Measuring Progress in Nutrition and Marketing to Children and Teens Fast Food FACTS 2013: Measuring Progress in Nutrition and Marketing to Children and Teens Authors: Jennifer L. Harris, PhD, MBA Marlene B. Schwartz, PhD Christina R. Munsell, MS, RD Cathryn Dembek, MBA Sai Liu, MPH Megan LoDolce, MA Amy Heard, BA Frances Fleming-Milici, PhD Bridgette Kidd, MS, RD Yale Rudd Center for Food Policy & Obesity November, 2013 Acknowledgements We would like to thank the following people for their valuable assistance in collecting data and preparing the report: Monica Chen Solomon Gezari Renee Gross Carol Hazen Maia Hyary Kelsey Lin Susan Munsell Megan Murphy Ida Tsutsumi-Acuna Lindsey Wahlstrom Thank you to our colleagues at the Rudd Center, especially Megan Orciari, Patrick Mustain, and Tricia Wynne. We thank Cavich Creative, LLC and Chris Lenz for the assistance in preparing the manuscript and website. Finally, we thank the leadership and staff at the Robert Wood Johnson Foundation, with special thanks to C. Tracy Orleans, Kathryn Thomas, and the rest of the Childhood Obesity Team. Support for this research was provided by a grant from the Robert Wood Johnson Foundation. Table of Contents Tables and Figures .............................................................................iii Executive Summary .............................................................................v Background . .9 Results ........................................................................................13 Overview of fast food market.....................................................................13 Fast food menu composition.....................................................................14 Kids’ meals ..................................................................................14 Main menu items..............................................................................19 Special menus................................................................................23 Traditional media advertising ....................................................................30 Advertising spending ..........................................................................30 Overview of TV advertising exposure ..............................................................31 TV advertising to children ...................................................................... 34 TV advertising to teens .........................................................................39 TV advertising nutrient content analysis ...........................................................40 Digital media marketing ........................................................................44 Website exposure ............................................................................44 Display advertising on third-party websites .........................................................47 Mobile advertising.............................................................................51 Social media marketing.........................................................................55 Marketing to Hispanic and black youth............................................................ 63 Advertising on Spanish-language TV . 63 Exposure to TV advertising by black youth.........................................................66 Targeted marketing on the internet ...............................................................68 Conclusions . 72 Endnotes .....................................................................................80 Ranking Tables................................................................................85 Appendices.................................................................................. 101 A. Methods...................................................................................101 B. Nutrition Profiling Model ..................................................................... 112 C. Menu item nutrition data ..................................................................... 117 Fast Food FACTS 2013 ii Table of Contents List of Tables Table 1: Fast Food FACTS 2010: Key findings ........................................................ 9 Table 2: Fast Food FACTS 2010: Recommendations ................................................... 11 Table 3: Fast food restaurant sales .................................................................13 Table 4: Kids’ meals offered by restaurant ...........................................................15 Table 5: NPI scores for kids’ meal menu options.......................................................16 Table 6: Calorie and sodium content of kids’ meal combinations ..........................................17 Table 7: Kids’ meal combinations available and the number that met all nutrition criteria .......................18 Table 8: Number of menu items per restaurant ....................................................... 20 Table 9: Nutrient content of all menu items by restaurant ............................................... 22 Table 10: Special menus by restaurant ..............................................................23 Table 11: Menu items on dollar/value menus .........................................................23 Table 12: Nutrient content of menu items available on dollar/value menus ................................. 24 Table 13: Number of menu items on healthy menus ....................................................25 Table 14: Nutrient content of menu items available on healthy menus .....................................26 Table 15: Sizes of soft drinks and french fries by restaurant..............................................27 Table 16: Changes in sizes of soft drinks and french fries ..............................................28 Table 17: Child exposure to TV advertising by product type and age group . 34 Table 18: Restaurant and product types advertised most often to preschoolers and children....................35 Table 19: Product types advertised on children’s networks ............................................. 36 Table 20: Teen exposure to TV advertising by product type and age group .................................39 Table 21: Restaurants and product types advertised most often to teens ...................................39 Table 22: Menu items advertised most often to children and teens .......................................40 Table 23: Total nutrient content of items in TV ads viewed by youth every day ...............................41 Table 24: Average calories and sodium in TV ads viewed by children and teens .............................41 Table 25: Twenty fast food restaurant websites with the most youth visitors................................. 45 Table 26: Websites with relatively high compositions of child visitors ..................................... 45 Table 27: Websites with relatively high compositions of teen visitors . .47 Table 28: Top kids’ websites with fast food display advertising ..........................................49 Table 29: Display ads viewed on kids’ websites by menu item...........................................49 Table 30: Ad views on Facebook and top third-party youth websites......................................49 Table 31: Menu items with the most display advertising on Facebook.com and youth websites................. 50 Table 32: Average monthly unique visitors to mobile and traditional fast food websites ........................51 Table 33: Mobile display ad instance by restaurant ....................................................52 Table 34: Mobile display ad instance by menu item or product ...........................................52 Table 35: Mobile smartphone applications ...........................................................53 Table 36: Menu items featured most often in Facebook posts ........................................... 58 Table 37: Activity on restaurants’ main Twitter profiles ................................................. 59 Table 38: Spending on Spanish-language TV advertising .............................................. 63 Table 39: Hispanic youth exposure to Spanish-language TV advertising by product type ..................... 65 Table 40: Twenty individual menu items viewed most by Hispanic youth in ads on Spanish-language TV ......... 65 Table 41: Restaurants with the highest black: white targeted ratios .......................................66 Table 42: Restaurant product types with the highest black: white targeted ratios ............................ 67 Table 43: Total nutrient content of items in TV ads viewed by black youth every day..........................68 Fast Food FACTS 2013 iii Table of Contents Table 44: Exposure to racial and ethnic targeted display ads ...........................................68 Table 45: Hispanic youth visitors to fast food websites..................................................70 Table 46: Black youth visitors to fast food websites ....................................................70 List of Figures Figure 1: Percent of kids’ meals that met various nutrition standards for children .............................18 Figure 2: Number of menu items offered by type for the top-five restaurants................................ 20 Figure 3: Percent of menu items by type that met nutrition criteria .........................................21 Figure 4: Percent of menu items by restaurant that met nutrition criteria ....................................21 Figure 5: Percent of items that met all nutrition criteria from full menus and