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Evaluating Fast Food Nutrition and Marketing to Youth

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Evaluating Fast Food Nutrition and Marketing to Youth Evaluating Fast Food Nutrition and Marketing to Youth Jennifer L. Harris, Ph.D., M.B.A. Marlene B. Schwartz, Ph.D. Kelly D. Brownell, Ph.D. Fast Food FACTS: Evaluating Fast Food Nutrition and Marketing to Youth Authors: Jennifer L. Harris, PhD, MBA Marlene B. Schwartz, PhD Kelly D. Brownell, PhD Vishnudas Sarda, MBBS, MPH Amy Ustjanauskas Johanna Javadizadeh, MBA Megan Weinberg, MA Christina Munsell, MS Sarah Speers Eliana Bukofzer, MPH Andrew Cheyne, MA Priscilla Gonzalez Jenia Reshetnyak, MS Henry Agnew Punam Ohri-Vachaspati, PhD Rudd Center for Food Policy and Obesity November, 2010 Revised December 3, 2010 Acknowledgements We would like to thank the following people for their valuable assistance in collecting data: Kelly Barrett Hannah Byrnes-Enoch, MPH Casey Carden Ashley Firth, MA Jay Imus Sharon Kirkpatrick, PhD, MHSc Sue Krebs-Smith, PhD, MPH, RD Carly Litzenberger Julie McComish Catherine Montgomery Kathryn O’Shaughnessy Doug Ranshaus Warren Sethachutkul Hannah Sheehy Kate Stearns Jill Reedy, PhD, MPH, RD Jackie Thompson Shannon Vargo Catherine Wright We would also like to thank our steering committee and other advisors: Frank Chaloupka, PhD William H. Dietz, MD, PhD Lori Dorfman, DrPH Steve Fajen Corinna Hawkes, PhD Shiriki Kumanyika, PhD, MPH Tim Lobstein, PhD Susan T. Mayne, PhD C. Tracy Orleans, PhD Lisa M. Powell, PhD Amelie Ramirez, DrPH Mike Rayner, PhD Mary Story, PhD, RD Stephen Teret, JD, MPH Ellen Wartella, PhD James G. Webster, PhD Jerome D. Williams, PhD Thank you to our colleagues at the Rudd Center, especially Rebecca Oren, Andrea Wilson, Megan Orciari and Tricia Wynne. We thank Cavich Creative, LLC, Chris Lenz, and Marian Uhlman for their assistance in preparing the manuscript and website. Finally, we thank the leadership and staff at the Robert Wood Johnson Foundation, with special thanks to the Childhood Obesity Team. Support for this project was provided by grants from the Robert Wood Johnson Foundation and the Rudd Foundation. Table of Contents List of Tables . iv Ranking Tables . .v Appendix Tables . vi List of Figures . vi Executive Summary . ix Introduction . .12 Methods . 17 Fast food menus and nutritional quality . 17 Marketing practices . 21 Marketing outcomes . 33 Results . 36 Overview of fast food market . 36 Fast food menu composition . 37 Menu items and special menus . 37 Nutritional quality of all menu items . .39 Dollar/value menus . 44 Healthy menus . 45 Kids’ meals nutritional quality . .47 Best and worst kids' meal choices . 49 Traditional media . 51 Advertising spending . 51 TV advertising exposure . .52 Content analysis of TV advertisements . 57 Ethnic and racial targeting . 63 Internet and other digital media . 71 Restaurant websites . 71 Banner advertising on third-party websites . 82 Social media marketing . 88 Mobile marketing . 96 Marketing inside restaurants . 103 Restaurant signs audit . 103 Pricing analysis . 111 Sales practices audit . 112 Marketing outcomes . 116 Restaurant visits . 116 Special menus and menu items purchased . 119 Conclusion . 131 Endnotes . 139 Ranking Tables . 144 Appendices . .168 A. Fast food menu composition . 168 B. Traditional media . 179 C. Internet and other digital media . 195 D. Marketing inside restaurants . .201 E. Marketing outcomes . 205 Fast Food FACTS iii List of Tables Table 1: Maximum acceptable calories and sodium for kids’ meals and individual menu items . 20 Table 2: Sales of top 20 fast food restaurants . 36 Table 3: Number of menu items per restaurant . 38 Table 4: Special menus by restaurant . 38 Table 5: Nutrient content of menu items by food category . .39 Table 6: Nutrient content of menu items by restaurant . 40 Table 7: Changes in sizes of soft drinks and french fries . 43 Table 8: Number of menu items available on dollar/value menus . 44 Table 9: Nutrient content of menu items available on dollar/value menus . 45 Table 10: Number of menu items available on healthy menus . 46 Table 11: Nutrient content of menu items available on healthy menus . 46 Table 12: Number of menu items and combinations available for kids’ meals . 48 Table 13: Summary nutritional quality information for kids’ meal combinations . 48 Table 14: Total advertising spending by fast food restaurants . 51 Table 15: Fast food restaurant TV advertising exposure for youth: Ads viewed in 2008 and 2009 . 52 Table 16: Fast food restaurant TV advertising exposure for adults: Ads viewed . 53 Table 17: Change in TV advertising exposure from 2008 to 2009 by restaurant and age group . 54 Table 18: Youth exposure to TV advertising in 2009 by product category and age group . 55 Table 19: Product categories by restaurant . 56 Table 20: Restaurants and product categories targeted to children . 59 Table 21: Restaurants and product categories targeted to teens . .61 Table 22: African American youth exposure to fast food advertising . 64 Table 23: Restaurants and product categories targeted to African American children and teens . 64 Table 24: Hispanic youth exposure to fast food advertising on Spanish-language TV . 65 Table 25: Restaurants and product categories advertised on Spanish-language TV . 66 Table 26: Three most frequently advertised menu items . 68 Table 27: Total nutrient content of items in TV ads viewed by youth every day . 69 Table 28: Nutrient content of menu items advertised on TV . 69 Table 29: Nutrient content of fast food products presented daily in TV ads viewed by African American and white youth on English-language TV and Hispanic youth on Spanish-language TV . 70 Table 30: Child-targeted websites ranked by level of engagement . 72 Table 31: Main restaurant websites ranked by level of engagement . 76 Table 32: Average monthly exposure to child-targeted websites . 80 Table 33: Average monthly exposure to main restaurant websites . 80 Table 34: Websites with a disproportionate number of African American youth visitors in 2009 . 81 Table 35: Banner advertising exposure by restaurant . 82 Fast Food FACTS iv Table 36: Exposure to child-targeted banner ads . 84 Table 37: Banner ads with a high proportion of ads viewed on youth websites . 86 Table 38: Exposure to racial- and ethnic-targeted banner ads . 87 Table 39: Facebook pages and fans . 88 Table 40: Restaurant Twitter accounts and followers . 92 Table 41: Specific menu items mentioned in Twitter accounts . 94 Table 42: Restaurant YouTube channels, viewers, and videos posted in 2009 . .95 Table 43: Ten mobile websites with the most frequent placement of restaurant banner ads . .97 Table 44: Mobile banner ad placements by restaurant . .97 Table 45: Top five monthly ad placements as measured by ad index for each restaurant . 98 Table 46: Smartphone application functions . 100 Table 47: iPhone application demographic profile . ..
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