- Email: [email protected]
Television advertising of food during children's programming in Nepal
Nutrition 55 56 (2018) 41 44
Contents lists available at ScienceDirect
Nutrition journal homepage: www.nutritionjrnl.com
Brief report
Television advertising of food during children's programming in Nepal 1XD XAndrew D. Menger-Ogle D2X XPh.D. a, D3X XAshlie N. Johnson D4X XB.S., B.A. a, D5X XJohn A. Morgan D6X XB.S. b, D7X X Dan J. Graham D8X XPh.D. a,* a b
Colorado State University, Fort Collins, Colorado Clemson University, Clemson, South Carolina
A R T I C L E
I N F O
Article History: Received 3 November 2017 Received in revised form 6 February 2018 Accepted 11 February 2018 Keywords: Nepal Children Food marketing Advertising Television
A B S T R A C T
Objective: The World Health Organization has recommended that advertising of unhealthy food to children decrease in quantity (exposure) and efficacy (power). The degree to which marketing practices align with these recommendations varies across countries. The purpose of this study is to describe the television food marketing landscape that children experience in the South Asian country of Nepal. Research Methods & Procedures: Commercials from 57 hours of television were recorded from three channels during hours that children's programming was played. In a content analysis of 1,203 food commercials, researchers coded commercials for nutrition content, product category and marketing appeal type. Results: Principal findings of this study were that nearly 21% of airtime during children's programming was dedicated to commercials, and 55% of that was dedicated to foods. Over 70% of food commercials aired advertised foods with excessive amounts of saturated fat, sugar, and/or sodium; nearly half of the commercials (47.7%) featured products that contained excess sugar. The most prevalent food types shown were ice cream and popsicles (20.7%), energy/nutritional supplements (20.6%), and candy (14.7%). Additionally, the three most commonly occurring marketing appeals featured highly-efficacious strategies for persuading children— animated effects (83.2%), movie, cartoon, animated, or costumed characters (36.8%), and television/movie tie-ins (16.5%). Conclusion(s): Results from this study suggest that many television commercials shown in Nepal do not meet WHO recommendations for advertising foods to children. This is likely to negatively impact the diet and health of the next generation of Nepalis. © 2018 Elsevier Inc. All rights reserved.
Introduction The debate around marketing food to children Children's diets are important. Health across the lifespan is influenced by eating habits that are adopted early in life [1]. One factor that contributes to a diet are the marketing messages for specific foods. A review of past [2 4] and recent [5] research suggests a positive correlation between exposure to food commercials and consumption among children. The television advertising of foods to children has been criticized by researchers and health advocates in recent decades because a large proportion of the advertised foods are unhealthy [6] and children are more susceptible to advertising messages than adults [7]. Research on food marketing to
* Corresponding author. Tel.: (970) 491-4622; fax: (970) 491-1032. E-mail address: [email protected] (D.J. Graham). https://doi.org/10.1016/j.nut.2018.02.027 0899-9007/© 2018 Elsevier Inc. All rights reserved.
children that was conducted in Sri Lanka [8], Bulgaria [9], Turkey [10], Peru [11], South Africa [12,13], United States [14,15], Germany [16], and other countries [6] has shown the widespread use of this practice. The U.S. food industry took steps to self-regulate the nutrition standards for children [17] and years later the Healthy Eating Research program by the Robert Wood Johnson Foundation supplemented those nutrition standards with marketing standards [18]. However, the World Health Organization (WHO) has released broader-reaching guidelines that discuss governments' role in directing industries to decrease children's exposure to the marketing of unhealthy foods and diminish the power (i.e., efficacy) of marketing appeals [19]. Subsequent to the WHO recommendations, government regulation, and industry self-regulation, a systematic review of research found contradictory evidence on children's continued exposure to this type of marketing along with a cross-country variation in exposure [20]. Because of this cross-country disparity, the
42
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
continued investigation into how the food industry engages the issue of using television to market products to children is worthwhile, especially in understudied populations. Television in Nepal Nepal is a low-income country that is located between India and China in South Asia. Despite its impoverished conditions, especially in the rural regions where 81% of Nepalis live [21], television ownership was determined at 76% of a small sample of people in rural Nepal [22]. The first Nepal-based television broadcast network was launched in December 1985. Even before this, the first television channels were broadcast into Nepal's plains region (i.e., Tarai) from the Indian state television network in the early 1980s in areas that were geographically closer to India than Kathmandu, which is the capital of Nepal [23]. Due to a paucity of publicly available information about the television sector in published literature, one of the authors interviewed a manager with the Kathmandu-based television and internet provider Subisu Cablenet, Ltd. A total of 275 television broadcast vendors have been reported in Nepal but three of these operators hold most of the market share (Y. Karki, personal communication, April 2014). The television channels that are shown by these large, popular vendors are produced in Nepal as well as India, Singapore, United States, United Kingdom, and the Emirate of Dubai but 90% of the channels are based in India. Advertisements that are directed toward children are principally shown during programs that appeal to children and at times when children are expected to watch television. The channels that predominantly feature children's programing in Nepal are Nickelodeon, the Cartoon Network, and the Disney Channel and are broadcast from India (Y. Karki, personal communication, April 2014).
