Food Advertising during Children's Television Programming

FOOD ADVERTISING DURING CHILDREN' S TELEVISION PROGRAMMING


By

ANNE L. JONES













A THESIS PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SCIENCE

UNIVERSITY OF FLORIDA


2006


































Copyright 2006

by

Anne L. Jones
































This thesis is dedicated to my husband Matt and my family in the Sunflower State.















ACKNOWLEDGMENTS

I extend my deepest gratitude to my supervisory committee chair Dr. Lisa House,

and committee member Dr. Al Wysocki, for their guidance and assistance over the course

of my thesis research.

I also wish to express my appreciation to the faculty and staff members in the Food

and Resource Economics Department, and to my fellow graduate students for their

support and encouragement throughout my course of study.

Finally, I would like to thank my family and friends for their constant support and

unwavering confidence.
















TABLE OF CONTENTS

page

A C K N O W L E D G M E N T S ................................................................................................. iv

LIST OF TABLES .................. .................. ................. ............ ............ .. viii

LIST OF FIGURES ............................... ... ...... ... ................. .x

ABSTRACT ........ .............. ............. ...... ...................... xi

CHAPTERS

1 IN TR O D U C TION .................................................. .. .... ........ ................

Focus of Present W ork .................. ..................................... .. ........ ....
The R esearchable Problem ........................................ ................................. 4
A nsw erable Q questions ................................................................. ........................ 4
R research O bjectives.......... ................................................................... ........ .... .5

2 REVIEW OF LITERATURE: PEER STUDIES.................................. ...7

U SA 1994 K otz and Story .............................................................. .....................7
U SA 1995 T aras and G age ........................................ ....................................... 10
U K 1998 L ew is and H ill ......... ................. ................. ................... ............... 12
USA 1999 Gamble and Cotugna ............................... ............... 14
A ustralia 1997 H ill and R adim er.......... ................. ........................ .... ........... 16
U SA 2000 Byrd-Bredbenner and Grasso ........................................ ............... 17
U K 2002 Chestnutt and A shraf .................................................................... .....20
Australia 2003 Zuppa, M orton, and M ehta .................................. ............... 22
U SA 2005 H arrison and M arske......................................... ......................... 24

3 REVIEW OF LITERATURE: NUTRITION AND GOVERNMENT ...........................28

D dietary Guidelines for Am ericans ........... ................... ................. .......... ......28
T he F ood G uide P yram id ......................................... .............................................33
Philosophical Goals............... .... .................... .......... 33
D ev elop m ent............................. .................................................. ............... 34
A acceptance and Criticism s ............................................................................ 38
M yPyram id ............................................................... .. ... ......... 38
D ev elop m ent............................. .................................................. ............... 3 9









Food Labeling ............................................ ......... ...............42
History and Development of Nutrition Labeling.................................................43
Key Provisions of the Nutrition Labeling and Education Act of 1990 .............46
The N nutrition Facts L abel......................................................... ............... 47
Inform ation in A action ......................................................... ............... 49

4 D A T A ............................................................................... 5 1

N etw ork Recording Plan ..................................... .......................... ...............51
C children's Program m ing .................................................. .............................. 54
V iew ing and C oding ................................................................. ......... ...... 55
F ood C om m ercials........... .............................................................. ................... 58

5 R E S U L T S ............................................................................ 6 1

N nutrition Facts C onversions ............................................... ............................ 61
Food Com m ercial Considerations ........................................ ......................... 62
Com posite N nutrition Facts Labels ............................. ... ........... ............... ... 63
Review of Nutrient Categories from Composite Nutrition Facts Labels ................66
Serving Size.......................................................... 66
Calories .................................... ................... 66
Fat and Cholesterol ........ .................. .. .......... ....... .... ..... 69
S odiu m .............. ..... ... ...... ...................................................... ............... 72
Carbohydrates Sugars and Fiber................................... ........ ............... 73
P ro te in ....................................................... ................... 7 6
V itam ins and M inerals .................................................................... ...............79
The Composite Food 1700 Calorie Diet ................................... .................82

6 CONCLUSION........ .......... ....... .. .. .... .... ................85

S u m m a ry .....................................................................................................8 5
C o n c lu sio n s........................................................................................................... 8 7
Future Study ............... ......... ........................89

APPENDIX

A UNITED STATES NUTRITION STANDARDS ACRONYMS...............................92

B COMPLETE RECORDING SCHEDULE .................................. ...............................93

C SUMMARY OF LITERATURE REVIEW STUDIES ........................... 100

D COMPLETE FOOD COMMERCIAL LOG ..........................................................105

E BAYLOR CHILDREN'S NUTRITION COMPARISON TABLE ..............................130

F OBSERVATIONS OF ADVERTISED FOOD PRODUCTS ..................................... 132









L IST O F R E FE R E N C E S ......................................................................... ................... 139

BIOGRAPH ICAL SKETCH .............................................................. ............... 144
















LIST OF TABLES

Table p

4-1. N etw orks and R recorded H ours............................................... ....... 53

4-2. Programs and Commercials...................... ....... .............................. 57

4-3. Commercials by Network and Rating ......................... .......................... ........... ... 57

4-4. Commercials by Product Category................................................................ 57

4-5. Food Categories and Exam ples ............................................................................ 58

5-1. Nutrition Facts label DVs and Children's DVs.............. ........ ................... 62

5-2. Com posite N nutrition Facts Labels ........................................ ......................... 65

5-3. Composite Labels Calorie Density ................... .................................................. 67

5-4. Standardized Calories Probit Results ........................................ ...... ............... 68

5-5. Standardized Calories Probit M arginal Effects .................................. ............... 68

5-6. % D V Calories, Fat, and Cholesterol ........................................ ....... ............... 71

5-7. 100% DV Calories (1700) and %DV Sodium ........... .......................................72

5-8. Standardized Sodium Tobit R results ........................................ ........ ............... 73

5-9. Calories, Total Carbohydrates, Sugar, and Fiber Content of Composite Labels........75

5-10. Standardized Protein Probit Results ........................................ ...... ............... 77

5-11. Standardized Protein Probit Marginal Effects............. .................................79

5-12. Daily Value Contribution of Vitamins and Minerals ............................................79

5-13. Standardized Calcium Tobit Results ............................................. ............... 81

5-14. The Composite Food 1,700 Calorie Diet....................................... ............... 83

A-1. United States Nutrition Standards Acronyms ............................................... 92









B -1. Com plete R recording Schedule........................................................ ............... 93

C-1. Summary of Literature Review Studies........................................ ............... 100

D P program C ode (P C )......................................................................... ................... 105

D -2 K ey for T able D -3 ......... ................. ......................................... ........................... 105

D-3. Complete Food Comm ercial Log .... .......... .............................. .................106

E-1. How Food Label Reference Values (DV) Compare to the Nutritional
R ecom m endations for Children ........................................ ........................ 130

F-1. Food Commercials, Food Products and Observations by Network, TV Rating
C ode and C ross Prom otion.......................................................... ............... 132















LIST OF FIGURES


Figure pge

3-1. Weight Range Chart from 1995 DGA.26 ........... ..........................................30

3-2. 2000 Dietary Guidelines for Americans Campaign.27....................... .....................31

3-3. 2005 Dietary Guidelines for Americans Cover Illustration.10.................................32

3-4. Proposed Food Guide Graphic-Circle.25........... ....................... ............. .35

3-5. Proposed Food Guide Graphic-Blocks in a Circle.25 .............................................36

3-6. Proposed Food Guide Graphic-Blocks in a Row.25 ........................... ................. 36

3-7. Proposed Food Guide Graphic-Inverted Pyramid (Funnel).25 ..................................37

3-8. Proposed Food Guide Graphic-Pyramid.25 ............................ .... .....................37
3-9. 2005 M yPyram id G graphic and Slogan.3m .................................................................... 42
3-9. 2005 MyPyramid Graphic and Slogan .......................... .............42

3-10. Example Nutrition Facts Label.36 .......................................................................47

4-1. C om posite N nutrition Facts L abel..................................................................... ..... 60















Abstract of Thesis Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Master of Science

FOOD ADVERTISING DURING CHILDREN' S TELEVISION PROGRAMMING

By

Anne L. Jones

May 2006

Chair: Lisa House
Major Department: Food and Resource Economics

Childhood obesity rates have reached epidemic levels-30% of all U.S. children

ages 6-19 are overweight by CDC guidelines, and half of that group is obese. Kids in the

U.S. also see about 10,000 food advertisements on television every year and most of the

products are laden with sugar and fat. This research examines whether or not TV food

and beverage commercials are counterproductive to children's health. Stated another

way, do food and beverages advertised represent a diet that adheres to government

healthful eating recommendations?

Data for this study were collected by video taping children's programming on

Orlando, Florida, affiliates ofNBC, CBS, ABC, WB, and the national cable networks

Nickelodeon and Cartoon Network. Commercial content was coded for network,

program time, program rating code, and use of licensed characters. Food and beverage

commercials were further evaluated for the product's nutritional density using

information from Nutrition Facts labels. "Composite labels" were created to reflect the

average information of the Nutrition Facts label for the foods advertised on each network,









during each TV rating code, and use of cross promotion. The nutrition information of

each composite label was then compared to children's nutrition recommendations created

by the Children's Nutrition Research Center at Baylor College of Medicine. Probit and

tobit tests were used to determine if differences exist among networks, program rating

codes, and use of licensed characters.

The collection of composite labels offers both positive and concerning nutritional

news. Fat, saturated fat, and cholesterol were all found to be present in amounts that are

within recommended limits for each composite label. Vitamins A and C were provided

in abundance according to each label. Each composite label, with the exception of the

television network NBC, indicated an adequate level of protein. Areas for concern

include sodium, sugar, fiber, and calcium. All composite labels reflected an assortment

of foods that, if consumed for an entire day, provide as much as twice the recommended

limit of sodium. The composite labels revealed that at least 28% of calories were from

sugar-a level beyond recommended limits. Fiber was found in amounts of about half the

recommendation for healthy eating. The same proportion was found for calcium.

While many significant differences were found among television networks, rating

codes, and use of cross promotion, the application of this information isn't practical for

parents and other caretakers seeking to limit children's exposure to advertising of foods

of low nutritional density. The value of this study lies in three other major areas:

understanding children's dietary needs, evaluating the nutritional density of foods, and

recognizing both the value and limitations of tools designed and provided by the

government.














CHAPTER 1
INTRODUCTION

The health of America's children is in danger. Thirty percent of American children

aged 6 to 19 are overweight according to Centers for Disease Control and Prevention

measures and half that group is clinically obese.1 More alarming is the rate at which the

obese trend has grown: since 1970 the proportion of obese (BMI for age greater or equal

to 95th percentile) children and adolescents has increased from about 4% to 16%.2

Contributing to the trend of overweight and obesity is the trend of inactivity related to the

reduction of physical education in schools, reduced support of after-school athletic

programs, and use of various media types at school and home.3 The American Academy

of Pediatrics recognizes that these trends present "an unprecedented burden in terms of

children's health as well as present and future health care costs."4

Obesity during childhood also places a significant burden on the individual. Obese

children may face medical problems during childhood and carry an early risk factor for

"much of adult morbidity and mortality."4 Medical problems common in obese children

and adolescents include cardiovascular problems such as hypertension and abnormal

cholesterol levels, endocrine problems including type 2 diabetes and menstrual

irregularity, and mental health issues including depression and low self-esteem.4

While overweight and obese children suffer from the effects of an energy

imbalance they may also be suffering the effects of nutritional imbalance. That is, more

than adequate caloric intake does not guarantee adequate nutrient intake. Calcium

consumption is of particular concern. According to Duane Alexander, M.D. and director









of the National Institute of Child Health and Human Development (NICHD),

"Osteoporosis is a pediatric disease with geriatric consequences."5 Of American children

aged 9 to 13 less than 10% of girls and 25% of boys consume the government

recommended daily amount of 1,300 milligrams of calcium.6 Calcium consumption

during childhood and adolescence is critically important because 90% of bone mass is

established by age 17. Inadequate calcium intake during childhood and adolescence

increases risk for developing osteoporosis later in life.7

Fiber consumption is another area of concern for children regardless of calorie

intake level. The National Academy of Sciences released a Dietary Reference Intake

(DRI) for fiber in 2002 for Americans of all ages. The recommendation states that 14

grams of fiber should be consumed for every 1,000 daily calories based on evidence that

cardiovascular disease risk is reduced at that level. Often children have different

nutritional needs from adults and different recommendations are made, but in the case of

fiber no distinction was made because "of the lack of scientific evidence to support

specific recommendations for children." Adequate fiber intake offers many other health

benefits including protection against constipation and diminished risk of some cancers,

diabetes, and obesity.8 Nutrition researchers Kranz, Mitchell, Siega-Riz, and Smiciklas-

Wright conducted a fiber intake study among American preschoolers and found

consumption levels to be well short of the new DRI of 14 grams per 1,000 daily calories.8

They did however find that diets with higher levels of dietary fiber were associated with

higher overall nutritional quality with one exception-higher-fiber diets were lower in

calcium.









Obesity and nutritional deficiencies are both cause for concern and action for the

health of America's children. Understanding how and where children and parents get

information for making eating choices may offer insights to the current situation. The

government and media are major and highly accessible sources of food and nutrition

information; as such their messages and methods must be evaluated.

The United States government has provided the public with guidance and

recommendations for healthful eating for more than a century. W.O. Atwater, the first

director of the Office of Experiment Stations in the US Department of Agriculture

(USDA), published tables of common food composition and dietary standards designed

to reflect the calorie and protein needs of the average man in 1894.9 Since then

government recommendations have evolved extensively and have most recently been

issued in two familiar forms: Dietary Guidelines for Americans and the Food Guide

Pyramid. A third tool, the Nutrition Facts label found on most foods, is regulated by the

government as well. These three tools are designed and provided for the public to

communicate the latest scientific knowledge and a recommended pattern for eating.10

Media is a bountiful source of information-from news on the internet to advertising

on television and more. Children in the U.S. are exposed to a tremendous amount of

information from media: on average they spend five and half hours a day using media

including television, videos, video games, and computers. The only activity they spend

more time doing is sleeping. During their time in front of the television children view an

average of 40,000 commercials a year, 25% of which are for food.3' 11 Other studies have

found that food and drink companies spend $13 billion annually marketing to children

and fast food restaurants alone spend $3 billion on television ads for children.3' 12









Beyond the amount of advertising targeted at children, more troubling is the information

children take away from the ads. A study of 6- to 8-year-olds found that 70% believed

fast foods were "more nutritious" than foods cooked at home. Another study asked 4th-

and 5th-graders to choose the healthier food from a pair of similar foods (corn flakes and

frosted flakes, for example). Children who watched more television were likely to

choose the less healthy option as the healthier food.3

Focus of Present Work

The primary purpose of this study is to examine and evaluate the product content of

television food advertising during children's programming. The secondary mission is to

review the United States government's role in providing nutrition education, information,

and tools through media and food packaging.

The Researchable Problem

To what extent do foods advertised during children's television programming

comply with government healthful eating guidelines?

Answerable Questions

What types of foods are advertised during children's television programming?

What does the nutritional profile of an advertised food look like? Recognizing the types

and nutritional profiles of foods advertised during children's programming is a simple but

important step. For the purposes of this study, coding the type of food in each

commercial determines if each daily traditional eating occasion is represented, and in

what proportion. This information reveals whether or not a viewer could conceivably

consume only those foods advertised on television as a complete daily diet.

