1

Introduction and Themes
of the Workshop
1

The childhood obesity epidemic is an urgent public health problem. The most recent data available show that nearly 19 percent of boys and about 15 percent of girls aged 2-19 are obese, and almost a third of U.S. children and adolescents are overweight or obese (Ogden et al., 2012). The obesity epidemic will continue to take a substantial toll on the health of Americans.

In the midst of this epidemic, children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children aged 2-11 saw an average of more than 10 television food ads per day (Powell et al., 2011). Children see and hear advertising and marketing messages for food through many other channels as well, including radio, movies, billboards, and print media. Most notably, many new digital media venues and vehicles for food marketing have emerged in recent years, including Internet-based advergames, couponing on cell phones, and marketing on social networks, and much of this advertising is invisible to parents.

The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A major 2006 report from the Institute of Medicine (IOM) documents evidence that television advertising influences

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1The planning committee’s role was limited to planning the workshop, and this summary was prepared by the rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the Institute of Medicine (IOM), and they should not be construed as reflecting any group consensus.



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1 Introduction and Themes of the Workshop1 T he childhood obesity epidemic is an urgent public health problem. The most recent data available show that nearly 19 percent of boys and about 15 percent of girls aged 2-19 are obese, and almost a third of U.S. children and adolescents are overweight or obese (Ogden et al., 2012). The obesity epidemic will continue to take a substantial toll on the health of Americans. In the midst of this epidemic, children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, chil- dren aged 2-11 saw an average of more than 10 television food ads per day (Powell et al., 2011). Children see and hear advertising and market- ing messages for food through many other channels as well, including radio, movies, billboards, and print media. Most notably, many new digi- tal media venues and vehicles for food marketing have emerged in recent years, including Internet-based advergames, couponing on cell phones, and marketing on social networks, and much of this advertising is invisible to parents. The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A major 2006 report from the Institute of Medicine (IOM) documents evidence that television advertising influences 1  The planning committee’s role was limited to planning the workshop, and this summary was prepared by the rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the Institute of Medicine (IOM), and they should not be construed as reflecting any group consensus. 1

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2 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH the food and beverage preferences, requests, and short-term consumption of children aged 2-11 (IOM, 2006). The report also documents a body of evidence showing an association of television advertising with the adiposity of children and adolescents aged 2-18. The report notes the prevailing pat- tern that food and beverage products marketed to children and youth are often high in calories, fat, sugar, and sodium; are of low nutritional value; and tend to be from food groups Americans are already overconsuming. Furthermore, marketing messages that promote nutrition, healthful foods, or physical activity are scarce (IOM, 2006). PURPOSE OF THE WORKSHOP To review progress and explore opportunities for action on food and beverage marketing that targets children and youth, the IOM’s Standing Committee on Childhood Obesity Prevention held a workshop in Washing- ton, DC, on November 5, 2012, titled “New Challenges and Opportunities in Food Marketing to Children and Youth.” The workshop was funded by the Robert Wood Johnson Foundation,2 which has a major commitment to reversing the epidemic of childhood obesity by 2015. The workshop featured invited presentations and discussions on contemporary trends in market­ng of foods and beverages to children and youth and the implications i of those trends for obesity prevention. Workshop presentations and discus- sions involving researchers, policy makers, advocates, and other stake­ olders h explored current efforts in the private, nonprofit, and government sectors to change the current marketing environment, and addressed such topics as • emerging marketing and communication strategies for the pro- motion of unhealthy foods and beverages to children and youth and their impact, as well as legal, policy, and consumer- and c ­ ommunity-based approaches for curbing their use; • international approaches to food and beverage marketing to chil- dren and youth; • emerging research on the effects of digital marketing, targeted market­ng, and other marketing and communication strategies; i • initiatives and opportunities to leverage emerging marketing strate- gies or inspire youth-led activities to promote healthy foods and beverages and/or counteract marketing of unhealthy foods and bev- erages; and • lessons learned from other public health initiatives that have employed regulatory and/or countermarketing tactics to curb mar- keting of unhealthy products. 2  For more information about the Robert Wood Johnson Foundation, see http://www.rwjf.org.

