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Trends in exposure to television food advertisements in South Korea
Appetite 62 (2013) 225–231
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Research report
Trends in exposure to television food advertisements in South Korea q Euna Han a, Lisa M. Powell b, Tae Hyun Kim c,⇑ a
College of Pharmacy, Gachon Institute of Pharmaceutical Sciences, Gachon University, Yeonsu-Dong, Teonsu-Gu, 406-799 Incheon, South Korea Health Policy and Administration, School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Room 558, M/C 275, Chicago, IL 60608, USA c Graduate School of Public Health, Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, South Korea b
a r t i c l e
i n f o
Article history: Available online 26 October 2012 Keywords: TV food advertising Targeted ratings data South Korea
a b s t r a c t Given the increased concern about the impact of TV food advertisements (ads) on individual food choices, we provide important evidence on TV food ad exposure between 2004 and 2009 in South Korea. We used monthly targeted ratings data by age group as the number of ads seen daily from Korean Nielsen Media Research. We generated six food groups: beverages (milk, soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and other); snacks/sweets (cookies/chips, candy, and chewing gum); fast food (Domino’s pizza, Lotteria, McDonald’s, Mr. Pizza, Pizza Hut, local chicken and pizza franchises, and other); instant noodle; full-service restaurants; and other. From 2004 to 2009, overall exposure to television food ads fell by 19.0% (from 6.8 to 5.5 ads daily), although exposure to full-service restaurant ads increased over that time period by 45.7%. While fast-food ad exposure fell overall, exposure to ads for local fried chicken franchises nearly doubled, making them the most commonly seen fast-food ads by 2009. Fast-food and instant noodle ads made up larger proportions of total ad exposure in 2009 than in 2004 in all age groups, with the largest increase among adolescents. Beverage ads continue to be the most prevalent food ads seen in South Korea. Differential trends found in exposure across and within food product categories and differences by age groups highlight the need for continued monitoring to help inform the regulatory policy debate on food advertising, particularly with regards to ads directed at children and adolescents. Ó 2012 Elsevier Ltd. All rights reserved.
Introduction Obesity prevalence has increased notably around the globe not only in developed countries but also in developing countries (Caballero, 2007; Wang, Monteiro, & Popkin, 2002). In the US, where the incidence of obesity has been the largest among OECD countries (Brunello, Michaud, & Sanz-de-Galdeano, 2009), more than one third of adults were estimated to be obese in 2009–2010 (Flegal, Carroll, Kit, & Ogden, 2012). The prevalence of obesity in South Korea (hereafter interchangeably called Korea) has also risen recently, particularly among the young population. Among adults, the prevalence of overweight (BMI P 25 kg/m2) reached 31.7% in 2007, up from 29.2% in 2005 and 26.0% in 1998 in Korea. For all children and adolescents less than 20 years of age, the prevalence of obesity in Korea was 10.9% in 2007, up from 5.8% in 1997 (Ministry of Health, 2009). Obesity is a well-known risk factor for various chronic health diseases such as cardiovascular disease, diabetes, and some types of cancer (US Department of Health, 2001), and even for higher mortalq Acknowledgements: We gratefully acknowledge research support from the Korea National Research Foundation (NRF-2012007096). The content is solely the responsibility of the authors and does not necessarily represent the official view of the Korea National Research Foundation. ⇑ Corresponding author. E-mail address: [email protected] (T.H. Kim).
0195-6663/$ - see front matter Ó 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.appet.2012.10.015
ity (Jee et al., 2006). Understanding individual and contextual factors associated with the increase in obesity, therefore, has been one of the key interests in the academic and policy arenas. Behavioral patterns related to body weight have shifted toward being more ‘‘obesogenic’’. Previous literature outside Korea reported an excess consumption of fat, sugar and sodium and less than recommended intake of fruits, vegetables, and micronutrients particularly among children (Wells, Cole, Bruner, & Treleaven, 2008; Fox, Condon, Briefel, Reidy, & Deming, 2010). Similar trends in food and nutrient consumption patterns have appeared in South Korea. Consumption of dietary fat and sugar was high, whereas fruit and vegetable consumption was low compared with dietary recommendations for Koreans (Korea Centers for Disease Control, 2006, 2010). The level of physical activity became lower at the same time with more screen time including traditional TV watching and a rapid dispersion of other media such as cable TV, internet, and online games over the same time period (Ah, Jeong, & Kim, 2010; Cho, Park, & Seo, 2009; Seo et al., 2008). Parallel to the increase in obesity prevalence and changes in individual behavioral patterns promoting obesity, environmental contextual factors including food advertising have been examined as modifiable sources that may impact individual behaviors with regards to obesity control. Also, public policy regulating advertising, particularly to children, has actively been debated in the US
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(IOM, 2006) and other developed countries (Hastings et al., 2003). The Korean government, too, has progressively enacted policies to help healthy food consumption since the late 2000s. Nutrition labeling has been newly required for all processed food products since September 2006. In addition, selling several ‘unhealthy’ foods, including coffee, carbonated drinks, instant noodles, and fast food in elementary (for 7–12 years of age), junior (for 13–15 years of age), and senior high schools (for 16–18 years of age) has been banned since 2008 in South Korea (Moon, 2009). Further, TV advertisements (ads) for specified foods, including large national fastfood franchises, candy, snacks, and instant noodles, have been banned during 5–7 pm, typical prime time for children, since 2010 (KFDA, 2010). However, no voluntary pledges from the food industry to further restrict the type of food ads promoted to children have accompanied to such governmental efforts, whereas by comparison, in the US there is a self-regulatory initiative to reduce children’s exposure to unhealthy food and beverage ads but no formal restrictions in place (Powell, Schermbeck, Szczypka, Chaloupka, & Braunschweig, 2011). TV ads are an important medium for promotion of food products in Korea. Advertising and marketing by the food, beverage and restaurant industry was estimated to be $165 million in 2007, of which about $54 million was for television ads (Advertising Information Center, 2008; Korea Broadcast Advertising Corporation, 2009). Adolescents in Korea spent 15.9 and 13.7 hour, on average, for TV watching and internet use, respectively, per week in 2006. The daily TV watching time among adolescents was 1.76 hour per day, on average, in 2006, which remained relatively unchanged from 1.99 hour per day in 2002 despite a rapid increase of the exposure to other media such as internet (Park, 2008). Korean adults spent 2 hour and 57 min per day, on average, watching TV with slightly longer hours among women than men in 2010 (TNS Media Korea, 2011). Previous literature has reported the extensive presence of food advertising on TV particularly on children’s programming. Studies using ratings data as an estimate of the number of people exposed to the ads have reported that food ads comprised 22–42% among all products advertising in the US (Harrison & Marske, 2005; Connor, 2006; Gantz, Schwartz, Angelini, & Rideout, 2007; Holt, Ippolito, Desrochers, & Kelley, 2007; Powell, Szczypka, & Chaloupka, 2007). Traditionally, cereals and sweets/snacks have been reported as the most frequently advertised food products for children composing 28–49% and 21–34% of all food advertising on TV, respectively, in the US (Condry, Bence, & Scheibe, 1988; Cotugna, 1988; Gamble & Cotugna, 1999; Kotz & Story, 1994; Powell et al., 2007; Taras & Gage, 1995). However, more recent evidence showed that fast-food ads are now the most frequently seen food ads (Powell, Szczypka, & Chaloupka, 2010; Powell et al., 2011) among children in the US. In Korea, beverages were the most frequently advertised food category (22.6% of the total TV ads), followed by franchise restaurants selling non-Asian food (16.6%), candy and snack (15.9%), instant or premade food (9.9%), dairy (8.7%), and fruit or vegetables juice products (7.2%) in 2008 (Moon, 2009). Building on the previous literature, this study examined changes in the extent of exposure to food advertising in Korea over 6 years between 2004 and 2009 using ratings data associated with each commercial advertised on TV, including analyses based on specific ratings by target age groups. Given the recent ban on TV advertisements for specific food groups in a limited time slot enacted in South Korea, our study can serve as a baseline for the pre-regulation landscape against which future post-regulation changes in food advertising exposure can be assessed.
