RESEARCH Advertising of fast food to children on Australian television: the impact of industry self-regulation Lana A Hebden, Lesley King, Anne Grunseit, Bridget Kelly and Kathy Chapman ne of the key recommendations of ABSTRACT the National Preventative Health Objective: To assess the impact of the quick-service restaurant industry (QSRI) self- Taskforce1 was that children’s expo- O regulatory initiative on fast-food advertising to children on Australian commercial television. sure to advertising of unhealthy foods should be reduced. This was because of the Design and setting: Analysis of advertisements for foods on the three main free-to-air negative impact this advertising had on chil- commercial television channels (channels 7, 9 and 10) in Sydney, Australia, over 4 days in dren’s food preferences and consumption, both May 2009 and April 2010 in terms of: number of advertisements; types of food and potentially on children’s weight status.2 (coded core [healthy] foods, non-core [unhealthy] foods, miscellaneous foods; or fast The Medical Journal of Australia ISSN: foods); whether advertised meals were intended for children; whether advertisements In response,0025-729X the federal4 July 2011 government 195 1 20-24 recom- mended that the Taskforce continue to mon- were broadcast during children’s peak viewing times; and whether the company in ©The Medical Journal of Australia 2011 question was a signatory to the QSRI initiative. itor thewww.mja.com.au impact of self-regulation by food and advertisingResearch industries before the gov- Main outcome measures: Change in the mean frequency and rate of food ernment took any further action.3 However, advertisements per hour from 2009 to 2010; change in the types of fast-food meals recent evidence has indicated that self-regu- (healthier alternatives [at least one nutrient-dense, low-energy food considered part of a lation is inadequate in protecting Australian healthy diet for children], non-core [high in undesirable nutrients and not considered children from the harmful effects of junk- part of a healthy diet for children], and other) being advertised; and proportion of food advertising.4,5 children’s energy requirements provided by fast-food meals. In Australia, statutory guidelines (the Results: From 2009 to 2010, the mean frequency of fast-food advertisements increased children’s television standards) regulate the from 1.1 to 1.5 per hour. While non-core fast foods comprised a lesser share of fast-food use of promotions, popular characters and advertising in 2010 than 2009, the mean frequency at which they were advertised during unsuitable material during time periods times when the largest numbers of children were watching television remained the same dedicated to children’s television programs.6 (1.3 per hour in both 2009 and 2010). Family meals advertised for children’s consumption However, these standards do not regulate in 2010 provided energy far in excess of children’s requirements. the types of foods that may be advertised to Conclusions: Children’s exposure to unhealthy fast-food advertising has not changed children (with the exception of alcohol), and following the introduction of self-regulation, and some fast foods advertised for do not apply during times when the highest children’s consumption contain excessive energy. The limited impact of self-regulation numbers of children are viewing.6,7 Recent suggests that governments should define the policy framework for regulating fast-food self-regulatory initiatives for responsible advertising to children. advertising to children, introduced by food MJA 2011; 195: 20–24 and advertising industries, have provided some specifications for the types of foods eMJA Rapid Online Publication 27 June 2011. and marketing techniques they consider appropriate for advertising to children and for defining child audiences.8,9 However defined set of nutrition criteria for assessing May 2009 (Saturday 16 May to Tuesday 19 these specifications are poorly defined, children’s meals), and/or represent a healthy May, 6.30 am to 10.30 pm) and in April highly permissive, and are voluntary for lifestyle in advertisements directed primarily 2010 (Saturday 17 April to Tuesday 20 food manufacturers and services.5,10 to children.8 April, 6 am to 11 pm). The most recent self-regulatory initiative, We aimed to measure the impact of the Food advertisements were identified and the Australian Quick Service Restaurant QSRI initiative on the rates of fast-food coded by food category, using a classifica- Industry (QSRI) Initiative for Responsible advertising on Australian commercial televi- tion system applied in previous studies:11 Advertising and Marketing to Children,8 sion; identify the types of fast foods adver- • core (healthy) foods: nutrient-dense, specifies that fast-food companies (ie, quick- tised in terms of their nutritional value; and low-energy foods considered part of a service restaurants) should “ensure that only estimate the likely energy contribution to healthy diet for children;12 food and beverages that represent healthier children’s diets of children’s meals advertised • non-core (unhealthy) foods: high in choices are promoted directly to by fast-food companies. undesirable nutrients and not considered children . .”