each product and the per-serving nutrition recommendations by the U.S. Interagency Working Group (IWG), which created nutrition standards for food products. The WHO has also set nutrition standards based on what an individual should consume in 1 d. In this study, the per-serving recommendations were chosen to evaluate the foods instead of the per-day recommendations because there was no way to know the total daily profile of food consumption for any given child. If more than one product was advertised in a commercial, the average of the products was compared with the nutrition standards. Two Nepali research assistants independently coded the marketing appeal types that were used in each commercial. The Cohen's Kappa values for each coding category ranged from 0.818 to 0.968. Foods were categorized by the authors via inductive coding on the basis of regional salience (i.e., categories were created post hoc to effectively organize the foods that appeared on Nepali television).
Results Foods advertised Commercials made up 20.8% of the broadcast time. Of the total of 2174 commercials that were shown during the nearly 12 h of recorded advertising, more than half (n = 1203) were food commercials. The commercials were comprised of 64 unique commercials although some of these had variants that differed by time or language. Across all commercials, the range in length was 5 s to 45 s (mean: 18.78; standard deviation: 7.50). With regard to language, written English and spoken Hindi were the most common and Nepali never appeared (Table 1). Categories The food products that were shown were sorted into 11 distinct categories and each commercial was only counted once. By and large, the food categories are discretionary foods that are not necessary for a healthy diet. Figure 1 shows the relative prevalence of each category among the total number of food commercials that were shown during the sample period.
Purpose Despite the widespread availability of television in Nepal, little is known about television food commercials or the degree to which they follow the WHO recommendations for advertising to children. Understanding this population-level influence on diet is important because Nepal is experiencing a nutrition transition including a rise in obesity [24]. Of related importance is the identification of the actual availability of products whose marketing messages originate outside of the country. The purpose of this study was to describe the television food marketing landscape that children experience in Nepal. Methods Sample In April 2014, television programming was digitally recorded in Kathmandu, Nepal on 9 separate days over a 20-d span: Three weekend days and six weekdays. The three recorded channels were Nickelodeon, the Cartoon Network, and the Disney Channel. Recording took place during hours that children's programming was played (07:30 h 12:00 h and 15:00 h 19:00 h). A total of 61 h were recorded but only 57 h remained after 4 h of recording had to be discarded due to broadcasting failures or the broadcasting of nonchildren's programming (e.g., home shopping program). Data processing and analysis After data collection, the digital recordings were edited to remove the actual television programs and approximately 12 h of commercials remained. A content analysis was conducted on the commercials and researchers categorized the food products that were advertised on the basis of existing coding schemes for food nutrition [25]. Researchers also coded commercials for marketing appeal types that were powerful (i.e., efficacious) for children [14]. Food nutrition codes were assigned on the basis of a comparison between the available nutrition content of
Nutrition profile The majority of commercials featured processed foods that contained proportions of sugar, saturated fat, trans fat, and/or sodium that exceeded the recommended standards that have been set forth by the IWG. In fact, 70% of the food commercials exceeded one or more recommendation by the IWG, 57.9% exceeded one recommendation, and an additional 12.1% exceeded two recommendations. The nutrient that most frequently exceeded the recommendation was sugar as nearly half (48.7%) of the commercials showed food products that contained more sugar than recommended. Nutrient information could not be found for 6.2% to 40.8% of the commercials depending on the nutrient. Therefore, it is possible that more commercials were showing food products that exceeded the recommendations (Table 2). Availability Most of the food commercials advertised food products that were widely available in Nepal (54.6%). However, other commercials showed food products that would need to be purchased from specialty shops (35.4%) or were not available for purchase in Nepal (10%). Table 1 Prevalence of languages in 1203 television food commercials broadcast in Kathmandu, Nepal Language
Written
Spoken
Hindi English Nepali
194 1195 0
998 404 0
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
Cereals 4% Spices 3%
Restaurants 1%
43
Dairy 3% Energy/Nutrion Supplement 20%
Ice cream/Popsicles 21%
Snacks (e.g., cheese crackers) 10% Cookies/Cakes 10%
Ready-made meals 10%
Flavored Drink 3%
Candy 15%
Fig. 1. Relative prevalence of each food product category in the total count of food commercials.
