International Journal of Obesity (2014) 38, 558–562 © 2014 Macmillan Publishers Limited All rights reserved 0307-0565/14 www.nature.com/ijo

PEDIATRIC ORIGINAL ARTICLE

The influence of the Children’s Food and Beverage Advertising Initiative: change in children’s exposure to food advertising on television in Canada between 2006–2009 M Potvin Kent1 and A Wanless2 OBJECTIVE: To assess whether children’s exposure to television food/beverage advertising has changed since the implementation of the self-regulatory Canadian Children’s Food and Beverage Advertising Initiative (CAI). DESIGN: Data on 11 advertised food/beverage categories (candy, chocolate bars, cookies, portable snacks, cheese, yogurt, cereal, juices, soft drinks, diet soft drinks and fast food) were purchased from Nielsen Media Research for May 2006, 2009 and 2011 for the broadcasting markets of Toronto and Vancouver. The number of advertisements aired on 27 television stations between 0600 hours–1200 hours was determined in Toronto and Vancouver for May 2006, 2009 and 2011 and the percentage change in the number of spots between May 2006 and May 2011 on all stations, on children’s specialty stations and on generalist stations was then calculated. The average number food/beverage spots seen by children aged 2–11 was determined for May 2006 and 2009 and the percentage change was calculated. RESULTS: On children’s specialty channels, a 4.5% decrease in total spots aired was observed while spots aired on generalist stations increased by 44% (Toronto) and 45% (Vancouver). On all stations, children’s total average exposure to food/beverage advertising increased by 16.8% in Toronto and 6.4% in Vancouver between 2006 and 2009. Significant increases were seen in snacks and yogurt in both cities, and in fast food in Toronto. On children’s specialty channels, children’s exposure to the food/beverage categories considered increased by 5.4% in Toronto and by 2.5% in Vancouver. CONCLUSIONS: Despite improvements in the volume of spots on children’s specialty channels, children’s exposure to food and beverage advertising has increased since the implementation of the CAI. The current self-regulatory system is failing to protect children from food marketing high in fat, sugar and sodium on television. Government regulation needs to be considered. International Journal of Obesity (2014) 38, 558–562; doi:10.1038/ijo.2014.4 Keywords: children; food marketing; policy; prevention

INTRODUCTION The relationship between food marketing and childhood obesity has been shown in two systematic reviews of the literature,1–2 and the World Health Organization has recently recommended the reduction of food and beverage marketing directed at children that is high in sugar, fat and sodium in order to help reduce the burden of obesity worldwide.3 In Canada, prevalence rates for overweight/obesity for children aged 6–11 increased from 13 to 26% between 1978 and 2004.4 In September 2010, the national and provincial ministers of health identified marketing to children as one of the three policy priorities to help curb childhood obesity.5 In Canada, advertising is mostly selfregulated by industry. The Canadian Children’s Food and Beverage Advertising Initiative (CAI) was initiated in April 2007 by 16 large food/beverage manufactures and fully implemented by December 2008.6 Cadbury Adams Canada, Coca-Cola Canada, Hershey Canada, Janes Family Foods, Mars Canada, McCain Foods Canada, PepsiCo Canada and Unilever Canada pledged to not direct any advertising to children under 12 years on multiple media platforms (television, radio, print and the Internet). Burger King Restaurants of Canada, Campbell Company of Canada, General Mills Canada Corporation, Kellogg Canada, Kraft Canada, 1

McDonald’s Restaurants of Canada, Nestle Canada, Parmalat Canada and Weston Bakeries Limited committed that 50% of their advertising directed at children under 12 years would consist of ‘healthier dietary choices’. Each participating company independently developed their own audience thresholds and definition of ‘healthier dietary choices’.6 Recent evidence evaluating the influence of a similar selfregulatory initiative in the United States has shown that children’s exposure to food/beverage marketing on television decreased by 17.8% for 2–5 year olds and by 6.9% for 6–11 year olds between 2003 and 2009.7 Another study reported that children’s exposure to food advertising decreased modestly from 14.0 advertisements per day in 2004 to 12.8 ads per day in 2011.8 Modest decreases have also been reported in Australia, where food advertisements on television decreased from 7 per hour in 2007 to 5.9 per hour in 2009 after the Australia Food and Grocery Council initiative was implemented.9 Research in Canada to date has shown that the companies participating in the CAI are responsible for more television food/beverage advertising during the preferred viewing times of children aged 10–12, engage in more repetition of advertising and advertise products that are less healthy compared with companies not participating in the CAI.10 No research in

Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada and 2Independent Consultant, Gatineau, QC, Canada. Correspondence: Dr M Potvin Kent, Interdisciplinary School of Health Sciences, University of Ottawa, 25 University Private, Room 140, Ottawa, ON, Canada K1N 6N5. E-mail: [email protected] Received 16 May 2013; revised 25 November 2013; accepted 1 January 2014; accepted article preview online 14 January 2014; advance online publication, 11 February 2014

Children's exposure to TV food advertising M Potvin Kent and A Wanless

559 Canada to date has compared the volume of food and beverage marketing on television and children’s exposure with this marketing before and after the implementation of the CAI. The purpose of this research study was to examine these questions. It was hypothesized that a reduction in food/beverage advertising and in children’s exposure would be seen on children’s specialty channels since implementation of the CAI.

MATERIALS AND METHODS Data for 11 advertised food/beverage categories (candy, chocolate bars, cookies, portable snacks, cheese, yogurt, cereal, juices, soft drinks, diet soft drinks and fast food) were purchased from Nielsen Media Research, a company that conducts marketing research relating to television viewing data and advertising information services. Data were purchased for May 2006, 2009 and 2011 for Vancouver and Toronto. Due to financial constraints, the 2009 data purchased excluded candy, chocolate and cookies. It is unclear as to why these categories were excluded as this decision was made prior to study conception and design. Food category definitions were those used by Nielsen Media Research. Candy included confectionary made from sugar, water, flavorings and food coloring. Chocolate bars included candy bars with chocolate typically packaged in a single serving size in a bar form. Cookies included all small baked sweet biscuits or cookies. Snacks included portable cereal-based and muffin-type snacks in bars, clusters or squares and processed and pure form fruit snacks in a bar, sheet or roll format that are packaged individually. It excluded cookie compartment snacks and toaster pastries. Cheese included all cheese products in brick, string or slice format. Yogurt included all yogurt products sold in tubes, tubs and in drink form. Cereals included cold cereals marketed as breakfast foods that are ready-to-eat from the package and excluded oatmeal and infant cereals. Juices included sweetened and unsweetened juice, drink and nectar beverages either liquid, frozen or concentrate, dry-packaged powder and granules that produce a drink when mixed with water. Regular soft drinks included nonalcoholic carbonated drinks such as colas, flavored water, lemonade and fruit punch. Sports drinks and energy drinks were excluded. Diet soft drinks included the diet version of the regular soft drink category. Fast food consisted of restaurants where ordering is undertaken at a counter or drive-through, menu boards are utilized, alcohol is not served, tips are not given and table clean-up is done by the customer. The broadcasting markets of Vancouver and Toronto were chosen because they are the two largest English language television markets in Canada and represent very different geographic areas of the country. Data were purchased for the month of May because of its distance from major holidays that could influence and possibly inflate advertising budgets. For each month/year examined, four weeks of programming, starting on a Monday and ending on a Sunday were examined. A total of 27 television stations available in both the Vancouver and Toronto markets were selected and included four conventional stations, two children’s specialty channels and 21 specialty channels. All food/beverage advertising for selected categories that was broadcasted between 0600 hours and 1200 hours was examined. The number of advertisements aired (also called advertising spots) per food category was determined using Nielsen Spotwatch software, a software program where one enters specific parameters (that is, geographic location, station names, time of programming so on) and requests the number of advertising spots. The number of spots advertised in 2006 and 2011 were compared by calculating the percentage change. The rate of food/beverage advertising per hour per station was also calculated for 2006 and 2011. To determine exposure to advertising, the average number of advertisements viewed by children aged 2–11 who saw at least one advertisement in this food category (also called the average frequency) was determined using Nielsen Borealis Blended software for May 2006 and 2009 data and PPM software for 2011. Exposure for children ages 2–11 years was the focus in this study as the CAI commitments extend to children in this age group. Nielsen Media Research sample sizes for this age group in Toronto consisted of 167, 188 and 242 children for 2006, 2009 and 2011 respectively. In Vancouver, sample sizes consisted of 78, 83 and 142 children for 2006, 2009 and 2011. The average frequency is calculated by Nielsen by first dividing the gross rating points (that is, the average number of people in an age category who have viewed a specific program divided by an estimate of the total number of individuals in that population) by the reach (that is, the percentage of individuals in that age © 2014 Macmillan Publishers Limited

