Obesity Abstracts

Background: There is considerable interest in tightening food and drink advertising restrictions to address childhood obesity. However, regulations often focus on protecting children aged <12 years, with the assumption that older children are cognitively capable of understanding advertising. This review aims to systematically examine whether advertising influences children and adolescents' critical reasoning in relation to health behaviours.

Methods: Inclusion criteria were broad (>5 years to <18 years; any advertising exposure; a measure of 'judgement' as an outcome; experimental, intervention, cross-sectional, longitudinal, and qualitative methodologies; with no restrictions on language or date). The following databases were searched: Ovid Medline, Cochrane, Scopus, Psych Info, ProQuest (ASSIA), Web of Science (Social Science and emerging sources), Social Policy and Practice, and Child Development and Adolescent Studies. Articles were double screened on title and abstract and EPPI-Reviewer 4 systematic review software used to manage the review and apply machine learning to screening. This narrative focused on contemporary studies (2010 onwards) with an administered exposure which measured understanding or attitudinal outcomes.

Results: A total of 7467 articles were identified with 505 potentially relevant on title and abstract. Of these, 52 articles were published from 2010, included an experimental design and reported understanding or attitudinal outcomes. The majority had a moderate to high risk of bias. Exposures were predominantly adverts for food and from television. Understanding of advertising and recognition of persuasive intent increased with age, but there was no clear evidence that this reached adult levels by 12 years. Children seemed more perceptive about subtle messaging as they got older, with more novel advertising formats appearing particularly difficult for younger children to understand. Advertising produced more positive attitudes in children of all ages but links between understanding and attitudes were unclear.

Conclusions: Understanding of advertising increased across childhood and into adolescence but there was no evidence of a ceiling effect at age 12 years. Advertising brought about more positive attitudes in children of all of ages. Therefore, there appeared potential for younger children in particular to be manipulated by advertising but effects on adolescents require further exploration.

Keywords: Advertising, critical reasoning, judgement, child, adolescent

Disclosures: None.