Marketing appeal and audience As predicted, a variety of the advertising appeal types that are powerful to children were utilized in the food commercials.
Table 2 Frequency of commercials with products that exceed nutrient recommendations Nutrient
Advertised foods not exceeding recommendation (%)
Advertised foods exceeding recommendation (%)
Advertised foods for which nutrient information was unavailable (%)
Saturated fat Trans fat Sugar Sodium
44.9 59.2 45.1 47.3
22.5 0 48.7 10.9
32.6 40.8 6.2 41.8
90%
The most common appeal technique, which appeared in more than 80% of the food commercials, was animation or animated effects. Figure 2 shows the proportions of the appeal types that were used. Every food commercial used at least one powerful appeal type. Children were the main protagonist in 45.7% of the food commercials, adults in 30.5%, and people did not appear in the remaining 23.8% of the food commercials. The disproportionate appearance of children in the starring roles of these commercials is more evidence that children are the targets of the marketing messages. Discussion Evidence from this study suggests that the media landscape in Nepal does not meet the WHO recommendations. Most food
83.2%
80% 70% 60% 50% 40%
36.8%
30% 20%
16.5%
15.8%
12.7%
12.7%
10%
1.2%
1.1%
0% TV or movie Celebries Showing Giveaways Web site or Use of Animaon e-mail e-in or athletes eang food (by mail or or animated characters address packaging) is fun (animated, effects costumed, etc.) Fig. 2. Food commercials by advertising appeal type.
Contests
44
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
commercials (70%) expose children to products that have too much sugar, fat, and/or sodium. Fortunately, no advertised food products were identified as containing trans fats. One hundred percent of the recorded food commercials were powerful and used marketing techniques (e.g., animation and animated effects) that are difficult for children to resist. The results of this study show the extent to which Nepali television programing reflects a global marketplace. The three channels that were assessed here originated from outside Nepal and primarily featured spoken Hindi with written English, yet the vast majority of the advertised food products (90%) could be purchased in Nepal. This means that seeing these commercials could increase the consumption of the specific unhealthy foods that were advertised. The increased consumption of unhealthy foods by Nepalis may extend beyond the products that were included in these television commercials. A review of the research has shown that not only does advertising for specific food brands lead to an increase in their consumption but also that the increase in consumption extends to other brands within the same category [26], which results in a greater overall consumption of the advertised unhealthy food categories. Conclusions As food markets and marketing practices become more global, nutrition transitions in developing nations may result [24,27,28]. Food media trends that target Nepal's youth including the failure of more than 70% of foods that are advertised during children's television programming to meet health recommendations may already be foreshadowing an increase in less healthy diets among the youngest generation. References [1] Ambrosini GL. Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc 2014;73:137–46. [2] Buijzen M, Schuurman J, Bomhof E. Associations between children's television advertising exposure and their food consumption patterns: a household diarysurvey study. Appetite 2008;50:231–9. [3] Andreyeva T, Kelly IR, Harris JL. Exposure to food advertising on television: associations with children's fast food and soft drink consumption and obesity. Econ Hum Biol 2011;9:221–33. [4] McGinnis M, Gootman J, Kraak V. Food marketing to children and youth: Threat or opportunity? Washington, DC: Institute of Medicine. 2006. [5] Longacre MR, Drake KM, Titus LJ, Harris J, Cleveland LP, Langeloh G, et al. Child-targeted TV advertising and preschoolers' consumption of high-sugar breakfast cereals. Appetite 2017;108:295–302. ~ o I, Berg C, et al. [6] Kelly B, Halford JC, Boyland EJ, Chapman K, Bautista-Castan Television food advertising to children: a global perspective. Am J Publ Health 2010;100:1730–6.
