Abstract
ObjectivesTo assess exposure to marketing of unhealthy food products and its relation to food related behavior and BMI in children aged 3–13, from different socioeconomic backgrounds in a south Indian town.MethodsChild-parent pairs (n = 306) were recruited at pediatric clinics. Exposure to food marketing was assessed by a digital logo recognition test. Children matched 18 logos of unhealthy food (high in fat/sugar/salt) featured in promotion material from the food industry to pictures of corresponding products. Children's nutritional knowledge, food preferences, purchase requests, eating behavior and socioeconomic characteristics were assessed by a digital game and parental questionnaires. Anthropometric measurements were recorded.ResultsRecognition rates for the brand logos ranged from 30% to 80%. Logo recognition ability increased with age (p<0.001) and socioeconomic level (p<0.001 comparing children in the highest and lowest of three socioeconomic groups). Adjusted for gender, age and socioeconomic group, logo recognition was associated with higher BMI (p = 0.022) and nutritional knowledge (p<0.001) but not to unhealthy food preferences or purchase requests.ConclusionsChildren from higher socioeconomic groups in the region had higher brand logo recognition ability and are possibly exposed to more food marketing. The study did not lend support to a link between exposure to marketing and poor eating behavior, distorted nutritional knowledge or increased purchase requests. The correlation between logo recognition and BMI warrants further investigation on food marketing towards children and its potential role in the increasing burden of non-communicable diseases in this part of India.
Highlights
In the light of the ongoing epidemic of child obesity and noncommunicable diseases globally, food marketing towards children has been increasingly recognized as an important health risk
Test of children’s food preferences and nutritional knowledge was fashioned after a scale developed in the U.S by Calfas et al [23] and modified to suit an Indian setting
Parents stated on the four item Likert scale that their children ‘‘always’’ (27% of responding parents) or ‘‘often’’ (29%) tried to influence them in purchase situations, succeeded in doing so (‘‘always’’ 20%, ‘‘often’’ 27%), showed independence and confidence when choosing food products (‘‘always’’ 46%, ‘‘often’’ 22%) and demanded specific brands and products that they had seen advertised (‘‘always’’ 21%, ‘‘often’’ 22%). (Table 3) Purchase request behavior was not significantly associated to age (p = 0.251) or gender (p = 0.205)
Summary
In the light of the ongoing epidemic of child obesity and noncommunicable diseases globally, food marketing towards children has been increasingly recognized as an important health risk. India experiences a growing epidemic of non-communicable diseases, attributable to a strong gene-environmental interaction [4] and lifestyle changes caused by modernization and urbanization. The incidence of coronary heart disease has increased fourfold in the past 40 years [5] and with its 50.8 million diabetics, India is today the country with the highest number of patients suffering from the condition [6]. A larger problem for the urban upper and middle income groups [9], non-communicable diseases are increasing in low socioeconomic groups [10]
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