Child Social Media Influencers and Unhealthy Food Product Placement Amaal Alruwaily, Chelsea Mangold, Tenay Greene, Josh Arshonsky, Omni Cassidy, Jennifer L

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Child Social Media Inﬂuencers and Unhealthy Food Product Placement Amaal Alruwaily, MPH,a Chelsea Mangold, MPH,a Tenay Greene, BA,a Josh Arshonsky, BA,a Omni Cassidy, PhD,a Jennifer L. Pomeranz, JD, MPH,b Marie Bragg, PhDa,b

OBJECTIVES: We aimed to determine the frequency with which kid influencers promote branded abstract and unbranded food and drinks during their YouTube videos and assess the nutritional quality of food and drinks shown. METHODS: Researchers used Socialbakers data to identify the 5 most-watched kid influencers (ages 3 to 14 years) on YouTube in 2019. We searched for 50 of their most-watched videos and 50 of their videos that featured food and/or drinks on the thumbnail image of the video. We coded whether kid influencers consumed or played with food or toys, quantified the number of minutes food and/or drinks appeared, and recorded names of branded food and/or drinks. We assessed the nutritional quality of foods using the Nutrient Profile Model and identified the number of drinks with added sugar. RESULTS: A sample of 418 YouTube videos met the search criteria, and 179 of those videos featured food and/or drinks. Food and/or drinks were featured in those videos 291 times. Kid influencers’ YouTube videos were collectively viewed .48 billion times, and videos featuring food and/or drinks were viewed 1 billion times. Most food and/or drinks were unhealthy branded items (n = 263; 90.34%; eg, McDonald’s), followed by unhealthy unbranded items (n = 12; 4.1%; eg, hot dogs), healthy unbranded items (n = 9; 3.1%; eg, fruit), and healthy branded items (n = 7; 2.4%; eg, Yoplait yogurt). CONCLUSIONS: Kid influencers generate millions of impressions for unhealthy food and drink brands through product placement. The Federal Trade Commission should strengthen regulations regarding product placement on YouTube videos featuring young children.

aDepartment of Population Health, School of Medicine and bSchool of Global Public Health, New York University, WHAT’S KNOWN ON THIS SUBJECT: Exposure to food New York, New York advertising is associated with poor diet, and food companies have increased online advertising in Ms Alruwaily made significant contributions to the conception and design of the study and acquired response to growing social media use. Young children the data; Ms Mangold made significant contributions to the acquisition of data; Ms Greene, Mr Arshonsky, and Ms Pomeranz made significant contributions to the analyses and interpretation of have limited cognitive abilities to recognize data and drafted sections of the manuscript; Dr Cassidy made significant contributions to the advertising, which may be exacerbated by branded conception and design of the study and drafted sections of the manuscript; Dr Bragg made influencer posts. significant contributions to the conception and design of the study and acquisition of data, WHAT THIS STUDY ADDS: This study is the first to conducted the analyses and interpretation, and drafted sections of the manuscript; and all authors critically revised the manuscript for important intellectual content, approved the final manuscript document the array of unhealthy branded products as submitted, and agree to be accountable for all aspects of the work. promoted through YouTube kid influencers. Most food advertising research has focused on television DOI: https://doi.org/10.1542/peds.2019-4057 commercials or online advertisements produced by Accepted for publication Aug 17, 2020 companies. This new frontier has been largely Address correspondence to Marie Bragg, PhD, Department of Population Health, School of Medicine, unstudied. New York University, 180 Madison Ave, Room 352, New York, NY 10016. E-mail: marie.bragg@ nyulangone.org To cite: Alruwaily A, Mangold C, Greene T, et al. Child PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Social Media Influencers and Unhealthy Food Product Placement. Pediatrics. 2020;146(5):e20194057 Copyright © 2020 by the American Academy of Pediatrics