food ads licensed from Nielsen Media Research in Korea. Nielsen Media Research collects its ratings data for TV ads in 13 designated market areas (DMAs) in Korea. A DMA consists of a group of administrative communities that comprise a major metropolitan area and surrounding geographic areas. DMAs are approximately equal to the largest public administrative communities in Korea, and DMAs do not overlap geographically. Television ratings data provide an estimate of people who watched a program (or an ad) out of total populations who belonged to sample households with a television over a specified time interval. That is, ratings data reflect actual exposure to an ad by counting sample persons who actually watched the ad. Ratings were measured both for a general audience and subgroups based on age. Nielsen Media Research assigns each product ad a product classification code that identifies it with a product category. Based on those classification codes, we generated six mutually exclusive food product categories including: (1) beverages; (2) snacks/ sweets; (3) fast food; (4) instant noodles; (5) full-service restaurants; and, (6) other foods. We examined the distribution of exposure to food advertising by those six food product categories. Beverages and snacks/sweets also were further classified with subgroups as follows: milk (both 100% soy and dairy milk), soda, fruit drinks (including any fruit-based drinks), sports/energy drinks, water, coffee/tea products, and other miscellaneous products for beverages; and, cookies/ chips, candy, and chewing gum for sweets/snacks. TV ads for water were prohibited in Korea until 2005, and thus, bottled water was included in this study since 2005. For fast-food products, we generated subgroups based on brand names as follows: Domino’s pizza; Lotteria (the largest domestic fast-food franchise in Korea, mainly selling hamburgers); McDonald’s; Mr. Pizza; Pizza Hut; local fast-food franchises mainly selling fried chicken products; local pizza franchises; and other miscellaneous fast food. Fast-food products were analyzed at the brand level given high initial exposure levels and substantial changes in exposure over time by brand as in previous studies (Powell et al., 2010). The level of exposure (as reported in the Tables) was measured as the average number of ads seen daily based on the total cumulated ratings per year. Ratings measure the percentage of households with televisions watching a program or an ad over a specified interval providing a measure of ad exposure. Total cumulated annual ratings were aggregated at the brand level and then categorized across food product categories to assess exposure for each category. We also calculated the proportion (%) of the daily number of ads seen for a specific food group out of the daily number of ads seen for all food products. Relative changes in the daily ad exposure between 2004 and 2009 also were calculated for each food product group. We examined the longitudinal time trend in exposure to TV ads of food products between 2004 and 2009 using general and specific ratings data based on subgroups of age including children (4– 12 years old), adolescents (13–19 years old), young adults (20– 34 years old), adults (35–64 years old), and elderly (65 years or older). We also disaggregated ratings data in each food group and assessed the proportions of subcategories within each of the six food groups across years between 2004 and 2009.
Methods
Table 1 shows the yearly trend of the level of exposure to food ads on TV, measured by the average number of TV ads seen daily by food group categories for six calendar years from 2004 to 2009. The level of exposure to TV food ads decreased during the
We assessed the time trend in the level of exposure to food ads on TV between 2004 and 2009 based on monthly ratings data of
Results Trends in exposure to TV food ads
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period overall except for full-service restaurants. Individuals saw 6.8 food ads, on average, on TV per day in 2004, which fell by 19.0% to 5.5 ads per day in 2009. Over this period, the number of ads seen for sweets/snacks reduced the most (by 60.6% from 1.0 to 0.4), followed by beverages (by 24.2% from 2.4 to 1.8) and instant noodles (by 16.5% from 0.5 to 0.4). On the contrary, the number of TV ads seen for full-service restaurants increased by 45.7% from 0.4 to 0.6 ads per day between 2004 and 2009. Among all food ads seen on TV, ads for beverages, fast food, sweets/snacks, and instant noodles made up 35.5%, 17.1%, 15.0%, and 7.5%, respectively, in 2004. By 2009, the proportions increased for fast food (to 19.4%) and instant noodles (to 7.7%), whereas those were fell slightly for beverages (to 33.3%) and fell by more than one half for sweets/snacks (to 7.3%). Trends in exposure to TV food ads by disaggregated food product category Further disaggregated results of ad trends for beverages, sweets/ snacks, and fast-food product categories are presented in Table 2. From 2004 to 2009, in the beverage category, exposure to TV ads for fruit drinks increased by 18.4% (from 0.3 to 0.4) despite the overall decrease in ad exposure for the whole beverage group. The amount of exposure to TV ads for milk fell the most in the beverage group for the same time period (by 47.5% from 0.7 to 0.4). For sweets/snacks, all the subcategories showed downward trends in the number of TV ads seen daily between 2004 and 2009 with the steepest drop among cookies/chips (by 72.8% from 0.5 to 0.1) and the least drop among chewing gum (by 9.3% from 0.11 to 0.10). For fast food, the number of TV ads seen daily increased slightly for Domino’s Pizza (by 11.4% from 0.08 to 0.09), almost doubled for local franchises selling chicken products (from 0.2 to 0.4), and more than doubled for Mr. Pizza (from 0.05 to 0.09) and local pizza franchises (from 0.02 to 0.06). In contrast, there was a large decrease in ad exposure for the two largest fast-food franchises, i.e., Lotteria (down by 65.3% from 0.3 to 0.1) and McDonald’s (down by 49.5% from 0.3 to 0.2) between 2004 and 2009. Trends in exposure to TV food ads by age group By age group, as shown in Table 3, the average number of TV ads seen for all food products except for full-service restaurants
dropped in all age groups. People in older age groups were exposed to more TV food ads in both 2004 and 2009 than those who were younger. The average number of TV ads seen daily for all food products dropped by almost one third between 2004 and 2009 for children (from 3.9 to 2.6), adolescents (from 4.3 to 2.8), and young adults (from 5.6 to 3.6), whereas the extent of the decrease was smaller for adults (by 19.3% from 6.9 to 5.6) and the elderly (by 16.6% from 7.8 to 6.5). The overall drop in exposure magnitude was mainly driven by sweets/snacks for which the exposure dropped by 63–73% across age groups. However, exposure to TV ads for full-service restaurants increased in all age groups with the largest extent among children (by 68.2% from 0.2 to 0.3) followed by elderly (by 67.7% from 0.5 to 0.9) and adults (by 33.9% from 0.6 to 0.7). In terms of the share of exposure, beverage ads made up the largest proportion among all TV food ads in both 2004 and 2009 in all age groups, which increased among children (from 29.6% to 34.3%) and adolescents (from 33.4% to 35.0%). The share for fast-food ads among all TV food ads was the next highest, which increased from 2004 to 2009 in all age groups particularly among adolescents (from 16.7% to 20.0%). The share for instant noodles and full-service restaurants also increased in all age groups. Daily exposure to TV ads for sweets/snacks fell by more than one half from 2004 to 2009 in all age groups. Trends in exposure to TV food ads by age group by disaggregated food product categories Table 4 shows changes in the daily exposure by viewers’ age group for disaggregated product categories. For beverages, the average number of TV ads seen daily for fruit drinks increased in all age groups with the largest increase among young adults (by 13.9% from 0.25 to 0.29) and the least increase among children (by 5.4% from 0.17 to 0.18). TV ads for water dramatically increased in all age groups although the absolute level of ads seen daily remained minimal. However, exposure to the most heavily advertised beverage in 2004, milk ads, dropped in all age groups particularly by more than a half among children (by 52.9% from 0.4 to 0.2), adolescents (by 58.0% from 0.4 to 0.2), and young adults (by 60.4% from 0.6 to 0.2) such that by 2009 exposure to fruit drink and sports/energy drink ads exceeded that of milk among children, adolescents and young adults. There were variations by age group
Table 1 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, all foods and by food product category. Food group
Daily number of ads watched
% change in ads/day seen 2004–2009
2004
2005
2006
2007
2008
2009
Beverage
2.411 (35.5)
2.247 (37.5)
2.128 (38.7)
1.906 (37.4)
1.570 (33.2)
1.828 (33.3)
24.2
Sweets/snacks
1.016 (15.0)
0.759 (12.7)
0.520 (9.4)
0.425 (8.3)
0.407 (8.6)
0.400 (7.3)
60.6
Fast food
1.157 (17.1)
0.948 (15.8)
0.858 (15.6)
0.750 (14.7)
0.921 (19.5)
1.067 (19.4)
7.8
Instant noodle
0.508 (7.5)
0.449 (7.5)
0.401 (7.3)
0.396 (7.8)
0.315 (6.7)
0.424 (7.7)
16.5
Full service restaurant
0.420 (6.2)
0.410 (6.8)
0.624 (11.3)
0.647 (12.7)
0.505 (10.7)
0.612 (11.1)
45.7
Other
1.273 (18.8)
1.183 (19.7)
0.972 (17.7)
0.971 (19.1)
1.002 (21.2)
1.164 (21.2)
8.6
Total
6.785 (100.0)
5.996 (100.0)
5.503 (100.0)
5.096 (100.0)
4.722 (100.0)
5.494 (100.0)
19.0
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each group and year. Numbers in parentheses are the distribution in % of each food category among the total number of daily TV ads watched in each year. Beverages included milk, soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and miscellaneous products. Snack and sweet products included cookies and chips, candy, and chewing gum and other. Fast-food products included Domino’s pizza, Lotteria (the largest local fast-food franchise in Korea), McDonald’s, Mr. Pizza, Pizza Hut, local fast food franchises mainly selling fried chicken products, local fast-food franchises mainly selling pizza, and other fast food. Totals may not add up exactly due to rounding. TV ads for water started in 2005.
