Monday, 7 July 2014

Children’s TV contains unhealthy 'food cues'

Children’s TV contains unhealthy 'food cues' “Children are being bombarded with scenes of unhealthy eating on TV,” The Independent reports. Researchers looking at public broadcasting in the UK and Ireland have found that children’s TV contains a high number of visual and verbal references to unhealthy foods.

In the UK, direct TV advertising of unhealthy food to children has been banned since 2008.

However, the researchers were still interested in whether children’s TV broadcast by state-funded organisations still promotes unhealthy food choices to young children.

Researchers assessed five weekdays of children programmes from the BBC and its Irish equivalent, RTE. They were interested in what they describe as “cues” – visual, verbal and plot-driven references to specific foods and drinks.

Unhealthy foods accounted for just under a half of specified food cues, and sugar-sweetened beverages for a quarter. The context of the food and drink cue was mostly positive or neutral, with celebratory/social motivations the most common.


As the programmes were on non-commercial TV, it could be the case that the inclusion of said cues was due to cultural, and not commercial, reasons.

The plot device of a “slap-up meal” as a reward for a job well done, or as a treat, is a constant in children’s fiction, ranging from Rastamouse to the Famous Five.

Importantly, however, the study can’t tell us whether the food and drink cues directly influence the children’s food and drink requests or their eating patterns.

Where did the story come from?

The study was carried out by researchers from the University of Limerick in Ireland and Dalhousie University, in Halifax, Canada. No sources of financial support are reported.

The study was published in the peer-reviewed medical journal Archives of Diseases of Childhood, and has been released on an open-access basis, so is free to read online.

Overall reporting of the study by BBC News and The Independent is of a good quality.

The BBC includes useful wider debate on the issue, with Malcolm Clark, coordinator of the Children's Food Campaign, saying: “It is disappointing that children’s TV seems to be so tamely reflecting the obesogenic environment we all live in, rather than presenting a more positive vision of healthy, sustainable food.”

An obesogenic environment is an environment that promotes unhealthy food choices, such as a workplace located next to lots of fast food outlets. We discussed obesogenic environments back in March of this year.

A BBC spokesperson defended its content, saying: “We broadcast lots of programmes to promote healthy eating to children and to help them understand where food comes from, with series like I Can Cook, Incredible Edibles and Blue Peter.”

What kind of research was this?

This was an observational study that examined the frequency and type of food and drink references contained on children’s TV programmes during five weekday mornings, comparing UK and Irish state-funded television channels.

Previous research has demonstrated how there is an association between child weight and the amount of TV that they watch.

The researchers suggest that this could be due to a combination of greater periods of inactivity, and exposure to food advertising while watching TV.

Advertisements targeted at children are said to be dominated by high-calorie, low nutritional-quality foods, and previous research has associated child TV viewing with consumption of low nutrient-density foods, persuading parents to purchase such food, which leads to the development of poor eating habits.

Direct advertising to children of “junk food” has been banned during children’s programming in the UK since 2008, although many children watch adult programming, such as talent shows and soap operas.

There is also the possibility that non-commercial programming may promote unhealthy food choices.

This study aimed to investigate this by looking at food and drink references in broadcasts aimed at children.

Understanding the influences and patterns on children’s eating habits may help in the development of further measures to improve healthy eating, in addition to targeting the overweight and obesity epidemic. However, this study only provides a small snapshot of food and drink references on child’s TV during a one-week period. It cannot tell us how the many other types of media advertising influence eating patterns, or capture the wider picture of all the lifestyle and environmental factors that are associated with overweight and obesity.

What did the research involve?

This research only reviewed the public broadcast channels of the BBC in the UK, and Radio Teilifis Eireann (RTE) in Ireland. These channels were said to be studied as they are “‘public-good’ channels, which aim to inform, educate and empower audiences”.

In July and October 2010, the researchers examined a total 82.5 hours of broadcast on these channels over five weekdays, looking at programmes broadcast between 06.00 and 11.30 on the BBC and between 06.00 and 17.00 on RTE.

The researchers looked at food or drink references (or cues), defined as “a product being displayed within a food-specific context with potential to be consumed”. Cues were coded by type of product and as healthy or non-healthy (based on the food pyramid).

Healthy foods included breads/grains, cereals, meats, dairy, fruit, vegetables, fish and sandwiches.

Unhealthy foods included fast food/convenience meals, pastries, savoury snacks, sweet snacks/bars, ice cream and candy.

Beverages were coded and grouped as water, juices, tea/coffee, sugar-sweetened or unspecified.

