Having struggled with his weight as a child, Texas pediatrician Stephen Pont knows the road to a healthy lifestyle isn’t easy.
“I was a big kid growing up,” Pont said. “What I remember most is the brand Del Monte, and they had a line of products called Del Monte Lite, so my friends would sometimes tease me by calling me Del Ponte heavy.”
Like most kids, Pont didn’t question the health value of the sugary cereal advertised alongside his Saturday morning cartoons as a child. But as the American Academy of Pediatrics chairman on obesity and a father of two young boys, Pont is now part of the effort to limit the advertising of unhealthy foods to kids.
“If we had less of this kind of advertising, it would make me more comfortable as a parent and less angry that these companies aren’t trying to manipulate my children into unhealthy habits,” Pont said. “Think about it: If an individual person tried manipulating your kids like that, you’d seek them out. That’s what companies are doing with some of these advertisements.”
In December 2005, the Institute of Medicine released a book-length study that food advertising aimed at children directly contributed to obesity rates among children and teens tripling since the 1980s.
The report called on the food industry to self-regulate the amount of advertising directed at children and the industry reacted. It created its own advertising watchdog organization, the Children’s Food and Beverage Advertising Initiative, in 2006. Since then, initiative vice president and director Elaine Kolish said there has been progress with food companies voluntarily changing recipes to cut out sugar or add more whole grains, making their products somewhat healthier.
Other companies with ties to the food industry have also made an effort. In 2006, Disney pulled its characters from advertisements for unhealthy food. In 2012, Disney went a step further and banned junk food ads from its TV stations, including ABC.
Since the report was published, the CDC has reported that childhood obesity rates have plateaued overall and have fallen slightly in many states, though it doesn't outline a change in advertising as an official reason.
But University of Arizona communications professor Dale Kunkel says the progress is minute compared to how far America has to go in reversing childhood obesity.
“Our levels of childhood obesity are unprecedented in human history because we’re producing unhealthy foods and we’re promoting them,” Kunkel said. “As long as we continue to do that, we can’t solve the problem of childhood obesity.”
While many things can contribute to a child’s health and weight, Pont says advertising is still a crucial piece of the obesity puzzle.
“There’s no one cause of obesity and there’s no one silver bullet,” Pont said. “But some contributors are bigger than others and advertising is a substantial contributor to the problem.”
Since the 2005 report, there’s been substantial research published to support the theory that the more children watch television, the higher their Body Mass Index (BMI), but Pont pointed out one 2009 study as seminal.
Researchers exposed two groups of elementary-school-age children to the same cartoon program with different commercials — one group saw food advertisements, while the other watched ads for other products. Both groups were given goldfish crackers as a snack while watching. The group exposed to food advertising consumed 45 percent more crackers than the other group.
“They’re being confused by seeing so much advertising for unhealthy foods that ads normalize the bad foods in children’s minds,” Kunkel said.
The study also found that because advertising focuses on sensory connections to food — like making a drink sound more appetizing by calling it “ice cold” — ads can create and normalize what’s called “hedonic hunger” or a person’s urge to eat or overeat when their body doesn’t need more food.
Kunkel says after decades of advertising and several generations growing up with it, advertising has made unhealthy foods normal fare for kids and adults.
“The industry has established these normative patterns for people — (for example) most Americans buy sugary cereals for their children,” Kunkel said. “Parents are ultimately responsible for their children, but if you create a social and cultural environment that makes it harder for parents to make right decisions, you cannot simply shrug off the industry advertising’s role in this problem.”
Pont and Kunkel say that advertising is such a problem in the obesity epidemic precisely because it works — by associating positive images and experiences with unhealthy foods, advertising makes children want them and it makes them seem harmless if eaten regularly.
“To average person, advertising seems like someone’s talking to you, like it’s coming from your neighbor. As adults, we know that,” Pont said. “With kids, these ads are additionally sinister because they manipulate the people who don’t have any way to decipher the mixed messages these ads send.”
Kunkel says the messages get more mixed when food companies change their recipes to make unhealthy foods seem more healthy.
“If you take 20 percent of sugar out of an Oreo, it’s still a lot of sugar and it’s not something you should eat every day,” Kunkel said.
But Kolish says the food industry is balancing trying to help end childhood obesity and still selling a product. The recipe tinkering, for example, is something Kolish says is not only difficult, but must be done slowly over time to allow customers to adjust to new taste profiles for some products. She counts cereal as one of the initiative’s biggest victories — as of 2013, the initiative banned any advertising designed for children on cereals with more than 10 grams of sugar per serving.
“Any home cook can tell you about altering a recipe a bit, but it’s even harder on a massive scale,” Kolish said. “You also have to consider how it’s used — some sugar is needed so the cereal doesn’t dissolve on contact with milk. Sodium keeps mold from growing in your food. It’s more than just taste.”
The solutions to childhood obesity aren't easily identified, either, since many answers that seem like common sense don’t always work on their own. Exercise, for example, sounds like an obvious solution to just about any weight problem, but Kunkel and Pont both say that a lack of physical activity isn’t necessarily connected to obesity.
While exercise is an essential part of being healthy, studies have shown that kids who have low levels of activity but partake in activities with less food advertising, like video or computer games rather than TV, show lower BMI rates than those exposed to more food advertising and low rates of physical activity.
Pont also says that if a child eats junk food every day, physical activity becomes moot.
“It’s very difficult to burn off enough calories to get to a healthier place without also thinking about food we consume,” Pont said. “If you’re exercising and you’re also eating junk every day, you can’t necessarily burn off what you consume.”
Striking a balance
Kolish readily admits that food advertising plays a role in the obesity epidemic, but she says the sheer volume of research tells her that obesity has roots that go beyond the media.
“I’ve been in this position 8 years and it seems like every other week there’s another study that comes out linking obesity to something new,” Kolish said. “I recently read one tying it to being born via C-section. Who knew?”
But if advertising alone has such a huge impact on people’s eating habits, then advertising for healthy foods should also work, Kolish said. But there’s little evidence that it does.
Take the iconic, long-running “Got Milk?” campaign from the National Dairy Board. The ads featured high-quality portraits of celebrities and athletes sporting milk mustaches above text extolling the health benefits of drinking milk. But the campaign was abandoned in 2014 after it failed to improve American milk consumption, which continues to fall even since “Got Milk?” began in 1993.
Kolish says part of the problem with campaigns like “Got Milk?” is that they market a commodity rather than a brand.
“If you’re advertising carrots, why would anyone buy X carrots rather than Y carrots?” Kolish said.
There’s also sometimes a disconnect between people saying they want healthy food and buying healthy products, Kolish said.
“Of course people want to eat healthy and people say they want healthy food,” Kolish said. “You can have the best of intentions when you walk into a sub shop and sometimes you still walk out with a meatball sub with cheese because it just sounded good.”
To be clear, Pont and Kunkel both pointed out that no one is advocating that food companies stop advertising to kids entirely, nor are they saying children should never eat any sort of treat. Pont recommends parents limit screen time in order to reduce how much food marketing kids see.
“Parents should try to get ahead of the game on other advertising besides TV — on the GPS, mobile phones and social media,” Pont said. “These companies might have access to your child in other ways. It’s very important to keep up with what kids are doing.”
After nearly a decade since the 2005 Institute of Medicine report came out, Kunkel says it might be time for more robust rules.
“The Institute of Medicine has already spoken,” Kunkel said. “It asked the food industry to reverse the predominance of food advertising on its own. If it doesn’t reverse it in the immediate future, Congress should adopt legislation to achieve that shift.”