[7] Kraak V, Story M. Influence of food companies' brand mascots and entertainment companies' cartoon media characters on children's diet and health: a systematic review and research needs. Obes Rev 2015;16:107–26. [8] Prathapan S, Wijewardena K, Low WY. Content analysis of food and beverages advertisements targeting children and adults on television in Sri Lanka. Asia Pac J Public Health 2016;28:86S–92S. [9] Galcheva SV, Iotova VM, Stratev VK. Television food advertising directed towards Bulgarian children. Arch Dis Child 2008;93:857–61. [10] Guran T, Turan S, Akcay T, Degirmenci F, Avci O, Asan A, et al. Content analysis of food advertising in Turkish television. J Paediatr Child Health 2010;46:427– 30. rez DH. Influencia de la publicidad televisiva [11] Rojas-Huayllani EC, Delgado-Pe peruana en el consumo de alimentos no saludables en escolares de 4° a 6° primaria. An Facul Med 2013;74:21–6. [12] Temple NJ, Steyn NP, Nadomane Z. Food advertisements on children's programs on TV in South Africa. Nutrition 2008;24:781–2. [13] Cassim SB. Food and beverage marketing to children in South Africa: Mapping the terrain. S Afr J Clin Nutr 2010;23:181–5. [14] Batada A, Seitz MD, Wootan MG, Story M. Nine out of 10 food advertisements shown during Saturday morning children's television programming are for foods high in fat, sodium, or added sugars, or low in nutrients. J Am Diet Assoc 2008;108:673–8. [15] Connor SM. Food-related advertising on preschool television: building brand recognition in young viewers. Pediatrics 2006;118:1478–85. [16] Effertz T, Wilcke AC. Do television food commercials target children in Germany? Public Health Nutr 2012;15:1466–73. [17] Council of Better Business Bureaus. Children's food and beverage advertising initiative. CFBAI's category-specific uniform nutrition criteria. Available from: https://www.bbb.org/storage/16/documents/cfbai/CFBAI%20Uniform% 20Nutrition%20Criteria%20Fact%20Sheet%20-FINAL.pdf. [Accessed 2 October 2017]. [18] Healthy Eating Research. Recommendations for responsible food marketing to children. Available from: http://healthyeatingresearch.org/research/recommendations-for-responsible-food-marketing-to-children/. [Accessed 18 September 2017]. [19] World Health Organization. Set of recommendations on the marketing of foods and non-alcoholic beverages to children World Health Organization. 2010. [20] Galbraith-Emami S, Lobstein T. The impact of initiatives to limit the advertising of food and beverage products to children: a systematic review. Obes Rev 2013;14:960–74. [21] The World Bank. Rural population. Available from: https://data.worldbank. org/indicator/SP.RUR.TOTL.ZS?page=1. [Accessed 3 October 2017]. [22] Zhou Y, Singh N, Kaushik PD. The digital divide in rural South Asia: survey evidence from Bangladesh, Nepal and Sri Lanka. IIMB Manag Rev 2011;23:15–29. [23] Liechty M. Suitably modern: Making middle-class culture in Kathmandu Kathmandu: Martin Chautari. 2008. [24] Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012;70:3–21. [25] Schermbeck RM, Powell LM. Nutrition recommendations and the children's food and beverage advertising initiative's 2014 approved food and beverage product list. Prev Chron Dis 2015;12:1–6. [26] Hastings G, Stead M, McDermott L, Forsyth A, MacKintosh AM, Rayner M, et al. Review of research on the effects of food promotion to children Glasgow: Centre for Social Marketing, University of Strathclyde. 2003. [27] Hawkes C. Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases. Global Health 2006;28:4. [28] Stuckler D, McKee M, Ebrahim S, Basu S. Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med 2012;9:e1001235.
