Trends in the nutritional content of television food advertisements seen by children in the United States: analyses by age, food categories, and companies.

OBJECTIVE To examine trends in children's exposure to food-related advertising on television by age, product category, and company. DESIGN Nutritional content analysis using television ratings data for 2003, 2005, 2007, and 2009 for children. SETTING Annual age-specific television ratings data captured children's exposure to broadcast network, cable network, syndicated, and spot television food advertising from all (except Spanish-language) programming. PARTICIPANTS Children aged 2 to 5 and 6 to 11 years. Main Exposure  Television ratings. MAIN OUTCOME MEASURES Children's exposure to food-related advertising on television with nutritional assessments for food and beverage products for grams of saturated fat, sugar, and fiber and milligrams of sodium. RESULTS Children aged 2 to 5 and 6 to 11 years saw, respectively, on average, 10.9 and 12.7 food-related television advertisements daily in 2009, down 17.8% and 6.9% from 2003. Exposure to food and beverage products high in saturated fat, sugar, or sodium fell 37.9% and 27.7% but fast-food advertising exposure increased by 21.1% and 30.8% among 2- to 5- and 6- to 11-year-olds, respectively, between 2003 and 2009. In 2009, 86% of ads seen by children were for products high in saturated fat, sugar, or sodium, down from 94% in 2003. CONCLUSIONS Exposure to unhealthy food and beverage product advertisements has fallen, whereas exposure to fast-food ads increased from 2003 to 2009. By 2009, there was not a substantial improvement in the nutritional content of food and beverage advertisements that continued to be advertised and viewed on television by US children.