Food advertising and broadcasting legislation--a case of system failure?

Abstract

This study analysed a sample of food advertisements shown during 63 hours of children's programming to investigate compliance and non-compliance with one of the Australian Children's Television Standards (CTS): CTS 20.2a. This standard regulates the way premium offers may, and may not, be used to sell products to children. Of the 1721 advertisements contained in the sample, 544 (32%) were for food. A significantly higher number of food advertisements (41%) were shown during 'C' programs (which are specifically regulated and produced for children six to 13 years of age and suitable for viewing without adult supervision), compared with 30% during the less regulated 'G' programs (P = < 0.001) (suitable for children to view without adult supervision but not produced specifically for a child audience). Over one-third of food advertisements (36%) in 'C' time contained a premium offer compared with 17% in 'G' time (P = < 0.0001). Using a precisely defined interpretation of CTS 20.2a, this study found 30 (31%) of food advertisements breached the standard during 'C' programs. This was a significantly higher proportion than the 54 (12%) of breaches in 'G' time (P = < 0.0001). From this study, the current regulatory system has not resulted in more responsible food advertising during 'C' programs, and the widespread breaches of CTS 20.2a indicate this standard is ineffective as a means of regulating food advertising. The Australian Broadcasting Authority has recognised that children need protection from unfair marketing practices and the improper use of premium offers to promote a food product, therefore CTS 20.2a needs urgent review to make it more effective.

Key words: food advertising, television, children, regulation

(Nutr Diet 2005;62:26-32)

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Introduction

The World Health Organization (WHO) and many governments emphasise the importance of healthy diets, especially for children, yet children have become an increasingly important market for food advertisers, with television the preferred medium for reaching them (1-3). Many studies have raised serious concerns about the types of foods promoted to children in television advertisements (4-9). With funding for public health education only a fraction of that available for making and broadcasting food advertisements (10), most children have had a greater exposure to advertising messages, over a number of decades, than to any nutrition message (11-15).

Many governments have struggled to find ways of protecting children from unfair practices and exploitation engendered by high advertising of energy dense, micronutrient poor (EDMP) foods and beverages (2). In 2002, the New South Wales Childhood Obesity Summit (16) passed a resolution calling for an independent review of the current Australian regulations which exist within a complex system of 'co-regulation'. The Australian Broadcasting Authority's (ABA) Children's Television Standards (CTS) operate alongside a system of self-regulation described by the voluntary Commercial Television Industry Code of Practice, which applies to all commercial broadcasting and must conform to the general advertising codes authorised by the Australian Competition and Consumer Commission (17).

The CTS form part of the regulatory framework that applies to the content of programs and advertisements shown during designated children's 'C' programs (those specifically produced for children six to 13 years of age). Television licensees are required to broadcast at least 260 hours of 'C' programs a year (or five hours per week). The programs must be entertaining and well produced with appropriate Australian content which enhances children's understanding and experience (17).

The broadcasting license for each television station is conditional on all advertisements broadcast during 'C' time complying with the relevant CTS. Advertisements broadcast during 'G' programs (those which are not produced specifically for a child audience but which are suitable for children to view without adult supervision) do not have to comply with the CTS. However, they are under the jurisdiction of the self-regulatory Industry Code of Practice. According to this code, advertisements directed to children must exercise special care and judgment, and comply with CTS 17-21 (18). Therefore, advertisements in 'G' time which do not comply with the CTS, while strictly not in breach of the CTS, are in breach of the Industry Code of Practice. This is an important distinction because breaches of the CTS carry more serious penalties than breaches of the Code.

None of the standards regulate the types of food which can be advertised or the number of food advertisements which can be shown. However, one standard, CTS 20.2a, relates to the way premium offers can be promoted to children in advertisements, including those for food. The regulation states: 'if a premium is offered, any reference to the premium must be incidental to the main product or service advertised' (18). Premium offers such as small plastic figures and toys have been given away 'free' with a variety of foods marketed to children for many years and CTS 20.2a regulates rather than prohibits this practice. CTS 20.2a only refers to food advertisements with premium offers and its aim is to protect children from one aspect of food advertising practices. It prohibits advertisers placing undue emphasis on a collectable toy. CTS 20.2a is an acknowledgement by the ABA that children need legislative protection and any breaches of CTS 20.2a must be taken seriously.