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Table 2 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, by disaggregated product categories for beverages, sweets/snacks, and fast food. Food group
Daily number of advertisements watched
% change in ads/day seen 2004–2009
2004
2005
2006
2007
2008
2009
Beverage Milk Soda Fruit drinks Sports/energy drinks Coffee/tea products Water Other Total
0.685 0.271 0.316 0.482 0.245 N/A 0.413 2.411
0.481 0.257 0.436 0.449 0.231 0.004 0.388 2.247
0.394 0.272 0.534 0.385 0.228 0.007 0.310 2.128
0.289 0.123 0.578 0.424 0.195 0.036 0.260 1.906
0.334 0.192 0.346 0.289 0.126 0.155 0.129 1.570
0.360 0.182 0.374 0.340 0.208 0.088 0.278 1.828
47.45 32.84 18.35 29.46 15.10 2100.00 32.69 24.18
Sweets and snacks Cookies and chips Candy Chewing gum Other Total
0.492 0.286 0.108 0.131 1.016
0.391 0.254 0.098 0.018 0.759
0.274 0.173 0.065 0.008 0.520
0.214 0.142 0.071 0.000 0.425
0.137 0.195 0.025 0.049 0.407
0.134 0.124 0.098 0.045 0.400
72.76 56.64 9.26 65.65 60.63
Fast food Domino’s Pizza Lotteria McDonald’s Mr. Pizza Pizza Hut Local fried chicken franchises Local pizza franchises Other Total
0.079 0.251 0.374 0.045 0.148 0.215 0.024 0.021 1.157
0.066 0.198 0.253 0.049 0.096 0.225 0.039 0.023 0.948
0.079 0.102 0.278 0.075 0.085 0.182 0.031 0.027 0.858
0.052 0.070 0.167 0.064 0.104 0.231 0.028 0.033 0.750
0.078 0.061 0.152 0.079 0.152 0.308 0.063 0.028 0.921
0.088 0.087 0.189 0.090 0.144 0.396 0.060 0.014 1.067
11.39 65.34 49.47 100.00 2.70 84.19 150.00 33.33 7.78
Notes: Numbers presented in this table are the average number of TV advertisements watched daily seen associated with each food product and year. Totals may not add up exactly due to rounding. TV ads for water started in 2005. Ads for water were banned in Korea until 2005, and thus, no ad exposure was measured for water before 2005.
in the average number of TV ads seen daily for soda and coffee/tea products although the extent of the changes was minor for all age groups. For sweets/snacks, the magnitude of exposure was reduced in 2009 compared to 2004 in all subcategories across all age groups. Exposure to cookies/chips fell by approximately 80–90% in all age groups with the largest decrease among children. For fast food, the number of TV ads seen daily for local fried-chicken franchises increased by between 23.9% (among children from 0.18 to 0.22) and 61.1% (among adults from 0.2 to 0.3) across all age groups. Exposure to TV ads for local pizza franchises almost doubled among adolescents (from 0.02 to 0.03), young adults (from 0.02 to 0.03), and elderly (from 0.03 to 0.05), and increased less among adults (from 0.03 to 0.04), whereas it decreased only among children (from 0.02 to 0.01). Ads for Domino’s Pizza and Mr. Pizza also were seen more in 2009 than in 2004 in all age groups except for children for Mr. Pizza and young adults for Domino’s Pizza. Children were exposed to fewer ads for Lotteria (by 73.1% from 0.11 to 0.03) and McDonald’s (by 66.3% from 0.2 to 0.1) by the largest extent compared to other age groups (see Table 4). Discussion This study examined trends in the level of exposure to food ads measured by the number of TV ads seen daily using ratings data associated with food products spanning 2004–2009 licensed from Korean Nielsen Media Research. Given the serious public health risk posed by poor diet, inactivity, and obesity and increased concern about the impact of food ads on TV on individual food choices, our study provided important empirical evidence on changes in the magnitude of actual exposure to TV food ads. Further assessment of the targeted ratings by age group in this present study also provided information regarding differential exposure and the potential need for targeted policies by viewers’ age group. Our study showed that the overall level of exposure to TV food ads fell by 19.0% (from 6.8 to 5.5 ads per day) between 2004 and
2009. However, disaggregation revealed that exposure actually increased for full-service restaurants (by 45.7% from 0.4 to 0.6) and that there was only a modest decline in exposure to fast-food restaurant ads with large increases for some outlets (i.e. local fried chicken and pizza and Mr. Pizza and Domino’s) and large decreases for others (i.e. Lotteria and McDonald’s). The present results further showed that relative exposure to TV ads for high-calorie, lownutrient food products including fruit drinks, fast food, instant noodle, and local fast-food franchises (selling fried chickens and pizza) increased particularly among children and adolescents. The increasing trend in exposure to full-service restaurant ads on TV is noteworthy and warrants further examination and monitoring in future studies. Korea has experienced a rapid nutrition transition toward more westernized diets including food consumption outside of the home (Kim, Moon, & Popkin, 2000; Lee, Popkin, & Kim, 2002; Song, Joung, Engelhardt, Yoo, & Paik, 2005). Studies reported that the total market size for food-away-from-home consumption was estimated to have increased to $60 billion in 2009 from $48 billion in 2004 and $18 billion in the 1990s (Korea Food Consumption Information, 2011). Unfortunately, to our knowledge, no publicly available data dissect food-away-from-home consumption by full-service versus fast-food restaurant sources in Korea, and thus, we could not assess such consumption patterns. However, we can hypothesize that the increasing trend of overall food-away-from-home consumption might be associated with the increased exposure to full-service restaurant on TV, which should be explored in future studies. The average number of TV ads seen for fruit drinks increased by 5.4–11.7% across different age groups between 2004 and 2009 despite the decrease in the exposure to TV ads for beverage products overall. Exposure to TV ads for soda increased only among children by 18.8% although soda still remained as the least seen beverage ad type in 2009 other than water. These findings of increased exposure to soda and fruit drink ads between 2004 and 2009 in children are noteworthy given that they have been linked to lower nutrient consumption, increased body weight, and higher risk of obesity
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each food product group and year. Numbers in parentheses are the distribution in % of each food category among the total number of daily TV ads watched in each year. Beverages included milk, any soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and miscellaneous products. Snack and sweet products included cookies and chips, candy, and chewing gum and other. Fast-food products included Domino’s pizza, Lotteria (the largest local fast food franchise in Korea), McDonald’s, Mr. Pizza, Pizza Hut, local fast-food franchises mainly selling fried chicken products, local small fast food franchises mainly selling pizza, and other fast food. Children, adolescents, young adults, adults, and elderly were respectively defined as individuals aged 4–12, 13–19, 20–34, 35–64, and 65 years or older.
16.6 6.509 (100.0) 7.803 (100.0) 19.3 5.639 (100.0) 6.985 (100.0) 35.3 3.617 (100.0) 5.591 (100.0) 34.6 2.782 (100.0) 4.251 (100.0) 32.7 3.892 (100.0) Total
2.618 (100.0)
0.1 1.508 (23.2) 1.507 (19.3) 4.0 1.234 (21.9) 1.286 (18.4) 31.7 0.71 (19.6) 1.04 (18.6) 35.3 0.559 (20.1) 0.864 (20.3) 41.7 0.895 (23.0) Other
0.522 (19.9)
67.7 0.892 (13.7) 0.532 (6.8) 33.9 0.743 (13.2) 0.555 (7.9) 11.5 0.388 (10.7) 0.348 (6.2) 17.1 0.233 (8.4) 0.199 (4.7) 68.2 0.176 (4.5) Full-service restaurant
0.296 (11.3)
12.1 0.586 (9.0) 0.667 (8.5) 13.8 0.495 (8.8) 0.574 (8.2) 28.8 0.338 (9.3) 0.475 (8.5) 28.1 0.248 (8.9) 0.345 (8.1) 24.9 0.285 (7.3) Instant noodle
0.214 (8.2)
6.7 0.955 (14.7) 1.024 (13.1) 11.8 0.849 (15.1) 0.963 (13.8) 28.8 0.622 (17.2) 0.874 (15.6) 21.3 0.557 (20.0) 0.708 (16.7) 29.7 0.717 (18.4) Fast food
0.504 (19.3)
66.5 0.379 (5.8) 1.132 (14.5) 63.0 0.356 (6.3) 0.963 (13.8) 68.5 0.252 (7.0) 0.801 (14.3) 70.6 0.21 (7.5) 0.715 (16.8) 72.5 0.669 (17.2) Sweets and snacks
0.184 (7.0)
25.6 2.189 (33.6) 2.941 (37.7) 25.8 1.962 (34.8) 2.643 (37.8) 36.3 1.307 (36.1) 2.052 (36.7) 31.4 0.974 (35.0) 1.42 (33.4) 22.0 0.898 (34.3) 1.152 (29.6) Beverage
% change ads/day seen 2004–2009 2009 2004 % change ads/day seen 2004–2009 2009
Adults (35–64 years old)
2004 % change ads/day seen 2004–2009 2009
Young adults (20–34 years old)
2004 % change ads/day seen 2004–2009 2009
% change ads/day seen 2004–2009
2009
Adolescents (13–19 years old)
2004
Children (4–12 years old)
2004
Food group
Table 3 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, all foods and by food product category, by age group.