Contents lists available at ScienceDirect
Nutrition journal homepage: www.nutritionjrnl.com
Brief report
Television advertising of food during children's programming in Nepal 1XD XAndrew D. Menger-Ogle D2X XPh.D. a, D3X XAshlie N. Johnson D4X XB.S., B.A. a, D5X XJohn A. Morgan D6X XB.S. b, D7X X Dan J. Graham D8X XPh.D. a,* a b
Colorado State University, Fort Collins, Colorado Clemson University, Clemson, South Carolina
A R T I C L E
I N F O
Article History: Received 3 November 2017 Received in revised form 6 February 2018 Accepted 11 February 2018 Keywords: Nepal Children Food marketing Advertising Television
A B S T R A C T
Objective: The World Health Organization has recommended that advertising of unhealthy food to children decrease in quantity (exposure) and efficacy (power). The degree to which marketing practices align with these recommendations varies across countries. The purpose of this study is to describe the television food marketing landscape that children experience in the South Asian country of Nepal. Research Methods & Procedures: Commercials from 57 hours of television were recorded from three channels during hours that children's programming was played. In a content analysis of 1,203 food commercials, researchers coded commercials for nutrition content, product category and marketing appeal type. Results: Principal findings of this study were that nearly 21% of airtime during children's programming was dedicated to commercials, and 55% of that was dedicated to foods. Over 70% of food commercials aired advertised foods with excessive amounts of saturated fat, sugar, and/or sodium; nearly half of the commercials (47.7%) featured products that contained excess sugar. The most prevalent food types shown were ice cream and popsicles (20.7%), energy/nutritional supplements (20.6%), and candy (14.7%). Additionally, the three most commonly occurring marketing appeals featured highly-efficacious strategies for persuading children— animated effects (83.2%), movie, cartoon, animated, or costumed characters (36.8%), and television/movie tie-ins (16.5%). Conclusion(s): Results from this study suggest that many television commercials shown in Nepal do not meet WHO recommendations for advertising foods to children. This is likely to negatively impact the diet and health of the next generation of Nepalis. © 2018 Elsevier Inc. All rights reserved.
Introduction The debate around marketing food to children Children's diets are important. Health across the lifespan is influenced by eating habits that are adopted early in life [1]. One factor that contributes to a diet are the marketing messages for specific foods. A review of past [2 4] and recent [5] research suggests a positive correlation between exposure to food commercials and consumption among children. The television advertising of foods to children has been criticized by researchers and health advocates in recent decades because a large proportion of the advertised foods are unhealthy [6] and children are more susceptible to advertising messages than adults [7]. Research on food marketing to
* Corresponding author. Tel.: (970) 491-4622; fax: (970) 491-1032. E-mail address: [email protected] (D.J. Graham). https://doi.org/10.1016/j.nut.2018.02.027 0899-9007/© 2018 Elsevier Inc. All rights reserved.
children that was conducted in Sri Lanka [8], Bulgaria [9], Turkey [10], Peru [11], South Africa [12,13], United States [14,15], Germany [16], and other countries [6] has shown the widespread use of this practice. The U.S. food industry took steps to self-regulate the nutrition standards for children [17] and years later the Healthy Eating Research program by the Robert Wood Johnson Foundation supplemented those nutrition standards with marketing standards [18]. However, the World Health Organization (WHO) has released broader-reaching guidelines that discuss governments' role in directing industries to decrease children's exposure to the marketing of unhealthy foods and diminish the power (i.e., efficacy) of marketing appeals [19]. Subsequent to the WHO recommendations, government regulation, and industry self-regulation, a systematic review of research found contradictory evidence on children's continued exposure to this type of marketing along with a cross-country variation in exposure [20]. Because of this cross-country disparity, the
42
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
continued investigation into how the food industry engages the issue of using television to market products to children is worthwhile, especially in understudied populations. Television in Nepal Nepal is a low-income country that is located between India and China in South Asia. Despite its impoverished conditions, especially in the rural regions where 81% of Nepalis live [21], television ownership was determined at 76% of a small sample of people in rural Nepal [22]. The first Nepal-based television broadcast network was launched in December 1985. Even before this, the first television channels were broadcast into Nepal's plains region (i.e., Tarai) from the Indian state television network in the early 1980s in areas that were geographically closer to India than Kathmandu, which is the capital of Nepal [23]. Due to a paucity of publicly available information about the television sector in published literature, one of the authors interviewed a manager with the Kathmandu-based television and internet provider Subisu Cablenet, Ltd. A total of 275 television broadcast vendors have been reported in Nepal but three of these operators hold most of the market share (Y. Karki, personal communication, April 2014). The television channels that are shown by these large, popular vendors are produced in Nepal as well as India, Singapore, United States, United Kingdom, and the Emirate of Dubai but 90% of the channels are based in India. Advertisements that are directed toward children are principally shown during programs that appeal to children and at times when children are expected to watch television. The channels that predominantly feature children's programing in Nepal are Nickelodeon, the Cartoon Network, and the Disney Channel and are broadcast from India (Y. Karki, personal communication, April 2014).