Downloaded from www.aappublications.org/news by guest on September 28, 2021 PEDIATRICS Volume 146, number 5, November 2020:e20194057 ARTICLE Poor dietary habits during childhood place youth at an increased risk for obesity and diet-related health conditions later in life, including cardiovascular disease and type 2 diabetes.1 One environmental contributor to children’s diet is exposure to food advertising.2 Food and beverage companies spend $1.8 billion annually on youth-targeted marketing,3 which is concerning given laboratory studies have revealed that children who are exposed to food advertisements consume more calories than children who are exposed to nonfood advertisements.2 Although television advertising is a major source of food marketing,3,4 companies have dramatically FIGURE 1 fl increased online advertising in A screenshot of food-related videos posted on 1 kid in uencer channel in the sample. response to consumers’ growing social media use.5,6 One of the most online celebrities with large social directly or via their parents.10 The popular social media sites accessed media fan bases who shape fans’ highest-paid YouTube influencer in by adults and youth is YouTube,7 opinions by subtly or overtly 2018 and 2019, for example, was an a video-sharing platform that allows endorsing products in their videos.9 8-year-old who earned $26 million users to post self-generated videos on In contrast to mainstream celebrities from advertisements that appeared their personal channels as well as (eg, LeBron James) who generate before the video and sponsored posts view, “like,” comment on, and share fame from traditional means (such as (ie, product placements that appear videos posted by others. YouTube professional sports or Hollywood during the video).13,14 The extent to also provides a significant amount of movies), influencers are “everyday which companies use kid influencers content that is viewed by children.7 people” whose primary tool for to market food and beverage More than 80% of parents with building fame involves creating products is unknown. a child ,12 years of age allow their entertaining or engaging YouTube child to watch YouTube, and 35% of videos or social media posts that help Psychological theories and parents report that their child them attract large numbers of social experimental research studies watches YouTube “regularly.”7 media followers. Kid influencers are suggest that kid influencers’ may Children as young as age 2 to 8 years children whose parents film videos of influence YouTube viewers in spend nearly an hour a day using the child playing with toys or multiple ways. First, product mobile devices, and 75% of those engaging in family-friendly activities placements build brand awareness children use their devices to watch (Fig 1).10 The parents then post those and shape product preferences videos on social media platforms like videos on YouTube for other children among children.15 Such product YouTube.8 Given that sites like and parents to watch for preferences can lead to increased YouTube have created a new entertainment. Burgeoning evidence “pester power,” in which children beg advertising frontier with the ability to suggests that consumers increasingly parents for specific products or reach large numbers of children and – perceive influencers as more relatable brands.16 20 In fact, pester power caregivers, it is critical to examine the and trustworthy than mainstream results in $190 billion in sales each extent to which these social media celebrities.11 Recognizing the year.21 Second, children ages sites promote unhealthy food and booming popularity of influencers, #8 years have limited cognitive beverage products that could shape companies are increasingly hiring abilities to recognize advertising.21,22 children and parents’ dietary these persuasive spokespersons to Many children ,8 years old cannot decisions. promote their products.12 Hiring kid distinguish between commercials and One novel social media advertising influencers has the added potential of cartoons.21 Such susceptibility to tool involves hiring “influencers,” reaching younger audiences either advertising may be exacerbated by