Elderly (65 years and older)
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(Block, 2004; CDC, 2006; Malik, Schulze, & Hu, 2006). Such increases among children are more alarming particularly when coupled with the decreased exposure to TV ads for milk over the same time period. Moving forward, further inquiry should be conducted to assess whether changes in consumption patterns have actually occurred parallel to the increases in TV ad exposure and the extent to which ad exposure has been associated with the actual beverage consumption. The proportion of the exposure to TV ads for instant noodle among all food ads increased between 2004 and 2009 particularly among children (from 7.3% to 8.2%) and adolescents (from 8.1% to 8.9%). Instant noodles, also known as ramen, are one of the most popular fast foods in Korea particularly among adolescents. Nearly 65% of adolescents were reported to consume instant noodles 1–3 times (servings) per week in 2005 (Ministry of Health, 2006). Koreans consumed instant noodles by a total of 3480 million packets (bags/cups) in 2009, up from a total of 3220 million packets in 2007 (World Instant Noodle Association, 2012). Korea was the world largest consumer of instant noodles, consuming approximately 75 bags/cups of instant noodles, on average, per year per capita in 2009 (World Instant Noodle Association, 2012). Instant noodles are a representative high-calorie-low-nutrient food with 381– 464 kcal per 100 g (approximately same as one bag/cup) with only 10 g of protein and containing almost no other nutrients (Korean Nutrition Society, 2005). Adolescent consumers of instant noodles compared to non-consumers showed significantly less intake of key nutrients such as calcium, niacin, and Vitamin C, and consumed significantly less vegetables, fruits, milk and other dairy products, whereas they consumed significantly more calories, fat, and sodium (Lee et al., 2009). Therefore, further targeted policy measures are needed to effectively control for ad exposure to instant noodles. There were large increases in the level of exposure to local fast-food franchises selling fried chicken and pizza products particularly among children. Pizza and fried chicken products are well-known fast food of which consumption has been linked to an increased body weight (French, Harnack, & Jeffery, 2000), an increased body mass index (Binkley, Eales, & Jekanowski, 2000), and a higher likelihood of being overweight (Bowman & Vinyard, 2004). Those local fast-food franchises were not included in the recent ban in Korea on TV advertisements from 5 to 7 pm for specified unhealthy foods which only included large national fast-food franchises, candy, snacks, and instant noodles (KFDA, 2010). Our results imply that continued monitoring and more scrutiny would be needed for public policies pertaining to TV fast-food ads, particularly for small local franchises. By using ratings data associated with each commercial on TV for food products spanning 6 years between 2004 and 2009, we were able to distinguish actual ad exposure rather than giving all ads an equal weight based simply on the airing of the commercial (Powell et al., 2007). Furthermore, we could assess variations in the absolute and relative levels of actual exposure to TV food ads among children and adolescents separately from adults and elderly by using targeted ratings data by age group. At the same time, we acknowledge that ratings data based on media market averages may not accurately reflect individual variations in exposure (Powell et al., 2007). Further, ratings data measure the level of exposure by the number of ads seen without accounting for variations in the extent of duration exposed to each ad. Nevertheless, previous literature has shown a high correlation between ratings and self-reported ad recall (Emery et al., 2005; Southwell, Barmada, Hornik, & Maklan, 2002; Wakefield et al., 2005), suggesting that greater potential exposure is associated with higher awareness and engagement with a TV ad. In light of the increased public concern regarding poor diet and consequential increased body weight and related health risks, our study provides important empirical evidence for policymakers and
4.0 63.6 36.9 75.0 19.6 50.2 84.6 56.5 0.078 0.068 0.161 0.091 0.127 0.371 0.048 0.010
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each food product group and year. TV ads for water started in 2005.
10.6 68.1 44.2 102.5 23.6 61.1 57.7 50.0 0.046 0.108 0.190 0.048 0.114 0.176 0.022 0.011 Fast food Domino’s Pizza Lotteria McDonald’s Mr. Pizza Pizza Hut Local fried chicken franchises Local pizza franchises Other
0.067 0.029 0.064 0.043 0.066 0.218 0.012 0.005
45.7 73.1 66.3 10.4 42.1 23.9 45.5 54.5
0.053 0.135 0.203 0.035 0.108 0.138 0.017 0.018
0.055 0.044 0.088 0.055 0.076 0.199 0.031 0.008
3.8 67.4 56.7 57.1 29.6 44.2 82.4 55.6
0.058 0.188 0.248 0.039 0.138 0.163 0.022 0.019
0.054 0.050 0.106 0.064 0.076 0.236 0.029 0.007
6.9 73.4 57.3 64.1 44.9 44.8 31.8 63.2
0.066 0.191 0.278 0.040 0.144 0.198 0.026 0.020
0.073 0.061 0.155 0.081 0.110 0.319 0.041 0.010
0.075 0.187 0.255 0.052 0.158 0.247 0.026 0.023
81.4 58.7 21.1 61.4 0.115 0.107 0.112 0.044 78.7 48.5 28.8 58.4 0.380 0.153 0.050 0.085 Sweets and snacks Cookies/chips Candy Chewing gum Other
0.043 0.075 0.048 0.018
88.7 51.0 4.0 78.8
0.377 0.191 0.059 0.087
0.072 0.071 0.048 0.019
80.9 62.8 18.6 78.2
0.434 0.201 0.090 0.077
0.082 0.090 0.055 0.024
81.1 55.2 38.9 68.8
0.520 0.229 0.125 0.089
0.111 0.118 0.089 0.037
0.618 0.259 0.142 0.114
42.3 37.3 5.9 27.7 4.3 1600.0 34.1 0.518 0.138 0.416 0.446 0.266 0.034 0.369 45.1 36.1 11.7 26.6 1.3 2600.0 37.8 0.348 0.080 0.167 0.228 0.117 0.001 0.210 Beverage Milk Soda Fruit drinks Sports/energy drinks Coffee/tea products Water Other
0.164 0.095 0.176 0.175 0.103 0.029 0.156
52.9 18.8 5.4 23.2 12.0 2800.0 25.7
0.398 0.151 0.184 0.281 0.163 0.002 0.245
0.167 0.110 0.199 0.181 0.136 0.030 0.149
58.0 27.2 8.2 35.6 16.6 1400.0 39.2
0.596 0.195 0.252 0.424 0.208 0.002 0.378
0.236 0.148 0.287 0.253 0.158 0.036 0.188
60.4 24.1 13.9 40.3 24.0 1700.0 50.3
0.801 0.202 0.333 0.552 0.234 0.002 0.521
0.440 0.129 0.372 0.405 0.237 0.054 0.324
0.898 0.220 0.393 0.617 0.255 0.002 0.560
2009 2004 % change ads/day seen 2004–2009 2009 2004 % change ads/day seen 2004–2009 2009 2004 2009
% change ads/day seen 2004–2009
2009 2004 2004
% change ads/day seen 2004–2009
Adults (35–64 years old) Young adults (20–34 years old) Adolescents (13–19 years old) Children (4–12 years old) Food group
Table 4 Trends in the average number of food advertisements seen daily on TV from 2004 and 2009, by disaggregated product categories for beverages, sweets/snacks, and fast food, by age group.
% change ads/day seen 2004–2009
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Elderly (65 years and older)
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public health advocates on the extent and trends in exposure to food and beverage advertising in Korea. Exposure to TV food ads is an important contextual environment which may influence individual food consumption, and thus, future studies should continue to monitor the level of exposure to food-related TV ads particularly with regards to recent public interest in Korea in regulating children’s exposure to TV ads for specific food products. In addition, further analyses of the nutritional content of ads seen particularly among children and adolescents is an important area for future work given that studies in the US, for example, have shown that despite self-regulatory efforts by the food industry the vast majority of ads seen by or directed at children are for unhealthy products (Harris, Schwartz, & Brownell, 2009, 2010; Harris et al., 2012; Kunkel, McKinley, & Wright, 2009; Powell et al., 2011). Finally, assessments of the associations of ad exposure with actual consumption patterns and weight outcomes also will provide important global information in designing policies to improve population health.