each product and the per-serving nutrition recommendations by the U.S. Interagency Working Group (IWG), which created nutrition standards for food products. The WHO has also set nutrition standards based on what an individual should consume in 1 d. In this study, the per-serving recommendations were chosen to evaluate the foods instead of the per-day recommendations because there was no way to know the total daily profile of food consumption for any given child. If more than one product was advertised in a commercial, the average of the products was compared with the nutrition standards. Two Nepali research assistants independently coded the marketing appeal types that were used in each commercial. The Cohen's Kappa values for each coding category ranged from 0.818 to 0.968. Foods were categorized by the authors via inductive coding on the basis of regional salience (i.e., categories were created post hoc to effectively organize the foods that appeared on Nepali television).
Results Foods advertised Commercials made up 20.8% of the broadcast time. Of the total of 2174 commercials that were shown during the nearly 12 h of recorded advertising, more than half (n = 1203) were food commercials. The commercials were comprised of 64 unique commercials although some of these had variants that differed by time or language. Across all commercials, the range in length was 5 s to 45 s (mean: 18.78; standard deviation: 7.50). With regard to language, written English and spoken Hindi were the most common and Nepali never appeared (Table 1). Categories The food products that were shown were sorted into 11 distinct categories and each commercial was only counted once. By and large, the food categories are discretionary foods that are not necessary for a healthy diet. Figure 1 shows the relative prevalence of each category among the total number of food commercials that were shown during the sample period.
Purpose Despite the widespread availability of television in Nepal, little is known about television food commercials or the degree to which they follow the WHO recommendations for advertising to children. Understanding this population-level influence on diet is important because Nepal is experiencing a nutrition transition including a rise in obesity [24]. Of related importance is the identification of the actual availability of products whose marketing messages originate outside of the country. The purpose of this study was to describe the television food marketing landscape that children experience in Nepal. Methods Sample In April 2014, television programming was digitally recorded in Kathmandu, Nepal on 9 separate days over a 20-d span: Three weekend days and six weekdays. The three recorded channels were Nickelodeon, the Cartoon Network, and the Disney Channel. Recording took place during hours that children's programming was played (07:30 h 12:00 h and 15:00 h 19:00 h). A total of 61 h were recorded but only 57 h remained after 4 h of recording had to be discarded due to broadcasting failures or the broadcasting of nonchildren's programming (e.g., home shopping program). Data processing and analysis After data collection, the digital recordings were edited to remove the actual television programs and approximately 12 h of commercials remained. A content analysis was conducted on the commercials and researchers categorized the food products that were advertised on the basis of existing coding schemes for food nutrition [25]. Researchers also coded commercials for marketing appeal types that were powerful (i.e., efficacious) for children [14]. Food nutrition codes were assigned on the basis of a comparison between the available nutrition content of
Nutrition profile The majority of commercials featured processed foods that contained proportions of sugar, saturated fat, trans fat, and/or sodium that exceeded the recommended standards that have been set forth by the IWG. In fact, 70% of the food commercials exceeded one or more recommendation by the IWG, 57.9% exceeded one recommendation, and an additional 12.1% exceeded two recommendations. The nutrient that most frequently exceeded the recommendation was sugar as nearly half (48.7%) of the commercials showed food products that contained more sugar than recommended. Nutrient information could not be found for 6.2% to 40.8% of the commercials depending on the nutrient. Therefore, it is possible that more commercials were showing food products that exceeded the recommendations (Table 2). Availability Most of the food commercials advertised food products that were widely available in Nepal (54.6%). However, other commercials showed food products that would need to be purchased from specialty shops (35.4%) or were not available for purchase in Nepal (10%). Table 1 Prevalence of languages in 1203 television food commercials broadcast in Kathmandu, Nepal Language
Written
Spoken
Hindi English Nepali
194 1195 0
998 404 0
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
Cereals 4% Spices 3%
Restaurants 1%
43
Dairy 3% Energy/Nutrion Supplement 20%
Ice cream/Popsicles 21%
Snacks (e.g., cheese crackers) 10% Cookies/Cakes 10%
Ready-made meals 10%
Flavored Drink 3%
Candy 15%
Fig. 1. Relative prevalence of each food product category in the total count of food commercials.