An Australian advocacy group, the Coalition on Advertising to Children (CFAC), had noted that many food advertisements with premium offers appeared to contain potential breaches of CTS 20a. Previous studies into television food advertising directed towards children have reported comprehensive nutritional content analyses of food advertising (7,9), but none has examined compliance with the CTS. This study sought to determine the amounts and types of premium offers used in food advertisements and whether these advertisements complied with CTS 20a during 'C' programs. It also investigated whether the current co-regulatory system led to different food advertising practices during 'C' and the less-regulated 'G' programs.

Methods

A total of 63 hours of children's television programs, including those classified as 'C' and 'G' were videotaped from Adelaide's three commercial channels (7, 9 and 10) during April 2001. The viewing times selected for their relevance to children were 7.00-10.30am and 3.30-7.30pm Monday to Friday, and 7.00-11.30am Saturday. News and current affairs programs were excluded on the grounds they are directed more to an adult audience. Community Service Announcements (CSA), station promotions and sponsorship announcements were also excluded.

All food advertisements broadcast during the 12.5 hours of recorded 'C' programs and 50.5 hours of 'G' programs were analysed for compliance with CTS 20.2a (disclaimers and premium offers). There is a view that CTS 20a is only relevant to food advertisements in 'C' time since compliance with the CTS is not required during 'G' programming. We included advertisements in 'G' time for comparison, and because the Industry Code of Practice requires all advertisements directed at children to comply with the CTS 17-21 (18). To distinguish between the two program zones, we designated any breaches in 'G' time as breaches of the Code, although the only difference between breaches of the CTS and breaches of the Code is that the former have legislative sanctions. Differences between the compliance during 'C' and 'G' programs were compared using chi-square tests. A detailed nutritional content analysis of the food advertisements has been published in a separate paper (9).

CTS 20a states 'if a premium is offered, any reference to the premium must be incidental to the main product or service advertised'. The ABA defines a premium as: 'anything offered with or without additional cost that is intended to induce the purchase of an advertised product or service' (17). This definition was originally based on the Code for Advertising to Children used by the Canadian Association of Broadcasters (19).

The term 'incidental' creates some confusion. Before 1989 the ABT regulations stated that 'the amount of time devoted to the premium must be in one continuous segment not exceeding either one-third of the duration of the advertisement or 20 seconds, whichever is the shorter' (19). The advertising industry lobbied to have this definition removed and their view prevailed (19). But since no new definition of the term 'incidental' has been introduced, this study used the former definition to define whether the premium offer could be considered significant or incidental. All the food advertisements, which used a premium offer as part of the sales pitch were viewed by a single observer (JZ) and the total time devoted to the offer was recorded. If the premium offer took up more than one-third of the total length of the advertisement, it was labelled a breach of the CTS in 'C' time and a breach of the Code in 'G' time. Following the coding by the primary coder, coding instructions were used by a second coder (HM) to re-code all the premium offer advertisements. Inter-coder reliability was 96%.

Results

Of the 1721 advertisements in the 63-hour sample of television, 544 (32%) were for food. The 12.5 hours of 'C' programs had 97 food advertisements and the 50.5 hours of 'G' programs in children's timeslots had 447. Table 1 shows 41% of advertisements in 'C' were for food, significantly higher than the 30% of advertisements in 'G' timeslots (P = < 0.001).

Table 2 shows that 35 (36%) of food advertisements during 'C' programs carried premium offers, significantly higher than the 76 (17%) in 'G' programs (P = <0.0001). Premium offers were included for 14 different food advertisements, shown on 111 occasions. Of the food advertisements containing a premium offer, 84 of the 111 were identified as not compliant with the CTS 20.2a requirement that the enticement should be incidental. A significantly greater proportion of these, 30 (31%) occurred in the 'C' time advertisements compared with 54 (12%) in 'G' time (P = < 0.0001).