category exposed to the program at least once). Next, the total number of spots or occasions the advertisement ran is divided by the reach. Please note that since the average frequency is weighted, the average number of spots viewed per month on children’s specialty channels and on generalist stations cannot be summed to give children’s total average exposure on all stations. When assessing the average frequency for fast food on all stations, the time period examined was changed from 0600 hours to 1200 hours to 0600 hours to 2330 hours as the Borealis software is unable to compute the average frequency when the spot count exceeds 20 000. Changing the time period by 30 min reduced the number of spots to less than 20 000 that allowed for this calculation. To compare the average frequency of exposure across time, data from May 2006 and May 2009 were compared. May 2009 was used as post measure for advertising exposure, rather than 2011, because the methodology for measuring television viewing changed in the fall of 2009. Before the fall of 2009, Nielsen Media Research used the Mark II wired Peoplemeter, which required participants (or their parents) to manually log into a system every time they watched television.11 From the fall of 2009 onwards, Portable Personal Measurement Technology, a wireless device similar to a pager that picks up the television’s audio signal, was used. This technology change has led to higher measures of exposure for panel members compared with that collected with the older Peoplemeter.11 Exposure data collected from the fall of 2009 onwards is therefore not comparable with that collected previously. As a result, in this study, all exposure data is compared between May 2006 and May 2009. The number of spots (advertisements aired) was not affected by this methodological change. The percentage change between 2006 and 2009 samples for average exposure frequency in each food category was calculated, except for candy, chocolate bars and cookies (as these data were not purchased). For these three categories, however, a 2006–2011 comparison was made to assess for decreases in exposure. Since the methodological change implemented in late 2009 increased exposure estimates, any decreases observed between 2006 and 2011 would represent actual decreases in advertisement exposure for the candy, chocolate bar and cookies categories (though degree of change cannot be estimated). Finally, for children aged 2–11, the average number of spots viewed per food category for May, 2011 are also reported, although these are based on the new Portable Personal Measurement Technology. All pre and post spots and exposure analyzes for Toronto and Vancouver were first conducted on all 27 stations, followed by an analysis on two subsets of stations: two children’s specialty channels and 25 generalist stations that consisted of the remaining stations not specifically oriented towards children under 12 years. It was not possible to calculate confidence intervals for this data as Nielsen Media Research software does not permit these calculations. For the purposes of this study, we considered a percentage change of ⩾ 15% to be significant.

RESULTS 2006–2011 spots Comparisons between 2006 and 2011 show that the number of advertisements on all stations increased by 38% in Toronto and 39% in Vancouver (see Table 1). The largest increases were for yogurt, snacks, cheese, cookies and fast food while decreases in both cities were seen in diet soft drinks and juices. Based on these data, advertising in these 11 food/beverage categories occurred at a rate of 2.7/h/station in both Toronto and Vancouver in 2006, but climbed to 3.7/h/station in Toronto and 3.8/h per station in Vancouver in 2011. On children’s specialty channels, the same advertisements were shown in both Toronto and Vancouver. As a result, data are only shown for Toronto. On these channels, there was a 4.5% decrease in the total number of spots aired for the 11 food/beverage categories, with the greatest decreases seen in diet soft drinks, juices, chocolate, regular soft drinks and cereals (see Table 2). Both cities saw an increase in the numbers of snacks, cheese and cookie spots aired. On children’s specialty channels, food/beverage advertisements occurred at a rate of 4.4/hour per station in both Toronto and Vancouver in 2006 and at 4.2/hour per station in 2011. International Journal of Obesity (2014) 558 – 562

Children's exposure to TV food advertising M Potvin Kent and A Wanless

560 Table 1.

Total number of spots on all stations in 2006, 2009, 2011 and percentage change between 2006–2011

Food category

Candy Chocolate bars Cookies Snacks Cheese Yogurt Cereals Juices Soft drinks Diet soft drinks Fast food Total

Toronto

Vancouver

May 2006

May 2009

May 2011

% Change

May 2006

May 2009

May 2011

% Change

583 5125 1619 742 1912 1031 5682 3614 642 899 14 566 36 415

NA NA NA 1313 4644 4069 3986 2728 1167 445 20 335 NA

593 6586 2919 1914 4296 5078 5315 2646 798 514 19 568 50 227

1.7 28.5 80.3 158.0 124.7 392.5 − 6.5 − 26.8 24.3 − 42.8 34.3 37.9

562 5123 1588 741 1916 1019 5714 3514 779 875 15 246 37 077

NA NA NA 1320 4732 3990 3967 2897 1114 409 20 132 NA

611 6558 2964 2074 4414 5151 5627 2624 795 530 20 336 51 684

8.7 28.0 86.6 179.9 130.4 405.5 − 1.5 − 25 2.1 − 39.4 33.4 39.4

Copyright ©2006, 2009, 2011, Nielsen Media Research using Spotwatch software.

