11 years. There is also weak evidence that it does not influence the usual dietary intake of teens ages 12–18 years.

With respect to diet-related health, food and beverage advertising on television is associated with the adiposity (body fatness) of children and youth:

  • Statistically, there is strong evidence that exposure to television advertising is associated with adiposity in children ages 2–11 years and teens ages 12–18 years.

  • The association between adiposity and exposure to television advertising remains after taking alternative explanations into account, but the research does not convincingly rule out other possible explanations for the association; therefore, the current evidence is not sufficient to arrive at any finding about a causal relationship from television advertising to adiposity. It is important to note that even a small influence, aggregated over the entire population of American children and youth, would be consequential in impact.

Most children ages 8 years and under do not effectively comprehend the persuasive intent of marketing messages, and most children ages 4 years and under cannot consistently discriminate between television advertising and programming. The evidence is currently insufficient to determine whether or not this meaningfully alters the ways in which food and beverage marketing messages influence children.

CONCLUSIONS AND RECOMMENDATIONS

The prevalence of obesity in children and youth has occurred in parallel with significant changes in the U.S. media and marketing environments. This relationship has lead to the committee’s primary inquiry about what the available data indicate as to the influence of food and beverage marketing on the diets and health of American children and youth. This issue was the focus of the committee’s systematic evidence review which is described in Chapter 5 and Appendix F.

Embedded in relevant sections throughout the text of the report, the committee presents findings in these key dimensions: health, diet, and eating patterns of children and youth; food and beverage marketing to children and youth; the influence of food and beverage marketing on the diets and diet-related health of children and youth; and the policy environment. These findings are listed again in Chapter 7. Based on these findings, the committee has identified five broad conclusions that serve as the basis for its recommendations (Box ES-1).

Reflective of the responsibilities of multiple sectors, the committee’s recommendations address actions related to food and beverage production, processing, packaging, and sales; marketing practice standards; media and



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