Incorporating the nutritional information of a daily diet of advertised foods reveals

important nutritional implications of a diet of advertised foods.









Most Americans are familiar with the Nutrition Facts label on most packaged

foods. What other nutrition information does the United States government supply?

How has the government's nutrition education program evolved? The Nutrition Facts

label has become a widely recognized tool for making food choices. The Food Guide

Pyramid is another widely recognized tool for making healthful eating decisions and

evolved from several editions of Dietary Guidelines for Americans. Since its

introduction in 1992 it has changed again-this time into an interactive and personalized

media system called MyPyramid. Understanding what each of the government's tools is

designed for and what they impart is important for communicating the results of this

study in a useful and meaningful format.

What are children's nutritional needs? How do their needs change through

childhood? How are they different from adults' needs? The Nutrition Facts label on

most packaged foods delivers nutritional information based on a typical adult's 2,000

calorie daily diet. Children, however, have different caloric and nutritional needs, and

foods advertised to children for consumption by children should be evaluated based on

children's needs.

Research Objectives

Three research objectives will guide the progress of this study. The first objective

is to assemble a database of advertising information collected during children's television

programming. Several steps will need to be taken to complete this objective including

evaluation and selection of national and cable networks, determination of a program

recording schedule that reflects the different networks and includes a variety of programs

for different ages, and watching and coding program and commercial content in the

database. Understanding and quantifying the nutritional needs of children is the second









objective. This objective is critically important to producing results that are relevant to

children specifically. Stated another way, most nutrition education and information tools

are created for adults who have different dietary needs. Producing results based on a

2,000 calorie diet, for example, wouldn't hold much meaning for children as 2,000

calories is outside the needs of children. Being prepared to use "adult" nutritional

information to generate information appropriate for children will be important. The third

objective then uses the insights and preparation of the second objective. Nutrition

information for advertised foods will be collected and analyzed for nutritional

contribution to a child's diet. The results of the analysis will show the nutritional

strengths and weaknesses of advertised foods as a complete day's diet. Other analysis

will compare "average" nutrition information between television networks, children's

television rating codes, and whether or not the food is advertised using cross promotion.















CHAPTER 2
REVIEW OF LITERATURE: PEER STUDIES

The relationships among children, television and other entertainment media, and

food have been studied over several decades through countless experimental designs by

researchers from varied fields. The following review of literature examines eight of the

most recent content analysis studies that focus specifically on the relationship of food

advertising and children. Even within this narrow spectrum, each of the studies is

unique: in location, methods, profession of researcher, and results. The diversity of the

research presented does provide rich levels of perspective and opportunities for additional

research into a set of universal questions. Among those: What types of food are

advertised to children? What advertising messages are used to sell the products? How

much food advertising are children watching? As a combination, the conclusions and

further questions of each study provide insight into the childhood condition as affected by

food advertising and a jumping off point for more research.

USA 1994 Kotz and Story

One of the first studies to focus on this topic was conducted by University of

Minnesota nutrition researchers Krista Kotz and Mary Story.13 In an article titled "Food

advertisements during children's Saturday morning television programming: Are they

consistent with dietary recommendations" Kotz and Story attempted "to identify the

types of foods advertised and examine messages used to see food products." The data for

this study was collected by recording 52.5 hours of children's television on five US









networks-four over the air and one cable station-during October 1991 and January and

February 1992. The 52.5 hours contained 997 commercials, 564 of which were for food.

The 68 public service announcements (PSAs) recorded included ten highlighting a

nutrition message. The "dietary recommendations" used to evaluate the food commercial

content of their taped programming was the then-new USDA Food Guide Pyramid,

released in August of 1992.14

Kotz and Story recorded all programs from 7 am until 10:30 am on Saturday

mornings "because all major networks reserve this period for children's programming"

but only analyzed those designed for children. The very programming schedule they

followed is one element that makes this study unique and highlights a change by the

national broadcasters. Others since have included Saturday mornings, but many major

networks no longer reserve this period for children's programming. The Saturday

morning children's programming recorded for the present study did not air until 10 am on

the national networks. The earlier slots are now primarily occupied by local news

broadcasts.

Food commercial and food PSA content was coded by Kotz for "product name and

company, whether toys or other product were used to promote the food being advertised,

whether the commercial was animated, whether children were in the commercial,

whether and where eating occurred, and whether there were any implicit or explicit

messages." This coding procedure addresses the purpose of examining messages.

Regardless of the nutritional quality of the foods advertised, this portion of the study

identifies how and which messages food advertisers use to communicate with the viewer.









Content analysis interrater and intrarater reliability calculations were made for the count

of explicit and implicit messages.

The results of this portion of the study show that messages of "taste" and "fun"

are most frequently used in explicit and implicit forms. "Get a free toy" is also a

frequently used explicit message as it is often a part of fast food children's meal

advertisements and "healthful or nutritious" is a frequently used implicit message at the

end of cereal commercials in the form of "part of a complete/nutritious/balanced

breakfast." Animation was found to be a widely used communication vehicle-only 27%

of food ads and PSAs used no animation. Children appeared in 84% of food commercials

and food PSAs, with 73.4% of that sample showing children eating the advertised

product and 54% of the sample eating with other children.

Advertised foods were then sorted into the categories of the Food Guide Pyramid

using the USDA Child Nutrition Program Criteria. These criteria mandate that "if the

primary ingredient by weight for a given food is either fat or sugar, the product is placed

in the 'fats, oils, and sweets' group." Cereals are also divided into high sugar (greater

than 20% by weight but not the first ingredient by weight) and low sugar (less than 20%

by weight) varieties. Of the 564 food advertisements high sugar cereals won the top spot

in advertising frequency with 188 ads, representing about 33% of all food products

advertised. Foods fitting into the capstone of the Food Guide Pyramid, "Fats, Oils, and

Sweets," accounted for 43.6% of all food ads with the biggest contributors being candy,

cereals (where the main ingredient by weight is sugar), and soft drinks. The second

largest category with 37.5% of the food commercial total was "Bread, Cereal, Rice, and

Pasta" which included 130 commercials for high sugar cereals, 34 for low sugar cereals,









and 29 for canned or packaged pasta. Chicken nuggets was the only food to qualify for

placement in the "Meats, poultry, fish, dry beans, eggs, and nuts" category. Twenty-two

ads fit into "Milk, cheese, and yogurt" and no fruit or vegetable commercials were

recorded. An especially important note on "combination meal" advertising-because the

contents of the combination meals advertised by fast food restaurants and children's

frozen combination meals don't fit into any one category they were left out of the Food

Guide Pyramid category calculations by Kotz and Story. However, it is important to

recognize the meals were made of "primarily high-fat foods" and did account for 75

commercials, or about 13.3% of the total food ads.

Kotz and Story conclude that "the diet presented on Saturday morning television

is the antithesis of what is recommended for healthful eating for children" and

recommend "the issue of television food advertising to young children be revisited on a

national level."

USA 1995 Taras and Gage

Howard L. Taras and Miriam Gage, both medical doctors from California

specializing in pediatrics and family medicine respectively, expanded upon Kotz and

Story's study by including weekday afternoon programs along with those aired Saturday

mornings.15 Also similar to the Kotz and Story study, Taras and Gage chose to "assess

the quantity and nutritional value of foods advertised on children's television." They did

not, however, explore the messages used in the advertising and did not perform any

reliability testing.

Weekday afternoon programming was recorded for four stations: two cable, one

national broadcaster, and one local independent station. The "big three" networks of

ABC, CBS, and NBC were recorded along with the four others on Saturday mornings









from 7 am until 12 noon. The authors note changing times in that "the three major

networks now direct a larger portion of 'after-school' broadcasting hours to adults."

Sixty hours of weekday afternoon (3 pm until 6 pm) and 35 hours of Saturday

morning programming were recorded during January and February 1993. Six hours of

the Saturday morning recordings, however, were found to be programs not commonly

viewed by children including the "TODAY Show," "NBA Sports," and "Perry Mason."

But upon statistical comparison, the full data set (95 hours) was not significantly different

than the reduced "children's programming only" data set of 89 hours in terms of

"commercials per hour," "food-related commercials per hour," and "number of advertised

foods that have no fat/sugar/salt."

The full 95-hour data set yielded 2004 total commercials, 958 of which (or 47.8%)

were "food related" (food products, beverages, or restaurants). The nutritional content of

the advertised foods was evaluated and coded by a registered dietician using individual

fat, sugar, and salt standards. Foods were classified as "high fat" if the American Heart

Association recommended limited consumption, "high sugar" if the food would be

restricted in weight loss or diabetic diets, and "high salt" if the food would be eliminated

in a diet that restricts sodium consumption to 3g per day.

Of the 958 food related commercials the greatest proportion went to cereals with

34.1%. The second highest represented group was "candy/snacks" with 29% of all food

commercials. Restaurants accounted for 15.6% and the remaining 21.3% of commercials

were sorted into the "other" category. "Other" foods included "meals like macaroni and

cheese, 'Spaghetti Os,' fruit, processed cheeses, and milk." Nearly 70% of all advertised

foods met the "high sugar" standard, including 84.6% of the advertised cereals. Nearly









40% of the foods fit into the "high fat" category and about 20% were "high salt." It is

important to note that the proportions do not sum to 100% because foods commonly fit

into more than one "high" category. Only 8.9% of all advertised foods were low in fat,

sugar, and salt. Stated another way, 86 commercials were low in the undesirable

nutrients which translates to less than one "healthy" food commercial per hour. This is in

stark contrast to the nearly 10 commercials per hour viewed for the less healthy foods.

Taras and Gage conclude that the proportion of food ads has decreased and the

types of food advertised have changed (proportionally fewer cereal ads and more "other"

food ads) but that the shift is nutritionally "irrelevant because the proportion of advertised

foods high in sugar, fat, and salt has barely changed."

UK 1998 Lewis and Hill

British psychiatry and behavioral sciences researchers MK Lewis and AJ Hill

collected food advertising data for the first of two studies in January and February 1996.

They published their methods and results in a 1998 article titled "Food advertising on

British children's television: a content analysis and experimental study with nine-year

olds."16

Lewis and Hill recorded 91.33 hours during weekday afternoons and weekend

mornings on four stations-two regional networks and two "subscriber-only satellite

stations," Nickelodeon and Cartoon Network. They coded advertisements for

information of four components: format, presenting characters, themes, and appeals. The

format component sorted information like advertisement frequency, animation, and pace.

The presenting characters component was concerned with qualities of the main character:

"real or animated, human or animal, male or female, adult or child." Information

recorded in the themes component reflected if the commercial had a "magic, fantasy,









violence, humor, or story format." And the appeals component specified the verbal,

product, or emotional appeals used in the commercial. Verbal appeals include statements

of "attributed qualities" or "product composition." Product appeals could be

"competitive" or "premium offer" (free toy). And the emotional appeals used by

commercials could be "fun/happiness/mood alteration," "adventure," or "achievement"

among others. Three viewers coded 10% of all food advertisements and reliability was

tested with Cohen's kappa for the themes and appeals components.

During the 91.33 hours, 828 advertisements were recorded: 575 on the regional

network stations and 253 on the satellite stations, averaging to 16 commercials per hour

on regional networks and 5 per hour on satellite. Food was the most advertised product

category at 49.4% of all commercials and cereal was again the most frequently advertised

with a 30.1% share of the food commercial pie. Like Taras and Gage, Lewis and Hill

identified an increase in "convenience food" advertising-products such as "ready meals,

frozen foods, tinned foods" and various sauces and spreads. The convenience food

category represented 21.2% of all food ads in their 1996 study; up from a comparative

1995 study where they accounted for 7.8%.

Lewis and Hill also found significant differences in the methods used to advertise

food and non-food products during children's television. Recalling the four coded

components (format, presenting characters, themes, and appeals) each had a preferred use

or style. Food commercials were significantly more likely to use the story format and

animation than non-food commercials. Non-food product commercials used the "value

for money" appeal significantly more often. Specifically child-oriented commercials

(which included the cereal, confectionary, and toy categories) employed more animation,









magic and fantasy themes, were aired more frequently, and used the emotional appeals of

achievement, fun, action, and adventure. The differences however, between food/non-

food commercials and child-oriented/adult-oriented commercials, were not of the same

magnitude. The food/non-food comparison produced fewer style differences, leading

Lewis and Hill to remind "food advertisements are not made exclusively for a child

audience." Going further, children are often not viewing children's programming alone

and are therefore not the only audience food advertisers have to communicate with.

Parents and other adult caretakers are also watching the commercials making "marketing

a product while children and parents...watch together... an excellent way of influencing

parental purchasing decisions."

USA 1999 Gamble and Cotugna

Margaret Gamble and Nancy Cotugna address the same issue as Kotz and Story in

a 25-year retrospective on Saturday morning television food advertising.17 The

University of Delaware nutrition and dietetics researchers used an experiment design

similar to Kotz and Story without evaluating the use of advertising messages. They

recorded sixteen hours of programming in January 1996 from 7 am until 11 am on four

stations-ABC, CBS, FOX, and Nickelodeon-noting that NBC was excluded because it

"eliminated its Saturday morning children's programming in the early 1990s." This is

another representation of the children's television programming shift to cable networks,

fewer early morning children's shows as observed in the present study, and more

weekday afternoon time devoted to adult programming.17 15 The nutritional value of

foods advertised was determined using the USDA's Food Guide Pyramid and the USDA

Child Nutrition Program Criteria-the same guides used by Kotz and Story.









The sixteen hours of programming yielded 353 product commercials and 33 PSAs

with 222 commercials (62.8%) being for food. Eight of the 33 PSAs were nutrition

related. Again the most frequently advertised food was high-sugar cereal accounting for

34.5% of all food ads. The bread, cereal, rice, and pasta group was represented in 56.3%

of all food commercials and the fats, oils, sugars group claimed 15.3% of the food ads.

As in the Kotz / Story study fast food restaurants and combination meals were their own

category and not sorted into a Food Guide Pyramid group. But again, it is important to

note that these meals are usually made up of high fat and sugar foods. Convenience

foods again played a large role in the children's TV advertising arena and in trends.

These foods ("canned dessert, frozen dinner, 'drive-in"') were responsible for 27.4% of

food ads, making them the second largest food category. Gamble and Cotugna note that

this is "a change from five years ago when the second most advertised products were

cookies, candy, gum, popcorn, and snacks." Their retrospective also showed that no ads

for fruit or vegetables had been aired in the last 25 years, save a few nutrition related

PSAs, and that while cereal advertising is down about 5% overall, the mix of cereals

advertised has changed: "the ratio of high-sugar cereal ads to low sugar cereal ads has

increased almost fourfold."

Instead of regulation reform to purge the airwaves of food ads during children's

television Gamble and Cotugna conclude by urging nutrition educators to "take a cue

from the advertisers...and promote healthful foods that taste good, are easy to prepare,

and will promote a positive self-image." They suggest that the problem is "a marketing

one" and can be addressed by better target market analysis, becoming more competitive,









and overcomingn) the influence of advertising rather than continuing) to lament trying

to change an industry that is resistant to promoting the messages of healthful behaviors."

Australia 1997 Hill and Radimer

Australian nutrition and dietetics researchers Jan Hill and Kathy Radimer repeated

Kotz and Story's 1991/1992 study in June and July of 1996 but recorded morning and

afternoon television every day of the week instead of just Saturday mornings.18 However

similar, several different and interesting results were reported.

Twenty-seven hours of children's programming were recorded from three networks

during June and July of 1996 in Brisbane, Australia and coded using an adaptation of

Kotz and Story's instrument. Advertised foods were nutritionally evaluated using the

Dietary Guidelines for Australians and advertising messages were assessed including the

use of implicit and/or explicit messages.