Table 2.

Total number of spots on children’s specialty stations in 2006, 2009, 2011 and percentage change between 2006–2011 Food category

Table 3. Average number of spots viewed by 2–11-year-olds per month on all stations in 2006, 2009 and percentage change between 2006–2009

Toronto Food category

Candy Chocolate bars Cookies Snacks Cheese Yogurt Cereals Juices Soft drinks Diet soft drinks Fast food Total

May 2006

May 2009

May 2011

% Change

258 298 180 175 338 0 1286 368 90 121 1342 4456

NA NA NA 920 200 29 1208 61 0 0 1959 NA

214 119 227 449 553 429 796 123 45 0 1302 4257

− 17.1 − 60.1 26.1 156.6 63.6 ∞ − 38.1 − 66.6 − 50.0 − 100.0 − 3.0 − 4.5

Copyright ©2006, 2009, 2011, Nielsen Media Research using Spotwatch software.

On generalist stations (data not shown), spots increased by 44% in Toronto and 45% in Vancouver. Overall, food/beverage advertisements occurred on generalist stations at a rate of 2.5/hour per station in Toronto and 2.6/hour station in Vancouver in 2006 and this rate increased to 3.6/hour per station in Toronto and to 3.8/hour per station in Vancouver in 2011. 2006–2009 exposure Samples in 2006 and 2009 for Toronto and Vancouver were compared and indicated that children’s overall average exposure to advertising of selected food/beverage categories increased by 16.8% for Toronto and 6.4% for Vancouver (see Table 3). Snacks and yogurt increased significantly for both sample sites and the average number of fast food advertisements seen by children in Toronto increased from 40–52 advertisements per month. Decreases in children`s exposure were seen on all stations for juices and diet soft drinks in both Toronto and Vancouver and for regular soft drinks in Toronto. The 2006 and 2011 comparisons for candy, chocolate bars and cookies (data not shown) revealed that the average number of candy advertisements viewed decreased in both Toronto and Vancouver. On children’s specialty channels, sample comparisons indicated that children’s total average exposure between 2006 and 2009 International Journal of Obesity (2014) 558 – 562

Snacks Cheese Yogurt Cereals Juices Soft drinks Diet soft drinks Fast food Total

Toronto

Vancouver

May 2006

May 2009

% Change

May 2006

May 2009

% Change

7.2 9.6 2.2 36.9 12.3 4.5 3.8

28.0 8.6 5.0 32.5 4.6 2.8 2.5

288.9 − 10.4 127.3 − 11.9 − 62.6 − 37.8 − 34.2

4.7 7.3 1.4 20.7 9.3 2.7 3.9

16.2 7.0 5.0 19.0 4.5 3.0 1.5

244.7 − 4.1 257.1 − 8.2 − 51.6 11.1 − 61.5

37.4a 87.4

36.8a 93.0

− 1.6 6.4

52.0a 39.9a 116.4 136

30. 16.8

Copyright ©2006, 2009, Nielsen Media Research using Borealis software. a Calculated on hours from 0600 hours to 2330 hours.

Table 4. Average number of spots viewed by 2–11-year-olds per month on children’s specialty channels in 2006, 2009 and percentage change between 2006–2009 Food category

Toronto May 2006

Vancouver

May 2009

% Change

May 2006

May 2009

% Change

Snacks (p) 7.3 29.2 Cheese 11.6 6.8 Yogurt 0 2.2 Cereals 37.5 36.3 Juices 13.9 3.7 Soft drinks 4.0 0 Diet soft drinks 4.2 0 Fast food 39.7 46.4 Total 118.2 124.6

