The effect of playing advergames that promote energy-dense snacks or fruit on actual food intake among children

Background: Previous studies have focused on the effects of television advertising on the energy intake of children. However, the rapidly changing food-marketing landscape requires research to measure the effects of nontraditional forms of marketing on the health-related behaviors of children. Objectives: The main aim of this study was to examine the effect of advergames that promote energy-dense snacks or fruit on children's ad libitum snack and fruit consumption and to examine whether this consumption differed according to brand and product type (energy-dense snacks and fruit). The second aim was to examine whether advergames can stimulate fruit intake. Design: We used a randomized between-subject design with 270 children (age: 8-10 y) who played an advergame that promoted energy-dense snacks (n = 69), fruit (n = 67), or nonfood products (n = 65) or were in the control condition (n = 69). Subsequently, we measured the free intake of energy-dense snacks and fruit. The children then completed questionnaire measures, and we weighed and measured them. Results: The main finding was that playing an advergame containing food cues increased general energy intake, regardless of the advertised brand or product type (energy-dense snacks or fruit), and this activity particularly increased the intake of energy-dense snack foods. Children who played the fruit version of the advergame did not eat significantly more fruit than did those in the other groups. Conclusion: The findings suggest that playing advergames that promote food, including either energy-dense snacks or fruit, increases energy intake in children. This trial was registered at www.controlled-trials.com as ISRCTN17013832. Am J Clin Nutr 2013; 97: 239-45.