Hill and Radimer's recordings contained 869 non-program items (including

commercials, program promotions, and other items) and 29 additional CSAs (community

service announcements). Food advertising amounted to 239 advertisements or about 28%

of the non-program items. One distinction of this study is that the number of foods

advertised was counted (275 different foods) and used in the nutritional evaluation. That

is, a commercial showing a bowl of cereal along with an orange could be counted as one

observation for the grains group and one observation for the fruit group. This method is

unique compared to the previously mentioned studies. The fast food restaurant category

was the most frequently advertised with 70 commercials primarily promoting

combination meals. Sixty-five commercials, however, promoted "core" foods-those that

the Dietary Guidelines for Australians would recommend. Cereals included in the "core"

foods were "low sugar" and required to have less than 20% total sugar by weight-a









criterion used in many studies. But these "core" food commercials, while representing

24% of food advertisements, only accounted for 19% of the total time of food

advertisements. Regardless, this proportion of recommended foods is quite high as

compared with similar studies. By counting the number of foods advertised in addition to

number of commercials Hill and Radimer also reported proportions of 10.9%, 8%, 4.3%,

and 1.1% for the grain, fruit, milk, and vegetable groups respectively as percent of total

foods advertised.

Six in ten fast food restaurant advertisements used the most popular promotional

strategy-toy giveaways. "Fun" messages were often used in promoting core foods,

especially those eaten as snacks. Explicit messages were used in 52% of the food

advertisements and 36% used an explicit nutrition message. Most often this message was

about cereal vitamin and mineral content. Forty-one ads contained a nutrition

information message consistent with recommendations to eat more bread and cereals and

foods containing iron. Animation and people eating the advertised product were also

widely used methods.

Hill and Radimer are in agreement with most contemporary studies that "the

overall diet portrayed to children during food advertisements on television programs in

Brisbane is poorly balanced." But they also present a finding which would normally be

unexpected (as most studies find prominent levels of high sugar cereal advertising): "with

the exception of [low sugar] breakfast cereal advertisements, very few advertisements

were consistent with the DGA [Dietary Guidelines for Australians]."

USA 2000 Byrd-Bredbenner and Grasso

As UK researchers Lewis and Hill briefly explored the advertising significance of

adults watching children's programming, Carol Byrd-Bredbenner and Darlene Grasso









explore the opposite in detail: children watching prime-time television in the US.19 The

researchers are not as interested in the nutritional qualities of the foods advertised as the

nutrition related information (NRI) that all of the non-program content presented. NRI is

described as "any visual or verbal reference to nutrition or food."

During two weeks of October 1998 a "composite" week of top-rated primetime (8

pm to 11 pm Monday through Saturday and 7 pm to 11 pm on Sunday) television was

recorded from five over-the-air national networks. The programs were all "heavily

viewed" by the 2 to 11 year old segment according to Nielsen Media Research. A total of

17.5 hours of television was taped and the sample for analysis was 700 commercials.

Commercials are defined as "advertisements for products and services," "promotions for

upcoming television programs," and PSAs. NRI was found in 229 or 33% of the

commercials.

A three-part instrument was used to analyze the non-program content. Part 1

documented the program information during which the non-program content was

broadcast as well as general information about the commercial. Visual and verbal

references to food (NRI) were recorded in part 2. The references were categorized into

"explicit, implicit, or background" and the non-background were further broken into

"accurate, accurate but misleading or incomplete, or inaccurate." Part 3 of the instrument

was completed only for food or beverage advertisements. The products were sorted into

ten food group categories adapted from the USDA Food Guide Pyramid and the

"nutrition and consumer-related promotional claims" were recorded.

"Advertisements for products or services" was the largest group of commercials

with 467 (67%) observations. About 42% of these commercials contained NRI; most









often during food and beverage and entertainment ads. Food and beverage ads were the

single largest "products and services" category with 108, or 23%, of the category

advertisements. The authors comment that it is "a decrease from the nearly 30% reported

by researchers two decades ago." By definition, NRI was found in all food and beverage

ads and 54% of the NRI was "misleading or inaccurate."

The most-represented Food Guide Pyramid group was the bread and cereals group

with 26% of all food references. The "protein-rich foods" group followed with 20%. A

modified "fats, sweets, and alcohol" group was next with 13% of all food references.

The majority of the foods referenced in these three groups were determined to be of low

nutrient density. Further, 54% of the foods eaten by actors were of low nutrient density

but 89% of the eating actors appear "slim and healthy" and "may be sending a conflicting

message to viewers."

Nutrition and consumer-related claims were used in different proportions during

food and beverage commercials. Consumer-related claims were used in 90% (97) of food

and beverage ads, most often in the form of flavor, convenience, and economy claims.

Nutrition claims were present in 42 advertisements; 86% of which "explicitly linked the

food or beverage to health." Just 12 commercials used only a nutritional claim to

promote the food or beverage.

The second type of "commercial" analyzed was "promotions for upcoming

television programs." This category accounted for 22% of the non-program time and

NRI was found in 31 of the 223 promotions. Food safety issues and the "hazards

associated with a new fad diet" were used to promote upcoming news programs. Other









program promotions included clips from the program which contained background

alcohol consumption and eating.

Public service announcements were by far the smallest non-program content

category with only 1% of non-program time. NRI was found in one PSA and the

message was unfortunate. The PSA discouraged drug use through showing that an

"average" teen doesn't use drugs while focusing on "eating French fries and stating that

the average kid could live on fries."

Byrd-Bredbenner and Grasso cite the success of the National Fluid Milk Processor

Promotion Board's "milk mustache" campaign and propose that it could serve as a model

for other organized fruit, vegetable, and grain growers. They also recommend that

"nutrition educators adopt the methods of advertisers" and "raise the profile of nutrition

among consumers" to thereby "increase advertisers' use of nutrition-related product

attributes to promote foods, which, in turn, can further reinforce the attributes'

importance to consumers."

UK 2002 Chestnutt and Ashraf

In a departure from most studies being conducted by nutrition educators

"Television advertising of foodstuffs potentially detrimental to oral health-a content

analysis and comparison of children's and primetime broadcasts" was completed by two

dental public health researchers from the UK. I.G. Chestnutt and F.J. Ashraf designed

their 2000 / 2001 study to "identify the potential of the food advertised to be detrimental

to oral health; and to compare the nature and context of advertisements aimed at children

with those transmitted during evening 'primetime' television."20

The researchers recorded 237 hours of children's television broadcast during

May/June 2000 and January/February 2001 during weekday afternoons and weekend









mornings. Primetime television was recorded on weekdays from 7pm to 10pm during

October/November 2000 for a total of 42 hours. All recorded programming was aired on

"the main independent, terrestrial television channel in South Wales." The nutrition

evaluation method was sugar content as an indication of whether the advertised foods

were "potentially detrimental to oral health or unlikely to be detrimental to oral health."

The children's programming portion yielded 3,326 commercials and 891

commercials were recorded during primetime. Food commercials dominated advertising

time during children's programming with a 62.5% share. Alternatively, only 18.4% of

advertising time during primetime was for food products. Similar proportions hold for

the likely or unlikely to be detrimental to oral health evaluation. Nearly three quarters of

the children's television advertising time used for foods promoted those that would be

"potentially detrimental to oral health." Why were these foods "potentially detrimental?"

Ninety-seven percent of the foods were high in sugar (confectionary and sugared cereals,

dairy products, and soft drinks) and another 2.5% of the soft drinks were included as a

reflection of their "erosive potential." And again, only about 18% of the time used for

food advertising during primetime supported the "potentially detrimental" products.

Though this study only appraised foods for sugar content the implication of the

results reach farther. About half of all commercials viewed during the children's

television portion of this study are for foods high enough in sugar to be considered a

health threat. What percent of the remaining half of all commercials, though

uncalculated, were for foods high in fat, sugar, and other nutrients measured in other peer

studies? Chesnutt and Ashraf conclude their discussion with a call for consumer and









television organizations to "have a view on these issues" and review regulations "in light

of he intensity with which sugar-rich foods pervade children's television programming."

Australia 2003 Zuppa, Morton, and Mehta

Most of the recent food advertising content analysis studies use data recorded from

several network television stations and make collective observations and conclusions.

An Australian study conducted during 2001 and published in 2003 sought to make

comparisons within the data set: among networks, program classifications, and viewing

times. The public health researchers, Julie Zuppa, Heather Morton, and Kaye Mehta, also

evaluated the advertised foods for nutritional value based on the Australian Guide to

Healthy Eating (AGHE).21

Sixty-three hours of children's programming was taped from three networks

broadcasting in Adelaide, Australia during April of 2001. Children's programs are

classified as "C" ("specifically produced for children six to 13") or "G" ("programs

suitable for children to view without adult supervision.") Regulation is an important

difference in the program classification. "C" programs and the surrounding advertising

time are regulated by the Australian Broadcasting Authority. Alternately, the advertising

standards for "G" programs are "self regulated through the Industry Code of Practice

administered by the Federation of Australian Commercial Television Stations." Of the

63 hours taped, 50.5 hours were of"G" programs and 12.5 hours were of"C" programs,

all of which yielded 1721 commercials.

Thirty-two percent of the commercials, or 544, were for foods, beverages, and

restaurants. Food commercials accounted for 41% of all advertisements during "C"

programs with 97 food commercials. "G" programs had a lower proportion of total

advertising devoted to food at 30%, but a higher count of food commercials at 447. The









researchers also found significant differences in advertised foods within the network

stations and time of day. The networks varied significantly in proportions of fast food

restaurant, other "extra" foods, and "core" food advertising. Fast food restaurants were

also found to be advertised at a statistically higher frequency during the weekday

afternoon and early evening viewing period than weekday and weekend mornings.

Sweetened cereals are a noticeably small category on the record of advertised foods

with only three commercials. Unlike other study results, sweetened cereals make no

appearance in the top-advertised food ranks. Instead fast food restaurants (with Hungry

Jack's and McDonald's leading the way) are the single largest category with 30% of all

food commercials. Chocolates and other confectionary are the second largest category

with 101 ads or 18% of all food commercials. An additional 51 commercials for grocery

store chains (not included in the 544 food ads) promoted 83 food products, 42% of which

were for chocolate. "Core" foods and beverages that would be part of the dietary

recommendations of the AGHE account for 21% or 112 of the total food advertisements.

Leading the way for the core category are milk and milk products (7% of total food ads),

bread and cereals (6%), and meat and fish (4%). The "C" programs showed 23 core food

commercials and "G" showed 89. Presented another way, core foods accounted for 24%

of all food ads aired during "C" programs (regulated by the government) and 20% during

"G" programs (self-regulated by the television industry) though statistical significance

was not calculated. Regardless, the authors call for "radical changes to the current

regulatory system" because "there is a lack of willingness by the food industry to

voluntarily constrain marketing activities."









USA 2005 Harrison and Marske

University of Illinois speech communication researchers Kristen Harrison and Amy

Marske use a different but also widely recognized nutrition evaluation tool in their 2003

study: the USDA's Nutrition Facts label.22 Harrison and Marske note that ten years into

its service the Nutrition Facts label has not been used to describe the nutritional profile of

foods advertised on television even though the label is both understood and used by

consumers. Simply, the researchers collected food advertising data from television

frequently watched by children and created composite Nutrition Facts labels that present

the summation of the nutritional offerings of the foods advertised.

The television sample criterion of "programs children watch most" is particularly

important and meaningful. Harrison and Marske recorded a total of 40 hours during the

spring of 2003 from the programs ranked "most popular nationwide among viewers aged

6-11 years" by Nielsen Media Research. This set then included programs in four

categories: "network Saturday, network prime time, syndication, and cable" which means

only some of the shows most popular with 6 to 11 year olds are actually created for their

age group. The age group is also significant because these children have money and

"freedom to purchase food...along with the linguistic skills to persuade parents to buy

foods advertised on television." Because childhood television watching is significantly

correlated with adult obesity the television watching habits of this age group should also

be closely monitored. So while the program's target audience was ignored,

advertisement target audience was specified and recorded for two reasons: to examine the

foods marketed to children that are particularly high in added sugar, and in recognition

that children "pay more visual attention to content featuring child actors and animation

than to adults and live action, regardless of the broader programming context."









The forty-hour sample yielded 1424 advertisements; 426 (29.9%) of which were

for food products. In the 426 food commercials, 725 specific food references were

recorded, and "275 unique foods were observed." Food commercials were coded for

target audience (child or general), food type, health-related messages, and commercial

features such as characters, eating, occasion, and location. The second portion of

analysis examined the nutritional content of the advertised foods as recorded from the

foods' Nutrition Facts labels.

Analysis results were similar and different between child-targeted and general

audience food commercials. Both audiences saw unequal distributions of food types.

Specifically, "candy, sweets, soft drinks, and convenience / fast foods were advertised

most frequently, followed distantly by breads and cereals." The sub-sample of ads

targeted at children (n=201) had a higher proportion of the candy, sweets, and soft drinks

category. The general audience ads (n=225) contained a higher percentage of

convenience / fast foods. Advertised foods were most often eaten as a snack across both

audiences. Not surprisingly, adult characters dominated general audience ads and child

characters were most prevalent in ads targeted at kids. In the child-audience sub-sample

"overweight male characters appeared more frequently than underweight male

characters" whereas the converse was true for female characters. Commercial characters

were also twice as likely to be male than female and male characters were more often

shown eating. These observations raised concern that "food consumption is more

appropriately linked with masculinity."

The nutritional quality of the collective foods in the child and general audiences

was calculated and presented in the format of the Nutrition Facts label for ease of









understanding and comparison. Both of the composite "foods" were standardized to 200

calorie servings also for ease of comparison. Harrison and Marske found that serving

size and fiber content were very similar. A serving of the child-audience composite food

was calculated to be 126 grams. The general audience serving was slightly less at 121

grams. Both audiences would get one gram of fiber from each serving. Significant

differences between the audiences' composite foods were found in fat, sodium, and sugar

content. One serving of the general audience food would provide 13% of the

recommended daily value (RDV) of total fat and saturated fat and 15% of daily sodium

with 8 grams of sugar. The composite food for child audiences provides 10% of daily

total fat, 9% of daily saturated fat, and 11% of daily sodium with a significantly higher 17

grams of sugar. Because the foods advertised to both audiences represented those eaten

at breakfast, lunch, dinner, and snacks it is possible one could exclusively from the list of

advertised foods, and therefore the composite food. A day's worth (2,000 calories) of the

composite food would undersupplyy some nutrients and oversupply others." Those

eating from the general audience composite food would consume more than the RDVs of

fat, saturated fat, and sodium, and not enough fiber, vitamin C, calcium, and iron. 2,000

calories of the child-audience composite food would provide inadequate amounts of fiber,

vitamin A, calcium, and iron, but nearly one cup (171 grams) of sugar.

Harrison and Markse do not immediately suggest parents are at fault for lagging

nutrition in children's diets but assert that "parental involvement is the most important

factor in the determination of the family diet." They also suggest limiting television

viewing for both children and parents, reminding that children's viewing habits are

correlated with obesity in adulthood. Limiting television exposure also prevents children






27


from seeing a portion of 11,000 food ads they could potentially view, and thereby may

reduce requests for advertised foods which are usually of low nutritional density. Further

research is suggested in "interviewing parents and children about their awareness of

dietary options." An opportunity to educate and counsel exists for nutritionists,

physicians, and other health professionals if that awareness is limited to foods advertised

on television.