300.0 − 41.4 ∞ − 3.2 − 73.4 − 100.0 − 100.0 16.9 5.4

4.6 6.2 0 22.7 6.0 3.0 3.0 21.4 66.9

16.5 4.8 2.5 21.3 1.4 0 0 22.1 68.6

258.7 − 22.6 ∞ − 6.2 − 76.7 − 100.0 − 100.0 3.3 2.5

Copyright ©2006, 2009, Nielsen Media Research using Borealis software.

increased by 5.4% in Toronto and by 2.5% in Vancouver (see Table 4). Average snack exposure increased from 7–29 advertisements per month in Toronto and from 5–17 advertisements per month in Vancouver. Exposure to yogurt © 2014 Macmillan Publishers Limited

Children's exposure to TV food advertising M Potvin Kent and A Wanless

561 advertisements also increased in both Toronto and Vancouver. Average fast food exposure increased from 40 advertisements per month to 46 advertisements per month in Toronto but did not change significantly in Vancouver. Decreases in average exposure were seen in regular and diet soft drinks (where average exposure was reduced to 0 in 2009), juices and cheese in both cities. The 2006–2011 comparison revealed that the average exposure to candy, chocolate bars and cookies all decreased. 2011 exposure The average number of spots viewed by children aged 2–11 in May 2011 using Nielsen Media Research new methodology is presented in Table 5. On all stations, the total average exposure of children in the sample was 165.8 food ads per month (or 5.9 food ads per day) in Toronto and 100.3 food ads per month (or 3.9 food ads per day) in Vancouver. Total exposure was highest for fast food, cereals, cheese, yogurt, snacks and chocolate bars. On children’s specialty channels, children’s average exposure was highest for fast food, cereal, snacks, cheese and yogurt in both Toronto and Vancouver. Children’s exposure in Toronto was higher on children’s specialty channels rather than generalist stations, whereas the reverse was true in Vancouver. Children’s exposure to candy and cereal advertisements came disproportionately from children’s specialty channels, whereas their exposure to chocolate bars, juices, diet soft drinks and fast food came disproportionately from the generalist channels.

DISCUSSION As hypothesized, our results indicate a 4.5% reduction in the number of food/beverage spots on children’s specialty channels since the implementation of the CAI. While impressive decreases were reported in some categories on children’s specialty channels (all beverages, chocolate bars, cereals, candy), these were partially offset by increases in other categories. Snacks increased by over 155%, cheese increased by 64% and cookies increased by 26%. The quantity of fast food advertising also remained high (24 spots per day per station) and virtually unchanged since 2006. The rate of food/beverage advertising also remains higher in 2011 on children’s stations (4.2 h per station) compared with generalist stations (3.8 h per station in May 2011) indicating that children are being marketed to more aggressively on children’s stations.

Clearly, efforts still need to be made to reduce the volume of advertising on children’s specialty channels. In terms of children’s exposure to food/beverage advertisements on children’s specialty channels, contrary to what was predicted, this study suggests children’s total average exposure has increased by 5.4% in Toronto and by 2.5% in Vancouver. Given that decreases in exposure were seen in many food categories on children’s specialty channels (that is soft drinks, diet soft drinks, juices, cheese), these total increases in exposure likely stem from the large (300%) increases in the snacks category which, in 2009 consisted of products with high sugar content such as fruit-like rolls and cereal snack bars. If food/beverage companies tightened their nutritional criteria with regards to sugar content and then harmonized this criteria, children would likely be more adequately protected from the marketing of high sugar foods. Improvements need to be made with regard to fast food advertising on children’s specialty stations given that exposure to such marketing has increased in Toronto from 40–46 advertisements per month between 2006 and 2009. Increases in fast food advertising to children have also been reported in the United States8,12,13 and Australia.14 Currently, only two fast food restaurants participate in the CAI, MacDonald’s and Burger King. In May 2009, eight fast food restaurants advertised on children’s specialty channels. The CAI membership clearly needs to be broadened to include the other fast food companies to ensure that at least minimum nutritional standards are being met by those who advertise on children’s specialty channels. Most significantly, this study found that children’s total average exposure to food/beverage advertising increased by 16.8% in Toronto and 6.4% in Vancouver between 2006 and 2009. This is consistent to what is being seen in the United States where children’s total exposure increased between 2007/2008 and 2011.8 Children’s fast food, chocolate bar and juice exposure came disproportionately from advertising exposure on generalist stations where CAI commitments likely do not apply given the high child audience thresholds set by CAI members, which ranged from 30–50% in 2011.15 Here, audience thresholds need to be tightened so that programs popular with children under 12 years on generalist stations receive some benefit from the CAI. As has been seen in the United States,8,12 industry has made great strides in decreasing children’s average exposure to juices, regular and diet soft drinks. Given that sweetened beverages have