.8 The QSRI initiative began in part of a healthy diet for children;12 August 2009 with seven signatories: METHODS • miscellaneous foods; or Chicken Treat, Hungry Jack’s, KFC, McDon- • fast foods: foods or beverages prepared ald’s, Oporto, Pizza Hut and Red Rooster.8 Data sources and coding by others outside the home, paid for before These companies agreed that in advertising All advertisements for food and non-food eating, with limited preparation or service to children under 14 years of age, they products broadcast on the three main Syd- required.13 would only advertise products that repre- ney free-to-air television channels (channels Fast-food advertisements were coded into sent healthier choices (as determined by a 7, 9 and 10), were recorded over 4 days in three subcategories — those promoting: 20 MJA • Volume 195 Number 1 • 4 July 2011 RESEARCH • healthier alternatives (with at least one conducted, according to food category half hour in regression models to account core food advertised); (core, non-core, fast-food and miscellan- for the different times sampled in 2009 and • non-core foods; or eous) and fast-food category (healthier 2010, but are presented per hour, for ease of • “other” (only the company brand or a alternatives, non-core and other), for the interpretation, with the incidence rate ratios specific promotion advertised). years 2009 and 2010 to examine change in (IRR) from the models. Each fast-food advertisement was further the extent of advertising between these As the QSRI initiative applies to advertis- coded by: years. Non-core fast-food advertisements ing to children under 14 years of age, the • company; were further analysed for all times and energy content of children’s meals, adver- • whether or not the company had signed during children’s peak viewing times, tised by fast-food companies in 2009 and up to the QSRI initiative; and including a year (2010 v 2009) by com- 2010, was compared with the daily energy • advertisement focus (single product, pany-type interaction (QSRI-initiative sig- requirements of boys and girls aged 4, 8 and meal, multiple products, or company brand/ natories v non-signatories). 12 years.16 Estimates were adjusted for a specific promotion). Counts of advertisements were analysed physical activity level (ratio of total to basal Meals were coded according to whether using four regression models: (i) Poisson; energy expenditure) of 1.6, based on esti- or not they were children’s meals. As the (ii) negative binomial; (iii) zero-inflated mates for Australian children.17 As a fast- QSRI initiative does not define what consti- Poisson (ZIP); and (iv) zero-inflated negative food meal is likely to be one of three meals tutes a children’s meal, other than noting binomial (ZINB). ZIP and ZINB models consumed each day in addition to snacks, a that it must comprise “at least a main and a were used where there were zero counts of 30% threshold of children’s daily energy beverage”,14 we adopted the following oper- the dependent variable (ie, no advertise- requirement was used to identify meals pro- ational definition of an advertisement for a ments). The best model was selected based viding excess energy. children’s meal, derived from previous on goodness-of-fit statistics, Vuong test (ZIP research: v Poisson, and ZINB v negative binomial) RESULTS . an advertisement for a meal, where and the dispersion parameter α (negative a child is depicted consuming the meal, binomial v Poisson). Offsets were total Sampled fast-food advertisements com- or which uses themes of fun/happiness advertisements (for fast-food, core, non-core prised those promoting healthier alterna- or fantasy/imagination to appeal to and miscellaneous foods) and total fast-food tives (at least one core food advertised), children.15 advertisements (for each fast-food category). non-core foods, or other (company brand or To examine fast-food advertising being Analyses were conducted using Stata, ver- specific promotion only) (Box 1). shown when the highest numbers of chil- sion 11.0 (StataCorp, College Station, Tex, The mean number of advertisements per dren were viewing television, annual televi- USA), with the significance threshold set at hour for all foods, each food category, and sion audience data for 2009 were used. P = 0.05. The reference year was 2009 each fast-food category are shown in Box 2, These data identified the peak viewing times (before the introduction of self-regulation), with the IRR comparing 2009 with 2010. for child audiences aged 5–12 years.7 Con- and the reference company type was compa- The mean frequency of total food advertise- sistent with previous research,4 peak times nies that were not signatories to the QSRI ments increased significantly from 6.0 per were defined as times when the child audi- initiative.