Table 3 lists the eight separate advertisements that were judged to breach CTS 20.2a. These were broadcast on a total of 84 occasions. Only four of the eight non-compliant advertisements were shown in 'C' time: for lollipops (16 occasions); two different fast food meals (eight and two occasions respectively); candy (four occasions); and fast food (twice). All eight advertisements judged non-compliant were shown during 'G' time.

Table 3 shows that six of the eight non-compliant advertisements (shown on a total of 77 occasions) used 95% or more of their advertising time describing the premium. Of these advertisements, three were for fast food restaurants and three were for chocolate milk, lollipops and breakfast cereals. Table 3 contains a brief description of the type of premium offers used in the food advertisements. In two other advertisements with premium offers, (chocolate and candy), half of the 30-second advertisement was used to promote the premium offer. Table 4 shows that each channel was judged to broadcast breaches of CTS 20.2a during 13 different 'C' programs shown on weekdays and Saturday mornings. During 'C' programs, 2.4 non-compliant advertisements were screened per hour compared with 1.1 per hour in 'G' time (P = < 0.0001).

Discussion

Like many countries, Australia has regulations to protect children against unfair marketing, but this study found infringements of one regulation. Using a precise interpretation of CTS 20.2a, many of these advertisements in this study were judged to contravene one of the ABA regulations designed to protect children from unfair advertising practices.

A study of 13 countries reported that Australia had the highest number of food advertisements during children's viewing periods (2). Sweden and Norway, with virtual bans on advertising directed towards children, had the lowest number (2). Quebec stipulates no advertisements are to be directed to children under 13 (20). In every country, which allowed food advertising to children, a variety of restrictions were placed on individual advertisements. In Australia concern has been consistently expressed over the way foods are promoted to children and the apparent inadequacy of current legislation to protect children's interests (14,21-23). This study found that children watching programs specifically classified as suitable for six- to 13-year-olds were exposed to high numbers of food advertisements, with the proportion during 'C' time being significantly higher than in the 'G' programs classified as suitable for a general audience (P = <0.001). In the study sample time, premium offers were widely used, with 36% in 'C' time and 17% in 'G' time (P = <0.0001). This was markedly different from a 1982 study, which found no premium offers in any food advertisement (4). Premium offers are attractive to children and are likely to stimulate requests for the product. Children watching programs which are specifically made for them ('C' programs) are exposed to proportionally more premium offers.

Using the classification system described, this analysis identified a high proportion of breaches of CTS 20.2a, meaning the premium offers were not merely incidental to the main product being advertised, as required in the regulations. Infringements were more frequent in 'C' time, with almost one third of advertisements in these programs containing premium offers that breached the regulations. This suggests the standards are widely ignored and/or inadequately monitored by the Australian Broadcasting Authority under the current regulations.

Most of the food advertisements in this study contained premium offers that would be attractive to an audience of younger children--four plastic animals, five movie character toys, six monster toys and three toy warriors. Children were encouraged to collect these by eating at the restaurant or buying the food product. Other advertisements offering premium competition vouchers to win such things as a 'million dollars worth of prizes' would also appeal to older children. The prizes included 1000 portable CD players, 100 digital video cameras, 150 computer games packs, 20 family trips to 'California's newest theme park next door to Disneyland', 'swim with Michael Klim' and 10 trips to the (Willie) Wonka factory in the USA with 'all the 'scrummy' lollies you can carry'.

CTS 20.2a in the ABA regulations is an acknowledgment of potential problems in marketing a food product or service to children by over-emphasising a premium offer rather than the attributes of the food. The ABA accepted that advertisements using such tactics to lure or entice children into buying a food product would be unsuitable and exploitative. The Industry Code of Practice also accepts that these regulations should apply to all advertisements directed to children.

