Faculty Bibliography

Exposure to unhealthy food and beverage marketing is a major contributor to excessive weight gain among young people and it may disproportionately affect Black and Latinx communities. Appropriate and comprehensive regulations on food and beverage companies are essential, particularly as companies expand their reach and leverage the latest technologies to create marketing experiences using immersive virtual reality (VR). Although immersive VR technology is in its infancy, the potential effects of immersive VR food and beverage marketing on consumption, coupled with the history of racially targeted marketing by food and beverage corporations toward Black and Latinx communities, and the heightened burden of diet-related illnesses in Black and Latinx communities underscore a critical need to investigate immersive VR marketing targeting young people of color. This viewpoint will provide a brief description of VR food and beverage marketing as the newest food and beverage marketing frontier, highlight key concerns and knowledge gaps, and underscore future directions in research.

Prior studies assessing the impact of calorie labels in fast-food settings have relied on comparisons across local and state jurisdictions with and without labeling mandates; several well-designed studies indicate a small reduction of calories purchased as a result of the labels. This study exploits a staggered roll-out of calorie labels in California to study the same issue using a novel comparison of in-store purchases with calorie information and drive-through purchases without calorie information at the same locations. With this design, consumers in both the treatment and comparison groups have been subject to the same social signals associated with the policy change and may have been exposed to calorie information during prior purchases, narrowing the intervention under study to the impact of posted menu labels at the point of purchase. Transactions (N = 201,418,976) at 424 unique restaurants at a single fast-food chain were included and a difference-in-differences design was used to examine changes one and two years after the implementation of labels at in-store counters compared to baseline. Using this comparison of consumer purchases within the same jurisdictions, we found no meaningful impact of posted calorie labels at the point of purchase, suggesting that such labels did not induce behavioral change. Additional methods to strengthen the impact of labeling policies are worthy of further study.

Background/UNASSIGNED:Social media advertising by fast food companies continues to increase globally, and exposure to food advertising contributes to poor diet and negative health outcomes (eg, cardiovascular disease). McDonald's-the largest fast food company in the world-operates in 101 countries, but little is known about their marketing techniques in various regions. The objective of this study was to compare the social media advertising practices of McDonald's-the largest fast food company in the world-in 15 high-income, upper-middle-income and lower-middle-income countries. Methods/UNASSIGNED:We randomly selected official McDonald's Instagram accounts for 15 high-income, upper-middle-income and lower-middle-income countries. We captured all the screenshots that McDonald's posted on those Instagram accounts from September to December 2019. We quantified the number of followers, 'likes', 'comments' and video views associated with each account in April 2020. We used content analysis to examine differences in the marketing techniques. Results/UNASSIGNED:The 15 accounts collectively maintained 10 million followers and generated 3.9 million 'likes', 164 816 comments and 38.2 million video views. We identified 849 posts. The three lower-middle-income countries had more posts (n=324; M, SD=108.0, 38.2 posts) than the five upper-middle-income countries (n=227; M, SD=45.4, 37.5 posts) and seven high-income countries (n=298; M, SD=42.6, 28.2 posts). Approximately 12% of the posts in high-income countries included child-targeted themes compared with 22% in lower-middle-income countries. Fourteen per cent of the posts in high-income countries included price promotions and free giveaways compared with 40% in lower-middle-income countries. Conclusions/UNASSIGNED:Social media advertising has enabled McDonald's to reach millions of consumers in lower-middle-income and upper-middle-income countries with disproportionately greater child-targeted ads and price promotions in lower-middle-income countries. Such reach is concerning because of the increased risk of diet-related illnesses, including cardiovascular disease, in these regions.

OBJECTIVES:We aimed to determine the frequency with which kid influencers promote branded and unbranded food and drinks during their YouTube videos and assess the nutritional quality of food and drinks shown. METHODS:Researchers used Socialbakers data to identify the 5 most-watched kid influencers (ages 3 to 14 years) on YouTube in 2019. We searched for 50 of their most-watched videos and 50 of their videos that featured food and/or drinks on the thumbnail image of the video. We coded whether kid influencers consumed or played with food or toys, quantified the number of minutes food and/or drinks appeared, and recorded names of branded food and/or drinks. We assessed the nutritional quality of foods using the Nutrient Profile Model and identified the number of drinks with added sugar. RESULTS:= 7; 2.4%; eg, Yoplait yogurt). CONCLUSIONS:Kid influencers generate millions of impressions for unhealthy food and drink brands through product placement. The Federal Trade Commission should strengthen regulations regarding product placement on YouTube videos featuring young children.