Table 5. Average number of spots viewed by 2–11-year-olds per month on all stations, children’s specialty stations and generalist stations in May 2011 Food category

Candy Chocolate bars Cookies Snacks Cheese Yogurt Cereals Juices Soft drinks Diet soft drinks Fast food Total

Toronto

Vancouver

All stations

Children’s specialty stations

Generalist stations

All stations

Children’s specialty stations

Generalist stations

6.9 12.5 8.2 12.8 15.7 15.2 25.2 7.7 3.1 2.3 56.2 165.8

7.5 2.0 3.8 13.2 10.9 9.2 19.4 3.8 1.8 0 22.3 93.9

1.7 12.2 7.3 5.2 10.0 10.9 12.7 8.2 2.8 2.3 42.2 73.3

5.3 14.4 7.6 12.3 15.7 13.9 18.9 7.2 2.8 2.2 77.2a 100.3

5.2 2.3 4.4 8.7 8.2 8.7 13.9 2.8 2.2 0 18.8 75.2

1.9 14.2 6.0 7.0 10.6 9.6 11.1 6.1 2.7 2.2 67.0 138.4

Copyright ©2011, Nielsen Media Research using Borealis software. aCalculated on hours from 0600 hours to 2330 hours.

© 2014 Macmillan Publishers Limited

International Journal of Obesity (2014) 558 – 562

Children's exposure to TV food advertising M Potvin Kent and A Wanless

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been associated with childhood obesity,16–18 this is a significant accomplishment. Strengths and limitations This study is the first in Canada to use Nielsen Media Research data to assess the potential changes in food/beverage advertising on television since the initiation of the CAI. However, limitations to this research must be noted. Ideally, with additional resources, we would have examined the entire year of television advertising in 2006, 2009 and 2011 rather than monthly data. Also, a direct comparison of the volume of advertisements in 2006 and 2011 and the average number of spots viewed between 2006 and 2009 could not be made given the different time periods examined. Ideally these two measures would have reflected the same time periods; however, this was impossible due to the methodological change implemented by Nielsen Media Research. It is possible that an assessment in the number of spots viewed between 2006 and 2011 would reveal decreases similar to that observed in the number of spots aired. In addition, non-probability sampling methods are used by Nielsen Media Research to select their samples, which introduces caution when generalizing to population level estimates. However, this data source is used by industry to make financially based decisions, which suggests an adequate level of external validity. Similar changes over time were seen in both Vancouver and Toronto markets, suggesting observed increases likely apply to other English language broadcasting markets in Canada. Our results cannot be generalized to the French broadcasting market in Montreal where statutory regulation bans commercial advertising to children under the age of 13 years when children consist of 15% of the audience.19 This study only considered advertising for 11 food/beverage categories and, therefore, does not represent children’s total exposure to such advertising. Our results therefore underestimate children’s total exposure. Other food categories that merit future examination include sports drinks, non-fast food restaurants, snack foods (which includes salty snacks like chips), compartment snacks and lunch kits, frozen pizza, cakes, ice cream and puddings and flavored gelatins among others. Also, the 27 stations selected are Canadian stations and children are also exposed to food/beverage advertising on American networks such as ABC, FOX, and NBC. The CAI has recently expanded its membership to 19 and companies that once pledged to devote 50% of their childdirected advertising to ‘better-for-you products’ have, since 2010, raised this percentage to 100%.15 Further research will be necessary to assess these changes. As seen in the United States7 and Australia,9 individual companies within and outside the CAI are likely not behaving identically with regard to marketing directed at children, and further research will be needed to clarify which companies have made the most significant improvements and which are lagging behind. CONCLUSION This study provides greater understanding of children’s exposure to television advertising in Canada and shows that, while some progress has been made in specific food categories, significant improvements to the food marketing environment remain necessary. Self-regulatory policies aimed to reduce food and beverage marketing to children are failing. Children’s environments are rife with mixed messages regarding proper nutrition20 and, given that 62% of Canadian parents strongly support restricting marketing to children that is high in fat, sugar and salt,21 government regulation in this area needs to be considered.

International Journal of Obesity (2014) 558 – 562

CONFLICT OF INTEREST The authors declare no conflict of interest.