Using a clear definition, breaches of the regulations were found widely in this sample of advertisements with premium offers such as small toys presumably to attract children's attention. In this case the marketing ploy could be seen to encourage children to pester adults to buy certain foods. A growing body of research has examined the effects of 'pester power' or the 'nag factor' on family buying patterns (3). According to Dalmeny et al. (24), 'pester power', or the ability of children to influence their parents' purchasing choices, has become a well-used part of the marketing landscape (24). The careful targeting of child consumers can also have the added advantage of engaging and maintaining brand loyalty over decades (24). A national survey in the US reported that 10% of 12-13-year-olds admit to asking their parents more than 50 times for a product seen advertised on television (25). In the UK, a member of Parliament was recently reported as insisting that an advertising agency publicly apologise for encouraging children to pester their parents to buy a snack food produced by Walkers Crisps (26), where the advertisement showed a child saying 'I am going to pester mum for them when she next goes shopping'. The CEO was quoted as admitting that 'the wording was unfortunate and we won't do it again' (26).

A former advertising copywriter concedes that television advertising is not a medium for information but for emotion (27). Covert, as well as overt messages should be examined and consideration given to the overall advertising environment. In Australia, two national advocacy bodies, the Coalition on Food Advertising to Children (CFAC) and Young Media Australia (YMA), have recorded parental complaints about the number of premium offers in food advertisements on Australian television and the pressure this exerts upon them (28).

This study suggests that some food companies may not be complying with CTS 20.2a. The time devoted to the premium offers of collectable toys or free entry to competitions appeared to overwhelm the sales pitch for the food, with 31% of the food advertisements in 'C' time containing a premium offer in breach of past regulations. Most devoted over 95% of the total advertising time to the premium. Food packets were more likely to be shown in the advertisement than the actual food product (data not shown). A further 15% of food advertisements in 'G' time were similarly non-compliant.

Paradoxically, this study found that during 'C' time, where legislation applies with strong penalties in order to protect children against unfair marketing practices, there is significantly less compliance with CTS 20.2a than during 'G' time when only a voluntary Code of Practice applies (P = <0.0001). This does not mean that the classification itself is the cause of the poor compliance in 'C' time. It may appear that advertisers have often saved aggressive advertising techniques for the timeslot when children's specially designated programs are shown and parents are more likely to feel their children are watching 'suitable' content which does not require supervision (14). The higher proportion of breaches in 'C' time suggests that children are not being protected by existing legislation.

With childhood obesity increasing and type 2 diabetes being diagnosed in obese children (29-35), healthy eating has become a public health priority for children and there is a need to discourage high consumption of energy-dense, micronutrient-poor foods. This analysis found the food advertisements with premium offers were predominantly for snack foods and fast food restaurants and most of the breaches of the premium offer regulations were by a few multinational companies. Reports indicate companies such as McDonalds, Hungry Jacks and KFC spend heavily on advertising directed to children (24,36,37).

It is reasonable to assume companies would not advertise food products during children's television programs if it was not effective in increasing sales (10). Food advertising has the potential to encourage poor eating habits among children and unfair marketing practices exploit their vulnerability (1,12,13,38). There is also potential for harm (39), with childhood eating habits being strong predictors of adult diets (40) and poor nutrition contributing to future health care costs (41).

In Australia, concerns about the regulation of food advertising to children are strengthening. This analysis demonstrates that if society permits food advertising directed towards children, regulations should be scrutinised, strengthened and adequately regulated. Using our precisely defined interpretation of CTS 20.2a, there were frequent breaches of one of the Australian Children's Television Standards on each commercial television station. It would appear that regulations with legislative force did not guarantee any more responsible advertising practices in 'C' time than in 'G' time.

The CTS was designed to exert some control over advertising, but we understand breaches are not routinely investigated in Australia. The regulations themselves have not been open to public debate for more than a decade. In 2002, the Coalition on Advertising to Children forwarded a detailed complaint about breaches of CTS 20.2a to the ABA regarding McDonald's Happy Meal which comprises an attractively packaged cheeseburger, small fries, a small soft drink and a toy. Almost a year later, the ABA rejected the complaint on the basis that a free offer such as the toy given was not a premium offer but an integral part of the meal (L Atkinson-MacEwen, ABA, 2002, Pers, comm., 15 November) Free coupons for entry into competitions were also not considered to be premium offers. Such reasoning and the time taken to reach this decision may explain why few complaints are made or upheld.

