Food and Beverage Marketing on Television During Children’s Preferred Viewing: The Influence of Regulatory and Self-regulatory Policies Monique Potvin Kent Thesis submitted to the Faculty of Graduate and Postdoctoral Studies in partial fulfillment of the requirements for the PhD degree in Population Health PhD Program in Population Health University of Ottawa © Monique Potvin Kent, Ottawa, Canada 2011 Table of Contents Page List of Tables ................................................................................................................................ ix List of Figures ................................................................................................................................ xi Abstract ......................................................................................................................................... xii Acknowledgements ..................................................................................................................... xiv CHAPTER 1: INTRODUCTION ......................................................................................1 1.1 Specific Objectives and Hypotheses ................................................................................2 1.2 Contributions to the Field of Population Health................................................................4 1.2.1 Definition of Population Health ..................................................................................4 1.2.2 Childhood Obesity ....................................................................................................5 1.2.3 Children‟s Food Intake ..............................................................................................6 1.2.4 A Population Health Framework that Addresses Obesity .........................................8 1.2.5 The Importance of Marketing Directed at Children ................................................10 1.2.6 Contributions of This Thesis to Population Health ..................................................11 1.3 Review of the Literature ..................................................................................................13 1.3.1 Marketing to Children ..............................................................................................13 1.3.2 How and Where Children Are Targeted by Marketing ...........................................14 1.3.3 The Amount Spent on Marketing Food and Beverages to Children ........................15 1.3.4 The Amount and Quality of Foods and Beverages Marketed to Children ..............16 1.3.5 The Relationship Between Food Advertising, Food Intake and Obesity .................18 1.4 The Regulatory Context in Canada ..................................................................................19 1.4.1 The Broadcast Code for Advertising to Children ....................................................20 1.4.2 The Canadian Children’s Food and Beverage Advertising Initiative .....................21 1.4.3 Other Advertising Policies in Canada ......................................................................23 1.5 The Regulatory Context in Quebec .................................................................................24 1.6 Advertising to Children in Canada on Television ...........................................................25 1.7 Content Analyses of Children‟s Viewing in Quebec ......................................................28 ii Table of Contents (cont’d) Page 1.8 The Influence of Self Regulation in Advertising on Children‟s on Children‟s Exposure to Food/Beverage Advertising ...............................................................................................33 1.9 The Influence of Statutory Regulations on Children‟s Exposure to Food/Beverage Advertising .............................................................................................................................34 CHAPTER 2: METHODOLOGICAL OVERVIEW ................................................37 2.1 Method Summary and Justification ..................................................................................37 2.2 Research Sequence ...........................................................................................................40 2.3 Supplementary Detail Regarding the Data Collection ....................................................41 2.3.1 Subject Recruitment ..................................................................................................41 2.3.2 Demographic Information .........................................................................................42 2.3.3 Television Viewing Data Collection and Data Coding.............................................43 2.4 School and Subject Participation Rates ............................................................................44 2.5 Subject Demographic Characteristics and Television Viewing Patterns ..........................46 2.6 Methodological Difficulties ..............................................................................................54 2.7 Knowledge Translation Strategy .....................................................................................55 CHAPTER 3: RESEARCH RESULTS ..........................................................................58 3.1 Food Marketing on Children‟s Television in Two Different Policy Environments .........59 Abstract ..............................................................................................................................60 Introduction ........................................................................................................................60 Methods..............................................................................................................................61 Subjects ..................................................................................................................61 Data Collection ......................................................................................................61 Definitions..............................................................................................................62 Analysis..................................................................................................................62 Results ................................................................................................................................62 Children‟s Preferred Television Viewing ..............................................................62 iii Table of Contents (cont’d) Page Advertisements ......................................................................................................62 Contests ..................................................................................................................63 Sponsorship Announcements .................................................................................63 Total Promotions ....................................................................................................64 Discussion ..........................................................................................................................64 Advertisements, Contests and Sponsorships..........................................................64 Total Promotions ....................................................................................................64 Policy Implications ................................................................................................66 Strengths and Weaknesses .....................................................................................67 Conclusion .........................................................................................................................67 Acknowledgements ............................................................................................................67 References ..........................................................................................................................67 3.2 A Nutritional Comparison of Foods and Beverages Marketed to Children in Two Advertising Policy Environments ...........................................................................................69 Title Page ...........................................................................................................................70 Abstract ..............................................................................................................................71 Introduction ........................................................................................................................72 Methods and Procedures ....................................................................................................74 Results ................................................................................................................................78 Children‟s Preferred Television Viewing ..............................................................78 Total Number of Advertisements ..........................................................................78 Macronutrients per 100 g of Food .........................................................................79 Macronutrients as a Percentage of Energy .............................................................80 Macronutrients According to Nutrient Recommendations ....................................80 The Marketing of “Healthy” Versus “Less Healthy” Foods ..................................81 Discussion ..........................................................................................................................81