/
METABOLISM R PASQUALI SECTION EDITOR Food and Beverage Marketing to Youth Andrew Cheyne METABOLISM R PASQUALI SECTION EDITOR Food and Beverage Marketing to Youth Andrew Cheyne

METABOLISM R PASQUALI SECTION EDITOR Food and Beverage Marketing to Youth Andrew Cheyne - PDF document

stefany-barnette
stefany-barnette . @stefany-barnette
Follow
511 views
Uploaded On 2014-11-28

METABOLISM R PASQUALI SECTION EDITOR Food and Beverage Marketing to Youth Andrew Cheyne - PPT Presentation

Despite some positive steps the evidence shows that the food and beverage industry selfregulation alone is not likely to significantly reduce mar keting of unhealthy foods and beverages to youth Avariety of research is needed to monitor industry mar ID: 18334

Despite some positive steps

Share:

Link:

Embed:

Download Presentation from below link

Download Pdf The PPT/PDF document "METABOLISM R PASQUALI SECTION EDITOR Foo..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

METABOLISM(RPASQUALI,SECTIONEDITOR) FoodandBeverageMarketingtoYouth AndrewCheyne & PamelaMejia & LauraNixon & LoriDorfman # SpringerScience+BusinessMediaNewYork2014 Abstract Afternearlyadecadeofconcernovertheroleof foodandbeveragemarketingtoyouthinthechildhoodobe- sityepidemic,Americanchildrenandadolescents — especial- lythosefromcommunitiesofcolor — arestillimmersedin advertisingandmarketingenvironmentsthatprimarilypro- moteunhealthyfoodsandbeverages.Despitesomepositive self-regulationaloneisnotlikelytosignificantlyreducemar- ketingofunhealthyfoodsandbeveragestoyouth.Avarietyof researchisneededtomonitorindustrymarketingofunhealthy productstoyoungpeople,andidentifythemostpromising approachestoimprovechildren ’ sfoodmarketingenviron- ments.Thecontinuedpresenceofunhealthymarketingtoward childrendespiteyearsofindustryself-regulationsuggestsitis timeforstrongeractionbypolicymakerstoprotectyoung peoplefromharmfulmarketingpractices. Keywords Marketing . Foodandbeveragemarketing . Children . Adolescents . . Policy . Digital . Foodenvironments . Schools Introduction Sincetheonsetofnationalconcernovertheepidemicratesof obesityamongyoungpeople,foodcompanies[ 1 ],govern- ments[ 2 , 3 ],andschools[ 2 , 3 ]haveallmadesomeeffortsto improveyoungpeople ’ sfoodmarketingenvironmentsinthe UnitedStates.Despitetheseefforts,however,youthneverthe- lessgrowupsurroundedprimarilybypromotionsforfoods andbeveragesthatfailindependentnutritionalcriteria[ 4 ]. peoplereceivemattersbecauseitinfluenceschildren ’ sfood preferences,requests,dietarybehaviorsandhealthoutcomes [ 5 ].Inparticular,youngpeople ’ sexposuretomarketingfor productswithfewnutrientsbuthighinsugar,salt,andsatu- ratedfatsisassociatedwithoverweightandobesity[ 6 ],with youthfromcommunitiesofcolorfacingdisproportionate burdensfromtheseconditions[ 7 ].Inturn,youngpeople whobecomeoverweightorobeseareatanelevatedriskfor avarietyofnutrition-relatedchronicdiseasesthatcanaffect themfortherestoftheirlives[ 8 , ]. Thisreviewexaminesthecontextofyouth ’ sexposureto foodandbeveragemarketing — especiallythedisparities facinglow-incomeandyouthofcolor,theprominentforms ofthesemarketingpractices,andtheimplicationsforpolicy interventionsandfutureresearchthatseektoprotectyouth fromtheseharmfulpractices. Youth,andYouthofColor,areSpecificallyTargeted MarketingFoodsandBeveragestoYouthThroughthe “ 4P ’ s ” Youngpeopleareakeyaudiencetargetedbyfoodandbever- agemarketers.Between1994-2004,companiesbroughtto market4447newfoodandbeverageproductsaimedatyouth, A.Cheyne( * ) : P.Mejia : L.Nixon : L.Dorfman BerkeleyMediaStudiesGroup,aprojectofthePublicHealth Institute,2130CenterSt.#302,Berkeley,CA94704,USA e-mail:andrewcheyne@gmail.com P.Mejia e-mail:mejia@bmsg.org L.Nixon e-mail:nixon@bmsg.org L.Dorfman e-mail:dorfman@bmsg.org A.Cheyne CaliforniaAssociationofFoodBanks,1624FranklinSt#722, Oakland,CA94612,USA CurrObesRep DOI10.1007/s13679-014-0122-y marketduringthattime[].In2009,themajorfoodandbeveragemanufacturersspent$1.8billiononpromotionstochildrenandadolescentsforproductswithgenerallyun-healthylevelsofsaturatedfat,sugar,orsodium[].Thisincludedadramatic50%increaseinexpendituresondigitalpromotions[].Marketerssuchasfast-foodcompaniesusepricestrategiessuchasdollarmenustoreachyoungpeoplewithlimiteddisposableincome[].Foodandbeveragecompaniesalsoinundatetheplacesyouthfrequent,includingschools,neighborhoods,youthevents,andthedigitalspacesinwhichyouthsocialize.MarketingTargetingYouthfromCommunitiesofColorYouthfromAfricanAmerican,Latino,andothercommunitiesofcolorarecovetedtargetaudiencesforfoodandbeveragemarketers.Theseyoungpeopleareearlyadopters[]andheavyusersofmediadevices[],andareconsideredculturaltrend-settersfortheirpeers[].Thismaybeinpartwhyfoodandbeveragecompaniestargetchildrenandyouthofcolor.Researchconsistentlyillustratesthatyouthofcoloraredisproportionatelytargetedwithmarketingforunhealthyfoodsandbeverages[Between2008and2010,whencomparedwithWhitechildrenandadolescents,AfricanAmericanyouthwereex-posedto80percentto90percentmoretelevisioncommercialsforsugarybeveragesandenergydrinks,whileLatinochildrenwereexposedto49percentmorecommercials[].AnalysesofEnglish-languageandSpanish-languagetelevisionadsforallfoodshavefoundthatfastfoodadvertisementsweremorecommononSpanish-languagetelevision[],andthatthefoodsadvertisedwereofpoorernutritionalquality[].Com-prehensivereviewsillustratethatLatinoyouthsareparticular-lylikelytobevulnerabletofoodandbeveragemarketingbecausetheyhavehigherlevelsofmediaexposureandcom-paniesusetargetedstrategiestoreachthispopulation,ulti-matelyconcludingthatindustryself-regulationislesseffec-tiveatprotectingLatinoyouths[LatinoandAfrican-Americanyouthalsotendtoliveinneighborhoodswithgreaterdensityofconveniencestoresandrestaurantsthatmarketunhealthyfoods,andthatspecificallytargetchildren[].Forexample,convenienceandgro-cerystoresarenearlytwiceaslikelytoincludecartoonchar-acterspromotingunhealthysnacks(48.1%versus26.3%)andbreakfastcereals(44.4%versus25.0%)inpredominantlyAfricanAmericanascomparedtoWhiteneighborhoods[Astudythatcomparedrestaurantmarketingbyneighborhoodfoundthatrestaurantsinlow-incomeneighborhoodswithhighminoritypopulationsweremorelikelytobefastfoodrestau-rants,hadfewerhealthyentreesthanthoseinotherneighbor-hoods,andweremorelikelytotargetchildrenwithmarketingstrategieslikechildrensmealsandspecialcharacters[Moreover,thefastfoodoutletslocatedinlow-incomecommunitiesofcoloremploymoreaggressiveplace-basedmarketingstrategies,suchasexterioradvertising,thantheircounterpartsinhigh-income,majorityWhiteneighborhoodss24].Community-centeredresearchsuggeststhatdespitepublichealthconcernsovertargetmarketingofunhealthyfoodsandbeverages,youthofcoloroftenhavemorenuancedrelation-shipswithfoodmarketers.FocusgroupswithAfricanAmer-icanyouthandadultsindicatethatsomerespondentsarehighlycriticalofusingculturalcuestotargettheircommunity,whileothersseetargetingasnormalbusinesspracticesandpraisespecialproductsortheuseofpopularcelebrities[].AqualitativestudyexaminingcaregiversperceptionsofAfrican-Americanchildrensfoodenvironmentsrevealedwidespreadawarenessoffoodmarketingassupportingun-healthyeating,butalsoloyaltytocompaniesthatsponsoredlocalevents,contributingtoconflictingviewsabouttheover-allimpactoffoodcompaniesimpactinAfricanAmericancommunities[ProminentFormsofFoodandBeverageMarketingTargetingYouthThefoodandbeverageindustryusesseveralprominentformsofmarketingtotargetyoungpeople,includingtelevision,digitalmedia,productpackaging,schoolandneighborhoodenvironments,andneuraltechniques.TelevisionThoughfoodandbeverageindustryspendingontelevisionexpenditureshasdeclined[],televisionremainstheprimarytoolformarketingtoyouth:in2009,televisionaccountedformorethanone-thirdofallfoodandbeverageadvertisingexpenditures[].Asof2011,theaveragechildaged2-11sawnearly13foodandbeverageadsperday[],whileteenssawanaverageof16perday[Cumulatively,childrenareonaverageexposedtomorethan900caloriesperdayfromtelevision[],primarilyfrompromotionsforunhealthyitems[].In2008,forexam-ple,childrensawfourtimesasmanyadsforhighsugarcerealsasdidadults[].Despitetheintroductionofindustryself-regulatorypledges,fast-foodadvertisingtochildrenontele-visionactuallyincreasedbymorethan20percentfrom2003to2009[];similarly,between2008and2010,childrenexposuretotelevisioncommercialsdoubledfornon-dietsodaa19].Sugarydrinksaccountedfor70%ofthebrandappear-anceschildrenidentifiedduringpopularprime-timeprogram-ming[Televisedfoodadsthatchildrenseeemployaseriesofpersuasivetechniques,mostcommonlyincludingpremium CurrObesRep offers(toygiveaways),appearancesbypromotionalcharac-ters,healthandnutritionclaims,andappealstotasteandfunn31].Thesetechniquesarefrequentlyusedtogether:licensedortrademarkedpromotionalcharactersappearinnearlythreeoutoffourchild-targetedfoodads,andthemajorityofthoseincludehealthornutritionmessages,despitethefactthatmostofthefoodsadvertisedareofpoornutritionalquality[Indeed,themajorityofcommercialsforunhealthyfoodsfeaturehealth-relatedmessages[]whilemostcom-mercialsfeaturingphysicallyfitprofessionalathletespromoteenergydense,nutrient-poorfoods[Beyondcommercials,themajorityoffoodandbeverageproductplacementsonyouth-orientedortweenprogram-ming(thatis,foodsthatareeaten,discussed,appearinthebackgroundoraspartofaplotline,etc.)donotconformtoindependentnutritionrecommendations[].Experimentalresearchsuggeststhatchildren,especiallyolderchildren,arevulnerabletoplacementsforunhealthyproductspromotedontelevision[Asubstantialbodyofresearchhighlightslimitationsofthefoodandbeverageindustrysself-regulatorypoliciesgoverningtelevisionthroughtheChildrensFoodandBever-ageAdvertisingInitiative(CFBAI).AccordingtoCFBAIguidelines,televisionshowsarechild-directediftheaudiencebasecomprisesmorethan35%childrenaged12andunderadefinitionthatexcludesslightlymorethanhalfofallfoodandbeverageadsseenbychildren[].Whencomparedtocommercialsseenbyadults,fast-foodadspromotingchil-drensmealsemphasizetoypremiumsandmovietie-inswithsubstantiallyreducedpromotionoffooditems,practicesthatcontraveneself-regulatorypledgesmadeintheCFBAIwhichpromisetohighlightfoodproductsinsteadoftoypremiumsinadvertisingdirectedtochildren[].Experimentalevidenceindicatesthatwhilefoodmarketerssuchasfast-foodcompa-nieshavechangedtheiradvertisingtopromotehealthierop-tionssuchasappleslicesinsteadofFrenchfries,childrenmistaketheapplesforfries,suggestingthatevenfast-foodadscompliantwithself-regulationcandeceivechildren[Overall,advertisementsfromCFBAImembercompaniespro-motefewerhealthyproductsthanadsfromnon-membercom-panies[]:accordingtoonestudy,almostalladsbyCFBAImembercompaniesthatappearedonchildrensprogrammingwereforproductshighincalories,saturatedandtransfats,sodiumortotalsugars[].Thoughthereisincreasingevi-dencethatteenswhoareespeciallyreceptivetofoodadver-tisingmaybeathigherriskforobesity[],theCFBAIdoesnotgovernmarketingtochildren12yearsandolder.DigitalFoodandBeverageMarketingtoYouthFoodandbeveragemarketersincreasinglyusedigitalmediatoengageyoungpeopleandintegratebrandsintotheironlineidentities[];between2006and2009,industryspendingondigitalmarketingtoyouthrosemorethan50%[].Mobilemarketingisakeyvenueforfoodandbeveragemarketingtoyouth,as95%ofadolescentsareonline,and37%reportowningasmartphone;93%of12-13year-oldareonline,and71%reporthavingmobileaccesstotheInternet[].Asearlyadoptersandtheheaviestusersofdigitalmediadevices,youthofcolorareparticularlyvulnerabletodigitalmarketingexpo-sures[Foodmarketersmaintainadominantpresenceonthedig-italchannelspopularwithyouthsuchassmartphoneapplica-tions,textmessaging,andbanneradsonmobilewebsitestoengageyouth[].OnFacebook,akeymarketingchanneltoreachyouth,unhealthyfoodandbeveragebrandsmakeupfiveofthetoptenmostpopularontheinfluentialsocialnetwork[].Suchsocialmediaactivityisanimportantpredictorofreal-worldbehavior:Coca-Colahasmorethan30millionFacebookfans,forexample,whoaretwiceaslikelytodrinkandtentimesmorelikelytobuyCoca-Colaproductsthanconsumerswhoarenotdeclaredfans[McDonaldsweb-basedmarketingtargetschildrenasyoungas2yearsold[Foodandsoftdrinkcompaniesusesophisticatedtech-niquestoembedmarketingcontentintoimmersiveonlineexperiencestotargetchildrenandadolescentsthatarede-signedtotapintoyouthssubconsciousprocessesthatcom-promiserationaldecision-making[].Scholarshavealsoindicatedthatthesepracticesmaybeinherentlydeceptiveandviolatechildrensprivacyprotections,becausesuchstrat-egiesintendtoreachyouthinpartbybypassingtheircognitivedefenses[Digitalfoodmarketingisapervasiveandhighlysuccessfulpractice,especiallywhenitinvolvesbrandedgameplaythroughadvergames.In2009,morethan2millionyouthvisitedfoodandbeveragewebsiteswithadvergamesonaver-ageeverymonth,spending88%longeronthesesitesthanonwebsitesthatdidnot[].Advergamespromotingunhealthyfoodsembedbrandedgamesintoplayfulenvironmentsthatbuildpositivebrandassociationsforyouthwithoutappearingtobeadvertising[].Sugarycerealadvergames,forinstance,teachchildrenthatthemostnutritionallypoorfooditemsarethemostvaluable,andthatconsumingthemwillnotaffecttheirhealth[MultiplestudieshavefoundthatCFBAI-participatingcompaniessuccessfullyuseadvergamestotargetchildrenwithfoodsthatfailCFBAIandindependentnutritionalcriteriaa47,56,57].AnanalysisofCFBAI-participatingcompaniesdigitalmarketingfoundthatone-halfofthewebsiteswithsubstantialaudiencesofchildrenincludedadvergamesfeatur-ingfoodsthatviolatedthecompaniesownnutritionalcriteriaformarketingdirectedtochildren;amongtheseadvergames,candywasthemost-frequentlypromotedfoodcategory[Offoodadvergamespopularwithchildren,nearly80%aresponsoredbyCFBAI-participatingcompanies[].Eighty- CurrObesRep