It is difficult to reconcile the ABA response when a premium offer is defined in the legislation as: 'anything offered with or without additional cost that is intended to induce the purchase of an advertised product or service' (17). Additionally, there is evidence that, unlike the ABA, the general public recognise items such as McDonald's Happy Meals' toy collections as premium offers. These premiums are offered for sale on many internet sites around the world and they are colloquially called Happy Meals premiums (42). With such confusion, the ABA needs to clarify its definition of premium offers in the regulations. In Finland, McDonald's is specifically forbidden to promote the toys in their advertisements for children's meals (24).

Conclusion

Food advertising on television is an important issue that warrants consideration of ethical concerns and social responsibility towards children. Policy, advocacy and educational issues and actions need to be established to ensure food messages reaching children in all countries are in their best interests (43). In North America, a recent report calls for current food advertising practices to be revisited and for laws and regulations to be strengthened to support parents' attempts to feed their children healthy diets (44).

The current study found major problems with food advertising practices in Australia. A legally enforceable code has not guaranteed compliance. Multiple breaches of the CTS concerned with premium offers in food advertisements were shown during the designated five hours per week of 'C' time, showing that many advertisements use unsuitable tactics to entice children to buy foods, many of which are energy dense and micronutrient poor.

Our experience demonstrates that reliance on self-regulation by the industry is not working effectively, and the complaints process is prolonged and unsatisfactory. Community values have also changed since the CTS were introduced and obesity and other diet-related diseases have increased dramatically. There is an urgent need to better protect children by creating a healthier television food environment. The authors assert that this is an issue that should be taken more seriously than currently appears by stakeholders and policy makers in Australia and throughout the world.

Table 1. The total number of food advertisements in a 63-hour sample of
children's 'C' and 'G' programming expressed as a percentage of all
advertisements broadcast in that timeslot (a)

                                               Total number of
                        Total program time in  advertisements including
Program Classification  hours                  food advertisements

'C'                         12.5                      236
'G'                         50.5                     1485
Total                       63                       1721

                        Total number of food     Food ads as a % of all
Program Classification  advertisements           advertisements

'C'                          97                      41.1% (a)
'G'                         447                      30.1%
Total                       544                      31.6%

(a) Chi-square for the difference between the percentage of food
advertisements in 'C' and 'G' time = 11.4, P = 0.001.

Table 2. The total number of food advertisements with a premium offer in
a 63-hour sample of children's 'C' and 'G' programming, including those
which 'breached' CTS20.2a (a)

                                                      Number and % food
                                                      advertisements
'C' & 'G' classified programs   Total number of food  with premiums
(with total hours in brackets)  advertisements        [rate per hour]

'C' programs                           97              35/97 (36%) (b)
(12.5 hrs)                                             [2.8 per hr]
'G' programs                          447              76/447 (17%)
(50.5 hrs)                                             [1.5 per hr]
Total                                 544              111 (20%)
(63 hrs)                                               [1.8 per hr]

                                  Number and % food advertisements
'C' & 'G' classified programs   which 'breached' CTS 20.2a [rate per
(with total hours in brackets)                hour]

'C' programs                              30/97 (31%) (c)
(12.5 hrs)                                [2.4 per hr]
'G' programs                              54/447 (12%)
(50.5 hrs)                                [1.1 per hr]
Total                                     84 (15%)
(63 hrs)                                  [1.3 per hr]

(a) Advertisements are judged to be in breach of CTS 20.2a if the total
time given to a premium offer was greater than 33% of the total
advertising time.
(b) Chi-square for the difference between the proportion of food
advertisements in 'C' and 'G' time with premium offers = 17.9 P = <
0.0001.
(c) Chi-square for the difference between the proportion of food
advertisements in 'C' and 'G' time that breach CTS 20.2a = 21.7 P = <
0.0001.