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Appetite journal homepage: www.elsevier.com/locate/appet
Research report
Trends in exposure to television food advertisements in South Korea q Euna Han a, Lisa M. Powell b, Tae Hyun Kim c,⇑ a
College of Pharmacy, Gachon Institute of Pharmaceutical Sciences, Gachon University, Yeonsu-Dong, Teonsu-Gu, 406-799 Incheon, South Korea Health Policy and Administration, School of Public Health, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Road, Room 558, M/C 275, Chicago, IL 60608, USA c Graduate School of Public Health, Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, South Korea b
a r t i c l e
i n f o
Article history: Available online 26 October 2012 Keywords: TV food advertising Targeted ratings data South Korea
a b s t r a c t Given the increased concern about the impact of TV food advertisements (ads) on individual food choices, we provide important evidence on TV food ad exposure between 2004 and 2009 in South Korea. We used monthly targeted ratings data by age group as the number of ads seen daily from Korean Nielsen Media Research. We generated six food groups: beverages (milk, soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and other); snacks/sweets (cookies/chips, candy, and chewing gum); fast food (Domino’s pizza, Lotteria, McDonald’s, Mr. Pizza, Pizza Hut, local chicken and pizza franchises, and other); instant noodle; full-service restaurants; and other. From 2004 to 2009, overall exposure to television food ads fell by 19.0% (from 6.8 to 5.5 ads daily), although exposure to full-service restaurant ads increased over that time period by 45.7%. While fast-food ad exposure fell overall, exposure to ads for local fried chicken franchises nearly doubled, making them the most commonly seen fast-food ads by 2009. Fast-food and instant noodle ads made up larger proportions of total ad exposure in 2009 than in 2004 in all age groups, with the largest increase among adolescents. Beverage ads continue to be the most prevalent food ads seen in South Korea. Differential trends found in exposure across and within food product categories and differences by age groups highlight the need for continued monitoring to help inform the regulatory policy debate on food advertising, particularly with regards to ads directed at children and adolescents. Ó 2012 Elsevier Ltd. All rights reserved.
Introduction Obesity prevalence has increased notably around the globe not only in developed countries but also in developing countries (Caballero, 2007; Wang, Monteiro, & Popkin, 2002). In the US, where the incidence of obesity has been the largest among OECD countries (Brunello, Michaud, & Sanz-de-Galdeano, 2009), more than one third of adults were estimated to be obese in 2009–2010 (Flegal, Carroll, Kit, & Ogden, 2012). The prevalence of obesity in South Korea (hereafter interchangeably called Korea) has also risen recently, particularly among the young population. Among adults, the prevalence of overweight (BMI P 25 kg/m2) reached 31.7% in 2007, up from 29.2% in 2005 and 26.0% in 1998 in Korea. For all children and adolescents less than 20 years of age, the prevalence of obesity in Korea was 10.9% in 2007, up from 5.8% in 1997 (Ministry of Health, 2009). Obesity is a well-known risk factor for various chronic health diseases such as cardiovascular disease, diabetes, and some types of cancer (US Department of Health, 2001), and even for higher mortalq Acknowledgements: We gratefully acknowledge research support from the Korea National Research Foundation (NRF-2012007096). The content is solely the responsibility of the authors and does not necessarily represent the official view of the Korea National Research Foundation. ⇑ Corresponding author. E-mail address: [email protected] (T.H. Kim).
0195-6663/$ - see front matter Ó 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.appet.2012.10.015
ity (Jee et al., 2006). Understanding individual and contextual factors associated with the increase in obesity, therefore, has been one of the key interests in the academic and policy arenas. Behavioral patterns related to body weight have shifted toward being more ‘‘obesogenic’’. Previous literature outside Korea reported an excess consumption of fat, sugar and sodium and less than recommended intake of fruits, vegetables, and micronutrients particularly among children (Wells, Cole, Bruner, & Treleaven, 2008; Fox, Condon, Briefel, Reidy, & Deming, 2010). Similar trends in food and nutrient consumption patterns have appeared in South Korea. Consumption of dietary fat and sugar was high, whereas fruit and vegetable consumption was low compared with dietary recommendations for Koreans (Korea Centers for Disease Control, 2006, 2010). The level of physical activity became lower at the same time with more screen time including traditional TV watching and a rapid dispersion of other media such as cable TV, internet, and online games over the same time period (Ah, Jeong, & Kim, 2010; Cho, Park, & Seo, 2009; Seo et al., 2008). Parallel to the increase in obesity prevalence and changes in individual behavioral patterns promoting obesity, environmental contextual factors including food advertising have been examined as modifiable sources that may impact individual behaviors with regards to obesity control. Also, public policy regulating advertising, particularly to children, has actively been debated in the US
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(IOM, 2006) and other developed countries (Hastings et al., 2003). The Korean government, too, has progressively enacted policies to help healthy food consumption since the late 2000s. Nutrition labeling has been newly required for all processed food products since September 2006. In addition, selling several ‘unhealthy’ foods, including coffee, carbonated drinks, instant noodles, and fast food in elementary (for 7–12 years of age), junior (for 13–15 years of age), and senior high schools (for 16–18 years of age) has been banned since 2008 in South Korea (Moon, 2009). Further, TV advertisements (ads) for specified foods, including large national fastfood franchises, candy, snacks, and instant noodles, have been banned during 5–7 pm, typical prime time for children, since 2010 (KFDA, 2010). However, no voluntary pledges from the food industry to further restrict the type of food ads promoted to children have accompanied to such governmental efforts, whereas by comparison, in the US there is a self-regulatory initiative to reduce children’s exposure to unhealthy food and beverage ads but no formal restrictions in place (Powell, Schermbeck, Szczypka, Chaloupka, & Braunschweig, 2011). TV ads are an important medium for promotion of food products in Korea. Advertising and marketing by the food, beverage and restaurant industry was estimated to be $165 million in 2007, of which about $54 million was for television ads (Advertising Information Center, 2008; Korea Broadcast Advertising Corporation, 2009). Adolescents in Korea spent 15.9 and 13.7 hour, on average, for TV watching and internet use, respectively, per week in 2006. The daily TV watching time among adolescents was 1.76 hour per day, on average, in 2006, which remained relatively unchanged from 1.99 hour per day in 2002 despite a rapid increase of the exposure to other media such as internet (Park, 2008). Korean adults spent 2 hour and 57 min per day, on average, watching TV with slightly longer hours among women than men in 2010 (TNS Media Korea, 2011). Previous literature has reported the extensive presence of food advertising on TV particularly on children’s programming. Studies using ratings data as an estimate of the number of people exposed to the ads have reported that food ads comprised 22–42% among all products advertising in the US (Harrison & Marske, 2005; Connor, 2006; Gantz, Schwartz, Angelini, & Rideout, 2007; Holt, Ippolito, Desrochers, & Kelley, 2007; Powell, Szczypka, & Chaloupka, 2007). Traditionally, cereals and sweets/snacks have been reported as the most frequently advertised food products for children composing 28–49% and 21–34% of all food advertising on TV, respectively, in the US (Condry, Bence, & Scheibe, 1988; Cotugna, 1988; Gamble & Cotugna, 1999; Kotz & Story, 1994; Powell et al., 2007; Taras & Gage, 1995). However, more recent evidence showed that fast-food ads are now the most frequently seen food ads (Powell, Szczypka, & Chaloupka, 2010; Powell et al., 2011) among children in the US. In Korea, beverages were the most frequently advertised food category (22.6% of the total TV ads), followed by franchise restaurants selling non-Asian food (16.6%), candy and snack (15.9%), instant or premade food (9.9%), dairy (8.7%), and fruit or vegetables juice products (7.2%) in 2008 (Moon, 2009). Building on the previous literature, this study examined changes in the extent of exposure to food advertising in Korea over 6 years between 2004 and 2009 using ratings data associated with each commercial advertised on TV, including analyses based on specific ratings by target age groups. Given the recent ban on TV advertisements for specific food groups in a limited time slot enacted in South Korea, our study can serve as a baseline for the pre-regulation landscape against which future post-regulation changes in food advertising exposure can be assessed.