eightpercentofthesegamesdonotincludeagelimitations,andcomparedtoadvergamesnotpopularwithchildren,thesegamesincludedhigherlevelsofbrandintegrationandpro-motedunhealthierfoods;gameswithgreaterbrandpresencewerealsomorelikelytobepopularwithchildren[].Cross-nationaldataindicatethatbecauseofrelativelylaxprotec-tions,whencomparedtoEuropeancountriessuchasFrance,U.S.digitalmarketingtochildrenemphasizesunhealthyfea-turessuchasbrands,games,andrewardsinsteadofnutritionandhealth[Agrowingbodyofworkextendscorefindingsabouttheeffectsoftelevisionfoodadvertisingonchildren[]toexam-inetheefficacyofdigitaltechniques.Experimentalstudieshavedivergedonwhethertheplacementofunhealthyprod-uctsinbrandedadvergamesinfluenceschildrentoconsumemoreunhealthyfoodsthanwhenchildrenareexposedtoadvergameswithhealthfulfoods[].Arandomizedtrialfoundchildrenplayinggamesfeaturingenergy-densesnacksorfruitateincreasedlevelsoffoodaftergamingcomparedtochildrenexposedtothecontrolcondition,suggestingthatevengamespromotinghealthyfoodscanencourageunhealthyeatingbehaviors[Researchontheeffectsofadvergamesconsistentlyshowsthatfewerchildrenareawareoftheadvertisinginadvergamesthanontelevision[],andhigherlevelsofchildrenreportingpositiveviewstowardadvertisinginsocialgamess60,61].Experimentalresearchshowsthattheunderlyingmechanismofthepersuasionprocessdiffersfortraditionalanddigitalmarketing,andthatacriticalattitudetowardmar-keting,ratherthancognizanceofit,isasuperiordefenseagainstthepersuasiveimpactofadvergames;thisindicatesthatchildrenmaybevulnerableuntilolderthanpreviouslysuggestedbystudiesusingtelevision,whensuchacriticalattitudecandevelop[].Thesocialaspectofonlinegamingisalsosalientbecausethesusceptibilitytopeerpres-sureisakeyinfluenceonchildrensdesireforthebrandspromoted[MarketingtoYouthwithProductPackagingMarketingthroughproductpackagingmayincludeavarietyoftechniqueslikecelebrityendorsements;theuseoflicensedmediacharactersorcompany-ownedspokescharacters;ormarketingmessagesthatevoketheproductstaste,conve-nience,nutritionalvalue,orotherattributes[].Thesetech-niquesareeffectiveinhelpingmarketersappealtobothchil-drenandtheirparents:forexample,researchindicatesthatwhenyoungchildrenseecerealboxesbrandedwithmediacharacters,theirpreferenceforthecerealinsideincreases[Parentsreportthattheyaremorewillingtobuytheirchildrencerealsthatfeaturehealthandnutritionclaims[],thoughsuchon-packagenutritionclaimshavebeenfoundtocreateabacklasheffectonchildren,leadingthemtochooselesshealthyproductsunderexperimentalconditions[].Despitetheeffectivenessofon-packagemarketingtechniques,CFBAIdoesnotapplytoproductpackagingatall,unlessthepackag-ingisitselffeaturedinadsthatdirectlytargetchildrenunderage12[Observationalsurveyshavefoundthatcompaniesregularlyuseon-packagemarketingtechniquestoreachchildren.AstudyofretailstoresinIllinoisfoundthatatmanyofthemostpopularstoresforfamilies,child-targetedpackagingtech-niquesappearedonthemajorityofproductsacrossallfoodcategories,andwereusedmostfrequentlyonthepackagingofunhealthyitems[].Similarly,aConnecticutstudyfoundthatmarketerstargetchildrenforthepurchaseofunhealthyfoodsbyincorporatingreferencestopopularathletes,sportsteams,andphysicalactivityintothepackagingofmanyfoodsandbeveragesthatdonotmeetnutritionalstandards[Marketersmayalsocombineon-packagemarketingtacticstomaximizetheirproductsappealtochildren:cerealsbrand-edwithchild-targetedspokescharacters,forexample,havebeenfoundtobestrategicallypositionedinstorestomaximizethecharacterseyecontactwithchildren,buildingtheirtrustinandconnectiontothebrandby16-28%[Foodpackagingthatsupportspoint-of-salemarketingpro-motionsisnotcoveredbyCFBAI[].Someeffortshavebeenmadeonalocalleveltoimprovethenutritionstandardsofthechildrensmealsofferedatfast-foodrestaurantsthatincludetoygiveaways,andthereisevidencethatatapopulationlevel,thesepoliciescouldhelpavertweightgainamongchildrenen69].However,preliminarystudiesofcountiesthathaveim-plementedsuchpoliciesindicatethattheyhaveproducedonlyminimalimprovementsinthenutritionalqualityofchildrenmealsoffered[FoodandBeverageMarketingtoYouthinSchoolsFoodandbeveragemarketinginelementaryandsecondaryschoolsiswidespread[].Muchofthisresearchhasexam-inedwhetherschoolfoodenvironmentsareincompliancewithnationalrequirements[],notablyTheHealthy,Hunger-FreeKidsActof2010,whichdirectedtheUSDAtoalignthenutritionstandardsforallfoodsandbeveragessoldinschoolswithcurrentdietaryguidelines.Anationalanalysisexaminingwhetherschooldistrictpoliciesoncompetitivefoodsconformedtothe2010USDADietaryGuidelinesforAmericansfoundthatlessthan5%ofschooldistrictspolicieswereincompliance,suggestinglittleimplementationofthisrequirementoftheHealthy,Hunger-FreeKidsActof2010[].Anationalsurveyofelementaryschoolsforthe20092010schoolyearfoundthat60%ofpublicelementarystudentswereabletopurchasebeveragesoutsidetheschoollunchprogram,asignificantincreasefrom20062007[].Overthesameperiod,aseparateanalysisoftheInstituteofMedicine(IOM)srecommendationthat CurrObesRep elementarystudentsonlyhaveaccesstohealthfulbeverages(1%milk,100%juice,andwater)increasedfrom10%to19%[].Acrossthecountry,10%ofelementaryschoolstudentsandalmostonethirdofhighschoolstudentshaveaccesstofastfoodatleastonceaweekduringschoollunchh75].Inaddition,whilefederallawmandatedpublicelementaryschoolstocreatewellnesspoliciesthatincludedcriteriaforcompetitivefoodsandbeveragesbythe2006schoolyear,only55%ofelementaryschoolshadsuchpoliciesforthe2009-2010schoolyear[].AnutritionalsurveyanalyzingvendingmachinesinsecondaryschoolsintheSt.Paul-Minneapolisareafoundthatmorethan95%offoodsofferedfailedIOMcriteriaforfoodssoldoutsideofmealprogramsms73].Toaddressconcernsabouttheimpactofcreatingwell-nesspolicieswithnutritionalcriteriaoncompetitivefoodsthatmeetthe2010DietaryGuidelinesforAmericans,anationalprojectionestimatedthatsuchpolicieswouldimprovethehealthstatusofstudentsespeciallyamongthosepopula-tionssufferingfromthegreatestexposuretounhealthyfoodandbeveragemarketing;atthesametime,anyrevenuede-clineschoolsexperiencewouldbeoffsetbyincreasedreim-bursementsfromgreatermealprogramparticipation[Inaddition,researchindicatesthatstudentsinlow-incomeschoolsaremorelikelytobeexposedtovariousformsoffoodandbeveragemarketingthanstudentsattendinghigh-incomeschools[],andarealsomorelikelytobeexposedtounhealthyfoodandfoodmarketinginbusinessesclosetotheirschools[].AstudymappingfastfoodlocationsandBoston-areaschools,forexample,foundthatschoolsinlow-incomeneighborhoodswereclosertofastfoodrestaurantsandcon-veniencestores,disproportionatelyexposingchildrenattend-ingthoseschoolstounhealthyeatingoptions[OutdoorFoodandBeverageAdvertisingTargetingYouthYoutharealsoexposedtosignificantmarketingwheretheylive,includingthefoodoutletsandoutdooradvertisingintheircommunities