Table 3. The type and number of premium offer food advertisements which
are in breach of CTS 20.2a in the 63-hour sample of children's 'C' and
'G' programming (a)

                                                    Total number of food
                                                    advertisements with
                                                    premium (number
                                                    in 'C' time in
Food advertisement   Premium offer                  brackets)

Mondo lollipops      Three 'Play with history'      30
                     collectable historical
                     warriors including Knights,
                     Zulus and Samurais
                                                    ('C' = 16)
McDonald's Pop-up    Four Lady & the Tramp pop-up   21
Dogs Happy Meal      dogs: collectables
                                                    ('C' = 8)
Hungry Jacks Kids    Five Rugrat straw-hugger       12
Club Meal            movie character toys:
                     collectables
                                                    ('C' = 2)
Milo                 'Win a swim with Michael        8
                     Klim' and other prizes
                     include 150 Nintendo games
                     packs.
                                                    ('C' = 0)
Kellogg's breakfast  Prizes include 1000 portable    4
cereals              CD players and 100 digital
                     video cameras and the main
                     prize is 20 family trips for
                     2 adults & 2 children to
                     'California's newest theme
                     park next door to
                     Disneyland'.
                                                    ('C' = 0)
KFC                  Six swap-monster collectable    2
'Chicky Meal'        figurines
                                                    ('C' = 0)
Wonka Oompa candy    Ten family trips to the Wonka   7
                     factory in the US ('and all
                     the 'scrummy' lollies you can
                     carry!')
                                                    ('C' = 4)
Mars Celebration     Win $20000 or Polaroid joy      1
                     camera
                                                    ('C' = 0)
Total                                               84
                                                    ('C' = 30)

                     Total number of food
                     advertisements with
                     premium (number        Percentage of time
                     in 'C' time in         spent promoting the
Food advertisement   brackets)              premium offer

Mondo lollipops       30
                      ('C' = 16)              100%
McDonald's Pop-up     21
Dogs Happy Meal
                      ('C' = 8)              >95%
Hungry Jacks Kids     12
Club Meal
                      ('C' = 2)              >95%
Milo                   8
                      ('C' = 0)              >95%
Kellogg's breakfast     4t
cereals
                      ('C' = 0)              >95%
KFC                    2
'Chicky Meal'
                      ('C' = 0)              >95%
Wonka Oompa candy      7
                      ('C' = 4)               50%
Mars Celebration
                      ('C' = 0)
                      84                      50%
Total                 ('C' = 30)

(a) Advertisements are judged to be in breach of CTS 20.2a if the total
time given to the premium offer was greater than 33% of the total
advertising time.

Table 4. Placement of food advertisements with premium offers which
breach CTS 20.2a (a) in an analysis of 12.5 hours of 'C' programs

                               Timeslot
                               (total program time  Premium offer food
Channel  Program               shown in brackets)   advertisement

 7       'Big Arvo'             4.00-4.30pm         Mondo
                                  (2.5hrs)          McDonald's
 7       'Time Masters'        10.30-11.00am Sat    Mondo
                                  (0.5 hrs)
 7       'Lil Horrors'          9.00-9.30am Sat     Mondo
                                  (0.5hrs)
10       'Totally Wild'         4.00-4.30pm         Mondo
                                  (2hrs)
10       'Wild Kat'             4.00-4.30pm         McDonald's
                                  (0.5hrs)
10       'Magic School Bus'     7.00-7.30am Sat     Mondo
                                  (0.5hrs)          McDonald's
10       'Fast Tracks'          7.30-8.00am Sat     Mondo
                                  (0.5hrs)          McDonald's
10       'Totally Wild'         8.00-8.30am Sat     Mondo
                                  (0.5hrs)          McDonald's
10       'Where in the World    8.30-9.00am Sat     Mondo
         is Carmen San Diego'     (0.5hrs)          McDonald's
 9       'Cushion Kids'         4.00-4.30pm         Hungry Jacks
                                  (2.5hrs)
 9       'Pick Your Face'       7.00-7.30am Sat     Oompa Candy
                                  (0.5hrs)
 9       'Good Sports'          7.30-8.00am Sat     Oompa Candy
                                  (0.5hrs)
 9       'Ship to Shore'        9.00-9.30am Sat     Oompa Candy
                                  (0.5hrs)
 9       'Download'             9.30-10.00am Sat    Oompa Candy
                                  (0.5hrs)
Total                          12.5 hours