They recorded the context of the cue (e.g. whether it was part of a meal, in the school or home setting, etc), and what motivations and consequences were associated with the food (e.g. as a reward, to relieve thirst or hunger).

What were the basic results?

The researchers recorded one food or drink cue every 4.2 minutes, equivalent to 450 on the BBC and 705 on RTE. The total recorded time involving food or drink cues was 4.8% of the total 82.5 hours, covering 3.94 hours and averaging 13.2 seconds per cue.

The most foods most commonly seen could not be grouped into a distinct food group (unspecified, 16.6%), followed by sweet snacks (13.3%), sweets/candy (11.4%) and fruit (11.2%). The most common beverages were also unspecified (35.0%), followed by teas/coffee (13.5%) and sugar-sweetened (13.0%). Unhealthy foods account for 47.5% of specified food cues, and sugar-sweetened beverages for 25%.

Just over a third of the cues were visual, a quarter verbal, and the remainder were visual and verbal combined.

A third of the cues were in the home setting, and in a third of cases, the food or drink was consumed.

Half of the programmes involving food and drink cues involved humans, and half were in animations (human or other). In a quarter of the cases, the motivation for the cue was celebratory/social; in a quarter, it was to relieve hunger/thirst.

In a third of the cases, the motivation and outcomes associated with the food cue were positive, in half they were neutral, and the remainder were negative.

When comparing the two broadcast channels (only the morning broadcasts when they had data for both), there were significantly more cues on the BBC than the Irish channel; correspondingly, this involved both significantly more healthy cue and unhealthy cues. On RTE, the most common types of foods depicted in 20.5% of cues were unspecified, though on the BBC sweet snacks topped the chart, at 19%.

RTE contained significantly more cues for breads/grains, condiments and breakfast pastries, while BBC had significantly more for fruit, sweet snacks and ice cream. For beverages, it was most commonly unspecified in both countries.

BBC included more visual cues, while RTE had more verbal. BBC also had more animated characters, while RTE had more human. For both countries, the motivation was most often celebratory/social, followed by hunger/thirst. Health was not recorded as a cue motivation on the BBC, while it was in 6.2% of RTE cues.

How did the researchers interpret the results?

The researchers concluded that, “This study provides further evidence of the prominence of unhealthy foods in children’s programming. These data may provide guidance for healthcare professionals, regulators and programme makers in planning for a healthier portrayal of food and beverages in children’s television”.

Conclusion

This study provides a snapshot of the food and drink cues/references contained in children’s TV programmes on BBC and RTE over five weekdays, totalling 82.5 hours of broadcasting.

The research demonstrates the frequency of cues, the types of food and drink associated, and the motivations for the food cue.

This includes the observation that unhealthy foods accounted for just under half of specified food cues, and sugar-sweetened beverages accounted for a quarter.

The context of the food and drink cue was mostly positive, with celebratory/social motivations the most common.

Importantly, this study can’t tell us whether these food and drink cues actually have any direct influence on a child’s food and drink requests or their eating patterns. While an association between a child’s duration of TV viewing and overweight/obesity has previously been established, this is unlikely to be a result of a single factor, such as exposure to food and drink cues in TV programmes. Other factors – most notably, lack of physical activity while watching TV, and possibly the mindless eating snacks while watching – are likely to have a big influence.

As both BBC and RTE are publicly funded broadcasters, it is unlikely that any unhealthy food cues were included for commercial reasons (notorious examples include the McDonalds “Hamburglar” or “Tony the Tiger”, which was used to sell sugared flakes).

The idea that food is a treat or celebration has long been part of children’s fiction, such as the Famous Fives' “lashing of ginger beer and ice creams”.

It would be interesting to take a broader look at the content across TV channels and over a broader period of time, and also compare the content in programmes targeted at children compared to teenagers and adults.

The food and drinks in this study were categorised into broad groups “healthy” or “unhealthy” groups, but this may not necessarily be the case. For example, healthy foods included breads/grains, cereals, meats, dairy and sandwiches. However, in all of these food groups, you can get many different “healthy” and “unhealthy” versions of each.

Ultimately, while television may be useful as an occasional babysitter, it is no substitute for parenting.

Teaching your child healthy habits at an early age increases the chances that such habits will persist into adulthood.

Read more about encouraging healthy eating in children.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join theHealthy Evidence forum.

Links To The Headlines

Children bombarded with unhealthy eating messages on TV, experts warn. The Independent, July 4 2014

Children's TV 'packed with junk-food references'. BBC News, July 4 2014

Links To Science

Scully P, Reid O, Macken A, et al. Food and beverage cues in UK and Irish children—television programming. Archives of Disease in Childhood. Published online June 30 2014

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