: Background: To determine how many adolescents follow food/beverage brands on Instagram and Twitter, and examine associations between brands' youth-targeted marketing practices and percentages of adolescent followers.

Unhealthy food advertisements ("advertisements" hereafter referred to as "ads") are linked to poor diet and obesity, and food companies disproportionally target Black youth. Little is known about the mechanisms whereby food ads influence diet. One possibility may be racially-targeted ads that appeal to Black youth. Those with food-related attentional biases may be especially vulnerable. The objective of this project was to assess the feasibility and initial effects of a pilot study testing the influence of racially-targeted food ads and food-related attentional biases on eating behaviors among a sample of Black adolescent females. Feasibility of recruitment, retention, and procedures were examined. Participants (N = 41, 12-17y) were randomized to view a television episode clip of the Big Bang Theory embedded with either four 30-second racially-targeted food ads or neutral ads. A computer dot probe task assessed food-related attentional biases. The primary outcome was caloric consumption from a laboratory test meal. Interactions based on weight and ethnic identity were also examined. Analyses of variance and regressions were used to assess main and interaction effects. Exposure to racially-targeted food ads (versus neutral ads) did not affect energy consumption (p > .99). Although not statistically significant, adolescents with obesity consumed nearly 240 kcal more than non-overweight adolescents (p = 0.10). There were no significant preliminary effects related to food-related attentional biases or ethnic identity (ps = 0.22-0.79). Despite a non-significant interaction, these data provide preliminary support that adolescents with obesity may be particularly vulnerable to racially-targeted food ads. An adequately powered trial is necessary to further elucidate the associations among racially-targeted food ads among Black adolescent girls with obesity.

INTRODUCTION/BACKGROUND:Social media is the most prominent source of online food and beverage advertisements (ads) seen by adolescents. Companies target adolescent social media users with ads that feature calorie-dense, nutrient-poor products, and exposure to ads drives poor diet and risk for future diet-related diseases. Black, Hispanic and lower socio-economic status youth are exposed to significantly more ads than White peers. Several state-level policies in the USA have passed restricting youth from accessing social media without parental approval, and some policies have banned advertising to youth. This protocol paper describes a current study that aims to understand the impact of such policies in two states, Louisiana and Texas, as they were among the first to be implemented with racially/ethnically diverse populations. METHODS AND ANALYSIS/METHODS:This study employs a repeated cross-sectional difference-in-difference design in which 700 youth ages 13-17 years are being recruited each year for 5 years (Louisiana n=175, Texas n=175, matched comparisons from other states n=350). Youth screen record their mobile devices for 60 minutes while they browse social media platforms (eg, TikTok, Instagram) or use the internet. They also complete a brief survey about a variety of topics (eg, health behaviours, mental health). Adolescents are compensated for screen recording ($75) and the survey ($25). Study team members are coding recordings for several characteristics, including media platforms used, appearances of food or beverages, and food or beverage type. We will estimate the impact of policies on food and beverage ads seen per hour using Ordinary Least Squares regression models and heterogeneity-robust standard errors clustered at the state level (by year and cumulatively). We will run additional models with interaction terms with income and race/ethnicity, separately, to test the role of the policies on health disparities. ETHICS AND DISSEMINATION/BACKGROUND:Study procedures have been approved by the Institutional Review Board of the NYU Grossman School of Medicine. We will distribute findings in peer-reviewed journals and at local and national conferences. To complement traditional dissemination pathways, we will create infographics to share with relevant community stakeholders. We will also share findings with policymakers in states that have passed or considered similar policies.

The concept of 'food justice' recognizes the systemic injustices embedded in the U.S. food system and the urgent need for transformative policies to ensure equitable access to affordable, nutritious, and culturally relevant food. Limited access to these foods drives food insecurity and increases the prevalence of diet-related diseases in low-income and minority communities. Dominant narratives that individualize hunger and food insecurity often blame the individual and overlook the underlying structural factors that sustain these issues. These narratives have considerable influence. They shape public opinion and can also guide policy decisions. This commentary explores the goals of the food justice movement in the U.S., describes how the food and racial justice movements intersect, and examines the role of commercial marketing and public policy in shaping the food justice discourse. We also reflect on the efforts that should be made to reframe these dominant narratives and facilitate meaningful change in the food environment.