Downloaded from www.aappublications.org/news by guest on September 28, 2021 2 ALRUWAILY et al influencers because their branded views, channel subscribers, and likes for increasing viewership because it posts are subtly interspersed with associated with the 5 most-watched is designed to attract viewers by their unbranded posts, making it kid influencer channels on YouTube; showcasing the video’s appealing more difficult for children or their (2) quantify the frequency of product content (Fig 1). Anyone who creates caregivers to discern persuasive placements for branded and YouTube videos controls which intent.5 Finally, social norms unbranded food and/or drinks in thumbnail appears by selecting an theory23–25 may inform how kid those kid influencers’ YouTube image they want to use as the influencers shape parents’ videos; (3) determine the amount of thumbnail.29 We then recorded behaviors. Social norms theory time food and/or drinks appear each video’s publication date and suggests that parents may see that during the videos; and (4) assess the the number of views and likes a video has millions of views and nutritional quality of the food and (Table 1). We also identified the age thousands of “likes,” which may drinks. of children shown in the videos by indicate that it is socially searching for other videos on their acceptable to allow children to watch channel in which their date of birth is METHODS the videos. In addition, influencers reported. may generate feelings of trust with Researchers identified kid influencer viewers because they are both channels on YouTube in July 2019 Quantifying the Frequency of Food celebrities and “everyday people,”11 through the YouTube statistics tool and/or Drink Product Placements fl ’ maintained by Socialbakers, which may in uence parents We created a content analysis a social media analytics program decisions to purchase endorsed codebook to identify (1) the that has been used in other public products. presence of foods and/or drinks, health research.28 Socialbakers Few studies have examined the food or drink brand logo, or food or staff review the most-viewed combined effects of social media drink toy; (2) whether a child channels on YouTube and influencers and food consumed or played with the food or manually sort them into categories advertisements.11,26 In one study drink item; and (3) how many on the basis of key words and involving adults, the authors found minutes food and/or drinks video content. In Fig 2 and that purchase intentions were higher appeared. We measured product Supplemental Table 3, we for products promoted by an placements in minutes instead of describe the search process and influencer compared with seconds to convey the deep inclusion and exclusion criteria, a celebrity.11 In an experimental integration of products in the which yielded a final sample of 5 study in children (ages 9–11 years), videos (ie, television commercials channels (Table 1). researchers found that children who usually range from 15 to 60 fl 30 fl saw a YouTube in uencer holding Determining the Number of Videos, seconds, but in uencer videos can unhealthy foods consumed more Views, Subscribers, and Likes showcase products for many calories than children who saw Associated With the Channels minutes). a YouTube influencer holding We then visited the YouTube home To complete codebook questions nonfood products.26 In another page for each channel in our sample (Supplemental Information), 2 laboratory study, researchers and recorded the following researchers began watching each randomly assigned 132 adolescents descriptive data: (1) the number of video and paused it whenever a food ages 13 to 16 years to view a social videos the channel posted to and/or drink item appeared. When media influencer who promoted YouTube, (2) number of views a food and/or drink appeared, we unhealthy food, vegetables, or generated across all videos posted by assigned 1 subcategory: the child a nonfood item and found that the channel, and (3) number of consumed the item (Fig 3), the child adolescents exposed to the healthy people who subscribe to the played with the item (Fig 4), the logo food posts did not consume more channel (Table 1). To select the appeared (eg, Starbucks cup vegetables.27 sample of videos to examine appeared but was not consumed), or Although companies’ use of kid for product placement, we the child or caregiver prepared food influencers is growing rapidly, no identified 50 videos with the most (eg, baking cookies with M&M’s). If study has examined the extent to views and the most recent 50 the child prepared and ate those which kid influencers include food videos that featured food or cookies, we coded it under the and beverage product placements in drink products or logos in the “consumption” subcategory because their YouTube videos. To address this video thumbnail (ie, the still image research reveals exposure to food gap in the literature, we aimed to (1) that appears alongside the video’s advertisements leads to increased determine the number of videos, title). The thumbnail is critical consumption among children.23 To

Downloaded from www.aappublications.org/news by guest on September 28, 2021 PEDIATRICS Volume 146, number 5, November 2020 3 Determining the Amount of Time Food and/or Drinks Appeared During the Videos We then used 3 steps to estimate the number of impressions generated by videos that featured food and/or drinks. First, we recorded the number of minutes the food and/or drinks appeared during each video. Then, we multiplied that number by the number of views for that video (eg, food was shown in a video for 1 minute and that video had 100 views, we calculated it as 100 impressions). Finally, we summed the total number of minutes for all videos.

Assessing the Nutritional Quality of Food and Drink Products We categorized foods as unhealthy if they received a score .4 on the Nutrient Proﬁle Model, a validated nutrition scoring tool.32 We categorized drinks as unhealthy if they contained .25 g of added sugar on the basis of recommendations by the American Academy of Pediatrics on sugary drink intake among children.33 We conducted all analyses using R (version 3.5).

RESULTS Kid influencer channels in the sample collectively generated 48.2 billion views and 38.6 million subscribers through 10 058 videos posted on YouTube, as of July 2019 (Table 1). Each channel featured 1 family with 2 or 3 children, and video topics included toy reviews (ie, playing with a toy while describing its features), FIGURE 2 playtime, or other family-friendly YouTube channel and video search flow diagram. activities. Each channel included videos of birthday parties or the birth of the kid influencers, which enabled assess interrater reliability, we which codebook items met the us to calculate their age. The average followed the recommendations of accepted threshold of $0.7 for age of the 9 kid influencers was 7.3 Lombard et al31 (ie, 2 researchers Krippendorf’s a, divided the years, as of July 2019. The children coded 10% of the data, calculated remaining 90% of the data, and coded who starred in the videos ranged in interrater reliability to determine those data). age from 3 to 14 years.