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INTRODUCITON AND THEMES OF THE WORKSHOP 3 The workshop agenda and brief biographies of the speakers and modera- tors are presented in Appendixes A and D, respectively. The Standing Committee on Childhood Obesity Prevention was estab- lished in 2008 to serve as a focal point for national and state-level policy discussions by governmental and other experts and leaders in the field and related disciplines; to provide the National Academies with strategic guid- ance on comprehensive work in this area by keeping abreast of emerging issues, research, and existing activities, both in the United States and inter- nationally; and to guide the selection of focused, policy-relevant topics in childhood obesity prevention to be examined through workshops, studies, public briefings, and publications. THEMES OF THE WORKSHOP During the course of the 1-day workshop, themes emerged from the individual presentations that structured the subsequent discussions. Those themes are presented here as an introduction to this workshop summary. A compilation of comments made during the discussions appears in Chapter 6. Progress Since Food Marketing to Children and Youth: Threat or Opportunity? (Chapter 2) • Limited to moderate progress has been made in achieving the rec- ommendations of the IOM’s 2006 report on food marketing and its relationship to children’s diets. (Ellen Wartella, Northwestern University) Emerging Issues in Food Marketing (Chapter 3) • The emergence of integrated marketing communications, which uses a variety of vehicles and venues to deliver reinforcing mes- sages, has created a marketing environment in which advertising is pervasive; powerful; and often disguised as entertainment, social networking, or viral marketing. (Minette Drumwright, The Univer- sity of Texas at Austin) • Children and adolescents are particularly heavy users of social media, mobile phones, Internet videos, and advergames, all of which are being used to market foods and beverages in increasingly individualized and comprehensive ways. (Kathryn Montgomery, American University) • Certain types of marketing to low-income and minority communi- ties can be pernicious, yet attempts to limit such marketing can appear to be paternalistic in that they may be seen as singling

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4 CHANGE IN FOOD MARKETING TO CHILDREN AND YOUTH out low-income and minority populations for special protection. (Jerome D. Williams, Rutgers Business School–Newark and New Brunswick) Innovations and Future Works in Industry Practices (Chapter 4) • Food and beverage retailers are placing increased emphasis on health and wellness to meet the demands of their customers for healthier products and information about healthier diets. (Cathy Polley, Food Marketing Institute) • The Children’s Food and Beverage Advertising Initiative has made substantial progress in limiting food advertising directed at children to healthier products. (Elaine Kolish, Children’s Food and Beverage Advertising Initiative) • Companies such as The Walt Disney Company can both offer and market healthier foods to children and youth through self- regulation of the products they sell and advertise. (Heather Rubin, The Walt Disney Company) • Despite the actions industry has taken, children still are inundated by ads for unhealthy foods. (Jennifer Harris, Yale University) Emerging Policy Initiatives and Communication Strategies (Chapter 5) • Public campaigns led by concerned mothers, taking full advantage of social media and other new communication vehicles, can mobilize policy makers as well as parents. (Monifa Bandele, ­ omsRising.org) M • Campaigns directed specifically at involving minority youth in con- tent creation and leadership can empower families to make healthy choices and create an environment that is conducive to healthy life- styles. (Terry Huang, University of Nebraska Medical Center) • Campaigns against tobacco advertising offer valuable lessons for campaigns against the marketing of unhealthy foods. (Cheryl ­Healton, Legacy) • The U.S. constitutional system is designed to balance compet- ing interests and adapt to new technological developments, scien- tific discoveries, and social norms; however, the current legal and political climates make government efforts to address the pervasive marketing of obesogenic foods and beverages to youth more chal- lenging (Samantha Graff, ChangeLab Solutions) • Efforts to limit the marketing of unhealthy foods in other coun- tries can inform similar efforts in the United States. (Tim Lobstein, International Association for the Study of Obesity)