How healthy and unhealthy food and beverages appear in movies and series for children: A comprehensive content analysis

Objective: Investigate which persuasive strategies are used in audiovisual media exposures of food and beverage items to children. Design: Content analysis of movies and series based on questionnaire responses from children and their parents. Setting: Six schools in rural as well as 6 schools in urban areas in Austria. Participants: A total of 648 children (aged 5–11 years) and 559 of their parents. Main Outcome Measures: Food and beverage categories (healthy = high nutritional value; unhealthy = high in fat, salt and/or sugars; mixed), composition-related, evaluative (nonverbal evaluation = facial expressions or sounds; verbal evaluation), and source-related strategies. Analysis: A logistic mixed-effects regression model with random intercepts predicting nutritional classification. Results: A total of 114 movies and 133 series (n = 12,320 food and beverage presentations) were coded. The study reveals that unhealthy food items are prominently featured in media aimed at children. Branded and centrally presented items had significantly higher odds of being classified as unhealthy (vs healthy; P < 0.001). Items that were interacted with or consumed were more likely to be unhealthy (vs healthy or mixed; P < 0.001). In addition, nonverbal positive evaluations increased the likelihood of items being unhealthy (vs healthy; P < 0.001), whereas negative nonverbal evaluations decreased the likelihood of items being unhealthy (vs healthy or mixed; P < 0.05). Conversely, items evaluated positively in a verbal-cognitive manner had lower odds of being unhealthy (vs healthy; P < 0.001). Conclusions and Implications: This study calls for more research on the effects of verbal and nonverbal evaluations of food depictions, particularly for diverging evaluative cues. Findings also emphasize the call to further regulate the depiction of foods and beverages in movies and series while encouraging content creators to make more mindful choices in how these items are portrayed.