.Asof2009,majorfoodandbeveragecompa-niesspent$113milliononin-storeandproductpackagingmarketing[],andmorethan$75milliononoutdooradver-tisingin2006[Agrowingbodyofresearchhasfoundthatbecausefoodmarketingisfrequentlyfoundinneighborhoodssurroundingschools[youthmaybeexposedtoadisproportionateamountofoutdoorfoodandbeverageadvertising,especiallyforunhealthyproductsts80].Surveyresultsfoundthatalmost70percentofstoresinLosAngelesCountyhadoutdooradvertisingpromotingunhealthyproductswhileonly12per-centofstoresdisplayedexterioradvertisingforhealthyprod-uctssuchasfreshfruitsorvegetables;manystoresarewithin1000feetofschoolsandarefrequentedbyyouthbeforeorafterschool[].PilotdatacollectednearfourmiddleschoolsinAustin,TX,found563advertisementsinthesurroundingarea,themajority(56%)ofwhichwereonnearbyconve-niencestoresorgasstations[Theconnectionsbetweenplace-basedmarketingandhealthoutcomesarecomplex.Muchoftheresearchonplace-basedmarketinghasfocusedondifferencesinexposureacrosscommunitiesbasedondifferencesinsocioeconomicandracialcharacteristics.Low-incomecommunitiesofcolorarelesslikelytohavegrocerystores[],andlow-incomeneighborhoodstendtohaveahigherdensityoffastfoodoutletsofferingunhealthyoptions[].Withinneighbor-hoods,thelowest-incomeresidentstendtoliveclosertofastfoodoutlets[].Somestudieshavefoundthatproximitytounhealthyfoodoutletssuchasfastfoodrestaurantsisassoci-atedwithunhealthyeatingpatternsamonglow-incomeAfri-canAmericanchildren[]andteens[],andhigherbodymassindex(BMI)amongadults[].Othershavefoundthattheoveralleconomichealthandretailvarietyoftheneighbor-hood,ratherthanthepresenceorabsenceoffastfoodoutlets,mayhavethegreatestimpactonsupportingorharmingchil-drensandteenshealth[YouthsNeuralResponsestoFoodandBeverageMarketingAgrowingbodyofresearchhighlightsthepowerfuleffectsoffoodandbeveragemarketingonchildrenbymeasuringneuralresponsesusingsophisticatedbrainscanningtechnologiessuchasfunctionalmagneticresonanceimaging(fMRI).Astudyof17childrencomparedresponsestofoodversusothercorporatelogos.Whenexposedtofoodlogos,childrenbrainsexperiencedsignificantactivationinareasknowntocontrolrewardresponsesandbrandrecognition,suggestingfoodlogosareespeciallyemotionallysalientforchildrenn88].Furtherresearchexaminedadolescentsresponsetofoodandnon-foodcontrolcommercials,insteadoflogos,withsimilarfindingsofmentalactivationaswellasheightenedrecall,indicatingthepoweroffoodmessages[].Astudyof27adolescentsfoundthatregularCoca-Coladrinkersexhib-itedlowerinhibitionwhenanticipatingconsumingCoca-Co-la,andgreaterstimulationwhenexposedtotheCokelogo,indicatingapotentialneurologicalbasistoperpetuatehabit-ualconsumptionn90].Thereissomedisagreementonwhetheroverweightyouthexhibitparticularvulnerabilitiestofoodmarketing.Acom-parativeanalysisoftenhealthyweightandtenobesechil-drensneuralresponsivityfoundthatobesechildrenexhibitedsignificantlylessresponsetofoodlogosinbrainregionsknowntoregulatecognitivecontrol,andsomewhatgreaterresponseinrewardregions[].Astudyof30adolescentsfoundthatleanadolescentsdisplayedthegreatestimpulsecontrolreactiontofoodcommercialscombinedwithmessagesaboutthedifficultyofweightcontrol,however,suggesting CurrObesRep thatallteensmaybevulnerabletofoodmarketingmessageses89].ImplicationsforAddressingUnhealthyFoodandBeverageMarketingtoYouthThisreviewsuggestsseveralimplicationsforprotectingchil-drenfromenvironmentsthatpromoteunhealthyfoodsandbeverages,includingevaluationsofexistingpolicies,im-provementstopoliciesthatprotectyouthfrommarketing,andareasforfutureresearch.EvaluatingPolicyEffortstoAddressFoodandBeverageMarketingtoYouthNationally,theprimarypolicyresponsetounhealthyfoodandbeveragemarketingtargetingyouthhasbeenindustryself-regulation.Whiletheindustrycontinuestoimproveitsself-regulatoryprograms[],significantloopholesandgapsremain.AcomprehensivereviewofallindustryactionstomeettheIOMsrecommendedactionsestablishedin2006toaddressunhealthyfoodmarketingtoyouth,foundthattheprivatesectorhasachievedonlylimitedmoderateadvancement[].Forexample,in2010,threeoutoffourchildrenscerealsakeyproductcategorymarketedtochildrenfailedtomeetthevoluntarynutritionalcriteriasuggestedashealthyformarketingtoyouthbytheInteragen-cyWorkingGrouponFoodMarketedtoChildren(IWG)[InJuly2011,theCFBAIannounceduniformnutritioncriteriawithinproductcategoriesthatconformtothe2010USDADietaryGuidelinesforAmericans,withmembercompaniespledgingtostopadvertisingproductsthatdonotmeettheuniformcriteriaasofJanuary1,2014[].Asofthiswriting,thosestandardshavenotbeenineffectlongenoughtoassess.Duringthesameperiod,foodandbeverageindustrylob-byistssoughttohaltthereleaseofcomprehensivevoluntarymarketingguidelinestoimprovethenutritionalqualityoffoodandbeverageproductsmarketedtoAmericanchildrenandadolescents.TheguidelinesweredevelopedattherequestofCongressbytheIWG,comprisedofagencyrepresentativesfromtheFederalTradeCommission(FTC),USDA,FoodandDrugAdministration(FDA),andCentersforDiseaseControlandPrevention(CDC).Amidst$37millioninindustrylob-bying[],theFTCinitiallyrecommendedthatthedraftIWGprinciplesexcludeavarietyoffoodactivitiesthattargetyouth,andthattheprinciplesapplyonlytochildrenunderage12insteadof17[].InDecember2011,Congressrequiredacost-benefitanalysisoftheproposedvoluntaryguidelineses98],effectivelyhaltingtheIWGprocesswithoutadditionalappropriationstofundtheanalysis.Evaluationsofinterventionsbylocalauthoritiestoimprovefoodandbeveragemarketingtochildrenhaveshownvariedresults.AnassessmentoftheSantaClaraCounty,CA,ordi-nancethatrequiredchildrensmealsatfast-foodchainrestau-rantsincludingtoypremiumstomeetnutritionalcriteriafoundthatwhilethepolicydidnotimprovethenutritionalqualityofchildrensmealsattheselocations,thefranchiseshadim-provedtheirmarketingpracticestopromotehealthieroffer-ingsasstipulatedbythepolicy[].AnevaluationofBostonpublicschoolslimitationonsugarybeveragesfoundthatthepolicysubstantiallyreducedtheaveragedailysugarybever-ageconsumptionamonghighschoolstudentsfrom1.71to1.38[].Anationally-representativesurveyofmiddleschools,however,foundthatpoliciestopreventthesaleofsomeorallsugarybeveragessuccessfullyreducedstudentsin-schoolaccesstotheseunhealthyproducts,butwasnotassociatedwithsignificantlydifferentoverallintakeofsugarybeverages[101ImprovingPoliciestoProtectYouthfromMarketingPublicschoolsarealogicalplacetoprotectchildrenfromfoodandbeveragemarketing.Becauseschoolsarevestedwiththelegalresponsibilityofinlocoparentistoprotectandcareforchildren,theyaresubjecttolowerthresholdstogovernmentalinterventionsoncommercialspeech,andareidealinstitutionstoimplementrestrictionsonmarketingpracticesforunhealthyfoods[102].USDAsproposedruleforlocalschoolwellnesspoliciestorestrictmarketingtofoodsandbeveragesthatmeettheSmartSnacksinSchoolsnutritionstandards[103]isanimportantopportunitytobringprotectionstochildrenfrommarketinginschools.Policiesandself-regulatorystrategiesbasedonresearchusingtelevisioncommercialsmustbeadjustedtotakeaccountoftheuniquepersuasionmechanismofinteractivedigitalmarketingtechniquestoprotectagainstchildrensparticularvulnerabilitiestotheseadvertisingforms[104].Currently,regulationsarebasedonamodelfromtelevisionresearchinwhichchildrendevelopcognitiveawarenessofadvertisingpersuasiveintentbyapproximatelyage12.Thisisnotasufficientmodelforprotectionagainstdigitalmarketing,whichrequirestheviewertoformacriticalattitudetowardmarketingthattypicallyoccursinalaterdevelopmentalstagee41].Aligningthecurrentlylargenumberofnutritionalguide-lines(USDA[105],FDA[106],IOM[107])intoastandard-izedsystem,suchasproposedthroughtheIWG,wouldbetterinformthepublicaboutthehealthfulnessoffoodsmarketedtochildrenandofferresearchersasinglemetricwithwhichtoevaluateindustryprogress[].Policiescouldthenconformaroundthatsinglestandard,makingiteasierforfoodandbeveragecompaniestoknowwhatwasexpectedandcomply. CurrObesRep Thescienceidentifyingsugaroftenfoundinlargequantitiesinproductsmarketedtoyouthasaddictivehasimportantpolicyimplications.Addictivenessistraditionallyassociatedwiththeintoxicationandoverdoseofsubstancesnotessentialforhumanlife;sugaraddictionreliesontheinabilitytoexertcontroloverconsumptionwhenfacingneg-ativeconsequences.Asthissciencematures,itwillsuggestlegalandregulatoryapproachestoaddressthehealthconse-quencesofsugaraddiction[108AreasforFurtherResearchBecausefoodandbeveragemarketingtoyouthincludesadynamiclandscapeofindustryplayersandpractices,aswellasanevolvingsetofpublichealthpolicyinterventions,thereareavarietyofimportantavenuesforfurtherresearch.Theseincludethetargetingofkeypopulations,thepowerofdigitalandotherstealthformsofmarketing,monitoringindustryself-regulatoryprograms,braindevelopmentstudiestoassesshowyouthareaffectedbymarketing,andlegalresearchonopportunitiesforpublicpolicyapproachestoprotectchildrenandyouthfromtheharmfuleffectsoffoodandbeveragemarketing.KeyPopulationsMoreresearchisneededtoassesstheeffectsoffoodandbeveragemarketingtargetingyouthfromlowincomeandcommunitiesofcolortohealthoutcomes[109].MostanalysesofmarketingtoyouthofcolorfocusonLatinoandAfricanAmericanpopulations,whileadditionalfocusisneededonAsianandPacificIslander,NativeAmerican,andotheryouthpopulationstargetedbymarketers[].Manyyoungpeoplefromthesecommunitiesalsostrugglewithlowincomes,makingthemparticularlyvulnerabletounhealthyfoodmar-keting,andfurtherresearchshouldexploretheseintersectionsandtheirimplications.StealthandDigitalMarketingAsyouthappeartobemorevulnerabletostealthh110formsofdigitalmarketingthantelevision,researchcouldidentifytheextentofchildrenssusceptibility,andspecifywhichdigitalmarketingtechniquesmaybeofprimarycon-cerntoinformpotentialregulatoryprotections[111112].Thisresearchcanfurtherdeterminetheageatwhichchildrenareawareofanddisplaycriticalattitudestowarddigitalmarket-ing,andwhattypesofinterventionstoprotectagainstdigitalpersuasionwillbemosteffective[Researchintofoodandbeveragemarketingtargetingyouthmustsimilarlyassessitasanintegratedmarketingcommuni-cationsapproach,simultaneouslyanalyzingtheentiresyner-gisticcommunications-wholee113].Thisgoesbeyondthesingularchannelsandovertformsofmarketingsuchastele-visioncommercialstoincludesubtler,subversiveformssuchasdigitalproductplacementandbrandsascontentcreators(MountainDewDewmocracycampaigncraftedentiredigitalprogramsinsteadoftraditionalstand-aloneads)[114Child,Adolescent,andAdultSusceptibilitytoMarketingResearchmustcontinuetoestablishthesusceptibilityofado-lescents,andevenadults,tothemarketingoffoodsandbeverages.Experimentalresearchwhichfindsthatexposuretofoodadvertisingaschildrenaffectspreferencesevenintoadulthood[115]suggestsquestionsaboutthetraditionalde-velopmentalparadigmthatchildrenareonlysusceptibletomarketinguntiltheydevelopsufficientcognitivedefenses[Newresearchshouldconfirmandelaboratethesefindings,includingtheefficacyoftheprevailingpolicyregime[]ofprotectingonlychildrenlessthan12yearsold[].ResearchemployingneuroimagingtechniquessuchasfMRIwouldinformgreatpromiseforpolicybecausetheymakevisiblechildrensvulnerabilitytofoodmarketingmessages.Inpar-ticular,thesestudieshelpmakethecaseforpoliciestoprotectallchildren,notonlythosealreadysufferinghealthconse-quencesfromunhealthyfoodmarketing,fromthethreatsposedbymarketingforunhealthyproducts[116IndustrySelf-regulationMonitoringandEvaluationAsthefoodindustryistheprimaryinfluenceonfoodenvi-ronmentsaffectingchildren,thereisanongoingneedtomonitorandevaluatetheimplementationandeffectivenessofindustryself-regulatorypledges[117].Ideally,thismoni-toringwouldcreateinternationalaccountabilitybenchmarksbycombiningpublicallyavailableinformationonfoodcom-panymarketingactivities,nutritionalprofilesoftheproductsmarketed,andinformationonotherrelevantcommercialprac-tices,suchaslobbyingactivity[118].Becausehigh-profileindustry-sponsoredresearchpraisestheresultsofself-regulatoryinitiativeswhileindependently-fundedresearchcontradictstheseresults,publichealthscholarsmustexecutehigh-quality,timely,andinnovativeresearchthatiswellpro-moted,includingthroughnewscoverage,toeffectivelyin-formthepublicandpolicymakers[119].Forexample,thereisanimmediateneedtoexamineimplementationoftheUSDASmartSnackrulesforso-calledcompetitivefoods(foodssoldoutsideofbreakfastandlunchmealprograms)thatwillcomeintoeffectforthe2014-2015schoolyear.LegalResearchScholarshipshouldcontinuetoaddressconcernsoverwhethertheFirstAmendmenttotheU.S.Constitutionprotectingthefreedomofspeechpermitsgovernmentregulationof CurrObesRep unhealthymarketingtoyouthascommercialspeech.Govern-mentregulationoffoodmarketingtoyouthmaysurvivesuchachallengebecauseyouthlackthecognitivedevelopmenttodefendthemselvesagainstmarketing,categorizingthesemes-sagesasinherentlymisleadingng52].Contemporarycharac-teristicsofchild-targetedfoodmarketingthatreliesonemo-tionalratherthanrationalappealstoyoungpeoplemaybemisleadingandthusmaynotwarranttheprotectionsaffordedbythecommercialspeechdoctrinedoctrine120].Thismaybeespeciallytrueofdigitaltechniquesthatexploityouthsvul-nerabilitiestoidentifyandprotectthemselvesagainstmarketing.ConclusionThisreviewconfirmspreviousanalysesthathavefoundmar-ketingforunhealthyproductsdominateschildrenandyouthfoodenvironments.Theubiquityofthesemessagesmakessuchmarketingappearunremarkable,influencingsocialnormsandbehaviorsofimpressionableyoungpeoplealreadyatunprecedentedriskofobesity-relatedchronicdiseases.In2006,theInstituteofMedicinerecommendedthattheU.S.DepartmentofHealthandHumanServicesmonitorprogressmadeinimprovingfoodmarketingtochildrenandWithin2years,theSecretaryshouldreporttoCongressontheprog-ressandadditionalactionsnecessarytoaccelerateprogresss5].NearlyadecadeafterthatlandmarkreportfarbeyondtheIOMsoriginaldeadlineresearchcontinuestodocumentthebillionsofdollarsofunhealthyfoodmarketingsaturatingchildrensenvironments.Itistimeforstrongereffortsfromlawmakerstoholdcompaniesaccountableforrecruitingchil-drentobetheirpresentandfuturecustomersoffoodsthatputtheirhealthatrisk.CompliancewithEthicsGuidelinesConflictofInterestAndrewCheyne,PamelaMejia,LauraNixon,andLoriDorfmandeclarethattheyhavenoconflictofinterest.HumanandAnimalRightsandInformedConsentThisarticledoesnotcontainanystudieswithhumanoranimalsubjectsperformedbyanyoftheauthors.References1.KraakVI,StoryM,WartellaEA,GinterJ.IndustryprogresstomarketahealthfuldiettoAmericanchildrenandadolescents.AmJPrevMed.2011;41(3):32233.2.WartellaE,KraakV,StoryM,GinterJ,VandewaterE.ProgressonPublicPolicy:TheAftermathofthe2005InstituteofMedicineReportonFoodMarketingandtheDietsofChildrenandYouth.In:WilliamsJD,PaschKE,CollinsCA,editors.AdvancesinCommunicationResearchtoReduceChildhoodObesity.NewYork:Springer;2013.p.1932.3.KraakVI,StoryM,WartellaEA.GovernmentandSchoolProgresstoPromoteaHealthfulDiettoAmericanChildrenandAdolescents:AComprehensiveReviewoftheAvailableEvidence.AmJPrevMed.2012;42(3):25062.4.PowellLM,HarrisJL,FoxT.Foodmarketingexpendituresaimedatyouth:puttingthenumbersincontext.AmJPrevMed.2013;45(4):45361.5.McGinnisJM,GootmanJA,KraakVI.Foodmarketingtochildrenandyouth:Threatoropportunity?WashingtonDC:InstituteofMedicine:CommitteeonFoodMarketingandtheDietsofChildrenandYouth.2006.6.ZimmermanFJ,BellJF.Associationsoftelevisioncontenttypeandobesityinchildren.AmJPublicHealth.2010;100(2):33440.7.OgdenCL,CarrollMD,KitBK,FlegalKM.PrevalenceofobesityandtrendsinbodymassindexamongUSchildrenandadolescents,1999-2010.JAMAJAmMedAssoc.2012;307(5):48390.8.FloresG.Racialandethnicdisparitiesinthehealthandhealthcareofchildren.Pediatrics.2010;125(4):e979e1020.9.Basen-EngquistK,ChangM.Obesityandcancerrisk:recentre-viewandevidence.CurrOncolRep.2011;13(1):7110.WilliamsJD.ProductProliferationforNewFoodandBeverageProductsTargetedtoChildren1994-2004.Austin,TX:UniversityofTexasWorkingPaper;2005.11.FederalTradeCommission.Areviewoffoodmarketingtochildrenandadolescents:follow-upreport.Washington,D.C.:FederalTradeCommission;2012.12.ChapmanM.McDonald'svaluemenuenticescustomersinfirstquarter.In.DeseretNews;2010.13.ZmudaN.HowCokeistargetingblackconsumers.In:AdAge;2010.14.CheyneA,GonzalezP,MejiaP,DorfmanL.Foodandbeveragemarketingtochildrenandadolescents:Limitedprogressby2012.Minneapolis,MN:HealthyEatingResearch;2013.15.RideoutVJ,FoehrUG,RobertsDF.GenerationM2:MediaintheLivesof8-to18-Year-Olds.MenloPark,CA:HenryJ.KaiserFamilyFoundation;2010.16.LassiterVC,GrierSA.UnderstandingCommunityPerspectives:AStepTowardsAchievingFoodMarketingEquity.In:WilliamsJD,PaschKE,editors.AdvancesinCommunicationResearchtoReduceChildhoodObesity.Heidelberg:Springer;2013.p.34366.17.RamirezAG,GallionK,AdeigbeR.LatinoYouthandObesity:Communication/MediaInfluenceonMarketing.In:AdvancesinCommunicationResearchtoReduceChildhoodObesity.Heidelberg:Springer;2013.p.36787.18.KunkelD,MastroD,OrtizM,McKinleyC.FoodMarketingtoChildrenonU.S.Spanish-LanguageTelevision.JHealthCommun.2013;18(9):108496.19.HarrisJL,SchwartzMB,BrownellKD,JavadizadehJ,WeinbergM,SardaV,etal.SugaryDrinkFACTS:Evaluatingsugarydrinknutritionandmarketingtoyouth.NewHaven,CT:YaleRuddCenterforFoodPolicy&Obesity;2011.20.Fleming-MiliciF,HarrisJL,SardaV,SchwartzMB.AmountofHispanicyouthexposuretofoodandbeverageadvertisingonSpanish-andEnglish-languagetelevision.JAMAPediatr.2013;167(8):72330.21.GermondC,RamirezA,GallionK.RegulationofFoodandBeverageMarketingtoLatinoYouths.Austin,TX:Salud!America.2013.22.Grigsby-ToussaintDS,MoiseIK,GeigerSD.Observationsofmarketingonfoodpackagingtargetedtoyouthinretailfoodstores.Obesity.2011;19(9):1898900.23.LeeRE,HeinrichKM,Reese-SmithJY,ReganGR,Adamus-LeachHJ.ObesogenicandYouthOrientedRestaurantMarketinginPublicHousingNeighborhoods.AmJHealthBehav.2014;38(2):21824. CurrObesRep 24.PowellL,RimkusL,IgorZ,BarkerD,ChaloupkaF.ExteriorMarketingPracticesofFast-FoodRestaurantsABTGResearchBrief.Chicago,IL:BridgingtheGapProgram,HealthPolicyCenter,InstituteforHealthResearchandPolicy,UniversityofIllinoisatChicago;2012.25.BaskinML,HerbeyI,WilliamsR,ArdJD,IvankovaN,Odoms-YoungA.CaregiverperceptionsofthefoodmarketingenvironmentofAfrican-American311-year-olds:aqualitativestudy.PublicHealthNutr.2013;16(12):223126.DembekC,HarrisJ,SchwartzM.Trendsintelevisionfoodadver-tisingtoyoungpeople:2011update.NewHaven,CT:YaleRuddCenterforFoodPolicy&Obesity;2012.27.PowellL,SchermbeckR,SzczypkaG,ChaloupkaF.Children'sexposuretofoodandbeverageadvertisingontelevision:Trackingcaloriessandnutritionalcontentbycompanymembershipinself-regulation.In:WilliamsJ,PaschK,CollinsC,editors.Advancesincommunicationresearchtoreducechildhoodobesity.NewYork:Springer;2013.p.17994.28.PowellLM,SchermbeckRM,SzczypkaG,ChaloupkaFJ,BraunschweigCL.TrendsinthenutritionalcontentoftelevisionfoodadvertisementsseenbychildrenintheUnitedStates:analysesbyage,foodcategories,andcompanies.ArchPediatrAdolescMed.2011;165(12):107886.29.LoDolceM,HarrisJ,SchwartzM.Sugaraspartofabalancedbreakfast?Whatcerealadvertisementsteachchildrenabouthealthyeating.JHealthCommunnIntPerspect;0:1-17.201330.SpeersSE,HarrisJL,SchwartzMB.Childandadolescentexposuretofoodandbeveragebrandappearancesduringprime-timetelevi-sionprogramming.AmJPrevMed.2011;41(3):29131.JenkinG,MadhvaniN,SignalL,BowersS.Asystematicreviewofpersuasivemarketingtechniquestopromotefoodtochildrenontelevision.ObesRev.2014;15(4):28193.32.CastonguayJ,KunkelD,WrightP,DuffC.Healthycharacters?Aninvestigationofmarketingpracticesinchildren'sfoodadvertising.JNutrEducBehav.2013;45(6):57133.CastonguayJ,McKinleyC,KunkelD.Health-relatedmessagesinfoodadvertisementstargetingchildren.HealthEduc.2013;113(5):42032.34.BraggMA,LiuP,RobertoC,SardaV,HarrisJ,BrownellK.Theuseofsportsreferencesinmarketingoffoodandbeverageproductsinsupermarkets.PublicHealthNutr.2012;16(4):73842.35.RosemanM,PoorM,StephensonT.Acontentanalysisoffoodreferencesintelevisionprogrammingspecificallytargetingyoungaudiencesaged11to14years.JNutrEducBehav.2014;46(1):2036.HudsonS,ElliotC.Measuringtheimpactofproductplacementonchildrenusingdigitalbrandintegration.JFoodProdMark.2013;19(3):176200.37.HarrisJ,SardaV,SchwartzM,BrownellK.Redefining"child-directedadvertising"toreduceunhealthytelevisionfoodadvertis-ing.AmJPrevMed.2013;44(4):35864.38.BernhardtA,WilkingC,Adachi-MejiaA,BergaminiE,MartijnissenJ,SargentJ.Howtelevisionfastfoodmarketingaimedatchildrencompareswithadultadvertisements.PLoSONE.2013;8(8):e72479.39.BernhardtAM,WilkingC,GottliebM,EmondJ,SargentJD.CHildrensreactiontodepictionsofhealthyfoodsinfast-foodtelevisionadvertisements.JAMAPediatr.2014.doi:10.1001/jamapediatrics.2014.14040.PowellL,SchermbeckR,ChaloupkaF.Nutritionalcontentoffoodandbeverageproductsintelevisionadvertisementsseenonchil-dren'sprogramming.ChildObes.2013;9(6):52431.41.HarrisJL,HeardA,SchwartzMB.Olderbutstillvulnerable:Allchildrenneedprotectionfromunhealthyfoodmarketing.NewHaven,CT:YaleRuddCenterforFoodPolicy&Obesity;2014.42.McClureA,TanskiS,Gilbert-DiamondD,Adachi-MejiaA,LiZ,LiZ,etal.Receptivitytotelevisionfast-foodrestaurantmarketingandobesityamongUSyouth.AmJPrevMed.2013;45(5):56043.MontgomeryK,ChesterJ.Digitalfoodmarketingtochildrenandadolescents:problematicpracticesandpolicyinterventions.NationalPolicy&LegalAnalysisNetworktoPreventChildhoodObesity(NPLAN):Oakland.201144.MaddenM,LenhartA,DugganM,CortesiS,GasserU.Teensandtechnology2013.Washington,D.C.:PewInternet&AmericanLifeProject;2013.45.GrierSA.AfricanAmericanandHispanicyouthvulnerabilitytotargetmarketing:implicationsforunderstandingtheeffectsofdig-italmarketing.In:SecondNPLAN/BMSGMeetingonDigitalMediaandMarketingtoChildren.Berkeley,CA:BerkeleyMediaStudiesGroup;2009.46.MontgomeryKC,ChesterJ.TheDigitalFoodMarketingLandscape:ChallengesforResearchers.In:AdvancesinCommunicationResearchtoReduceChildhoodObesity:Springer;2013.p.221-242.47.HarrisJL,SpeersSE,SchwartzMB,BrownellKD.USfoodcom-panybrandedadvergamesontheinternet:children'sexposureandeffectsonsnackconsumption.JChildMedia.2012;6(1):5168.48.Mashable.Howthe10mostpopularFacebookbrandsrankbyengagement.In:Mashable;2011.49.PostW.ClarksaysCoca-Colausessocialmediaformarketing.In.Washington,D.C:WashingtonPost;2011.50.HarrisJL,SchwartzMB,BrownellKD,SardaV,UstjanauskasA,JavadizadehJ,etal.FastfoodFACTS:Evaluatingfastfoodnutri-tionandmarketingtoyouth.NewHaven,CT:YaleRuddCenterforFoodPolicy&Obesity;2010.51.CampbellA.AComplaintandRequestforInvestigationofPepsiCo'sandFritoLay'sDeceptivePracticesinMarketingDoritostoAdolescents.Washington,D.C.:InstituteforPublicRepresentationGeorgetownUniversitySchoolofLawCenter;2011.52.GraffS,KunkelD,MerminSE.GovernmentCanRegulateFoodAdvertisingToChildrenBecauseCognitiveResearchShowsThatItIsInherentlyMisleading.HealthAff.2012;31(2):39253.HarrisJL,GraffSK.ProtectingYoungPeopleFromJunkFoodAdvertising:ImplicationsofPsychologicalResearchforFirstAmendmentLaw.AmJPublicHealth.2012;102(2):21422.54.vanReijmersdalEA,RozendaalE,BuijzenM.EffectsofProminence,Involvement,andPersuasionKnowledgeonChildren'sCognitiveandAffectiveResponsestoAdvergames.JInteractMark.2012;26(1):3342.55.ThomsonDM.ThemixedhealthmessagesofMillsberry:acriticalstudyofonlinechild-targetedfoodadvergaming.HealthCommun.2011;26(4):32331.56.PaekH-J,QuilliamET,KimS,WeatherspoonLJ,RifonNJ,LeeM.Characteristicsoffoodadvergamesthatreachchildrenandthenutrientqualityofthefoodstheyadvertise.InternetRes.2014;24(1):6381.57.WeatherspoonLJ,QuilliamET,PaekH-J,KimS,VenkateshS,PlasenciaJ,etal.PeerReviewed:ConsistencyofNutritionRecommendationsforFoodsMarketedtoChildrenintheUnitedStates,20092010.Preventingchronicdisease;10.201358.LascuD-N,ManraiAK,ManraiLA,AmissahFB.Onlinemarket-ingoffoodproductstochildren:theeffectsofnationalconsumerpoliciesinhigh-incomecountries.YoungConsumers:InsightandIdeasforResponsibleMarketers;14(1):19-40.2013.59.FolkvordF,AnschützDJ,BuijzenM,ValkenburgPM.Theeffectofplayingadvergamesthatpromoteenergy-densesnacksorfruitonactualfoodintakeamongchildren.AmJClinNutr.2013;97(2):23945.60.RozendaalE,SlotN,vanReijmersdalEA,BuijzenM.Children'sResponsestoAdvertisinginSocialGames.JAdvert.2013;42(23):14254. CurrObesRep 61.PanicK,CaubergheV,DePelsmackerP.ComparingTVAdsandAdvergamesTargetingChildren:TheImpactofPersuasionKnowledgeonBehavioralResponses.JAdvert.2013;42(226473.62.OwenL,LewisC,AutyS,BuijzenM.IsChildren'sUnderstandingofNontraditionalAdvertisingComparabletoTheirUnderstandingofTelevisionAdvertising?JPublicPolicyMark.2013;32(2):195206.63.Grigsby-ToussaintDS,RooneyMR.FoodMarketingTargetingYouthandFamilies:WhatDoWeKnowaboutStoresWhereMomsActuallyShop?JEnvironPublicHealth.2013.doi:1155/2013/67418164.LapierreM,YaalaS,LinebargerD.Influenceoflicensedspokescharactersandhealthcuesonchildren'sratingsofcerealtaste.ArchPediatrAdolescMed.2011;1(165):22934.65.HarrisJL,ThompsonJM,SchwartzMB,BrownellKD.Nutrition-relatedclaimsonchildren'scereals:whatdotheymeantoparentsanddotheyinfluencewillingnesstobuy?PublicHealthNutrition;1(1):1-6.66.MillerEG,SeidersK,KennyM,WalshME.Children'suseofonpackagenutritionalclaiminformation.JConsumBehav.2011;10(3):12232.67.KolishE,HernandezMD,BlanchardK.(2011).TheChildren'sFoodandBeverageAdvertisingInitiativeinaction:Complianceandimplementationduring2010andfiveyearretrospective2006-2011.Availableat:http://www.bbb.org/storage/16/documents/cfbai/cfbai-2010-progress-report.pdf.AccessedFebruary4,2014.68.TanA,MusicusA,WansinkB.EyesintheAisles:WhyIsCapCrunchLookingDownatMyChild.In:SocialScienceResearchNetwork;2014.69.FreijM,SellR,BozackA,WeissL,GarciaA.Modelingpotentialeffectsofreducedcaloriesinkids'mealswithtoygiveaways.ChildObes.2014;10(1):5863.70.OttenJJ,HeklerEB,KrukowskiRA,BumanMP,SaelensBE,GardnerCD,etal.Foodmarketingtochildrenthroughtoys:re-sponseofrestaurantstothefirstU.S.toyordinance.AmJPrevMed.2012;42(1):5660.71.Terry-McElrathYM,TurnerL,SandovalA,JohnstonLD,ChaloupkaFJ.CommercialisminUSElementaryandSecondarySchoolNutritionEnvironments:TrendsFrom2007to2012.JAMAPediatr.2014.doi:10.1001/jamapediatrics.2013.452172.SchneiderL,SchermbeckRM,ChriquiJF,ChaloupkaF.Theextenttowhichschooldistrictcompetitivefoodandbeveragepoliciesalignwiththe2010dietaryguidelinesforAmericans:Implicationsforfederalregulations.JAcadNutrDiet.2012;112:89273.PaschKE,LytleLA,SamuelsonAC,FarbakhshK,KubikMY,PatnodeCD.Areschoolvendingmachinesloadedwithcaloriesandfat:anassessmentof106middleandhighschools.JSchHealth.2011;81(4):21274.TurnerL,ChaloupkaFJ.Wideavailabilityofhigh-caloriebeveragesinUSelementaryschools.ArchPediatrAdolescMed.2011;165(3):22375.Terry-McElrathY,TurnerL,SandovalA,JohnstonL,ChaloupkaF.CommercialisminUSelementaryandsecondaryschoolnutritionenvironments:Trendsfrom2007-2012.JAMAPediatr.2014;168(3):23442.76.TurnerL,ChaloupkaF,SandovalA.SchoolPoliciesandPracticesforImprovingChildren'sHealth:NationalElementarySchoolSurveyResults:Schoolyears2006-07through2009-10.Chicago,IL:BridgingtheGapProgram,HealthPolicyCenter,InstituteforHealthResearchandPolicy,UniversityofIllinoisatChicago;2012.77.PewCharitableTrusts.HealthImpactAssessment:NationalNutritionStandardsforSnackandalaCarteFoodsandBeveragesSoldinSchools.Washington,D.C.:PewCharitableTrusts;2012.78.WalkerR,BlockJ,KawachiI.TheSpatialAccessibilityofFastfoodRestaurantsandConvenienceStoresinRelationtoNeighborhoodSchools.AppliedSpatialAnalysisandPolicy:1-14.2013.79.AdvertisingAge.100leadingnationaladvertisers.In:2007MarketerProfilesYearbook;2007.80.PaschK,PoulosN.Outdoorfoodandbeverageadvertising:Asaturatedenvironment.In:WilliamsJ,PaschK,CollinsC,editors.Advancesincommunicationresearchtoreducechildhoodobesity.NewYork:Springer;2013.p.30315.81.HealthyStoresHealthyCommunities.HealthyStoresforaHealthyCommunity.In;2014.82.LamichaneA,WarrenJ,PuettR,PorterD,BottaiM,Mayer-DavisE,etal.Spatialpatterningofsupermarketsandfastfoodoutletswithrespecttoneighborhoodcharacteristics.HealthPlace.2013;23:15764.83.ReitzelLR,ReganSD,NguyenN,CromleyEK,StrongLL,WetterDW,etal.DensityandProximityofFastFoodRestaurantsandBodyMassIndexAmongAfricanAmericans.AmJPublicHealth.2013;104(1):11084.Carroll-ScottA,Gilstad-HaydenK,RosenthalL,PetersSM,McCaslinC,JoyceR,etal.DisentanglingNeighborhoodContextualAssociationswithChildBodyMassIndex,DietandPhysicalActivity:TheRoleofBuilt,Socioeconomic,andSocialEnvironments.SocSciMed.2013;95:10614.85.BabeyS,WolsteinJ,DiamantA.Foodenvironmentsnearhomeandschoolrelatedtoconsumptionofsodaandfastfood.LosAngeles,CA:UCLACenterforHealthPolicyResearch;2011.86.BaderMD,Schwartz-SoicherO,JackD,WeissCC,RichardsCA,QuinnJW,etal.MoreneighborhoodretailassociatedwithlowerobesityamongNewYorkCitypublichighschoolstudents.HealthPlace.2013;23:10410.87.BergeJM,WallM,LarsonN,ForsythA,BauerKW,Neumark-SztainerD.Youthdietaryintakeandweightstatus:Healthfulneigh-borhoodfoodenvironmentsenhancetheprotectiveroleofsupport-ivefamilyhomeenvironments.HealthPlace.2014;26:6977.88.BruceAS,BruceJM,BlackWR,LeppingRJ,HenryJM,CherryJB,etal.Brandingandachild'sbrain:anfMRIstudyofneuralresponsestologos.SocCognAffectNeurosci.2014;9(1):11822.89.GearhardtAN,YokumS,SticeE,HarrisJL,BrownellKD.Relationofobesitytoneuralactivationinresponsetofoodcommercials.SocialCognitiveandAffectiveNeuroscience:nst059.201390.BurgerKS,SticeE.Neuralresponsivityduringsoftdrinkintake,anticipation,andadvertisementexposureinhabituallyconsumingyouth.Obesity.2013;22(2):44150.91.BruceAS,LeppingRJ,BruceJM,CherryJBC,MartinLE,DavisAM,etal.BrainResponsestoFoodLogosinObeseandHealthyWeightChildren.JPediatr.2013;162(4):759764.e2.92.KolishE.TheChildrensFood&BeverageAdvertisingInitiativeWhitePaperonCFBAIsUniformNutritionCriteria.In.Washington,D.C.:CounciloftheBetterBusinessBureaus,Inc.;2011.93.NationalRestaurantAssociation.KidsLiveWell.HealthyChoices.HappyKids.In.Washington,D.C.:NationalRestaurantAssociation.2011.94.BlackPRWire.McDonaldsUSAsnewHappyMealcampaigntoengagefamiliesinthebenefitsofactiveplay,balancedeating.In:BlackPRWire;2011.95.PestanoP,YeshuaE.SugarinChildrensCereals:PopularBrandsPackMoreSugarthanSnackCakesandCookies.Washington,D.C.:EnvironmentalWorkingGroup;2011.96.WatzmanN.Foodandmediacompanieslobbytoweakenguide-linesonmarketingfoodtochildren.In.Washington,D.C.:SunlightFoundationReportingGroup;2011.97.VladeckD.PreparedStatementoftheFederalTradeCommissionontheInteragencyWorkingGroupinFoodMarketedtoChildrenbeforetheHouseEnergyandCommerceCommitteeSubcommitteeonCommerce,Manufacturing,andTradeandtheSubcommitteeon CurrObesRep Health.In.Washington,D.C.:UnitedStatesHouseofRepresentatives;2011.98.ElBoghadadyD.Lawmakerswantcost-benefitanalysisonchildfoodmarketingrestrictions.In.Washington,D.C.:WashingtonPost;2011.99.OttenJJ,HeklerEB,KrukowskiRA,BumanMP,SaelensBE,GardnerCD,etal.Foodmarketingtochildrenthroughtoys:ResponseofrestaurantstothefirstUStoyordinance.AmJPrevMed.2012;42(1):5660.100.CradockAL,McHughA,Mont-FergusonH,GrantL,BarrettJL,WangYC,etal.Effectofschooldistrictpolicychangeonconsumptionofsugar-sweetenedbeveragesamonghighschoolstudents,Boston,Massachusetts,2004-2006.PrevChronicDis.2011;8(4):A74.101.TaberDR,ChriquiJF,PowellLM,ChaloupkaFJ.Banningallsugar-sweetenedbeveragesinmiddleschools:reductionofin-schoolaccessandpurchasingbutnotoverallconsumption.ArchPediatrAdolescMed.2012;166(3):25662.102.LiuPJ,WisdomJ,RobertoCA,LiuLJ,UbelPA.UsingBehavioralEconomicstoDesignMoreEffectiveFoodPoliciestoAddressObesity.AppliedEconomicPerspectivesandPolicy.Availableat:nals.org/content/early/2013/10/02/aepp.ppt027.abstract.AccessedOctober2,2013.103.UnitedStatesDepartmentofAgriculture.LocalSchoolWellnessPolicyImplementationUndertheHealthy,Hunger-FreeKidsActof2010.In.Washington,D.C.:UnitedStatesDepartmentofAgriculture;2013.104.CairnsG.Evolutionsinfoodmarketing,quantifyingtheimpact,andpolicyimplications.Appetite.2013;62:194105.U.S.DepartmentofAgricultureandU.S.DepartmentofHealthandHumanServices.DietaryGuidelinesforAmericans.7thed.Washington,D.C.:U.S.GovernmentPrintingOffice;2010.106.NationalInstitutesofHealthOfficeofDietarySupplements.DailyValues.In;2014.107.StallingsVA,YaktineAL,editors.NutritionStandardsforFoodsinSchools:LeadingtheWaytowardHealthierYouth.Washington,D.C.:NationalAcademiesPress;2007.108.GearhardtA,RobertsM,AsheM.IfSugarIsAddictiveWhatDoesItMeanfortheLaw?JLawMedEthics.2013;41:46109.SchwarteL,LafleurM,WilliamsJD.TargetedMarketingofJunkFoodtoEthnicMinorityYouth:FightingBackwithLegalAdvocacyandCommunityEngagement.In:WilliamsJD,PaschKE,CollinsCA,editors.AdvancesinCommunicationResearchtoReduceChildhoodObesity:Springer;2013.p.389-405.110.CalvertSL.BradleyJ.Bond,MelissaN.Richards,Calvert,SandraL.In:LemishD,editor.TheRoutledgeInternationalHandbookofChildren,Adolescents,andMedia:Taylor&Francis;2013.p.232.111.BladesM,OatesC,LiS.ChildrensrecognitionofadvertisementsontelevisionandonWebpages.Appetite.2013;62:190112.MontgomeryKC,GrierSA,ChesterJ,DorfmanL.FoodMarketingintheDigitalAge:AConceptualFrameworkandAgendaforResearch.Princeton,NJ:RobertWoodJohnsonFoundation;2011.113.JacksonM,HarrisonP,SwinburnB,LawrenceM.Unhealthyfood,integratedmarketingcommunicationandpower:acriticalanalysis.CritPublicHealth:1-18.2014114.ZmudaN.NewPepsiDewmocracyPushThreatenstoCrowdOutShops.In:AdAge;2009.115.ConnellPM,BrucksM,NielsenJH.HowChildhoodAdvertisingExposureCanCreateBiasedProductEvaluationsThatPersistintoAdulthood.JConsumRes;41(June2014).116.GearhardtAN,BrownellKD.TheImportanceofUnderstandingtheImpactofChildren'sFoodMarketingontheBrain.JPediatr.2013;163(4):672117.SwinburnB,SacksG,VandevijvereS,KumanyikaS,LobsteinT,NealB,etal.INFORMAS(InternationalNetworkforFoodandObesity/noncommunicablediseasesResearch,MonitoringandActionSupport):overviewandkeyprinciples.ObesRev.2013;14(S1):112.118.SacksG,SwinburnB,KraakV,DownsS,WalkerC,BarqueraS,etal.Aproposedapproachtomonitorprivatesectorpoliciesandpracticesrelatedtofoodenvironments,obesityandnoncommuni-cablediseaseprevention.ObesRev.2013;14(S1):3848.119.HarrisJL,WeinbergM,JavadizadehJ,SardaV.MonitoringFoodCompanyMarketingtoChildrentoSpotlightBestandWorstPractices.In:WilliamsJD,PaschKE,CollinsCA,editors.AdvancesinCommunicationResearchtoReduceChildhoodObesity:Springer;2013.p.153-175.120.HarrisJL,GraffSK.Protectingchildrenfromharmfulfoodmarket-ing:optionsforlocalgovernmenttomakeadifference.PrevChronicDis.2011;8(5):A92. CurrObesRep