ACKNOWLEDGEMENTS Data were purchased from Nielsen Media Research by the Public Health Agency of Canada. Salary support for Monique Potvin Kent was provided by the National Science and Engineering Research Council of Canada.

REFERENCES 1 McGinnis JM, Gootman J, Kraak VI (eds). Food Marketing to Children and Youth: Threat or Opportunity. The National Academies Press: Washington DC, USA 2006. 2 Hastings G, McDermott L, Angus K, Stead M, Thomson S. The Extent, Nature and Effects of Food Promotion to Children: A Review of the Evidence. World Health Organization: Geneva, Switzerland, 2006. 3 WHO. Set of Recommendations on the marketing of foods and non-alcoholic beverages to children. In: Resolution of the Sixty-third World Health Assembly WHA63.14: Marketing of Food and Non-alcoholic Beverages to Children. World Health Organization: Geneva, Switzerland, 2010. 4 Shields M. Overweight and obesity among children and youth. Health Rep 2006; 17: 27–42. 5 Public Health Agency of Canada. Curbing Childhood Obesity. A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights. Public Health Agency of Canada: Ottawa, Canada, 2010. 6 Advertising Standards Canada. The Canadian Children's Food and Beverage Advertising Initiative: Year One Compliance Report. Advertising Standards Canada: Toronto, Canada, 2009. 7 Powell LM, Schermbeck RM, Szczypka G, Chaloupka FJ, Braunschweig CL. Trends in the nutritional content of television food advertisements seen by children in the United States. Arch Pediatr Adolesc Med 2011; 165: 1078–1086. 8 The Yale Rudd Center for Food Policy and Obesity. Trends in Television Food Advertising to Young People. 2011 Update. Rudd Centre For Food Policy and Obesity, Yale University: New Haven, CT, 2012. 9 King L, Hebden L, Grunseit A, Kelly B, Chapman K, Venugopal K. Industry self-regulation of television food advertising: responsible or responsive? Int J Pediatr Obes 2011; 6: e390–e398. 10 Potvin Kent M, Dubois L, Wanless A. Self-regulation by industry of food marketing is having little impact during children's preferred television. Int J Pediatr Obes 2011; 6: 401–408. 11 BBM Canada. The Lowdown on Incredible Portable Personal Measurement Technology. BBM Canada: Toronto, ON, Canada, 2009. 15 September 2009. 12 Powell LM, Szczypka G, Chaloupka FJ. Trends in exposure to television food advertisements among children and adolescents in the United States. Arch Pediatr Adolesc Med 2010; 164: 794–802. 13 Harris JL, Schwartz MB, Brownell KD, Vishnudas S, Ustjanauskas A, Javadizadeh J et al. Fast Food Facts: Evaluating Fast Food Nutrition and Marketing to Youth. Rudd Centre For Food Policy and Obesity, Yale University: New Haven, CT, 2010. 14 Hebden LA, King L, Grunseit A, Kelly B, Chapman K. Advertising of fast food to children on Australian television: the impact of industry self-regulation. Med J Aust 2011; 195: 20–24. 15 Advertising Standards Canada. The Canadian Children’s Food and Beverage Advertising Initiative: 2010 Compliance Report. Advertising Standards Canada: Toronto, Canada, 2011. 16 Wang YC, Bleich SN, Gormaker SL. Increasing caloric contribution from sugarsweetened beverages and 100% fruit juices among US children and adolescents, 1988–2004. Pediatr 2008; 121: e1604–e1614. 17 Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugarsweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; 357: 505–508. 18 Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006; 84: 274–288. 19 Office de la protection du consommateur. Loi sur la protection du consommateur. Guide d'application des articles 248 et 249 (publicité aux moins de 13ans). Office de la protection du consommateur: Quebec, Canada, 1980. 20 Hawkes C. Self-regulation of food advertising: what it can could and cannot do to discourage unhealthy eating habits among children. Br Nutri Foundation Nutrition Bulletin 2005; 30: 374–382. 21 Ipsos Reid. Canadians’ Perception of, and Support for, Potential Measures to Prevent and Reduce Childhood Obesity. Ipsos Reid: Ottawa, Canada, 2011.

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The influence of the Children's Food and Beverage Advertising Initiative: change in children's exposure to food advertising on television in Canada between 2006-2009.

To assess whether children's exposure to television food/beverage advertising has changed since the implementation of the self-regulatory Canadian Chi...
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