Channel      Number of advertisements

 7               9
                 3
 7               1
 7               1
10               1
10               1
10               1
                 1
10               1
                 1
10               1
                 1
10               1
                 1
 9               2
 9               1
 9               1
 9               1
 9               1
Total           30 advertisements

(a) Advertisements are judged to be in breach of CTS 20.2a if the total
time given to the premium offer was greater than 33% of the total
advertising time.

References

1. World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases: Report of the Joint WHO/FAO Expert Consultation. Geneva: WHO Technical Report Series; 916;2003.

2. Dibb S, Harris L. A spoonful of sugar. Television food advertising aimed at children: an international comparative study. London: Consumers International; 1996.

3. McNeal J. The kids' market: Myths and realities. New York: Lexington Books; 1999.

4. Morton H. The television advertising of food to children: a South Australian study. J Food Nutr 1984;41:170-5.

5. Story M, Faulkner P. The prime time diet: A content analysis of eating behaviour and food messages in TV program content and commercials. Am J Public Health 1990;80:738-40.

6. Taras HL, Gage M. Advertised foods on children's television. Arch Pediatr Adolesc Med 1995;149:649-52.

7. Hill J, Radimer KL. A content analysis of food advertisement in television for Australian children. Aust J Nutr Diet 1994;54:174-81.

8. Hammond KM, Wyllie A, Casswell S. The extent and nature of televised food advertising to New Zealand children and adolescents. Aust N Z J Public Health 1999;23:49-55.

9. Zuppa JA, Morton H, Mehta K. TV food advertising: Counterproductive to children's health? A content analysis using the Australian Guide to Healthy Eating. Nutr Diet 2003;60:78-84.

10. Nestle M. Food politics. How the food industry influences nutrition and health. Berkeley: University of California Press; 2002.

11. Cotugna, N. TV ads on Saturday morning children's programming--what's new? J Nutr Educ 1988;20:125-7.

12. Morton, H. Television food advertising: a challenge for the new public health in Australia. Community Health Study 1990;14:153-61.

13. Kotz K, Story M. Food advertisements during children's Saturday morning television programming: are they consistent with dietary recommendations? J Am Diet Assoc 1994;94:1296-300.

14. Morton H. The television advertising of foods to children: a case for regulation. In multidisciplinary approaches to food choice. Conference on Food Choices: Adelaide; 1996.

15. Sustain: The Alliance for Better Food and Farming. Protecting children from unhealthy food advertising: A briefing paper for the National Clinical Director for Children; London: Sustain; 2002.

16. NSW Department of Health. NSW Childhood Obesity Summit: Government Response. Sydney; 2003.

17. Australian Broadcasting Authority. The Children's Television Standards and Australian Content Standards. Sydney: ABT; 1999.

18. Federation of Commercial Television Stations. The Commercial Television Code of Practice. Sydney: FACTS; 1999.

19. Australian Broadcasting Tribunal. Kidz TV: An Inquiry into Children's Television Standards. Vol 1. Sydney: ABT; 1991.

20. Caron A. Children, advertising and television choices in a new media environment. In: Frith S, Biggins B, editors. Children and advertising: A fair game? Sydney: New College Institute for Values Research, UNSW; 1994.

21. Australian Consumers Association. Into the mouths of babes. Choice Magazine 1990;Oct:4-7.

22. Kunkel D. Advertising regulations and child development: perspectives on social policy making. In: Frith S, Biggins B, editors. Children and advertising: A fair game? Sydney: New College Institute for Values Research, UNSW; 1994.

23. Stanton R. Into the mouths of babes: Marketing to children. J Home Econ Inst Aust 1998;5:7-13.

24. Dalmeny K, Hanna E. Lobstein T. Broadcasting Bad Health: Why food advertising needs to be controlled. [Author: place?] International Association of Consumer Food Organisations; July, 2003.