Marketing appeal and audience As predicted, a variety of the advertising appeal types that are powerful to children were utilized in the food commercials.
Table 2 Frequency of commercials with products that exceed nutrient recommendations Nutrient
Advertised foods not exceeding recommendation (%)
Advertised foods exceeding recommendation (%)
Advertised foods for which nutrient information was unavailable (%)
Saturated fat Trans fat Sugar Sodium
44.9 59.2 45.1 47.3
22.5 0 48.7 10.9
32.6 40.8 6.2 41.8
90%
The most common appeal technique, which appeared in more than 80% of the food commercials, was animation or animated effects. Figure 2 shows the proportions of the appeal types that were used. Every food commercial used at least one powerful appeal type. Children were the main protagonist in 45.7% of the food commercials, adults in 30.5%, and people did not appear in the remaining 23.8% of the food commercials. The disproportionate appearance of children in the starring roles of these commercials is more evidence that children are the targets of the marketing messages. Discussion Evidence from this study suggests that the media landscape in Nepal does not meet the WHO recommendations. Most food
83.2%
80% 70% 60% 50% 40%
36.8%
30% 20%
16.5%
15.8%
12.7%
12.7%
10%
1.2%
1.1%
0% TV or movie Celebries Showing Giveaways Web site or Use of Animaon e-mail e-in or athletes eang food (by mail or or animated characters address packaging) is fun (animated, effects costumed, etc.) Fig. 2. Food commercials by advertising appeal type.
Contests
44
A.D. Menger-Ogle et al. / Nutrition 55 56 (2018) 41 44
commercials (70%) expose children to products that have too much sugar, fat, and/or sodium. Fortunately, no advertised food products were identified as containing trans fats. One hundred percent of the recorded food commercials were powerful and used marketing techniques (e.g., animation and animated effects) that are difficult for children to resist. The results of this study show the extent to which Nepali television programing reflects a global marketplace. The three channels that were assessed here originated from outside Nepal and primarily featured spoken Hindi with written English, yet the vast majority of the advertised food products (90%) could be purchased in Nepal. This means that seeing these commercials could increase the consumption of the specific unhealthy foods that were advertised. The increased consumption of unhealthy foods by Nepalis may extend beyond the products that were included in these television commercials. A review of the research has shown that not only does advertising for specific food brands lead to an increase in their consumption but also that the increase in consumption extends to other brands within the same category [26], which results in a greater overall consumption of the advertised unhealthy food categories. Conclusions As food markets and marketing practices become more global, nutrition transitions in developing nations may result [24,27,28]. Food media trends that target Nepal's youth including the failure of more than 70% of foods that are advertised during children's television programming to meet health recommendations may already be foreshadowing an increase in less healthy diets among the youngest generation. References [1] Ambrosini GL. Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc 2014;73:137–46. [2] Buijzen M, Schuurman J, Bomhof E. Associations between children's television advertising exposure and their food consumption patterns: a household diarysurvey study. Appetite 2008;50:231–9. [3] Andreyeva T, Kelly IR, Harris JL. Exposure to food advertising on television: associations with children's fast food and soft drink consumption and obesity. Econ Hum Biol 2011;9:221–33. [4] McGinnis M, Gootman J, Kraak V. Food marketing to children and youth: Threat or opportunity? Washington, DC: Institute of Medicine. 2006. [5] Longacre MR, Drake KM, Titus LJ, Harris J, Cleveland LP, Langeloh G, et al. Child-targeted TV advertising and preschoolers' consumption of high-sugar breakfast cereals. Appetite 2017;108:295–302. ~ o I, Berg C, et al. [6] Kelly B, Halford JC, Boyland EJ, Chapman K, Bautista-Castan Television food advertising to children: a global perspective. Am J Publ Health 2010;100:1730–6.
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