Children's recall of fast food television advertising-testing the adequacy of food marketing regulation.
OBJECTIVE
In the United States, the fast food companies McDonald's and Burger King participate in marketing self-regulation programs that aim to limit emphasis on premiums and promote emphasis of healthy food choices. We determine what children recall from fast food television advertisements aired by these companies.


METHODS
One hundred children aged 3-7 years were shown McDonald's and Burger King children's (MDC & BKC) and adult (MDA & BKA) meal ads, randomly drawn from ads that aired on national US television from 2010-11. Immediately after seeing the ad, children were asked to recall what they had seen and transcripts evaluated for descriptors of food, healthy food (apples or milk), and premiums/tie-ins.


RESULTS
Premiums/tie-ins were common in children's but rarely appeared in adult ads, and all children's ads contained images of healthy foods (apples and milk). Participants were significantly less likely to recall any food after viewing the children's vs. the adult ad (MDC 32% [95% confidence interval 23, 41] vs. MDA 68% [59, 77]) p <0.001; BKC 46% [39, 56] vs. BKA 67% [58, 76] respectively, p = 0.002). For children's ads alone and for both restaurants, recall frequency for all food was not significantly different from premium/tie-ins, and participants were significantly more likely to recall other food items than apples or milk. Moreover, premiums/tie-ins were recalled much more frequently than healthy food (MDC 45% [35, 55] vs. 9% [3, 15] p<0.001; BKC 54% [44, 64] vs. 2% [0, 5] respectively, p<0.001).


CONCLUSIONS
Children's net impressions of television fast food advertising indicate that industry self-regulation failed to achieve a de-emphasis on toy premiums and tie-ins and did not adequately communicate healthy menu choices. The methods devised for this study could be used to monitor and better regulate advertising patterns of practice.
Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America.
Amy M
AM
Bernhardt
Public Health Advocacy Institute, Northeastern University School of Law, Boston, Massachusetts, United States of America.
Cara
C
Wilking
Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America.
Diane
D
Gilbert-Diamond
Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America.
Jennifer A
JA
Emond
Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America.
James D
JD
Sargent
D000328:Adult; D000329:Advertising / Q000331:legislation & jurisprudence*; D002648:Child; D002675:Child, Preschool; D057140:Fast Foods / Q000191:economics*; D005260:Female; D019649:Food Industry / Q000191:economics / Q000331:legislation & jurisprudence; D033161:Government Regulation; D006801:Humans; D008297:Male; D011939:Mental Recall; D013690:Television