Downloaded from www.aappublications.org/news by guest on September 28, 2021 4 ALRUWAILY et al TABLE 1 Summary Data for the 5 Kid Influencers’ YouTube Channels Based on Publicly Available Data videos featured food and/or drinks, on Their Channels and food and/or drinks appeared Summary Data for the 5 Kid Influencer Channels As Of July 2019 N % of Sample 291 times during those 179 videos No. views for the 5 kid influencer channels 48 155 726 233 100 (reference) (Table 2). The 179 videos that No. subscribers for the 5 kid influencer channels 38 643 321 — featured food and/or drinks were No. videos posted by the 5 kid influencer channels 10 058 — viewed .1 billion times and a No. views for the Ryan’s World channel 30 876 473 599 64.1 generated 2.6 million likes on No. views for the Sandaroo Kids channel 7 124 249 920 14.8 YouTube. Food and/or drink product No. views for the TheEngineeringFamily channel 4 478 806 127 9.3 fl No. views for the Daily Bumps channel 3 439 380 339 7.1 placements in those kid in uencer No. views for The Tube Family channel 2 236 816 248 4.6 videos generated ∼16.5 million —, not applicable. impressions for items that were a Formerly Ryan ToysReview. mostly unhealthy branded products.

The majority of food and/or drinks Our search criteria yielded 418 excluded. That variable attempted to promoted were unhealthy branded videos because 3 channels had ,50 identify instances when a kid items (n = 263; 90.3%; eg, videos featuring food and/or drinks inﬂuencer was overtly promoting the McDonald’s), followed by unhealthy in the thumbnail. One variable from brand (eg, listing attributes) versus unbranded items (n = 12; 4.1%; eg, our codebook did not meet acceptable subtly promoting the brand in the hot dogs), healthy unbranded items interrater reliability and was story line. A total of 179 (42.8%) (n = 9; 3.1%; eg, fruit), and healthy

FIGURE 3 A Ryan’s World (formerly Ryan ToysReview) video with 27 million views.

Downloaded from www.aappublications.org/news by guest on September 28, 2021 PEDIATRICS Volume 146, number 5, November 2020 5 FIGURE 4 A Sandaroo Kids video with 204 000 views. branded items (n = 7; 2.4%; eg, Cola (n = 8), Kellogg’s Froot Loops placement is particularly Yoplait yogurt) (Supplemental (n = 8), Dairy Queen (n = 6), Pop concerning because nearly 90% of Table 4). Branded food and/or drink Tarts (n = 5), Reese’s(n = 5), Taco the food and drinks shown in this toys appeared 107 times across the Bell (n = 5), and Starbucks (n = 5), all sample promoted unhealthy 179 videos that featured food and/or of which promoted only unhealthy branded products like McDonald’s. drinks (Table 2), including instances branded items (Supplemental In fact, McDonald’s accounted for in which toys appeared in the Table 4). the highest number (30.0%) of thumbnail (Fig 1), and, in 95 (53.1%) the branded product placements. of those videos, a child consuming food and/or drinks (n = 156 instances DISCUSSION Kid influencers provide marketers of consumption) was shown. In In this study, we quantified the with targeted access to parents contrast, in 49 (27.4%) of those frequency with which a sample of and children. Influencer videos, a child playing with a food videos from popular kid influencers endorsements can generate and/or drink toy (n = 55 instances) on YouTube promote food and drink millions of views, and industry was featured. In 35 (19.6%) of the products and determined the data suggest these endorsements can videos, a food and/or drink logo nutritional quality of the foods and increase sales by up to 28% for (Fig 1) or someone cooking food and/ drinks being promoted. Our results the endorsed product.34 or drinks was shown. The most indicated that .40% of kid influencer Estimates suggest that companies frequently featured brands were videos in our sample featured food will spend .$15 billion over the McDonald’s(n = 81), Hershey’s(n = and/or drinks, generating .16 next few years on influencer-based 16), Kinder (n = 13), M&M’s(n = 12), million impressions for these food marketing.35 These estimates, Skittles (n = 11), Oreo (n = 9), Coca- and drinks. This amount of product coupled with the current findings,