CHAPTER 3
REVIEW OF LITERATURE: NUTRITION AND GOVERNMENT

Two of the most visible signs of the United States government's interest and

involvement in nutrition education and promotion are the Food Guide Pyramid (the 1992

and the 2005 versions) and the Nutrition Facts label. A less "visual" but equally

important contribution is the set of publications know as the Dietary Guidelines for

Americans (DGA). This review of literature explores how the Food Guide Pyramid and

Nutrition Facts label, supported by the DGA, clarify and sometimes confuse the issues of

what Americans should eat.

Dietary Guidelines for Americans

The Dietary Guidelines for Americans, now in its 5th edition, "provide authoritative

advice for people two years and older about how good dietary habits can promote health

and reduce risk for major chronic diseases."23 With respects to the Food Guide Pyramid

and the Nutrition Facts label, the DGA are also "the basis for Federal food and nutrition

education programs."23 The DGA are the product of cooperation by the United States

Department of Agriculture (USDA) and the Department of Health and Human Services

(HHS).

The development of what are now the DGA began in 1977 with the publication of

"Dietary Goals for the United States" by the U.S. Senate Select Committee on Nutrition

and Human Needs. These "dietary goals" sparked controversy and discussion among

"some nutritionists and others concerned with food, nutrition, and health."9 Two years

later "Healthy People: The Surgeon General's Report on Health Promotion and Disease









Prevention" was published as the culmination of research completed by the American

Society for Clinical Nutrition. In response to the American people's desire to have one

authoritative report on diet and health "Nutrition and Your Health: Dietary Guidelines for

Americans" was published by the partnership of the USDA and HHS in 1980. The DGA

presented the American public with seven basic recommendations:

1. Eat a variety of foods.

2. Maintain ideal weight.

3. Avoid too much fat, saturated fat, and cholesterol.

4. Eat foods with adequate starch and fiber.

5. Avoid too much sugar.

6. Avoid too much sodium.

7. If you drink alcohol, do so in moderation. 24

These guidelines also generated considerable debate and the Senate ordered a

committee to review the "scientific evidence" and return with a report on recommended

revisions. This committee, nine nutritionists from outside the Federal government,

completed their work over 1983 and 1984 and in 1985 the second edition of the DGA

was issued by the USDA and HHS which was widely accepted and became the basis of

"consumer education messages."9

Over the next five years (1985-1990) two committees were ordered into action.

The first was the reconvening of the revision committee which was charged with

evaluating the changes and advancements in scientific knowledge and recommending

further revisions. The second committee was newly formed by the USDA and HHS to

decide if the 1985 DGA needed to be revised, and if so, their specific revision

recommendations. The reports of these committees produced two important results: the









1990 National Nutrition Monitoring and Related Research Act which requires revision

and publication of the DGA every five years, and the publication of the third edition of

the DGA in November of 1990. The language of this 3rd edition was s significant

change: it was "more positive, was oriented toward the total diet, and provided more

specific information regarding food selection."9 This edition made numerical

recommendations for limits of dietary and saturated fat intake for the first time and gives

clear guidance on body weight.9

The 4th edition of Nutrition and Health: Dietary Guidelines for Americans was

released in December 1995. The 1995 edition continued to support the basic guidelines

introduced in the 1980 DGA and also introduced new tools and information. Two of the

most significant additions were the 1992 Food Guide Pyramid and the Nutrition Facts

label. Other additions included "boxes highlighting good food sources of key nutrients

and a chart illustrating three weight ranges."9

















Figure 3-1. Weight Range Chart from 1995 DGA.26

A fundamental change was made to the seven point recommendation format in the

2000 DGA. In their revisions the USDA and HHS decided to create a physical activity
Irit











Figure 3-1. Weight Range Chart from 1995 DGA.26

A fundamental change was made to the seven point recommendation format in the

2000 DGA. In their revisions the USDA and HHS decided to create a physical activity








point separately from the past "weight control" recommendation, split fruits and

vegetables from grains "for greater emphasis," and add a new section on food safety.9

The ten recommendations were also sorted into three action steps which was also the

campaign slogan of the 2000 DGA: "Aim...Build... Choose... for Good Health."















CHOOSE





Figure 3-2. 2000 Dietary Guidelines for Americans Campaign.27

The 6th and most recent edition was issued January 12th, 2005. The new DGA is a

71-page document-considerable growth from the 11 pages published in 1980. The new

DGA is broken into ten chapters-one for each of the nine key recommendations and an

introduction-and each contains a wealth of scientific information, nutritional evaluations

of foods, specific recommendations. The key recommendations/chapters were modified

for this edition:

1. Background and Purpose of the DGA

2. Adequate Nutrients within Calorie Needs









3. Weight Management

4. Physical Activity

5. Food Groups to Encourage

6. Fats

7. Carbohydrates

8. Sodium and Potassium

9. Alcoholic Beverages

10. Food Safety28

Since the 2000 DGA, fruit/vegetable and grains recommendations were combined

into "Food Groups to Encourage" and "Let the Pyramid Guide Your Choices" was

eliminated for 2005. The importance of healthy weight and appropriate caloric intakes is

emphasized with the addition of the "Adequate Nutrients within Calorie Needs" chapter.

The first appendix gives Americans an eating plan for four different calorie levels,

example foods, and appropriate serving sizes. The second appendix identifies food

sources and serving sizes of important nutrients. But Americans may find that the

coordinating consumer brochure "Finding Your Way to a Healthier You" offers the

recommendations of the complete DGA in a more accessible and simplified format.


rI' Ir' Guidelines
for Americans
2005
Figure 3-3. 2005 Dietary Guidelines for Americans Cover Illustration.10










The Food Guide Pyramid

For many of the same reasons the Dietary Guidelines for Americans was

introduced in 1980, the development of a new food guide was also called for. The same

1977 report "Dietary Goals for the United States" that spurred interest in an authoritative

nutritional guide also inspired change to the "Basic Four" food guide. A colorful booklet

"The Hassle-Free Guide to a Better Diet" was produced in 1979 that added a fifth group

to the Basic Four-fats, oils, sweets, and alcohol. The Hassle-Free Guide also highlighted

the importance of dietary fiber and need to moderate use of fats, sugar, and alcohol. As

the Dietary Goals for the United States evolved into the first edition of the DGA in 1980,

research was initiated to examine the need for a more evolved and comprehensive food

guide.

Each successive version of Dietary Guidelines for Americans is a more extensive

and detailed document. The Food Guide Pyramid was designed as a quick and easy to

use graphical representation of the concepts of the DGA and quickly became a widely

recognized symbol of healthy and balance eating. Development of The Food Guide

Pyramid began "after the first addition of the Dietary Guidelines for Americans was

issued in 1980" and was introduced to the American public in August of 1992.25, 14

Philosophical Goals

The Food Guide Pyramid was designed with eight "philosophical goals" developed

from a survey of the professional nutrition community.25

1. Overall Health-The Food Guide should not direct consumption to treat or prevent
any specific disease but rather should be in line with the recommendations of the
DGA which is aimed at healthy people over age two.

2. Current-The Recommended Dietary Allowances (RDAs) the preceding Basic Four
food guide referenced were from 1953. One of the primary complaints of the









nutritionists who were surveyed about a replacement food guide was the Basic
Four's "failure to assure nutrient adequacy." That is, the Basic Four system was
"designed to provide about eighty percent or more of the nine nutrients for which
there were RDAs." The call for more current information meant the Food Guide
Pyramid would be designed to reflect updated and added nutrient RDAs.

3. Total Diet-In another criticism of the Basic Four, nutritionists wanted a food guide
to provide a complete diet perspective-not the "foundation diet" presented by the
Basic Four. A "total diet" food guide would have to present recommendations that
dealt with the competing interests of limiting calories, fat, sodium, and sugar while
ensuring adequate vitamin and mineral intake.

4. Useful-The Food Guide Pyramid was designed to be useful to its target audience-
American consumers. Past food guides had educated consumers to choose foods
from different food groups. To continue to be useful to consumers the same basic
food groups were built upon using three criteria: how consumers use the food, the
nutrient profile of the food, and which group the food belonged to in past guides.

5. Realistic-Consumers should be able to meet the nutrient intake goals of the food
groups by consuming commonly used foods. In other words, the overall nutrient
profile goal of a group should not rely on the consumption of a food that is
generally a small or uncommon part of the typical diet.

6. Flexibility-The Food Guide Pyramid was created using the lowest fat and no sugar
added foods to allow consumers the flexibility to decide where to get their fat and
other limited-intake nutrients with the assurance important nutrient needs are met
first. The goal is creation of a whole diet that is healthy overall-not rigid adherence
to foods of a specific nutrient profile.

7. Practical-Because different people have different nutritional needs the ideal eating
pattern for every member of a family could be different. But preparing a ideal
nutrient composition meal for each person is impractical for families. The Food
Guide Pyramid offers foods that provide for different nutritional needs in different
serving sizes.

8. Evolutionary-Similar to the "useful" criteria, consumers should not have to unlearn
the lessons of past food guides to take in new recommendations. And "to the
extent possible, the food guide should be able to accommodate the anticipated
direction of dietary recommendations in the future."25

Development

After the establishment of the philosophical goals of the new food guide the

research began to determine food groups, nutrient goals, serving sizes, and other guide

specifics. The research findings were compiled into a new food guide and released for









instruction to the American Red Cross and included in the 1990 DGA. Despite

documented desire for new nutritional guidance and information from the public, they

and even some professionals perceived the new guide to be the same as the Basic Four.

The Food Guide Pyramid of 1992 was then developed to bring attention through

innovative presentation to the new information.25

The first phase of food guide graphical representation research used focus groups

of 21-55 year old men and women. Five graphical versions of the food guide information

were presented for their evaluation:

1. Circle-This graphic was easily understood by the American Red Cross classes that
used it, but it was perceived as old or not providing new information.






A Pattn lo Dlly
Food Choies





4i ,' ^ '^1iTSI r



." ....." .... /. .


Circle


Figure 3-4. Proposed Food Guide Graphic-Circle.25

2. Blocks in a circle-Evaluators "almost universally disliked" this graphic because it
was "too hard on the eyes." Positive comments were that it represented the "total
diet" concept well.





















Blocks in a Circle


Figure 3-5. Proposed Food Guide Graphic-Blocks in a Circle.25
3. Blocks in a row-This graphic was called "2-3-6 a Day" and focus group members
liked the simplicity of remembering the servings. The members didn't like the
limited information it communicated.

6 A DAY



30
2 un



Blocks in a Row
Figure 3-6. Proposed Food Guide Graphic-Blocks in a Row.25
4. Inverted pyramid-The orientation of the pyramid was so confusing for some
evaluators that the message of the food guide was lost. Most found it "unsettling"
or "off-balance."









S6 //
Brsaa & Cereal /


Inverted
S2; Pyramid
^ (Funnel)





Figure 3-7. Proposed Food Guide Graphic-Inverted Pyramid (Funnel).25

5. Pyramid-The upright pyramid was well-received. Focus group participants liked
the "proportionality" and the "good foundation" of grains. Comments revealed
some participants thought it was very usable and easy to memorize.25






Pyramid


6 "-- J ': -

Bread & Cerera

Figure 3-8. Proposed Food Guide Graphic-Pyramid.25

The final version of the Food Guide Pyramid was introduced to the public on

April 28, 1992 in a much anticipated press conference and the initial stock of brochures

was quickly dispersed. The Food Guide Pyramid was soon adopted by and incorporated

into promotional materials by several leading food manufacturers, marketers, and

restaurants and quickly became the most recognized nutritional guide in the country.29









Acceptance and Criticisms

The 1992 Food Guide Pyramid was quickly embraced and put into use by the

public and nutrition professionals who had asked for a new representation of food guide

information. Why then was this design replaced in 2005 with My Pyramid? Some feel

nutritional messages were overly simplified by the Food Guide Pyramid especially in

regard to fats, carbohydrates, and meats. The case has been made that the Pyramid leads

consumers to believe "fats are bad and carbohydrates are good, despite important

subtleties between types of fats and carbohydrates."29 As an example, all fats are in the

top triangle Fats, Oils, and Sweets group with instruction to "use sparingly" though the

benefits of mono and poly unsaturated fast were known in the 1960s and 1970s. Also,

the grain group makes no differentiation between whole and refined grains or others of

the represented complex carbohydrates. Similarly, no distinctions are made among red

meat and lean poultry and fish which are lower in saturated fat and higher in healthier

versions of unsaturated fat while still satisfying protein requirements. And as a graphical

representation of the recommendations of the DGA, the Food Guide Pyramid of 1992

does not reflect any healthy weight or exercise guidelines.

MyPyramid

The USDA introduced the new MyPyramid in April of 2005. This new pyramid

kept the same food groups as the 1992 Food Guide Pyramid and addressed many of its

criticisms. Beyond addressing criticism of the 1992 pyramid the USDA also presented

two sets of reasons for updating and revising the pyramid. First, the USDA wanted to

update the science of the food guide and second, they wanted to improved effectiveness

with consumers.30
with consumers.









Several changes had occurred in the underlying science of the 1992 Food Guide

Pyramid. The RDAs (Recommended Dietary Allowances) of the 1992 pyramid were

replaced by DRIs (Dietary Reference Intakes)-the "new standards for nutrient intakes" as

developed by the National Academy of Sciences Institute of Medicine.30 DRIs for all

nutrients were completed in 2004.31 (See Appendix A for complete explanation of many

nutritional standard acronyms). Three editions of the Dietary Guidelines for Americans

had been published since 1992 reflecting updates in science-including the 2005 revision

with which MyPyramid was developed.30 New "food consumption and food composition

data" was also available. This data is important in developing a realistic (one of the eight

philosophical goals from the 1992 pyramid left unchanged) new pyramid that reflects

foods Americans are actually eating. Effectiveness with consumers was to be improved

through motivational and educational tools including a new graphic and slogan, a new

website, and other interactive resources.

Development

As with the 1992 Pyramid, developers started with philosophical goals for the new

pyramid. In this case these eight "guiding principles" were left unchanged. The

remaining development was split into two stages: scientific and consumer.

The scientific base was built from 2001- 2004 along with the 2005 Dietary

Guidelines for Americans. The task of building this scientific base was to "establish the

food intake patterns" or "what and how much to eat." This task was broken into four

steps:

1. Determine calorie needs-Researchers determined required energy intake ranges
using age, sex, height, and weight over a spectrum of physical activity levels.
Target calorie levels for each food intake pattern were set toward the lower calorie
end of the range to ensure nutrient needs would be met within calorie limits even
for those who are sedentary.









2. Set nutrient goals-Nutrient intake goals were set for seventeen vitamins and
minerals and eight macronutrients (carbohydrates, fats, protein, etc). using DRIs
and the DGA. Goals were set for each sex and age group based on needs.

3. Calculate food group nutrient profiles-The goal of calculating the nutrient profile
for each food group is to know the amount of each nutrient each food group
provides. Researchers approached this task through using nutrient information for
foods typically eaten in each food group and creating a weighted average nutrient
contribution. That is, researchers weighted the contribution of each nutrient in each
food by the likelihood the food would be eaten according to national food
consumption data. The result is the expected nutrient contribution by a food from
that particular food group.