25. Centre for the New American Dream. Just the Facts about Advertising and Marketing to Children; Takoma Park, Maryland: Centre for the New American Dream; 2002.

26. Wintour P. Ad agency apologises over child 'pester power' brief. The Guardian 2003 November 14.

27. Rubinstein P. Food and advertising. In: Wahlqvist ML, editor. Food and health: Issues and directions. London: John Libbey and Company Ltd; 1987. p.97-100.

28. Biggins B. Breaches of the Children's Television Standards. Food Advertising--Is TV feeding young Aussie children?--An early childhood seminar for teachers, health workers, parents and students. Adelaide: Advocacy Network on Food Advertising to Children (ANFAC); 2000 October 11.

29. Magarey AM, Daniels LA, Boulton TJ. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust 2001;174:561-4.

30. Booth ML, Wake M, Armstrong T, Chey T, Hesketh K, Mathur S. The epidemiology of overweight and obesity among Australian children and adolescents, 1995-7. Aust N Z J Public Health 2001;25:162-9.

31. Olds TS, Harten NR. One hundred years of growth: the evolution of height, mass and body composition in Australian children, 1899-1999. Hum Biol 2001;73:727-38.

32. Frankish H. Obesity and diabetes epidemics show no sign of abating. Lancet 2001;358:896.

33. Lancet Editor. Childhood obesity: an emerging public health problem. Lancet 2001;357:1989.

34. Lytle LA. Nutritional issues for adolescents. J Am Diet Assoc 2001;102:8S-12S.

35. Rosenbloom AL. Increasing incidence of type 2 diabetes in children and adolescents: treatment considerations. Paediatr Drugs 2002;4:209-21.

36. AC Nielsen. TV Trends 1998. Sydney: AC Nielsen & BT Weekly; 1999.

37. Langlois A, Adam V, Powell A. Food Manufacturing. Obesity: the big issue. London: European Equity Research, JP Morgan Chase & Co; 2003.

38. Wilson N, Quigley R, Mansoor O. Food ads on TV: a health hazard for children. Aust N Z J Public Health 1999;23:647-50.

39. Borzekowski DL, Robinson TN. The 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers. J Am Diet Assoc 2001;101:42-6.

40. Boulton TJ, Magarey AM, Cockington RA. Tracking of serum lipids and dietary energy, fat and calcium intake from 1 to 15 years. Acta Paediatr 1995;84:1050-5.

41. Segal L, Carter R, Zimmet P. The cost of obesity: the Australian perspective. Pharmacoeconomics 1994;5(Suppl):45-52.

42. Sodaro RJ, Malloy AG, Kiddie meal collectibles: A comprehensive guide to fast-food toys and premiums. Krause Publications: Ida, Wisconsin; Collector Book; 2003.

43. Story M. Television and food advertising: An international health threat to children? Nutr Diet 2003;60:72-3.

44. Centre for Science in the Public Interest. Pestering parents: How food companies market obesity to children. Nutrition Policy Project. Washington DC: CSPI; 2003.

Department of Public Health, School of Medicine, University of Adelaide 

H. Morton, BA, DipT, MSc, MSocSc, Lecturer 

School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney

R. Stanton, BSc, CNut/Diet, Dip Admin, PhD (Hon), APD, Visiting Fellow

Barossa Community Health Service and Modbury Public Hospital

J. Zuppa, BHSc, MNut/Diet, Dietitian 

Department of Nutrition & Dietetics, School of Medicine, Flinders University of South Australia, Adelaide

K. Mehta, BSc, GDipNut/Diet, CMge, Lecturer

Correspondence: H. Morton, Department of Public Health, University of Adelaide, Mail Drop: 207, Level 9/ 10 Pulteney Street, SA 5005.

Email: [e-mail]

K. Mehta, H. Morton and J. Zuppa planned the details of the study. J. Zuppa and H. Morton collected and analysed the data. H. Morton wrote the first draft of the paper which was revised with substantial assistance from R. Stanton.