food preferences, consumption, and health. Given the powerful influence of marketing on childrens diets, this cross-sectional study examined the types of foods, the nutritional quality of those foods, and the marketing techniques and messages used in food advertising during Saturday morning childrens television programming. During 27.5 hours of programming in May 2005, 49% of advertisements shown were for food (281 food advertisements out of 572 total advertisements). The most commonly advertised food categories were ready-to-eat breakfast cereal and cereal bars (27% of all food advertisements), restaurants (19% of food advertisements), and snack foods (18% of food advertisements). Ninety-one percent of food advertisements were for foods or beverages high in fat, sodium, or added sugars or were low in nutrients. Cartoon characters were used in 74% of food advertisements, and toy or other giveaways were used in 26% of food advertisements. About half of food advertisements contained health/nutrition or physical activity messages and 86% of food advertisements contained emotional appeals. This study provides food and nutrition professionals with information about the amount and types of food children are encouraged to eat during Saturday morning television programming. The findings can help food and nutrition professionals counsel children about healthful eating and/or develop programs or policies to balance those advertisements with healthful eating messages.

Exploratory Analysis of Fast-Food Chain Restaurant Menus Before and After Implementation of Local Calorie-Labeling Policies, 2005–2011

Introduction Since 2008, several states and municipalities have implemented regulations requiring provision of nutrition information at chain restaurants to address obesity. Although early research into the effect of such labels on consumer decisions has shown mixed results, little information exists on the restaurant industry’s response to labeling. The objective of this exploratory study was to evaluate the effect of menu labeling on fast-food menu offerings over 7 years, from 2005 through 2011. Methods Menus from 5 fast-food chains that had outlets in jurisdictions subject to menu-labeling laws (cases) were compared with menus from 4 fast-food chains operating in jurisdictions not requiring labeling (controls). A trend analysis assessed whether case restaurants improved the healthfulness of their menus relative to the control restaurants. Results Although the overall prevalence of “healthier” food options remained low, a noteworthy increase was seen after 2008 in locations with menu-labeling laws relative to those without such laws. Healthier food options increased from 13% to 20% at case locations while remaining static at 8% at control locations (test for difference in the trend, P = .02). Since 2005, the average calories for an à la carte entrée remained moderately high (approximately 450 kilocalories), with less than 25% of all entrées and sides qualifying as healthier and no clear systematic differences in the trend between chain restaurants in case versus control areas (P ≥ .50). Conclusion These findings suggest that menu labeling has thus far not affected the average nutritional content of fast-food menu items, but it may motivate restaurants to increase the availability of healthier options.

Poor Nutrition on the Menu: Children’s Meals at America’s Top Chain Restaurants

BACKGROUND We evaluated the nutritional quality of childrens meals at chain restaurants, because children obtain about a third of their daily calories from away-from-home foods and studies show that restaurant foods are often higher in calories and lower in nutritional value than foods prepared at home. METHODS We assessed the nutritional quality of childrens meals at the 50 largest U.S. restaurant chains by visiting each chains web site or calling the company. Eighteen of the chains did not have childrens meals and 10 did not provide adequate nutrition information to be included in the study. The nutritional quality of each meal combination was evaluated against a set of nutrition standards based on key nutrition recommendations in the Dietary Guidelines for Americans. RESULTS Of the 22 restaurants that had childrens menus and available nutrition information, 99% of 1662 childrens meal combinations were of poor nutritional quality. CONCLUSIONS Restaurants should support healthier choices for children by reformulating existing menu items and adding new healthier items, posting calories on menus, and setting nutrition standards for marketing to children.

The Nation Needs to Do More to Address Food Marketing to Children

r p c Foodmarketing has never been more important, as childhood obesity rates remain high, and food and beverage marketing takes on ever new and more ophisticated forms. Yet despite strong recommendaions from the IOM, there has been little progress to ddress it, as Kraak et al. demonstrate in their paper in this issue of theAmerican Journal of PreventiveMedicine. In 2006, the IOM threw down the gauntlet with its seminal report, Food Marketing to Children: Threat or Opportunity? It answered the request from Congress to ssess the evidence onwhether foodmarketing influences hat children and adolescents eat. After evaluating more han 300 studies, the Committee on FoodMarketing and he Diets of Children and Youth determined that food arketing causes children and adolescents to prefer, reuest, and consume foods high in salt, sugars, and fats. he Committee made ten recommendations for how the ood industry and the government could reverse this ituation. In this issue of the Journal, Kraak and colleagues asess progress on five recommendations the Committee ade for parents, schools, and government. Unfortuately, they found that there has been little progress. heir evaluation concludes that “the prevailing marketng environment continues to threaten children’s health nd miss opportunities to promote a healthful diet and reate healthy eating environments.” In a prior study, the same authors found equally disappointing results for the recommendations the IOM made for the food and beverage industry. With the current study, we learn that government has not done what it can to protect children from marketing that infiltrates family life and interferes with good health. This lack of progress puts parents at a disadvantage and children’s health at risk. For example, with noprogress on the IOM’s recommendation for a national social marketing campaign, our government is ceding education about nutrition to the food and beverage industry, which

Policy and system changes in marketing foods to children.

In the October issue of Childhood Obesity, David Katz called for action on so-called ‘‘kid’’ food and proposed a day of national boycott to focus attention on this issue and bring about change. This roundtable brings together experts in policy, nutrition, and pediatrics to discuss the availability of kid food and the marketing of unhealthy food to children. The panel presents strategies and ideas on advocacy efforts and policy and system change to accelerate progress in regulating food marketing and reducing advertising of unhealthy foods to children.

Nutritional Quality of Menu Offerings at Eight Fast-Food Chains in the U.S.: A Commentary

690 Am J P In this issue of the American Journal of Preventive Medicine, Hearst and colleagues use the U.S. Department of Agriculture (USDA)’s Healthy Eating Index to provide a much-needed assessment of the nutritional quality of fast food and evaluate how it has changed over 14 years. Their results show that the nutritional quality of fast food has improved little over the last decade, rising a mere three points out of a 100point scale. This tiny increase is disappointing, and a bit surprising, given the many pronouncements by companies that they have added healthier menu options, switched to healthier cooking fats, are reducing sodium, and are touting other changes in company press releases and advertising. While some improvement is better than none, the food from the fast-food restaurants analyzed in this study earned an average score of just 48 out of a possible 100 points. That score is even lower than the average American diet’s score of 55, which the USDA considers ‘‘far from optimal.’’ Component scores are low for providing enough fruits, vegetables, and whole grains, and for containing too much saturated fat and sodium. Fastfood restaurants earned only two optimal component scores, with restaurants offering plenty of meat and oil. The nutritional quality of restaurant foods may not have mattered as much, decades ago when people ate out less often. Americans now spend 41% of their food dollars on foods eaten outside the home, up from 26% in 1970. Adults and children consume an average of one third of their calories from eating out. Given the increased prominence of restaurant foods in Americans’ diets, restaurant operators need to change their thinking about the role their foods play in their customers’ diets and their possible contribution to obesity and other diet-related health problems, such as diabetes, high cholesterol, and high blood pressure. Birthdays, anniversaries, and other special occasions