Television Advertising and Children's Diet Activity and Obesity Prevalence

描述（由申请人提供）：不良饮食、不活动和肥胖与许多慢性疾病（包括癌症和心血管疾病）的风险增加有关。儿童中存在的肥胖和相关健康风险因素可能会持续到成年。这项研究将调查电视广告中的食品、饮料、餐馆和公共服务健康饮食和体育活动（HDPA）健康促进信息与儿童和青少年的饮食、体育活动、身体质量指数（BMI）和肥胖之间的关系。绝大多数（97.8%）美国儿童在电视上看到的食品广告营养成分很差，糖、脂肪或钠含量很高。大多数研究评估广告的影响是基于1）看电视时间与不良饮食和/或肥胖相关的证据;或2）小规模的自然实验，这些实验集中在食物要求或有限的特定食物选择上，这些食物选择可能具有较低的外部有效性。拟议的项目将在很大程度上建立在以前的文献基础上。具体目标有三个方面：1）研究食品、饮料和餐馆广告的曝光率（通过使用年龄和种族特定评级的广告的总产品曝光率和营养含量来衡量）与儿童和青少年的饮食摄入模式（即，特定食物产品/组的消费和远离家的食物（包括快餐），饮食质量（即，总热量摄入、饮食中的%脂肪和%糖以及总体健康饮食指数）、BMI和肥胖; 2）检查暴露于HDPA健康促进广告与饮食、身体活动、BMI和肥胖之间的关系;以及3）检查食物相关和HDPA健康促进广告与邻近环境因素（即，食品价格和餐馆、食品商店和与身体活动相关的商店可用性）和饮食、活动和BMI/肥胖。为了实现这些目标，拟议的研究将进行二次数据分析，使用四种类型的数据的独特组合：1）从尼尔森媒体研究公司购买的106个指定媒体市场的所有食品，饮料，餐馆和减肥广告的电视年龄和种族特定收视率数据; 2）关于广告食品的详细营养成分信息，3）关于食品价格和出口密度测量的本地区域背景数据; 4）来自全国健康和营养检查调查和儿童早期纵向研究的人口饮食摄入量、身体活动以及测量的身高和体重数据，这两项调查具有全国代表性，其中一项是纵向调查。该项目代表了迄今为止对食品、饮料、餐馆和HDPA健康促进广告与饮食、活动和BMI之间关系的最全面探索。鉴于不良饮食、不活动和肥胖造成的严重公共健康风险，这项研究可以为政策制定者和公共健康倡导者提供重要信息，说明规范儿童食品电视广告的潜在有效性，并利用电视媒体宣传作为改善这些健康结果的政策工具。 公共卫生相关性：该研究将使用市场水平的电视收视率数据和全国代表性的横截面和纵向人口数据，调查食品，饮料，餐馆和公共服务健康饮食和体育活动健康促进信息的电视广告与儿童和青少年的饮食，体育活动，体重指数和肥胖之间的关系。鉴于不良饮食、不活动和肥胖造成的严重公共健康风险，包括癌症和心血管疾病，这项研究可以为政策制定者和公共健康倡导者提供重要信息，说明规范儿童食品电视广告的潜在有效性，并利用电视媒体宣传作为改善这些健康结果的政策工具。

DESCRIPTION (provided by applicant): Poor diet, inactivity and obesity have been linked to increased risks for a number of chronic diseases including cancer and cardiovascular diseases. Obesity and related health risk factors present in children are likely to persist into adulthood. The proposed research will investigate the relationships between televised advertisements for food, beverages, restaurants, and public service healthy diet and physical activity (HDPA) health promotion messages, and diet, physical activity, body mass index (BMI) and obesity among children and youth. The overwhelming majority (97.8%) of food product ads seen on television by American children are of poor nutritional content, being high in either sugar, fat or sodium. Most research has assessed the effect of advertising based on 1) evidence that TV watching time correlates with poor diet and/or obesity; or, 2) small- scale natural experiments that have focused on food requests or limited specific food choices which may have low external validity. The proposed project will build substantially on the previous literature. The specific aims are threefold: 1) examine the relationship between exposure to food, beverage and restaurant advertising (measured by total product exposure and nutritional content of ads using age and race-specific ratings) and children's and youths' dietary intake patterns (i.e., consumption of specific food products/groups and food away from home including fast food), diet quality (i.e., total caloric intake, % fat and % sugar in diet and overall healthy eating index), BMI and obesity; 2) examine the relationship between exposure to HDPA health promotion ads and diet, physical activity, BMI and obesity; and 3) examine the interactions between food- related and HDPA health promotion ads and neighborhood contextual factors (i.e., food prices and restaurant, food store, and physical activity-related outlet availability) and diet, activity and BMI/obesity. To accomplish these aims, the proposed research will conduct secondary data analyses, using a unique combination of four types of data: 1) television age- and race-specific ratings data for all food, beverage, restaurant, and anti- obesity advertisements, purchased from Nielsen Media Research for 106 designated media markets; 2) detailed nutritional content information about the advertised food products, 3) local area contextual data on food prices and outlet density measures; 4) data on population dietary intake, physical activity and measured height and weight from the National Health and Nutrition Examination Survey and the Early Childhood Longitudinal Study, two nationally representative population surveys one of which is longitudinal. The proposed project represents the most comprehensive exploration to date of the relationship between food, beverage, restaurant and HDPA health promotion advertising and diet, activity and BMI. Given the serious public health risk posed by poor diet, inactivity and obesity, this research can provide important information for policymakers and public health advocates about the potential effectiveness of regulating food television advertising to children and using TV media campaigns as policy tools for improving these health outcomes. PUBLIC HEALTH RELEVANCE: The proposed research will investigate the relationships between televised advertisements for food, beverages, restaurants, and public service healthy diet and physical activity health promotion messages, and diet, physical activity, body mass index and obesity among children and youth using market-level television ratings data and nationally representative cross-sectional and longitudinal population data. Given the serious public health risks including cancer and cardiovascular diseases posed by poor diet, inactivity and obesity, this research can provide important information for policymakers and public health advocates about the potential effectiveness of regulating food television advertising to children and using TV media campaigns as policy tools for improving these health outcomes.