Downloaded from www.aappublications.org/news by guest on September 28, 2021 6 ALRUWAILY et al TABLE 2 Descriptive Statistics for the Promotion of Unhealthy Foods and Drinks During YouTube Videos Posted by 5 Kid Influencers’ YouTube Channels Data Categories N % of Sample Summary data for videos sampled from the 5 kid influencer channels Total No. videos 418 100 (reference) No. videos showing food and/or drinks 179 42.8 No. videos showing food and/or drink brand on thumbnail 123 29.4 Total No. likes on videos 17 888 398 100 (reference) No. likes on videos showing food and/or drinks 2 572 189 14.4 Total No. views for videos showing food and/or drinks 1 062 424 656 — Summary data for food and/or beverage brand appearances during 179 videos that featured food and/or drinks Total No. instances showing food and/or drinks 291 100 (reference) No. instances showing branded food and/or drinks 270 92.7 No. instances showing unbranded food and/or drinks 21 7.2 Total No. unique food and/or drink brands that were shown 63 — Impressions generated by food and/or drink appearances in the 179 videos in which food/drinks were shown No. videos showing food and/or drinks .1 min 132 73.7a No. videos showing food and/or drinks ,1 min 24 13.4a No. videos in which food and/or drinks flashed on the screen 23 12.8a Total estimated No. impressions for food and/or drinksb 16 584 118 — Nutritional quality of 291 food and/or drinks shown during the 179 videos that featured food and/or drinksc No. instances unhealthy branded items 263 90.3d No. instances in which branded toys appeared 107 40.6 No. instances in which branded food and/or drinks appeared 156 59.5 No. instances of unhealthy unbranded items 12 4.1d No. instances of healthy unbranded items 9 3.1d No. instances of healthy branded items 7 2.4d Summary data for how food and/or drinks were presented during the 179 videos that featured food and/or drinks No. videos in which a child consumed the food and/or drink (eg, M&M’s) 95 53.1b No. videos in which child played with food and/or drink (eg, plastic toys) 49 27.4b No. videos that showed the logo or someone preparing food 35 19.6b One family maintains each channel. —, not applicable. a Calculated by using 179 videos as reference. b The number of minutes the food and/or drink was shown, multiplied by the number of views for that video. c Branded and unbranded food and drinks featured in the videos are included in Supplemental Table 4. d Calculated by using 241 instances as reference. demonstrate an urgent need to regulatory efforts (ie, the Children’s general enforce the FTC Act and state reduce unhealthy food and Food and Beverage Advertising consumer protection acts, drink product placement in videos Initiative) also aim to mitigate the respectively. Yet the FTC’s featuring and targeting young harmful effects of child-targeted enforcement on YouTube is not children. advertisements, but studies consistent with other media. have revealed that industry self- For example, host-selling is As online media use increases among regulation is not reducing child- prohibited on television but not on 8 young children, kid influencers targeted marketing of unhealthy YouTube.38 In fact, the new carry the potential to increase food on television,35 and their YouTube Kids app has been children’s exposure to unhealthy food guidelines do not mention the role characterized as “host-selling and promotions that may increase poor of kid influencers in promoting character marketing on steroids.”36,38 2,26 dietary behaviors. Recognizing the unhealthy products.37 As kid influencers become more power of media and influencers, the ubiquitous, federal and state Federal Trade Commission (FTC) Many kid influencer tactics (eg, ability actions to protect children under issued guidelines regarding to generate feelings of trust,11 existing authorities are social media influencers’ blurring content with necessary. Simultaneously, new responsibility to disclose advertising, and use of host-selling regulations and enforcement endorsements. Such written or oral [when the main “character” mechanisms may be necessary to disclosures, however, may easily be delivers the commercial content]) protect children from these disregarded or not understood by may qualify as unfair and evolving marketing strategies. children, as identified in a 2019 deceptive acts and practices These protections are critical, given complaint filed with the FTC directed at children under federal educating parents about against one of the channels in our and state consumer protection laws. deceptive marketing practices may sample.36 The food industry’s self- The FTC and state attorneys not be effective in reducing their