food ads licensed from Nielsen Media Research in Korea. Nielsen Media Research collects its ratings data for TV ads in 13 designated market areas (DMAs) in Korea. A DMA consists of a group of administrative communities that comprise a major metropolitan area and surrounding geographic areas. DMAs are approximately equal to the largest public administrative communities in Korea, and DMAs do not overlap geographically. Television ratings data provide an estimate of people who watched a program (or an ad) out of total populations who belonged to sample households with a television over a specified time interval. That is, ratings data reflect actual exposure to an ad by counting sample persons who actually watched the ad. Ratings were measured both for a general audience and subgroups based on age. Nielsen Media Research assigns each product ad a product classification code that identifies it with a product category. Based on those classification codes, we generated six mutually exclusive food product categories including: (1) beverages; (2) snacks/ sweets; (3) fast food; (4) instant noodles; (5) full-service restaurants; and, (6) other foods. We examined the distribution of exposure to food advertising by those six food product categories. Beverages and snacks/sweets also were further classified with subgroups as follows: milk (both 100% soy and dairy milk), soda, fruit drinks (including any fruit-based drinks), sports/energy drinks, water, coffee/tea products, and other miscellaneous products for beverages; and, cookies/ chips, candy, and chewing gum for sweets/snacks. TV ads for water were prohibited in Korea until 2005, and thus, bottled water was included in this study since 2005. For fast-food products, we generated subgroups based on brand names as follows: Domino’s pizza; Lotteria (the largest domestic fast-food franchise in Korea, mainly selling hamburgers); McDonald’s; Mr. Pizza; Pizza Hut; local fast-food franchises mainly selling fried chicken products; local pizza franchises; and other miscellaneous fast food. Fast-food products were analyzed at the brand level given high initial exposure levels and substantial changes in exposure over time by brand as in previous studies (Powell et al., 2010). The level of exposure (as reported in the Tables) was measured as the average number of ads seen daily based on the total cumulated ratings per year. Ratings measure the percentage of households with televisions watching a program or an ad over a specified interval providing a measure of ad exposure. Total cumulated annual ratings were aggregated at the brand level and then categorized across food product categories to assess exposure for each category. We also calculated the proportion (%) of the daily number of ads seen for a specific food group out of the daily number of ads seen for all food products. Relative changes in the daily ad exposure between 2004 and 2009 also were calculated for each food product group. We examined the longitudinal time trend in exposure to TV ads of food products between 2004 and 2009 using general and specific ratings data based on subgroups of age including children (4– 12 years old), adolescents (13–19 years old), young adults (20– 34 years old), adults (35–64 years old), and elderly (65 years or older). We also disaggregated ratings data in each food group and assessed the proportions of subcategories within each of the six food groups across years between 2004 and 2009.
Methods
Table 1 shows the yearly trend of the level of exposure to food ads on TV, measured by the average number of TV ads seen daily by food group categories for six calendar years from 2004 to 2009. The level of exposure to TV food ads decreased during the
We assessed the time trend in the level of exposure to food ads on TV between 2004 and 2009 based on monthly ratings data of
Results Trends in exposure to TV food ads
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period overall except for full-service restaurants. Individuals saw 6.8 food ads, on average, on TV per day in 2004, which fell by 19.0% to 5.5 ads per day in 2009. Over this period, the number of ads seen for sweets/snacks reduced the most (by 60.6% from 1.0 to 0.4), followed by beverages (by 24.2% from 2.4 to 1.8) and instant noodles (by 16.5% from 0.5 to 0.4). On the contrary, the number of TV ads seen for full-service restaurants increased by 45.7% from 0.4 to 0.6 ads per day between 2004 and 2009. Among all food ads seen on TV, ads for beverages, fast food, sweets/snacks, and instant noodles made up 35.5%, 17.1%, 15.0%, and 7.5%, respectively, in 2004. By 2009, the proportions increased for fast food (to 19.4%) and instant noodles (to 7.7%), whereas those were fell slightly for beverages (to 33.3%) and fell by more than one half for sweets/snacks (to 7.3%). Trends in exposure to TV food ads by disaggregated food product category Further disaggregated results of ad trends for beverages, sweets/ snacks, and fast-food product categories are presented in Table 2. From 2004 to 2009, in the beverage category, exposure to TV ads for fruit drinks increased by 18.4% (from 0.3 to 0.4) despite the overall decrease in ad exposure for the whole beverage group. The amount of exposure to TV ads for milk fell the most in the beverage group for the same time period (by 47.5% from 0.7 to 0.4). For sweets/snacks, all the subcategories showed downward trends in the number of TV ads seen daily between 2004 and 2009 with the steepest drop among cookies/chips (by 72.8% from 0.5 to 0.1) and the least drop among chewing gum (by 9.3% from 0.11 to 0.10). For fast food, the number of TV ads seen daily increased slightly for Domino’s Pizza (by 11.4% from 0.08 to 0.09), almost doubled for local franchises selling chicken products (from 0.2 to 0.4), and more than doubled for Mr. Pizza (from 0.05 to 0.09) and local pizza franchises (from 0.02 to 0.06). In contrast, there was a large decrease in ad exposure for the two largest fast-food franchises, i.e., Lotteria (down by 65.3% from 0.3 to 0.1) and McDonald’s (down by 49.5% from 0.3 to 0.2) between 2004 and 2009. Trends in exposure to TV food ads by age group By age group, as shown in Table 3, the average number of TV ads seen for all food products except for full-service restaurants
dropped in all age groups. People in older age groups were exposed to more TV food ads in both 2004 and 2009 than those who were younger. The average number of TV ads seen daily for all food products dropped by almost one third between 2004 and 2009 for children (from 3.9 to 2.6), adolescents (from 4.3 to 2.8), and young adults (from 5.6 to 3.6), whereas the extent of the decrease was smaller for adults (by 19.3% from 6.9 to 5.6) and the elderly (by 16.6% from 7.8 to 6.5). The overall drop in exposure magnitude was mainly driven by sweets/snacks for which the exposure dropped by 63–73% across age groups. However, exposure to TV ads for full-service restaurants increased in all age groups with the largest extent among children (by 68.2% from 0.2 to 0.3) followed by elderly (by 67.7% from 0.5 to 0.9) and adults (by 33.9% from 0.6 to 0.7). In terms of the share of exposure, beverage ads made up the largest proportion among all TV food ads in both 2004 and 2009 in all age groups, which increased among children (from 29.6% to 34.3%) and adolescents (from 33.4% to 35.0%). The share for fast-food ads among all TV food ads was the next highest, which increased from 2004 to 2009 in all age groups particularly among adolescents (from 16.7% to 20.0%). The share for instant noodles and full-service restaurants also increased in all age groups. Daily exposure to TV ads for sweets/snacks fell by more than one half from 2004 to 2009 in all age groups. Trends in exposure to TV food ads by age group by disaggregated food product categories Table 4 shows changes in the daily exposure by viewers’ age group for disaggregated product categories. For beverages, the average number of TV ads seen daily for fruit drinks increased in all age groups with the largest increase among young adults (by 13.9% from 0.25 to 0.29) and the least increase among children (by 5.4% from 0.17 to 0.18). TV ads for water dramatically increased in all age groups although the absolute level of ads seen daily remained minimal. However, exposure to the most heavily advertised beverage in 2004, milk ads, dropped in all age groups particularly by more than a half among children (by 52.9% from 0.4 to 0.2), adolescents (by 58.0% from 0.4 to 0.2), and young adults (by 60.4% from 0.6 to 0.2) such that by 2009 exposure to fruit drink and sports/energy drink ads exceeded that of milk among children, adolescents and young adults. There were variations by age group
Table 1 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, all foods and by food product category. Food group
Daily number of ads watched
% change in ads/day seen 2004–2009
2004
2005
2006
2007
2008
2009
Beverage
2.411 (35.5)
2.247 (37.5)
2.128 (38.7)
1.906 (37.4)
1.570 (33.2)
1.828 (33.3)
24.2
Sweets/snacks
1.016 (15.0)
0.759 (12.7)
0.520 (9.4)
0.425 (8.3)
0.407 (8.6)
0.400 (7.3)
60.6
Fast food
1.157 (17.1)
0.948 (15.8)
0.858 (15.6)
0.750 (14.7)
0.921 (19.5)
1.067 (19.4)
7.8
Instant noodle
0.508 (7.5)
0.449 (7.5)
0.401 (7.3)
0.396 (7.8)
0.315 (6.7)
0.424 (7.7)
16.5
Full service restaurant
0.420 (6.2)
0.410 (6.8)
0.624 (11.3)
0.647 (12.7)
0.505 (10.7)
0.612 (11.1)
45.7
Other
1.273 (18.8)
1.183 (19.7)
0.972 (17.7)
0.971 (19.1)
1.002 (21.2)
1.164 (21.2)
8.6
Total
6.785 (100.0)
5.996 (100.0)
5.503 (100.0)
5.096 (100.0)
4.722 (100.0)
5.494 (100.0)
19.0
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each group and year. Numbers in parentheses are the distribution in % of each food category among the total number of daily TV ads watched in each year. Beverages included milk, soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and miscellaneous products. Snack and sweet products included cookies and chips, candy, and chewing gum and other. Fast-food products included Domino’s pizza, Lotteria (the largest local fast-food franchise in Korea), McDonald’s, Mr. Pizza, Pizza Hut, local fast food franchises mainly selling fried chicken products, local fast-food franchises mainly selling pizza, and other fast food. Totals may not add up exactly due to rounding. TV ads for water started in 2005.
