Child-targeted fast-food television advertising exposure is linked with fast-food intake among pre-school children

Objective: To determine whether exposure to child-targeted fast-food (FF) television (TV) advertising is associated with children's FF intake in a non-experimental setting. Design: Cross-sectional survey conducted April-December 2013. Parents reported their pre-school child's TV viewing time, channels watched and past-week FF consumption. Responses were combined with a list of FF commercials (ads) aired on children's TV channels during the same period to calculate children's exposure to child-targeted TV ads for the following chain FF restaurants: McDonald's, Subway and Wendy's (MSW). Setting: Paediatric and Women, Infants, and Children (WIC) clinics in New Hampshire, USA. Subjects: Parents (n 548) with a child of pre-school age. Results: Children's mean age was 4.4 years; 43.2% ate MSW in the past week. Among the 40.8% exposed to MSW ads, 23.3% had low, 34.2% moderate and 42.5% high exposure. McDonald's accounted for over 70% of children's MSW ad exposure and consumption. Children's MSW consumption was significantly associated with their ad exposure, but not overall TV viewing time. After adjusting for demographics, socio-economic status and other screen time, moderate MSW ad exposure was associated with a 31% (95% CI 1.12, 1.53) increase and high MSW ad exposure with a 26% (95% CI 1.13, 1.41) increase in the likelihood of consuming MSW in the past week. Further adjustment for parent FF consumption did not change the findings substantially. Conclusions: Exposure to child-targeted FF TV advertising is positively associated with FF consumption among children of pre-school age, highlighting the vulnerability of young children to persuasive advertising and supporting recommendations to limit child-directed FF marketing.