Reading the mind of children in response to food advertising: a cross-sectional study of Malaysian schoolchildren's attitudes towards food and beverages advertising on television

Abstract

Background: Television food advertising (TVFA) is the most dominant medium in the obesogenic environment promoting unhealthy food choices in children.

Methods: This cross-sectional study investigated children's attitudes towards TVFA by examining four well-cited induction factors namely advertisement recognition, favourite advertisement, purchase request, and product preference. Malaysian urban schoolchildren (7 to 12 years) of equal ethnic distribution were voluntarily recruited (n = 402). Questionnaire administration was facilitated using a food album of 24 advertised food products.

Results: Majority of children were older (66.2 %), girls (56.7 %) with one-third either overweight or obese. TV viewing time for weekend was greater than weekdays (4.77 ± 2.60 vs 2.35 ± 1.40 h/day) and Malay children spent more time watching TV compared to Chinese (p < 0.001) and Indian (p < 0.05) children. Chinese children spent significantly more time surfing the internet compared to either Malay or Indian (p < 0.01). Median score trend was advertisement recognition > favourite advertisement and product preference > purchase request, and significantly greater (p < 0.001) for non-core than core food advertisements. TV viewing time and ethnicity significantly influenced all induction factors for non-core foods. After correcting for all influencing factors, 'favourite advertisement' (IRRfinal adj: 1.06; 95 % CI: 1.04 to 1.08), 'purchase request' (IRRfinal adj: 1.06; 95 % CI: 1.04 to 1.08) and 'product preference' (IRRfinal adj: 1.04; 95 % CI: 1.02 to 1.07) still were significantly associated with TV viewing time. For every additional hour of TV viewing, the incidence rates increased significantly by 1.04 to 1.06 for 'favourite advertisement', 'purchase request' and 'product preference' related to non-core foods amongst Malay and Indian children. However, Chinese children only demonstrated a significant association between TV viewing time and 'favourite advertisement' (IRRadj: 1.06; 95 % CI: 1.01 to 1.10).

Conclusion: This study highlights TVFA as a powerful medium predisposing the mind of children to non-core foods through appealing TV commercials, promoting purchase request and generating unhealthy food preferences in early childhood.

Fig. 1

The flowchart of school selection. Abbreviation: n = number of schools

Fig. 2

Distribution of time spent daily by children. The average time spent daily (hour ± standard error of mean) by children as per ethnic groups for TV viewing, physical activity and internet surfing (only analysed children who reported using internet, n = 230)

Fig. 3

a-d Weighted unadjusted incidence rate ratio (IRR) for induction factors related to non-core TVFA targeting children. Incidence rate ratio of scores for (a) advertisement recognition, (b) favourite advertisement, (c) purchase request, and (d) product preference related to influencing factors such as TV viewing time, TV in bedroom, gender (Male vs Females), age, ethnic (Malay vs Non-Malay; Chinese vs Non-Chinese; Indian vs Non-Indian), body mass index of children [BMI] (Severely wasted or Wasted or Possible risk of overweight or Overweight/ Obese or Obese vs normal), physical activity level [PAL] (1–3 times or 4–6 times or Everyday vs Less than once weekly), daily internet surfing time, daily pocket money and monthly household income (Low: ≤RM2300 vs Medium and high: >RM2300). Note: A vertical line represents incidence rate ratio of 1. If the value of 1 falls within 95 % confidence interval, there is no significant association between tested induction factors and influencing factors (p > 0.05).

Fig. 4

Attractive reasons of food advertisements targeting children. Cited reasons among children to be attracted towards favourite advertisements (n = 402)