4. Create food intake patterns that meet goals Twelve food intake patterns were
developed for different calorie level needs. Each pattern was developed from
recommended amounts from the 1992 Pyramid and adjusted to meet nutrient goals
within calorie limits. Calories remaining after nutrient needs were met are
"discretionary calories" and are used for an allowance of added sugar or fat or
alcohol.30

The USDA used a "systems approach" in developing consumer presentation

materials over 2004 and 2005. This systems approach includes a graphic symbol and

slogan, consumer messages, personalized interactive tools, print materials, and resources

for professionals. The graphic symbol, slogan, and messages were intended to

communicate need-to-know information. Interactive tools were designed to provide

more information for those seeking detailed guidance. Print materials were designed and

produced for those without internet access, and professionals' tools were created with the

scientific background necessary for professionals to adapt guidelines for their own

populations.30

In creating new materials for communicating the most critical information

researchers first asked consumers about the 1992 Pyramid. They found out consumers

have a general understanding of what "healthy eating" means but finding putting it into

practice difficult, they find the Food Guide Pyramid to be complicated and placement of

the food groups confusing, and have only a limited understanding of different types of









fats, grains, and vegetables. Consumers also consider a "serving" (the term used in the

Food Guide Pyramid) to be "what is on their plate"-not a measured amount that health

professionals use. The consumer concept of "serving" lead the USDA to "eliminate the

use of the term 'servings' in describing how much to eat." Instead, MyPyramid was

developed using cups and ounces to describe recommended daily intake. The cups and

ounces can then be divided among different portions of different foods throughout the

day.30

Other communications shortcomings of the 1992 Pyramid were addressed through

a new graphic and slogan and six "essential concepts." Consumers didn't have a good

understanding of the placement of the food groups in the Food Guide Pyramid but

preferred a pyramid shape and felt it "represented healthy eating." Stairs were added to

emphasize the importance of activity (the first essential concept of MyPyramid) and a

person climbing the stairs helps personalize (another essential concept) the message for

consumers. The name "MyPyramid" also "suggests an individual approach" that

personalizes the new tool. A number of slogans were tested with consumer groups and

"Steps to a Healthier You" was preferred which communicates "the need for physical

activity and the need to take action" and the essential concept of gradual improvement.

The final graphic and slogan promote "the concept of finding a balance between food

intake and physical activity."30



















MyPyramid.gov
STEPS TO A HEALTHIER yOU


Figure 3-9. 2005 MyPyramid Graphic and Slogan.30

The colored vertical segments of the pyramid also have different meanings to

communicate the remaining three essential concepts. The different colors of the bands

remind consumers to choose a variety of foods from each food group every day. Each

food group is color coded as well-orange is grains, green is vegetables, red is fruits, blue

is milk, and purple is meats and beans. The narrow yellow band represents oils, some of

which are needed in the total diet, but is not a food group. Proportionality is represented

by the differing widths of the colored bands. As an illustration, the orange band is the

widest segment suggesting grains are an important diet foundation. Proportionally less

(as the band is thinner) of the purple meat and beans group is needed for good health.

Moderation is illustrated by the MyPyramid graphic in the bands narrowing towards the

peak which suggests consuming nutrient dense foods. Four of the essential concepts

come from recommendations of the DGA: activity, variety, proportionality, and

moderation.30

Food Labeling

How do consumers know how the foods they eat fit into the recommendations of

MyPyramid? How do consumers know they are following the suggestions of the Dietary









Guidelines for Americans? The Nutrition Facts label, MyPyramid, and Finding Your

Way to a Healthier You (the consumer brochure of the 2005 DGA) are a system of tools

designed to work together and provide guidance and information for making better food

and activity choices. The Nutrition Facts label now offers consumers "more complete,

useful and accurate nutrition information than ever before."32

History and Development of Nutrition Labeling

The Nutrition Facts label however is the oldest member of this triad of consumer

tools as it was introduced to consumers in 1994 and the information used to design the

label is "based on previous editions of the Dietary Guidelines and on Recommended

Dietary Allowances"-measures that are being replaced by DRIs.30 The road to new food

labeling however, began in 1973. The U.S. Food and Drug Administration (FDA)

established the first nutrition labeling program in 1973 in response to a 1969 conference.

The program was created through regulatory initiative (not legislation) and was largely

voluntary. Nutrition information on foods was mandatory however when foods were

fortified or "made a nutrient claim."33 The USDA (which regulates meat and poultry

products and other foods containing "more than 2% by weight of meat or poultry)

established a similar program by policy memoranda. These labeling programs

highlighted nutrients for which adequate consumption had traditionally been a concern:

vitamins, minerals, and protein. More public and private effort was invested in dietary

guidance in 1977 with the publication of Dietary Goals for the United States-the same

document that inspired and preceded the Dietary Guidelines for Americans series and a

new food guide. Food labeling reform legislation was presented a year later but

eventually tabled.33









The 1980s were a decade of scientific advancement and agreement in the

relationship between diet and long term health. Three influential reports were released in

the 1980s that emphasized the importance of modifying intakes of fat, protein, salt,

carbohydrate, fiber, and calcium to reduce risk of chronic diseases and improve life

expectancy. Increasing consumer demand for more nutritional information on fats,

carbohydrates, fiber, protein, and salt was observed and met by major food

manufacturers. In 1984 a cereal producer began labeling its high-fiber products as cancer

risk reducers.33

1989 and 1990 brought major changes in food labeling through federal law and

agency policies. Legislation was introduced in 1989 that would reform the FDA's

authority in food labeling. The same year the FDA announced its plans to change food

labeling. In partnership with the USDA the FDA commissioned a study to "address the

nutrition components of food labeling." The study which was completed by the National

Academy of Sciences Institute of Medicine (IOM) and released in September 1990 made

many recommendations for new food labeling:

* Foods to be covered by nutrition information

* Nutrients to appear on labels

* Format of the label

* "Legal authority" that could make such labeling changes

* New nutrient listings: cholesterol, saturated and unsaturated fats, complex and
simple carbohydrates, fiber, and potassium

* "Efforts should be made to extend point-of-purchase nutrition information to fresh
foods (produce, meats / poultry, and seafood) in grocery stores and restaurants and
institutions."33









The Nutrition Labeling and Education Act of 1990 (NLEA) was signed by

President Bush on November 8, 1990 and gave the FDA "explicit authority to require

nutrition information on the labels of most foods, even when a claim was not made."33

The USDA announced their own food labeling reform plans for meat and poultry

products in 1991 along with a desire to "work with the FDA to harmonize both its

regulatory requirements."33 The USDA joining with the FDA to reform food labeling is

significant because meat and poultry products regulated by the USDA were exempt from

the requirements of the NLEA; thus the USDA's effort was entirely voluntary. The

USDA's reformed labeling regulations proposal was issued in November of 1991 along

with the FDA's regulation proposal. Final regulations were published in January of 1993

and compliance was required by May 8, 1994 for foods covered by the FDA and July 8,

1994 for foods regulated by the USDA.33

The FDA and USDA however were not the only federal agencies affected by food

labeling and education reform. The Federal Trade Commission (FTC) regulates food

advertising, including those ads that make health or nutrient claims. But under the NLEA

the FTC was not held to the same health and nutrient claims provisions. This difference

is cause for concern because consumers may be confused by conflicting information. An

enforcement policy statement issued in May of 1994 corrected the difference: the FTC

"will look to standards set by the Food and Drug Administration's food labeling

regulations to evaluate whether nutrient and health claims in advertising are deceptive."34

The goal of the policy statement was to ensure "food advertising messages are consistent

with those on food labels."34









Key Provisions of the Nutrition Labeling and Education Act of 1990

Key requirements of NLEA food labeling include nutrient content information (as

specified through mandatory nutrient reporting and fortification reporting), complete

ingredient listings, percent fruit juice information, "standards for nutrient content and

health claims," and the creation and execution of a nutrition education program.33 Most

packaged foods were covered by the NLEA and required nutrition labeling but some

foods were designated as exempt from nutrition labeling:

* foods prepared for immediate consumption like vending machine foods, cookies at
a mall counter, and foods served in hospital cafeterias

* foods prepared on-site but not for immediate consumption such as bakery and deli
items

* foods shipped in bulk but not sold to customers in bulk

* foods used for medical purposes and infant formula

* coffee, tea, and spices that offer no significant amounts of any nutrients

* foods produced by small businesses that meet requirements according to a 1993
NLEA amendment.32

Other foods aren't required to have nutrition labeling but carry strong incentives to

do so. For example, the FDA's voluntary raw food and fish labeling program only

remains voluntary as long as sixty percent of retailers nationwide provide nutrition

information for the "twenty most frequently eaten raw fruits, vegetables, and fish each."32

The USDA's voluntary meat and poultry program covers the forty-five best selling cuts.32

The FDA issued another exemption rule in August of 1996 that changed labeling

rules for restaurants-those who had been covered by the "foods prepared for immediate

consumption" exemption. The new rule removed the restaurant exemption and created

"criteria under which restaurants must provide nutrition information for menu items."35











The Nutrition Facts Label


Nutrition Facts
Seving Size 1 cup(228g)
Servirig Pw Contner 2

Amrrunmt PN Suin
Caborde 2& C ores frm Fat 120


Total Ft 13s 20%
SfuIatedW Fat So9 MS
Trgns Fat 2g
Cholesterotd 0rO 10%
Sodium SW a 28%
Total Car bohy *ate 31 L-.
Oielary Fiber 0%
Sugars g
ProtsIn 5g

Vitamin A4% Vtanin C 2%
Caciaunl5% Iron 4%
Pmernrt D4ly Uwm am Im ma 2,tdO oweia t.
Yojr Duty flae* OyW btoe Vm or wr wninalrg on
you0 olo4f nlft
...i P La. iiin ..i M g
SO Fitt mAn Eb ?
cCoItoMl Lea le 30ng 30CnMD
S~dCm Lea*m A~gnag z400mgi
T'4d CabChy*dw 30 3750
DilJrN Fibr ta 30a
Cglarispear pgre
FaA9 Cbatpal4 Pmtaen4


Figure 3-10. Example Nutrition Facts Label.36



The first section of the Nutrition Facts label tells consumers the serving size and

servings per container. Like previous nutrition labeling programs, the single serving size

remains the standard for reporting nutrition content. But as an improvement on previous

programs when serving sizes were the choice of the manufacturer serving sizes are now

"more uniform and reflect the amounts people actually eat."32 The serving sizes also

must be expressed in common household measurements like "cup" or "tablespoon,"

portions like "piece" or "slice," or containers like "jar" or "tray." The serving size must

also be expressed in metric mass measurement.32









The next section lower details the nutritional content of one serving of the

product. When NLEA regulations were finalized in 1993 fourteen nutritional

components were required on the Nutrition Facts label: total calories, calories from fat,

total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars,

protein, vitamin A, vitamin C, calcium, and iron.37 In the fist significant change to the

1993 regulations, trans fat will be added as a mandatory component. However, if total fat

in a food is less than 0.5 gram per serving and no claims are made about fat or cholesterol

content, trans fat does not need to be listed. This new rule goes into effect January 1,

2006; that is, manufacturers must label foods for trans fat content produced on or after

January 1, 2006.36 For other nutrients, such as other vitamins and minerals, if a food is

fortified or a claim is made based on the nutrient it must be listed in addition to the

thirteen mandatory nutritional components.32

In addition to listing mandatory nutrients, the amount of the nutrients must be

expressed in mass and / or percent of Daily Value (% DV). As discussed previously,

Daily Values are the synthesis of Daily Reference Values (DRVs) and Reference Daily

Intakes (RDIs), but only DVs appear on the label to avoid consumer confusion. DRVs

for energy providing nutrients are based on calories consumed per day. During

development of the Nutrition Facts label the public and nutrition and health professionals

were asked for input in establishing a base calorie level. The FDA settled on a daily

intake of 2,000 calories in part because it reflects the needs of postmenopausal women, a

group particularly at risk for excess fat and calorie consumption.32 Since this study is

concerned with the intake patterns of children with different calorie needs, different

DRVs and RDIs were used in analysis. The DRIs for children, for example, are higher in









calcium and lower in protein than 2,000 calorie diet "adult" DRIs. The different needs of

children are described in detail in the Results chapter of this thesis.

The diets of the youngest children are so different and important that some

nutrition information may not be expressed on nutrition labels. Foods for children under

the age of two "may not carry information about saturated fat, polyunsaturated fat,

monounsaturated fat, cholesterol, calories from fat, or calories from saturated fat."32 This

restriction is in place to protect parents from "wrongly assuming" fat intake should be

controlled for these young children whose development and growth depends on adequate

fat consumption.32 Foods produced for children age four and under may only list % DVs

for protein, vitamins, and minerals because they are the only nutrients for which the FDA

has established DVs.32

Another special case that appears frequently in the data of this study is food meant

to be further prepared before consumption-such as boxed macaroni and cheese and dry

cereal. For these foods the FDA encourages manufacturers to create another column on

Nutrition Facts label reflecting the nutrition information of the food in its prepared

state.32

Information in Action

Though consumers have more information than ever about the foods they eat, many

are not making healthy choices. A study commissioned by the Agricultural Research

Service found that teens who read the Nutrition Facts label don't necessarily make

healthier eating choices than those who don't read labels. In fact, higher fat intake was

associated with boys who "always read" labels.38 The same association was not found in

girls. A 1996 study by Rodolfo Nayga examined the relationship between nutrition

knowledge and label use. Nayga's results suggested "nutrition knowledge does not have






50


an effect on label use" and the resources invested in consumer nutrition education do not

translate into the "adoption of healthy eating habits."38














CHAPTER 4
DATA

Data for this research was collected by modeling the methods used by the

researchers highlighted in the literature review section; particularly Zuppa, Morton, and

Mehta. Television was taped using videocassette recorders according to a set schedule of

time slots and selected channels and later viewed and analyzed. Programming was

recorded during October and November of 2003 from Orlando, FL and Kansas City, KS

standard cable providers. A complete recording schedule can be found in Appendix B.

Network Recording Plan

After reviewing the data collection methods of similar studies the first decisions

included which channels to tape and how many hours to sample. One of the

distinguishing features of the present study is inclusion of cable networks with children's

programming. To represent the national networks, the "big three" networks, ABC, CBS,

and NBC, were selected. Cable and other network candidates were PBS, The WB, The

Disney Channel, Cartoon Network, The Learning Channel, and Nickelodeon. Several

hours of programming from each channel were viewed and the non-program content was

evaluated to make a final determination of inclusion. PBS was excluded because of the

style of its non-program content. PBS does not air "traditional" commercials or

advertising. Instead, companies sponsor programming and air a sponsorship

announcement at the conclusion of the program. Programs are not interrupted with other

content. Because the message of these sponsorship announcements is not clearly to

purchase or request purchase PBS was not selected for inclusion in the study. The









Disney Channel and The Learning Channel were also excluded for similar reasons. The

Disney Channel only airs non-program content promoting their programs, specials,

personalities, and wellness messages. The Learning Channel's children's programming

is aired during the early morning and is geared toward preschool aged kids. This

programming block does not include any advertising messages except those promoting

upcoming programming. The remaining network candidates, Cartoon Network,

Nickelodeon, and The WB, all air a wide variety of children's programming every day of

the week and sell non-program time for traditional advertising spots. The WB, however,

is not a cable network like Cartoon Network and Nickelodeon. The WB is a national

over-the-air network with smaller viewership than the major three national networks. A

sizeable portion of The WB's programming is syndication of programs produced by other

national networks and cable channels. These three networks were included in the

research with the major three national networks.

In summary, six networks were selected for this study (ABC, CBS, NBC, the

Cartoon Network, Nickelodeon, and The WB). The nine studies included in the Review

of Literature were examined to determine an appropriate amount of programming time to

record. Table 4-1 summarizes the network and recorded hours information from the eight

studies that reported the information.