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Table 2 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, by disaggregated product categories for beverages, sweets/snacks, and fast food. Food group
Daily number of advertisements watched
% change in ads/day seen 2004–2009
2004
2005
2006
2007
2008
2009
Beverage Milk Soda Fruit drinks Sports/energy drinks Coffee/tea products Water Other Total
0.685 0.271 0.316 0.482 0.245 N/A 0.413 2.411
0.481 0.257 0.436 0.449 0.231 0.004 0.388 2.247
0.394 0.272 0.534 0.385 0.228 0.007 0.310 2.128
0.289 0.123 0.578 0.424 0.195 0.036 0.260 1.906
0.334 0.192 0.346 0.289 0.126 0.155 0.129 1.570
0.360 0.182 0.374 0.340 0.208 0.088 0.278 1.828
47.45 32.84 18.35 29.46 15.10 2100.00 32.69 24.18
Sweets and snacks Cookies and chips Candy Chewing gum Other Total
0.492 0.286 0.108 0.131 1.016
0.391 0.254 0.098 0.018 0.759
0.274 0.173 0.065 0.008 0.520
0.214 0.142 0.071 0.000 0.425
0.137 0.195 0.025 0.049 0.407
0.134 0.124 0.098 0.045 0.400
72.76 56.64 9.26 65.65 60.63
Fast food Domino’s Pizza Lotteria McDonald’s Mr. Pizza Pizza Hut Local fried chicken franchises Local pizza franchises Other Total
0.079 0.251 0.374 0.045 0.148 0.215 0.024 0.021 1.157
0.066 0.198 0.253 0.049 0.096 0.225 0.039 0.023 0.948
0.079 0.102 0.278 0.075 0.085 0.182 0.031 0.027 0.858
0.052 0.070 0.167 0.064 0.104 0.231 0.028 0.033 0.750
0.078 0.061 0.152 0.079 0.152 0.308 0.063 0.028 0.921
0.088 0.087 0.189 0.090 0.144 0.396 0.060 0.014 1.067
11.39 65.34 49.47 100.00 2.70 84.19 150.00 33.33 7.78
Notes: Numbers presented in this table are the average number of TV advertisements watched daily seen associated with each food product and year. Totals may not add up exactly due to rounding. TV ads for water started in 2005. Ads for water were banned in Korea until 2005, and thus, no ad exposure was measured for water before 2005.
in the average number of TV ads seen daily for soda and coffee/tea products although the extent of the changes was minor for all age groups. For sweets/snacks, the magnitude of exposure was reduced in 2009 compared to 2004 in all subcategories across all age groups. Exposure to cookies/chips fell by approximately 80–90% in all age groups with the largest decrease among children. For fast food, the number of TV ads seen daily for local fried-chicken franchises increased by between 23.9% (among children from 0.18 to 0.22) and 61.1% (among adults from 0.2 to 0.3) across all age groups. Exposure to TV ads for local pizza franchises almost doubled among adolescents (from 0.02 to 0.03), young adults (from 0.02 to 0.03), and elderly (from 0.03 to 0.05), and increased less among adults (from 0.03 to 0.04), whereas it decreased only among children (from 0.02 to 0.01). Ads for Domino’s Pizza and Mr. Pizza also were seen more in 2009 than in 2004 in all age groups except for children for Mr. Pizza and young adults for Domino’s Pizza. Children were exposed to fewer ads for Lotteria (by 73.1% from 0.11 to 0.03) and McDonald’s (by 66.3% from 0.2 to 0.1) by the largest extent compared to other age groups (see Table 4). Discussion This study examined trends in the level of exposure to food ads measured by the number of TV ads seen daily using ratings data associated with food products spanning 2004–2009 licensed from Korean Nielsen Media Research. Given the serious public health risk posed by poor diet, inactivity, and obesity and increased concern about the impact of food ads on TV on individual food choices, our study provided important empirical evidence on changes in the magnitude of actual exposure to TV food ads. Further assessment of the targeted ratings by age group in this present study also provided information regarding differential exposure and the potential need for targeted policies by viewers’ age group. Our study showed that the overall level of exposure to TV food ads fell by 19.0% (from 6.8 to 5.5 ads per day) between 2004 and
2009. However, disaggregation revealed that exposure actually increased for full-service restaurants (by 45.7% from 0.4 to 0.6) and that there was only a modest decline in exposure to fast-food restaurant ads with large increases for some outlets (i.e. local fried chicken and pizza and Mr. Pizza and Domino’s) and large decreases for others (i.e. Lotteria and McDonald’s). The present results further showed that relative exposure to TV ads for high-calorie, lownutrient food products including fruit drinks, fast food, instant noodle, and local fast-food franchises (selling fried chickens and pizza) increased particularly among children and adolescents. The increasing trend in exposure to full-service restaurant ads on TV is noteworthy and warrants further examination and monitoring in future studies. Korea has experienced a rapid nutrition transition toward more westernized diets including food consumption outside of the home (Kim, Moon, & Popkin, 2000; Lee, Popkin, & Kim, 2002; Song, Joung, Engelhardt, Yoo, & Paik, 2005). Studies reported that the total market size for food-away-from-home consumption was estimated to have increased to $60 billion in 2009 from $48 billion in 2004 and $18 billion in the 1990s (Korea Food Consumption Information, 2011). Unfortunately, to our knowledge, no publicly available data dissect food-away-from-home consumption by full-service versus fast-food restaurant sources in Korea, and thus, we could not assess such consumption patterns. However, we can hypothesize that the increasing trend of overall food-away-from-home consumption might be associated with the increased exposure to full-service restaurant on TV, which should be explored in future studies. The average number of TV ads seen for fruit drinks increased by 5.4–11.7% across different age groups between 2004 and 2009 despite the decrease in the exposure to TV ads for beverage products overall. Exposure to TV ads for soda increased only among children by 18.8% although soda still remained as the least seen beverage ad type in 2009 other than water. These findings of increased exposure to soda and fruit drink ads between 2004 and 2009 in children are noteworthy given that they have been linked to lower nutrient consumption, increased body weight, and higher risk of obesity
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each food product group and year. Numbers in parentheses are the distribution in % of each food category among the total number of daily TV ads watched in each year. Beverages included milk, any soda, fruit drinks, sports/energy drinks, water, coffee/tea products, and miscellaneous products. Snack and sweet products included cookies and chips, candy, and chewing gum and other. Fast-food products included Domino’s pizza, Lotteria (the largest local fast food franchise in Korea), McDonald’s, Mr. Pizza, Pizza Hut, local fast-food franchises mainly selling fried chicken products, local small fast food franchises mainly selling pizza, and other fast food. Children, adolescents, young adults, adults, and elderly were respectively defined as individuals aged 4–12, 13–19, 20–34, 35–64, and 65 years or older.
16.6 6.509 (100.0) 7.803 (100.0) 19.3 5.639 (100.0) 6.985 (100.0) 35.3 3.617 (100.0) 5.591 (100.0) 34.6 2.782 (100.0) 4.251 (100.0) 32.7 3.892 (100.0) Total
2.618 (100.0)
0.1 1.508 (23.2) 1.507 (19.3) 4.0 1.234 (21.9) 1.286 (18.4) 31.7 0.71 (19.6) 1.04 (18.6) 35.3 0.559 (20.1) 0.864 (20.3) 41.7 0.895 (23.0) Other
0.522 (19.9)
67.7 0.892 (13.7) 0.532 (6.8) 33.9 0.743 (13.2) 0.555 (7.9) 11.5 0.388 (10.7) 0.348 (6.2) 17.1 0.233 (8.4) 0.199 (4.7) 68.2 0.176 (4.5) Full-service restaurant
0.296 (11.3)
12.1 0.586 (9.0) 0.667 (8.5) 13.8 0.495 (8.8) 0.574 (8.2) 28.8 0.338 (9.3) 0.475 (8.5) 28.1 0.248 (8.9) 0.345 (8.1) 24.9 0.285 (7.3) Instant noodle
0.214 (8.2)
6.7 0.955 (14.7) 1.024 (13.1) 11.8 0.849 (15.1) 0.963 (13.8) 28.8 0.622 (17.2) 0.874 (15.6) 21.3 0.557 (20.0) 0.708 (16.7) 29.7 0.717 (18.4) Fast food
0.504 (19.3)
66.5 0.379 (5.8) 1.132 (14.5) 63.0 0.356 (6.3) 0.963 (13.8) 68.5 0.252 (7.0) 0.801 (14.3) 70.6 0.21 (7.5) 0.715 (16.8) 72.5 0.669 (17.2) Sweets and snacks
0.184 (7.0)
25.6 2.189 (33.6) 2.941 (37.7) 25.8 1.962 (34.8) 2.643 (37.8) 36.3 1.307 (36.1) 2.052 (36.7) 31.4 0.974 (35.0) 1.42 (33.4) 22.0 0.898 (34.3) 1.152 (29.6) Beverage
% change ads/day seen 2004–2009 2009 2004 % change ads/day seen 2004–2009 2009
Adults (35–64 years old)
2004 % change ads/day seen 2004–2009 2009
Young adults (20–34 years old)
2004 % change ads/day seen 2004–2009 2009
% change ads/day seen 2004–2009
2009
Adolescents (13–19 years old)
2004
Children (4–12 years old)
2004
Food group
Table 3 Trends in the average number and distribution of food advertisements seen daily on TV from 2004 and 2009, all foods and by food product category, by age group.