Downloaded from www.aappublications.org/news by guest on September 28, 2021 PEDIATRICS Volume 146, number 5, November 2020 7 influence on children and “marketing disguised as use of objective nutrition adolescents. Researchers have tested entertainment” on YouTube and scoring tools. media literacy interventions, YouTube Kids. Finally, the American including educational efforts in Academy of Pediatrics published CONCLUSIONS schools to teach children critical a report that describes the subtle and fi viewing skills and skepticism about interactive features of social media- This study is the rst to document the food advertising.39 However, those based advertising, including wide array of unhealthy food and interventions do not consider undisclosed marketing of toys in beverage brands that are promoted marketing effects that occur without YouTube influencer videos,41 and through user-generated YouTube fl conscious perception of the future American Academy of videos featuring kid in uencers. Most marketing itself. Research also Pediatrics publications may benefit food advertising research has reveals that such interventions only from describing the unique role of kid been focused on television achieve minor increases in older influencers in promoting unhealthy commercials or online ’ $ advertisements produced by children s (age 8 years) self- food and beverages. 3,4 reported skepticism of companies. This new advertising advertisements and only if they This study has some limitations. First, frontier, however, has been largely n remember to access the the sample included a subset ( = unstudied and underregulated. Our fi information,21,40 but these 418) of the 10 058 videos posted on ndings suggest the need for future interventions have little to no these channels, so our results experimental studies to examine the effect on younger children’s underestimate the amount of product extent to which viewing these typesof preferences for those placement generated by these kid videos increases consumption of fl advertised foods, reinforcing in uencers. Although we instructed unhealthy foods and assess whether fl ’ the critical need for policy coders to pause the video when food kid in uencers endorsements solutions.21 and/or beverages appeared, they may increase the preferences for the have missed some appearances. In product among toddlers, young In future studies, researchers future studies, researchers should children, and parents. The FTC should should examine the extent to which segment videos to better organize the enact regulations that more children and adolescents can coding process. We also calculated adequately address unhealthy food fl identify when kid in uencers the number of minutes food and and beverage brands promoted by kid engage in product placement, which beverages appeared in videos, but, in influencers. would inform the extent to which future studies, researchers could be the FTC should strengthen their more precise by calculating the fl ’ ACKNOWLEDGMENTS response to kid in uencers number of seconds products We thank Krystle A. Tsai, MA, for her endorsements. More research is appeared. Although our data suggest contributions to the article revisions needed to understand that McDonald’s accounts for the fl ’ and assistance with article whether in uencers endorsements of most product placement, it is possible preparation. We also thank the food and/or drinks causes that our search methods missed other following research assistants for increased caloric intake among brands. Second, data on how much their contributions to data youth. In one study, researchers families were paid for these products extraction and coding (Reem found that adolescents ate more placements are not publicly available. fl Alrowaili, MS, and Christopher Park, when exposed to the in uencer One family in our sample, however, MPH) and generating article tables promoting food versus nonfood has reportedly earned $26 million (Kaicy Naranjo). The items, but the study lacked from their YouTube channel, aforementioned contributors have no a control group that featured including at least $1 million for paid fl 26 conflicts of interest to report. We food without the in uencer. sponsorship videos.13,14 Finally, we appreciate the early career Given the enormous reach of did not examine how these product training provided to Dr Bragg by kid influencers’ videos on placements may affect dietary the NIH Behavioral Sleep YouTube, pediatricians can play choices, which is an area of future Medicine PRIDE Grant # a critical role in encouraging research. Our study has several R25HL105444. parents to limit children’s screen strengths, including being the first to time on YouTube, even on channels analyze a sample of videos to that characterize themselves as determine the frequency of food and/ “child friendly” or educational. or drink product placements, the ABBREVIATION Pediatricians can also inform inclusion of the most-watched FTC: Federal Trade Commission parents about the presence of channels that target children, and the

Downloaded from www.aappublications.org/news by guest on September 28, 2021 8 ALRUWAILY et al FINANCIAL DISCLOSURE: The authors have indicated they have no ﬁnancial relationships relevant to this article to disclose. FUNDING: Partially supported by National Institutes of Health grant DP5OD021373-05 (to Dr Bragg) and Agency for Healthcare Research and Quality grant 1T32HS026120-01 (to Dr Cassidy). Funded by the National Institutes of Health (NIH). POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conﬂicts of interest to disclose.

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Downloaded from www.aappublications.org/news by guest on September 28, 2021 Child Social Media Influencers and Unhealthy Food Product Placement Amaal Alruwaily, Chelsea Mangold, Tenay Greene, Josh Arshonsky, Omni Cassidy, Jennifer L. Pomeranz and Marie Bragg Pediatrics 2020;146; DOI: 10.1542/peds.2019-4057 originally published online October 26, 2020;

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