Table 4-1. Networks and Recorded Hours
Study Authors Networks Used Recorded Average Hours /
Hours Network
Kotz and Story 5 52.5 5.25
Taras and Gage 7 95 13.6
Lewis and Hill 4 91.33 22.8
Gamble and Cotugna 4 16 4
Hill and Radimer 3 27 9
Byrd-Bredbenner and Grasso 5 17.5 3.5
Chestnutt and Ashraf 1 279 279
Zuppa, Morton, and Mehta 3 63 21

Following the lead of Chestnutt and Ashraf was clearly not the most reasonable

choice for recording programming from six networks-that method would yield 1,674

hours! Instead, Lewis and Hill and Zuppa, Morton, and Mehta were chosen as examples.

In keeping close to their hours per network proportions a schedule of 125 recording hours

was chosen. 125 hours spread among six networks averages to about 21 hours per

network. Appendix C summarizes the major components of each study included in the

Review of Literature including number of hours recorded from number of networks.

A recording schedule was arranged over ten weeks from October 2003-December

2003 to ensure similar amounts of recorded programming from each channel. Ten weeks

was necessary as each channel dedicates a different amount of time to children's

programming. Specifically, the major three networks (ABC, CBS, and NBC) only air

programs specifically designed for children on Saturday and Sunday mornings. The WB

airs children's programming weekday afternoons, Saturday mornings, and Sunday

afternoons. Nickelodeon airs only programming suitable for children and most Cartoon

Network programs are designed for children. The recording schedule was created so the

major three networks would be equally represented with The WB, Cartoon Network, and

Nickelodeon in recorded program time. Approximately 19 hours from each network









were recorded. All 19 hours from the major three networks were recorded from weekend

morning television. Approximately 19 hours were also recorded from The WB, Cartoon

Network, and Nickelodeon; this however included both weekend morning television and

non-weekend morning time such as weekday after school hours.

Children's Programming

Other studies have used data compiled by independent research firms to determine

which programs on which networks have the highest viewership by children aged 6 to 11.

This is a measurement of the most popular programming among children and it usually

includes many prime time programs designed for adult viewing. The "children's

programming" in this study is specifically defined by the Television Rating system

created by the Federal Communications Commission (FCC). 1996 and 1997 brought the

implementation of many important legislated changes in children's television. The

Telecommunications Act of 1996 mandated "identification and rating of video

programming that contains sexual, violent, or other indecent material about which parents

should be informed before it is displayed to children." A collaboration of the television

industry and advocacy groups was then given one year to establish and implement a set

of rules and codes for rating video content. Broadcasters began using the rating system

and displaying the codes during programming in January of 1997. Further designations

were implemented in October of 1997; one being the "FV" designation for some TV-Y7

programming with certain levels of fantasy violence.39

The programs used in this study represent four of the TV rating codes: TV-Y, TV-

Y7, TV-Y7-FV and TV-G. Each rating was defined through a joint effort of the

television industry and advocacy groups and made publicly available by the FCC:









* TV-Y: "(All Children -- This program is designed to be appropriate for all
children). Whether animated or live-action, the themes and elements in this
program are specifically designed for a very young audience, including children
from ages 2-6. This program is not expected to frighten younger children."

* TV-Y7: "(Directed to Older Children -- This program is designed for children age 7
and above). It may be more appropriate for children who have acquired the
developmental skills needed to distinguish between make-believe and reality.
Themes and elements in this program may include mild fantasy or comedic
violence, or may frighten children under the age of 7. Therefore, parents may wish
to consider the suitability of this program for their very young children."

* TV-Y7-FV: Meets all requirements of TV Y7 programs and "For those programs
where fantasy violence may be more intense or more combative than other
programs in this category, such programs will be designated TV-Y7-FV."

* TV-G: "(General Audience -- Most parents would find this program suitable for all
ages). Although this rating does not signify a program designed specifically for
children, most parents may let younger children watch this program unattended. It
contains little or no violence, no strong language and little or no sexual dialogue or
situations."40

Use of the TV rating codes for program selection were important to this study

because they ensured data would meet two desired conditions: that the age group of the

target audience could be determined (6 and under and 7 and older); and that the television

programs recorded were designed for children, thereby making children the target

audience of the advertisers. The rating codes themselves also provided a parameter for

analysis of the commercial content.

Viewing and Coding

Several features of the taped programming were recorded in a commercial log

during the viewing and coding portion of this study. A single viewer, the primary author

of this study, watched all of the non-program content recorded over the ten-week taping

period and recorded pertinent commercial information. Only information from non-

program content with the intent of selling the advertised product was recorded in the

commercial log and included in analysis. Examples of non-program content not included









are public service announcements (PSAs), network promotions for future programs, and

sweepstakes offerings. The complete food commercial log is available in Appendix D.

The commercial log includes the following categories (descriptive statistics of the

commercials recorded are shown in Tables 4-2, 4-3, and 4-4):

* Observation number-an observation number was assigned to individual
observations for ease of sorting.

* Videotape number each tape was given a number to simplify the viewing process.

* Date- date the program was taped.

* Time-the time slot the program aired.

* Network-the network the program and commercial aired on.

* Program-the name of the program during which each commercial was aired.

* TV rating-the FCC rating assigned to the program in which the commercial was
aired.

* Commercial-a description of the commercial. Great care was taken in noting the
specific product advertised in addition to brand information. For example, each
food product in a Checker's commercial was noted-not just that the commercial
was for Checker's.

* Cross promotion-each commercial was evaluated for use of cross promotion
techniques. A product was coded as cross promoted when a character, personality,
or food unrelated to the specific product was used to enhance the advertising
message.

* Category-products were sorted into broad categories: boy toy, girl toy, movie,
DVD / CD, electronics / game, food, and other. Further analysis used only those
products sorted into the food category.

* Duration-commercials were also timed using the counter feature of the VCR so
individual commercials could be easily located after initial viewing and coding and
so total commercial time could be calculated.









Table 4-2. Programs and Commercials
Time % of Commercial
Number hm:s % of Program Time Tim
(h:m:s) Time
Programs 249 125:00:00
All Commercials 2939 19:32:45 15.6% 100%
Food 743 5:01:00 4.0% 25.7%
Commercials


Table 4-3. Commercials by Network and Rating
Time Commercials % All
(h ) Program Programs Commercials Commercials
(h:m:s) per Program Commercials
Time
ABC 19:00:00 15.2 38 568 14.9 19.3
CBS 25:30:00 20.4 51 430 8.4 14.6
NBC 19:00:00 15.2 38 342 9.0 11.6
WB 21:30:00 17.2 43 561 13.0 19.1
NICK 20:00:00 16.0 40 496 12.4 16.9
TOON 20:00:00 16.0 39 542 13.9 18.4
Y 58:30:00 46.8 117 1327 11.3 45.2
Y7 40:00:00 32.0 80 919 11.5 31.3
Y7-FV 14:00:00 11.2 28 371 13.3 12.6
G 12:30:00 10.0 25 322 12.9 10.6


Table 4-4. Commercials by Product Category
Product Category Number Commercials % Total Commercials
Movie 167 5.7
DVD / CD 244 8.3
Other 378 12.9
Electronics / Game 384 13.1
Boy toy 422 14.4
Girl toy 601 20.4
Food 743 25.3


Product category statistics are particularly interesting because of the timing of

program recording: October and November, the months leading to the holiday gift giving

season. The data collected may have a greater proportion of toy, electronics, DVD, and

other gift item observations than if a year-long sample had been taken. The same

seasonality may hold true for the "movie" advertising category, which only reflected









commercials of new theatre-release films. Three children's holiday "blockbusters" were

heavily advertised in the sample collected. The proportion of movie advertising would be

expected to change throughout the year.

Food Commercials

Additional coding and data collection was performed for the subset of food

commercials. All food observations were sorted out of the larger data set and each food

was assigned a more specific food category adapted from those used by Harrison and

Marske: bread / cereals, candy / sweets / soft drinks, convenience / fast foods, and dairy.


Table 4-5. Food Categories and Exam les
Category Commercials Examples
(% of Food
Commercials)
Bread / Cereals 188 (25.3%) Frosted Flakes, Honey Nut Cheerios
Candy / Sweets / 133 (17.9%) Skittles, Twinkies, Sunny D, Fruit by the Foot
Soft Drinks
Convenience /Fast 410 (55.2%) Kid Cuisine, McDonald's, Checkers, Campbell's
Foods Chicken Noodle Soup, Pillsbury Dunkables
Dairy 12 (1.6%) Trix yogurt, Go-Gurt


The statistics in Table 4-5 reflect every food commercial; however, not every food

commercial was used in further analysis.

The next step toward analysis of the food commercials required gathering the

information from each food's Nutrition Facts label. This label is required by law for

most of the advertised foods. The manufacturers of those foods for which a Nutrition

Facts label is not required sometimes choose to provide the information voluntarily.

Others not required by law to provide the information do not provide the information,

even when requested. For the purposes of the analysis of this study, Nutrition Facts label

availability was of critical importance and therefore if the label information was not









available for the advertised food, the food was eliminated from the analysis. A food

commercial was also eliminated from the study if the message of the commercial was

promotion of a restaurant-not individual foods. Under these two conditions a number of

food commercials were not included in the final food data set: Wendy's, Checker's, Pizza

Hut, Pizza Street, Culver's, Chuck E. Cheese's, and Golden Corral.

Nutrition Facts information was gathered from three sources: actual Nutrition Facts

labels from foods at a grocery store, company websites, and company consumer

information hotlines. The information was entered into a separate log with the same

categories and measurement units as those presented on the Nutrition Facts label in

addition to the manufacturer of the food product. That said, the measurement units of the

micronutrients commonly reported on the Nutrition Facts label (vitamins A and C and

minerals calcium and iron) are "% DV" or percent Daily Value (not mass), which is

calculated from a base 2,000 calorie diet. Other information is reported in grams (g),

milligrams (mg), or milliliters (mL) alone or in combination with % DV.

Since this study focuses on the diets of children, the 2,000 calorie "adult" diet base

was not appropriate for analysis. Children have different caloric, macronutrient

(carbohydrates, fats, and proteins), and micronutrient (vitamins and minerals) needs as

they grow and develop. The conversion of standard Nutrition Facts information to the

nutrition requirements of children is addressed in the Results chapter of this thesis.

Regardless, a summary Nutrition Facts label (based on the 2,000 calorie diet) was

calculated by averaging the information from Nutrition Facts labels using one occurrence

of each advertised food for each commercial:










NUTRITION FACTS
Serving Size 112 g
Calories 169
Calories from Fat 43

Nutrient Amount per Serving % Daily Value
Total Fat 5 g 8
Saturated Fat 1 g 5
Trans Fat 0 g 0
Cholesterol 8 mg 3
Sodium 289 mg 12
Total Carbohydrate 28 g
Dietary Fiber 1 g4
Sugars 13 g
Protein 4 g 8
Vitamin A 5
Vitamin C 17
Calcium 5
Iron 9

Figure 4-1. Composite Nutrition Facts Label.

The composite Nutrition Facts label provides an overview of the set of nutrition

data and a reference point as analysis is completed. Understanding that the label

information was calculated with one observation of each food is critical because the

calculations do not reflect the impact of frequent advertising. For example, Kellogg's

Frosted Flakes were advertised 50 times. Frosted Flakes' nutrition information would

need to be weighted with a factor of 50 to include the effect of advertising in a composite

Nutrition Facts label. Factor weighting is a method described and used in the Results

chapter.














CHAPTER 5
RESULTS

Nutrition Facts Conversions

The Nutrition Facts label was used as an analysis tool for all of the nutrition

information gathered from the foods advertised during children's television. With that in

mind, the standard Nutrition Facts label is not perfectly suited for evaluating foods

advertised to children. Much of the information on a Nutrition Facts label is based on a

2,000 calorie diet consumed by a healthy and moderately active adult. Growing children

have different nutrient and calorie needs; therefore, the Nutrition Facts label must be

modified for use as a tool for children's studies. This modification involves a different

interpretation of the quantities of nutrients tailored to a child's diet.

The Children's Nutrition Research Center at Baylor College of Medicine has

created a table that compares children's Dietary Reference Intakes (DRIs), which are age

and sex appropriate nutritional recommendations, with the Daily Values (DVs), which

are standards developed for the 2,000 calorie base Nutrition Facts label.41 The complete

Baylor table can be found in Appendix E. A new set of children's DVs was developed

for this study using the Baylor table. Since the television programming during which the

food advertisements to be analyzed was directed to school aged children average DRIs of

the 4-8 year old and 9-13 year old groups were calculated. These new averaged DRIs

were used as DVs for a Nutrition Facts label suitable for use in analysis of children's

diets as detailed in Table 5-1.









Table 5-1. Nutrition Facts label DVs and Children's DVs
Nutrition Facts label DV Children's DV
Calories 2,000 1,700
Fat (g) 65 62
Saturated Fat (g) 20 19
Cholesterol (mg) 300 300
Sodium (mg) 2,400 1,700
Fiber (g) 23 24
Protein (g) 50 27
Vitamin A (IU) 5,000 1,667
Vitamin C (mg) 60 35
Calcium (mg) 1,000 1,050
Iron (mg) 18 9

Micronutrients (vitamins and minerals) are only expressed in percent of DV on the

Nutrition Facts label. The Baylor table was also used to convert percent DV into the

mass measurements of the micronutrients. The same conversion procedure was used to

then convert the children's recommended micronutrient masses into the same user-

friendly percent of DV to be expressed on composite Nutrition Facts labels discussed

later in this chapter.

Food Commercial Considerations

The other major consideration before analysis was how to treat repeated

advertisements and foods in the advertisements. Seventy-one unique foods (with

available nutrition information) were advertised in the 125 hours of programming

analyzed. However, there were 792 observations of food advertising. The difference is

explained by repetition of commercials. Frosted Flakes, for example, is one unique food

but is advertised in 50 commercials. Harrison and Markse also acknowledged repeated

commercials and chose to include them in analysis because "they represent multiple

attempts to persuade viewers to consume the advertised food(s), and initial resistance to

temptation does not guarantee future resistance."22 This study makes calculations using a









data set of each and every commercial unless otherwise specified. Including the repeated

airings of commercials reflects what viewers experience and have the opportunity to be

influenced by better than one observation of each different commercial. The method of

including the influence of the number of airings of the commercial in analysis is called

factor weighting.

A second issue is the display of multiple foods in one commercial. This study

included each food advertised within the commercial in an effort to have the analysis data

set accurately reflect what consumers see in the ads. For example, McDonald's

commercials often showed several foods. One specific commercial showed a

cheeseburger, French fries, and a soft drink. Another showed just a meal box and soft

drink. In these two cases the identifiable foods were each recorded as one food

observation for each instance of the commercial airing. A complete chart of each

commercial, number of airings, and individual foods of each commercial can be found in

Appendix F.

Composite Nutrition Facts Labels

The considerations just discussed were issues in creating the main quantitative

results of this study: composite nutrition facts labels. The average values of nutrient

categories required on the Nutrition Facts label were calculated for each network and TV

rating category and for products using and not using cross promotion. Two additional

"composite labels" were created to reflect the average of one observation of each food

and the average as weighted by number of times the food was advertised. All %DV

figures were calculated using the 1,700 calorie diet and child-specific micronutrient DRIs

identified earlier on Table 5-1.






64


The composite nutrition information for one observation of each different food was

named "Average" and used in each of further calculations. Weighted averages,

multiplied by the number of times the food was advertised, were also created An average

(rounded to the nearest whole number) was calculated for each nutritional category and

used to create a composite Nutrition Facts label for each network, TV rating, and cross

promotion / no cross promotion category. Table 5-2 is the complete collection of

composite Nutrition Facts labels.











Table 5-2. Composite Nutrition Facts Labels
I-, r),-c- oo~- % DV (based on
C O a 1.7K diet)


Label N 0




Average 86 112 169 43 5 1 0 8 289 28 1 13 4 16 29 5 18
Weighted 792 114 151 34 4 1 0 6 231 27 1 14 3 14 37 4 16
Average
ABC 138 149 143 33 4 1 0 7 236 25 1 15 3 9 33 3 9
CBS 118 145 152 33 4 1 0 7 200 27 1 14 3 11 37 3 16
NBC 150 115 151 43 5 1 0 3 151 26 1 15 2 8 40 2 8
WB 173 75 133 25 3 1 0 4 203 25 1 12 2 19 46 7 27
NICK 96 89 161 35 4 1 0 7 297 28 1 12 4 26 38 6 23
TOON 117 117 176 37 4 1 0 7 343 31 1 15 4 16 22 2 14
Y 350 121 144 29 3 1 0 6 225 26 1 14 3 15 39 4 17
Y7 279 115 155 38 4 1 0 5 217 27 1 14 3 11 37 3 12
Y7FV 104 82 140 26 3 1 0 4 214 26 1 13 2 20 41 6 24
G 59 119 191 57 6 2 1 10 351 30 1 13 5 14 17 4 15
Cross 425 146 148 36 4 1 0 6 188 25 1 14 3 10 52 4 10
Non-Cross 367 77 155 32 4 1 0 5 280 28 1 14 3 20 19 4 23










Review of Nutrient Categories from Composite Nutrition Facts Labels

Serving Size

The first piece of information the Nutrition Facts label provides is the serving size

the other nutrition information is calculated from. The full data set of 792 food

observations was used to understand more about the serving sizes of food advertised

during children's television.

The average serving size was calculated to be 114 grams. Examples of foods of

approximately this serving size are a McDonald's cheeseburger and one container of Trix

Yogurt. The median serving size of the 792 observations was 62 grams. McDonald's 4-

piece Chicken McNuggets and a bag of Skittles each measure about 62 grams. The mode

serving size was 30 grams-a common serving size for cold cereals. The difference in the

mean and median (the mean being significantly higher in this case) is an indication that

most of the serving sizes were less than 114 grams. Relatively few foods of larger

serving sizes skewed the mean size higher.

Calories

The information from remaining nutritional categories of the Nutrition Facts label

was normalized for analysis by dividing into serving size. Normalizing the data allows

for comparison without referencing the scale of different observations. The calories of

one serving of each food were divided into the mass of one serving of the food,

producing a measure of calories per gram of serving size.










Table 5-3. Composite Labels Calorie Density
Composite Label Serving Size (g) Calories (kcal) Calorie Density
(kcal /g)
Average 112 169 1.51
Weighted Average 114 151 1.32
ABC 149 143 0.96
CBS 145 152 1.05
NBC 115 151 1.31
WB 75 133 1.77
NICK 89 161 1.81
TOON 117 176 1.50
Y 121 144 1.19
Y7 115 155 1.35
Y7-FV 82 140 1.71
G 119 191 1.61
Cross 146 148 1.01
Non-Cross 77 155 2.01

Products advertised without cross promotion had the highest calorie density. At

first glance this seems counterintuitive. Many products advertised with cross promotion

are high fat and sugar fast foods which could lead consumers to believe those products

advertised with others are generally less nutritious for the calories they provide. The

evidence of this study however is that non-cross promoted products were more calorie

dense than cross promoted. The data shows 124 McDonald's and Burger King

commercials, all of which used cross promotion techniques (sometimes even more than

once per commercial), and advertised foods high in fat and sugar. The data also shows

another 172 cross-promoted commercials for less calorie dense foods like Kellogg's

Frosted Flakes and Pringles Prints potato crisps. This combination of foods produced a

less calorie dense collection of foods than non-cross promoted products. Examples of

non-cross promoted products contributing to the higher calorie density include Nestle

Break Apart Cookies refrigerated cookie dough, several frozen breakfast pastry products

and other meals, other fast foods, and rice side dish mixes.









Further analysis of individual calories and serving sizes reveals relationships

between normalized calories and qualities of the commercials. An ordered probit was

performed to quantify these relationships where network TOON, TV rating Y7, and non-

cross promoted ads were base dummy variables. Confidence was calculated at the 95%

level. Standardized calories (calories per gram of serving size) were sorted into three

groups: less than three calories per gram, three calories and greater but less than four

calories per gram, and four calories and more per gram. The naive prediction was

calculated to be 36.36% and the actual prediction frequency was 40.91%.


Equation 5-1. Standardized Calories Probit
Standardized Calories =(ABC, CBS, NBC, WB, NICK, Y, Y7-FV, G, Cross)

Table 5-4. Standardized Calories Probit Results
Variable Coefficient P [IZl>z1
ABC 0.526 0.000
CBS 0.449 0.004
NBC 0.813 0.000
WB 0.673 0.000
NICK 0.534 0.000
Y 0.090 0.431
Y7-FV 0.308 0.012
G 0.423 0.002
Cross -0.133 0.071

Table 5-5. Standardized Calories Probit Marginal Effects
Variable X < 3 kcal / g 3 < X < 4 kcal / g X > 4 kcal /g
ABC -0.139 0.019 0.120
CBS -0.060 0.008 0.051
NBC -0.330 0.045 0.284
WB -0.413 0.057 0.356
NICK -0.232 0.032 0.200
Y 0.056 -0.007 -0.048
Y7-FV 0.016 -0.002 -0.014
G -0.048 0.006 0.041
Cross 0.141 -.0019 -0.121









ABC, CBS, NBC, WB, and NICK were all significantly more likely to have

advertised foods with higher calories per gram than TOON. Using the calorie groups,

any given advertised food from the significantly different networks was found to be about

14 to 41% less likely (than a food advertised on TOON) to belong to the lowest calorie

density group (less than three calories per gram). At the other end of the spectrum, these

stations were 12 to 35% more likely than TOON to advertise foods that belong in the

greater than four calories per gram group. Interestingly, the TV ratings Y, Y7-FV, and G

were not found to be predictors of calorie density significantly different that the Y7

dummy variable. Cross promoted products were found to be less calorie dense than those

not cross promoted. A cross promoted product is about 14% more likely than a non-cross

promoted product to belong in the lowest calorie density group and about 12% less likely

to belong in the highest calorie density category.

Fat and Cholesterol

The Total Fat component of the composite Nutrition Facts labels is a measure of

grams of total fat per serving. This measure is comprised of the amounts of three

different types of fats-unsaturated, saturated, and trans fat. Saturated fat must be listed

on the Nutrition Facts label when the product contains 0.5 grams or more per serving.32

And beginning January 1, 2006 trans fat content must also be listed when the product

contains 0.5 grams or more per serving.42 Food manufacturers could start labeling trans

fat content earlier though. Because of this "phase in" period where trans fat labeling is

not yet mandatory some of the products in this study did not list trans fat content and

some did. To ensure accurate calculations the trans fat value of products not listing trans

fat was left blank. Through the design of calculations blank values were ignored in

determining an average value for trans fat. Stated another way, the trans fat values









determined for the composite labels are averaged only from foods listing an amount for

trans fat. Cholesterol is listed on the Nutrition Facts label in milligrams (mg) per serving.

A product is only "cholesterol free" when it contains less than 2 mg per serving and 2

grams or less per serving of saturated fat.43

Fat content of all varieties and cholesterol was generally within the

recommendations of the Baylor children's DRI table mentioned previously. According to

government recommendations, cholesterol should be limited to no more than 300

milligrams daily, total fat should range from 39 to 85 grams (or 25-35% of daily calories)

depending on age and sex, and 16 to 24 grams of saturated fat (or less than 10% daily

calories) also depending on age and sex. Table 5-5 was calculated to compare percent

Daily Values of calories, fat, and cholesterol and show fat and cholesterol of the example

Nutrition Facts label are in line with the percent daily calories the label presents. As

mentioned previously, the Baylor children's DRI table makes recommendations in ranges

for children based on other factors. For the purposes of this table the median of those

ranges were used and different figures for boys and girls were averaged to find mean

values.










Table 5-6. %DV Calories, Fat, and Cholesterol
Composite Calories Fat Saturated Fat Cholesterol
Label (%DV) (%DV (%DV) (%DV)
Average 10 8 7 3
Weighted 9 6 6 2
Average
ABC 8 6 6 2
CBS 9 6 6 2
NBC 9 8 7 1
WB 8 5 4 1
NICK 9 6 6 2
TOON 10 7 6 2
Y 8 5 5 2
Y7 9 7 6 2
Y7-FV 8 5 5 1
G 11 10 9 3
Cross 9 6 7 2
Non-Cross 9 6 5 2

The important message of this table is that no %DV of any nutrient to be limited is

higher than the percent of daily calories the composite label represents. Stated another

way, if only the composite label "food" was eaten for a day, when the consumer reached

100% of daily calories they would not reach or exceed recommended limits for fat,

saturated fat, or cholesterol.

Even though all the composite labels stay within guidelines for fat, saturated fat,

and cholesterol, there are important differences within the labels. NBC, WB, and NICK

advertised foods were found to have slightly but significantly higher amounts of total fat

than foods advertised on TOON. Foods advertised during TV-G were also slightly higher

in total fat than foods advertised during TV-Y7. No differences existed among Y and

Y7-FV from Y7.









Sodium

Sodium content is a much different story than fat or cholesterol content. Whereas

someone eating only the composite label "food" for a day would stay within fat and

cholesterol recommendations, one would not stay within recommended sodium limits.

For example, a full day's calories from foods advertised on ABC would provide 175% of

the recommended DV of sodium. Table 5-7 lists the %DV of sodium that would be

provided by a day's worth of each composite label "food."

Table 5-7. 100% DV Calories (1700) and %DV Sodium
Composite Label % DV Sodium at 100% DV Calories
Average 170
Weighted Average 156
ABC 175
CBS 133
NBC 100
WB 150
NICK 189
TOON 200
Y 163
Y7 144
Y7-FV 163
G 191
Cross 122
Non-Cross 178

A tobit model was used to examine the relationship between sodium content and

networks, TV ratings, and promotion technique. Again, the dummy variables were the

network TOON, TV rating Y7, and non-cross promoted.


Equation 5-2. Standardized Sodium Tobit
Standardized Sodium =(ABC, CBS, NBC, WB, NICK, Y, Y7-FV, G, Cross)










Table 5-8. Standardized Sodium Tobit Results
Variable Coefficient P II|Z>z1
ABC 1.753 0.000
CBS 2.245 0.000
NBC 2.769 0.000
WB 3.638 0.000
NICK 4.036 0.000
Y -0.098 0.777
Y7-FV 0.668 0.075
G 2.471 0.000
Cross 0.406 0.070

Significant differences were found among networks and TV ratings in sodium

content. TOON-advertised foods were found to have significantly less standardized

sodium than all of the other five networks. Foods advertised on ABC were likely to

contain 1.75 mg more sodium than foods advertised on TOON. CBS, NBC, WB, and

NICK foods were likely to contain 2.25, 2.77, 3.64, and 4.04 more milligrams of sodium

respectively. A four milligram increase from one network to another seems a large

difference when four milligrams is actually only two-tenths of one percent of the daily

limit. So while the differences are significant, the magnitudes of the differences are

small. Only TV rating G was found to have foods with different sodium content. Foods

advertised during TV-G programming are likely to contain 2.47 mg more sodium than

those foods advertised during TV-Y7 shows. No difference in sodium content was found

between products cross promoted and not cross promoted.

Regardless of significant network or TV rating differences, each composite label

reflects advertised foods containing far more sodium than what is recommended.

Carbohydrates Sugars and Fiber

Like the other two calorie-providing nutrients-fat and protein-the government

recommends a healthy range for amounts of carbohydrates to consume. For healthy









adults and most children, carbohydrates should make up 45-65% of daily calories.44 For

a child consuming 1,700 calories a day carbohydrates should make up 765 to 1,105

calories. The Nutrition Facts label lists Total Carbohydrates in grams and as a percent of

the Daily Value of 300 grams and then breaks the carbohydrates into two subcategories:

sugars and fiber.35 The sugars listed on the Nutrition Facts label encompass both

naturally occurring and added; the amount of fiber listed may be both soluble and

insoluble. The government does provide intake recommendations for added sugar and

fiber. Added sugar should be limited to 6 to 10% of daily calories according to the

USDA's Food Guide Pyramid. The National Academy of Sciences, on the other hand,

advises that added sugar intake be restricted to 25% of daily calories or less.45 44 Fiber,

however, does have an established Daily Value. For adults consuming 2,000 daily

calories, the recommendation is 23 grams. For children, the Baylor children's DRI table

suggests 19-23 grams for 4 to 8 year olds and 23-31 grams for 9 to 13 year olds,

depending on sex. Table 5-9 describes the sugar and fiber content of composite label

"foods" in relationship to calories.









Table 5-9. Calories, Total Carbohydrates, Sugar, and Fiber Content of Composite Labels
Composite Calories Total Sugars Sugars Fiber Fiber
Label (%DV) Carbohydrates (g) (% (g) (%DV)
_(g) calories)
Average 10 28 13 31 1 4
Weighted 9 27 14 37 1 4
Average
ABC 8 25 15 41 1 4
CBS 9 27 14 38 1 4
NBC 9 26 15 38 1 4
WB 8 25 12 37 1 4
NICK 9 28 12 30 1 4
TOON 10 31 15 35 1 4
Y 8 26 14 38 1 4
Y7 9 27 14 37 1 4
Y7-FV 8 26 13 38 1 4
G 11 30 13 28 1 4
Cross 9 25 14 38 1 4
Non-Cross 9 28 14 35 1 4

Both sugars and fiber are out of line with recommendations but in opposite

directions. Each composite label reflects a food that provides in excess of 25% of its

calories (the National Academy of Sciences recommended limit) from sugars. An

examination of the foods in this study reveals that virtually no foods are in whole form

and most are highly processed. The combination of high sugar content and extensive

processing makes assuming most of the sugar content is added sugar a reasonable

conclusion. In contrast, fiber content in each of the composite labels is lacking with just

4% of the DV. Figure 5-1 further illustrates the extent to which fiber content is out of

proportion with percent of daily calories. While the composite label food supplies 8-

11% of daily calories it only provides 4% of daily fiber requirements. Stated another

way, if a consumer were to consume only the composite food for a day they would

receive, at best, 50% of their fiber need.



















8

C 6

c 4

2

0 i il
l a 0 f )c co m U) Z o- > 0 o n on
8 :( < C) -- 0 0 p






Figure 5-1. % Daily Calories and Fiber.

Protein

Adequate protein intake is critical to the growth and development of children. The

Daily Value used for calculating %DV on packaged food is 50 grams. In other words,

healthy adults consuming 2,000 calories per day should be aiming for 50 grams of protein

in their diet. Children's protein needs however are different and grow dramatically as

they grow. The Baylor children's DRI table shows two and three year olds need 13 daily

grams of protein and four to eight year olds need 19 grams. At nine years the need

increases to 34 grams and at age fourteen, girls need 46 grams and boys require 53 grams

of daily protein. Analyzing the protein content of the advertised foods is particularly

important because of the age range of the typical viewer: school-aged children, about 7 to

10 years old. This is the stage in development when protein needs increase the most.