Elderly (65 years and older)
E. Han et al. / Appetite 62 (2013) 225–231
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(Block, 2004; CDC, 2006; Malik, Schulze, & Hu, 2006). Such increases among children are more alarming particularly when coupled with the decreased exposure to TV ads for milk over the same time period. Moving forward, further inquiry should be conducted to assess whether changes in consumption patterns have actually occurred parallel to the increases in TV ad exposure and the extent to which ad exposure has been associated with the actual beverage consumption. The proportion of the exposure to TV ads for instant noodle among all food ads increased between 2004 and 2009 particularly among children (from 7.3% to 8.2%) and adolescents (from 8.1% to 8.9%). Instant noodles, also known as ramen, are one of the most popular fast foods in Korea particularly among adolescents. Nearly 65% of adolescents were reported to consume instant noodles 1–3 times (servings) per week in 2005 (Ministry of Health, 2006). Koreans consumed instant noodles by a total of 3480 million packets (bags/cups) in 2009, up from a total of 3220 million packets in 2007 (World Instant Noodle Association, 2012). Korea was the world largest consumer of instant noodles, consuming approximately 75 bags/cups of instant noodles, on average, per year per capita in 2009 (World Instant Noodle Association, 2012). Instant noodles are a representative high-calorie-low-nutrient food with 381– 464 kcal per 100 g (approximately same as one bag/cup) with only 10 g of protein and containing almost no other nutrients (Korean Nutrition Society, 2005). Adolescent consumers of instant noodles compared to non-consumers showed significantly less intake of key nutrients such as calcium, niacin, and Vitamin C, and consumed significantly less vegetables, fruits, milk and other dairy products, whereas they consumed significantly more calories, fat, and sodium (Lee et al., 2009). Therefore, further targeted policy measures are needed to effectively control for ad exposure to instant noodles. There were large increases in the level of exposure to local fast-food franchises selling fried chicken and pizza products particularly among children. Pizza and fried chicken products are well-known fast food of which consumption has been linked to an increased body weight (French, Harnack, & Jeffery, 2000), an increased body mass index (Binkley, Eales, & Jekanowski, 2000), and a higher likelihood of being overweight (Bowman & Vinyard, 2004). Those local fast-food franchises were not included in the recent ban in Korea on TV advertisements from 5 to 7 pm for specified unhealthy foods which only included large national fast-food franchises, candy, snacks, and instant noodles (KFDA, 2010). Our results imply that continued monitoring and more scrutiny would be needed for public policies pertaining to TV fast-food ads, particularly for small local franchises. By using ratings data associated with each commercial on TV for food products spanning 6 years between 2004 and 2009, we were able to distinguish actual ad exposure rather than giving all ads an equal weight based simply on the airing of the commercial (Powell et al., 2007). Furthermore, we could assess variations in the absolute and relative levels of actual exposure to TV food ads among children and adolescents separately from adults and elderly by using targeted ratings data by age group. At the same time, we acknowledge that ratings data based on media market averages may not accurately reflect individual variations in exposure (Powell et al., 2007). Further, ratings data measure the level of exposure by the number of ads seen without accounting for variations in the extent of duration exposed to each ad. Nevertheless, previous literature has shown a high correlation between ratings and self-reported ad recall (Emery et al., 2005; Southwell, Barmada, Hornik, & Maklan, 2002; Wakefield et al., 2005), suggesting that greater potential exposure is associated with higher awareness and engagement with a TV ad. In light of the increased public concern regarding poor diet and consequential increased body weight and related health risks, our study provides important empirical evidence for policymakers and
4.0 63.6 36.9 75.0 19.6 50.2 84.6 56.5 0.078 0.068 0.161 0.091 0.127 0.371 0.048 0.010
Notes: Numbers presented in this table are the average number of TV advertisements watched daily for each food product group and year. TV ads for water started in 2005.
10.6 68.1 44.2 102.5 23.6 61.1 57.7 50.0 0.046 0.108 0.190 0.048 0.114 0.176 0.022 0.011 Fast food Domino’s Pizza Lotteria McDonald’s Mr. Pizza Pizza Hut Local fried chicken franchises Local pizza franchises Other
0.067 0.029 0.064 0.043 0.066 0.218 0.012 0.005
45.7 73.1 66.3 10.4 42.1 23.9 45.5 54.5
0.053 0.135 0.203 0.035 0.108 0.138 0.017 0.018
0.055 0.044 0.088 0.055 0.076 0.199 0.031 0.008
3.8 67.4 56.7 57.1 29.6 44.2 82.4 55.6
0.058 0.188 0.248 0.039 0.138 0.163 0.022 0.019
0.054 0.050 0.106 0.064 0.076 0.236 0.029 0.007
6.9 73.4 57.3 64.1 44.9 44.8 31.8 63.2
0.066 0.191 0.278 0.040 0.144 0.198 0.026 0.020
0.073 0.061 0.155 0.081 0.110 0.319 0.041 0.010
0.075 0.187 0.255 0.052 0.158 0.247 0.026 0.023
81.4 58.7 21.1 61.4 0.115 0.107 0.112 0.044 78.7 48.5 28.8 58.4 0.380 0.153 0.050 0.085 Sweets and snacks Cookies/chips Candy Chewing gum Other
0.043 0.075 0.048 0.018
88.7 51.0 4.0 78.8
0.377 0.191 0.059 0.087
0.072 0.071 0.048 0.019
80.9 62.8 18.6 78.2
0.434 0.201 0.090 0.077
0.082 0.090 0.055 0.024
81.1 55.2 38.9 68.8
0.520 0.229 0.125 0.089
0.111 0.118 0.089 0.037
0.618 0.259 0.142 0.114
42.3 37.3 5.9 27.7 4.3 1600.0 34.1 0.518 0.138 0.416 0.446 0.266 0.034 0.369 45.1 36.1 11.7 26.6 1.3 2600.0 37.8 0.348 0.080 0.167 0.228 0.117 0.001 0.210 Beverage Milk Soda Fruit drinks Sports/energy drinks Coffee/tea products Water Other
0.164 0.095 0.176 0.175 0.103 0.029 0.156
52.9 18.8 5.4 23.2 12.0 2800.0 25.7
0.398 0.151 0.184 0.281 0.163 0.002 0.245
0.167 0.110 0.199 0.181 0.136 0.030 0.149
58.0 27.2 8.2 35.6 16.6 1400.0 39.2
0.596 0.195 0.252 0.424 0.208 0.002 0.378
0.236 0.148 0.287 0.253 0.158 0.036 0.188
60.4 24.1 13.9 40.3 24.0 1700.0 50.3
0.801 0.202 0.333 0.552 0.234 0.002 0.521
0.440 0.129 0.372 0.405 0.237 0.054 0.324
0.898 0.220 0.393 0.617 0.255 0.002 0.560
2009 2004 % change ads/day seen 2004–2009 2009 2004 % change ads/day seen 2004–2009 2009 2004 2009
% change ads/day seen 2004–2009
2009 2004 2004
% change ads/day seen 2004–2009
Adults (35–64 years old) Young adults (20–34 years old) Adolescents (13–19 years old) Children (4–12 years old) Food group
Table 4 Trends in the average number of food advertisements seen daily on TV from 2004 and 2009, by disaggregated product categories for beverages, sweets/snacks, and fast food, by age group.
% change ads/day seen 2004–2009
E. Han et al. / Appetite 62 (2013) 225–231
Elderly (65 years and older)
230
public health advocates on the extent and trends in exposure to food and beverage advertising in Korea. Exposure to TV food ads is an important contextual environment which may influence individual food consumption, and thus, future studies should continue to monitor the level of exposure to food-related TV ads particularly with regards to recent public interest in Korea in regulating children’s exposure to TV ads for specific food products. In addition, further analyses of the nutritional content of ads seen particularly among children and adolescents is an important area for future work given that studies in the US, for example, have shown that despite self-regulatory efforts by the food industry the vast majority of ads seen by or directed at children are for unhealthy products (Harris, Schwartz, & Brownell, 2009, 2010; Harris et al., 2012; Kunkel, McKinley, & Wright, 2009; Powell et al., 2011). Finally, assessments of the associations of ad exposure with actual consumption patterns and weight outcomes also will provide important global information in designing policies to improve population health.
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