Because adequate protein consumption is so critical for proper growth and

development, the results of advertisement analysis offer good news. Each composite

label, with the exception of NBC, represents a mix of advertised foods that provide daily

protein in an amount of at least 26.5 grams-the average recommended daily intake.

An ordered probit was performed to examine in detail the relationships among

protein content, network, and TV rating. The marginal effects were also calculated for

specific comparisons. TOON was chosen to be the dummy network and the TV rating

Y7 was the dummy rating. Non-cross promoted was the dummy selection for promotion

technique. Confidence was calculated at the 95% level. Standardized protein (grams of

protein per gram of serving size) were sorted into three groups: zero protein per gram,

0.02-0.049 grams protein per gram serving size, and 0.05 grams or more protein per

gram serving size. The naive prediction was calculated to be 25.30% and the actual

prediction frequency was 55%.


Equation 5-3. Standardized Protein Probit
Standardized Protein =(ABC, CBS, NBC, WB, NICK, Y, Y7-FV, G, Cross)

Table 5-10. Standardized Protein Probit Results
Variable Coefficient P II|Z>z1
ABC 0.458 0.000
CBS 0.627 0.000
NBC 0.600 0.000
WB 0.700 0.000
NICK 0.837 0.000
Y 0.016 0.863
Y7-FV 0.246 0.016
G 0.632 0.000
Cross 0.114 0.062









All networks were found to have advertised foods of significantly different and

higher protein levels from the base network TOON. Using the three protein level groups,

any given advertised food was found to be 13% (NBC) to 51% (NICK) less likely (than a

food advertised on TOON) to contain zero grams protein per serving. All networks were

more likely to have an advertised food fit in the middle protein level group. ABC and

NBC were each approximately 4% more likely than TOON to air a middle level protein

food; NICK was again the greatest amount more likely (15%) to contain an ad for a food

fitting into the middle group. At the highest level of protein density all networks were

more likely than TOON (9% to 35%) to have a given food advertisement fitting in the

category.

Protein content was not however as varied by TV rating. The rating Y7 was used

as the dummy variable and two ratings, Y7 FV and G, were found to have significantly

different and higher levels of protein in advertised foods. TV rating Y was not found to

be different from Y7. Marginal effects calculations reveal that food advertising during

TV rating G programs is most different from Y7 in protein content. Foods advertised

during TV-G programs are 27% less likely to have zero grams protein per serving, 8%

more likely to have 0.02-0.049 grams per gram serving size, and 19% more likely to

contain 0.05 grams or more per gram of serving size.

At the 90% confidence level cross promoted foods were found to contain slightly

more protein than their non cross promoted counterparts. The marginal effects are also

small. Marginal effects for network, TV rating, and cross promotion are summarized in

Table 5-11.









Table 5-11. Standardized Protein Probit Mar inal Effects
Variable 0 grams protein 0.02 < X < 0.05 g X 2 0.05 g
ABC -0.142 0.042 0.100
CBS -0.301 0.089 0.212
NBC -0.133 0.039 0.094
WB -0.406 0.120 0.286
NICK -0.506 0.150 0.356
Y 0.088 -0.026 -0.062
Y7-FV -0.436 0.012 0.030
G -0.271 0.080 0.191
Cross 0.048 -0.014 -0.033

Vitamins and Minerals

Vitamins A and C and the minerals calcium and iron were the most commonly

reported vitamins and minerals on the Nutrition Facts labels of the advertised foods.

Each is critical for healthy growth and development as well as disease prevention, but not

all are equally represented in the advertised foods of this study. Vitamin and mineral

content is summarized in Table 5-12.

Table 5-12. Daily Value Contribution of Vitamins and Minerals
Mean DV 1700 cal 1667 IU 35 mg 1050 mg 9 mg
Composite Calories A C Calcium Iron
Label (% DV) (% DV) (% DV) (% DV) (% DV)
Average 10 16 29 5 18
Weighted 4 16
14 37 4 16
Average 9
ABC 8 9 33 3 9
CBS 9 11 37 3 16
NBC 9 8 40 2 8
WB 8 19 46 7 27
NICK 9 26 38 6 23
TOON 10 16 22 2 14
Y 8 15 39 4 17
Y7 9 11 37 3 12
Y7-FV 8 20 41 6 24
G 11 14 17 4 15
Cross 9 10 52 4 10
Non-Cross 9 20 19 4 23









Examination of Table 5-12 reveals vitamins A and C and iron content is more than

keeping pace with contribution of calories. Stated another way, for the percent of the

day's calories the composite food makes up, vitamins A and C and iron are present

beyond that percent. Calcium, on the other hand, does not keep pace with calorie

contribution. There are specific reasons for the seeming abundance of A, C, and iron and

relative lack of calcium. First, the calculations of Table 5-12 are based on the 1,700

calorie children's diet and Baylor children's DRI table. Children's A, C, and iron

requirements are significantly less than adult's whereas children's calcium needs are

higher. In addition, nutrition information listed on the Nutrition Facts panel of foods is

based on the 2,000 calorie diet which is designed and appropriate for adults in both

calories and nutrient requirements. Another important consideration in evaluating the

vitamin and mineral nutritional content of the advertised foods is the food preparation.

Of the 743 food commercials, 188 (25%) were for cereals. The composite nutrition facts

labels were calculated using only the specific advertised food in its unprepared state to

avoid variation. So in the case of cereal the nutritional contribution of the usual milk was

left out. Had milk been included in these calculations vitamin A and calcium content of

composite labels would be higher as well as other nutrients such as protein and fat

depending on the type of milk added. These probable increases were calculated for

vitamin A and calcium content of the weighted average composite label. One half-cup

vitamin A and D added skim milk contributes 5% of a 2,000-calorie diet's calcium need

and 4% of a 2,000-calorie diet's vitamin A need. As discussed earlier, a child's needs are

different than those met by the typical 2,000 calorie diet. The calcium in a half-cup of

milk contributes about 4.76% of a child's need and the vitamin A in a half-cup of milk









provides about 12.00%. Weighted average calcium content would increase by 1.13%

vitamin A content would increase by 2.85%. Weighted average content would then be

(rounded to the nearest whole number) 5% for calcium and 17% for vitamin A.

A tobit analysis was performed on the mineral calcium because it was the major

micronutrient lagging in DV contribution behind DV calorie contribution. Dummy

variables for the analysis were again TOON, TV Y7, and non cross promoted.


Equation 5-4. Standardized Calcium Tobit
Standardized Calcium = f(ABC, CBS, NBC, WB, TOON, Y, Y7-FV, G, Cross)

Table 5-13. Standardized Calcium Tobit Results
Variable Coefficient P [|Z|>z1
ABC -0.015 0.117
CBS 0.002 0.855
NBC -0.061 0.000
WB 0.083 0.000
NICK 0.043 0.000
Y -0.017 0.084
Y7-FV -0.031 0.003
G 0.005 0.659
Cross -0.032 0.000

Three networks were found to be significantly different from TOON at the 95%

confidence level: NBC, WB, and NICK. Foods advertised on NBC were likely to contain

0.06 grams less calcium. WB and NICK advertised foods were likely to contain more

calcium-0.08 grams and 0.04 grams respectively. Only TV rating TV Y7-FV was found

to have advertised foods with significantly different calcium levels; Y7-FV foods were

likely to contain 0.03 grams less calcium. The same conclusion is also true for cross

promoted products. They were found to be likely to contain 0.03 grams less calcium than

their non cross promoted counterparts.






82


The Composite Food 1700 Calorie Diet

The concept of the 1,700 calorie diet has been mentioned previously but will be

examined here in more detail. A 1,700 calorie diet is an average desirable intake for

school aged children and because the composite food labels contain foods typically

consumed at each meal and snack during the day it is conceivable that a child could

consume only the average composite "food" for an entire day and day's worth of calories.

The nutritional significance and impact of that eating pattern is described in Table 5-14.











Table 5-14. The Composite Food 1,700 Calorie Diet
C O Oi % DV
o 0 0 -. =

0r z B ?a TO r 8
Label A 2



DV N/A 1700 NA 62 19 NA 300 1700 NA 24 NA 26.5 100 100 100 100
Average 1130 1700 431 48 14 4 80 2917 281 9 131 42 165 294 46 183
Weighted Avg. 1280 1700 382 43 12 3 63 2595 298 8 156 33 161 414 43 182
ABC 1770 1700 396 44 14 1 84 2796 297 8 176 35 107 388 32 107
CBS 1612 1700 366 41 13 5 79 2226 298 7 160 39 126 415 36 175
NBC 1292 1700 487 54 14 1 32 1693 287 6 163 21 86 445 23 93
WB 956 1700 318 36 10 3 48 2595 313 8 157 31 243 593 86 340
NICK 942 1700 366 41 12 3 74 3140 295 9 126 38 270 405 60 242
TOON 1124 1700 353 39 10 3 71 3311 300 8 149 37 153 211 20 136
Y 1429 1700 345 39 12 3 71 2660 305 8 162 36 178 456 49 204
Y7 1258 1700 415 46 13 1 50 2377 294 7 157 29 124 404 30 130
Y7FV 1002 1700 317 36 10 3 51 2609 316 8 163 30 240 498 68 297
G 1057 1700 507 56 16 5 92 3127 263 10 117 40 129 155 32 132
Cross 1678 1700 413 46 15 3 71 2167 289 6 162 36 110 605 45 121
Non-Cross 842 1700 348 39 9 2 54 3067 308 9 150 30 217 204 40 249










Most nutritional components reflected in the Nutrition Facts label are within or

meet government recommendations. Those columns in bold print however are outside

recommended limits and would need to be modified for a healthful diet. Sodium is

expressed in milligrams and each composite label weighs in with around twice the

recommended intake. Sugar is the other category of concern with too much. Though

recommendations for limiting sugar vary from 6% to 25% of daily calories, all composite

labels reflect a diet with at least 28% (Table 5-9) of calories coming from sugar. It is

important to remember however that the sugar component of the Nutrition Facts label

takes both naturally occurring and added sugar into account. Fiber and calcium are in

italics because a 1,700 calorie diet of the composite label foods would not provide

adequate amounts for children. In each case the composite label foods do not even

provide half of the recommended daily values.














CHAPTER 6
CONCLUSION

Summary

The mission of this study was to collect information on and evaluate the food and

beverage products advertised during children's television programming. The nutrition

information tools developed by the United States government were also reviewed for

historical precedent and current usefulness and limitations. The Nutrition Facts label was

particularly important in the communication of the results of this study and was chosen as

the primary tool because of its widespread use and acceptance.

Three research objectives were developed and met through the completion of this

study. Food advertising data was collected by viewing and recording information from

video taped children's television programming. A recording schedule was created by

evaluating several national and cable networks for variety and quantity of children's

programming. Six networks were selected and approximately 20 hours of programming

were recorded from each. The information from all commercials was assembled into a

database that was used to categorize data for further analysis and calculate summary

statistics. Only food and beverage advertisements were used in further analysis. The

nutrition information was collected for the advertised foods and beverages and assembled

into an additional database. Research was the conducted to determine how children's

nutritional needs are different; this information was then used to convert "2,000 calorie"

base information from the Nutrition Facts label found on foods into a child-appropriate

1,700 calorie base. "Composite labels"-averaged nutrition information for each network,









TV rating, and cross promotion-were created to compare nutrition information across the

networks, ratings, and cross promotion use. Another variation of the Nutrition Facts label

was created to show what a day's worth-1,700 calories for a child-of advertised foods

would provide nutritionally.

The collection of composite labels offers both positive and concerning nutritional

news. Fat, saturated fat, and cholesterol were all found to be present in amounts that are

within recommended limits for each composite label. Vitamins A and C are provided in

abundance according to each label. Each composite label, with the exception of the

television network NBC, indicated an adequate level of protein. Areas for concern

include sodium, sugar, fiber, and calcium. All composite labels reflected an assortment

of foods that, if consumed for an entire day, provide as much as twice the recommended

limit of sodium. Percent of calories from sugars was calculated to estimate if added sugar

content stayed within recommendations. Even though there are differing

recommendations on added sugar consumption, the composite labels reflect foods that get

at least 28% of their calories from sugar-a value beyond any of the recommended limits.

It is however important to note that "sugars" listed on the Nutrition Facts label reflects

both naturally occurring and added sugars. But because nearly all the foods in this study

are highly processed most of the sugar they contain is added. The flip side of the

carbohydrate coin-fiber-was found in amounts too low for healthy eating. A full day's

diet of any of the composite labels will provide a maximum of half the recommended

value of 24 grams. The same is true for calcium. Only the television network WB had a

composite label that nearly met calcium consumption recommendations: for every 8% of









daily calories provided, 7% of the daily calcium need was met. Other composite labels

contained about half the required amount of daily calcium.

Conclusions

While many significant differences were found among television networks, rating

codes, and use of cross promotion, the application of this information isn't practical for

parents and other caretakers seeking to limit children's exposure to advertising of foods

of low nutritional density. For example, forbidding a child to watch children's programs

on TOON because their advertised foods are statistically higher in sodium than another

network isn't practical and probably won't create dietary habits of low sodium

consumption. Instead, the value of this study lies in three other major areas:

understanding children's dietary needs, evaluating the nutritional density of foods, and

recognizing both the value and limitations of tools designed and provided by the

government.

Understanding children's specific nutritional needs is the first step to preventing

under or over-nutrition and the complications that go along with them. Depending on the

age and activity level of the individual child their calorie needs may also be higher or

more likely lower than the standard 2,000 calorie diet that nutrition information is based

on. Knowing the appropriate calorie intake level for an individual child also partially

dictates their need for nutrients. Preschool aged children, for example, need far less iron

and protein than adults, yet the packaged foods they consume will list nutrition

information appropriate for adults consuming 2,000 calories. On the other hand,

"tweenage" and teenage girls and boys need 30% more calcium than adults, but again,

Daily Values on packaged food reflect a typical adult's need for 1,000 mg of calcium.41

Parents and other caretakers need to recognize, understand, and make (and guide children









to make) food choices that meet key nutritional requirements: foods provide the unique

amounts of nutrients they need and stay within an energy-balanced level of daily calories.

The danger for children consuming large amounts of advertised foods with similar

nutrient profiles as those advertised on television in this study is not consuming enough

calcium and fiber or other nutrients while taking in too many calories, especially from

added sugar. In this case neither of the key nutritional requirements is met: children are

not getting the nutrition they need, yet consume more calories than they require.

The ability to distinguish nutrient-dense "core" foods from "extra" foods is the

next important contribution of this study. Once an understanding of what a child's diet

should look like is in place, parents and caretakers must be able to choose foods that

provide adequate nutrition within energy limits. Examining the Composite Food 1,700

Calorie Diet table from the Results chapter reveals the nutritional adequacies and

shortcomings of foods advertised on children's television programming. Parents and

caretakers must note the trends indicated in the table (advertised foods contain too much

sodium and sugar and lack calcium and fiber) and exercise caution and control when

children request foods advertised on television. The Nutrition Facts label is an important

source of information for choosing foods that provide nutrients in a calorie-efficient way.

A major skill in selecting nutrient-dense foods from "extras" is using the tools

developed and provided by the government, particularly the Nutrition Facts label found

on many foods. Knowing how to and using the information required by the government

on this label is a simple way to make healthy food choices; however, these skills may not

be instinctive. Children in particular may need training to understand the content of the

Nutrition Facts label.38 And some foods aren't required to carry a Nutrition Facts label-