When it comes to kids under age 5, can parents ever be certain about what they say they're feeling, is true? And further, since they have a limited ability to know themselves physically, and express themselves, is what they're saying always accurate? Or is it just roughly true? Or can they say things that on occasion may not even be true at all?
Well, if it's hard to say for sure, consider that these are some of the important questions hanging over a recent study which sought to determine whether little kids can be influenced to eat by TV food commercials when they are not hungry.
Certainty is an essential element in any study, and obviously those with some uncertainty baked right in should be viewed with a skeptical eye. And that's what it appears we have here with a study led by Jennifer Emond, PhD, from Dartmouth College's Geisel School of Medicine titled "Randomized Exposure to Food Advertisements and Eating in the Absence of Hunger Among Preschoolers."
Dr. Emond and colleagues set out to address both mindless, unnecessary eating and the obesity epidemic facing American youngsters. Both laudable, worthwhile goals. However, there seems to be several questionable factors that enter into their work. But before we get to those, here's how the study, published online in the journal Pediatrics, was conducted.
Between 2015-16, from 88 children screened aged 2-to-5, 60 were enrolled in a one-hour study. All were given a so-called healthy snack consisting of cheese, crackers, banana and water, for the purposes of making sure they were not hungry during testing. Then, they were shown a 14-minute program from Sesame Street, with half of the kids also watching an embedded commercial for Bugles corn chips, during which kid-actors ate that same salty snack. The other half viewed a TV ad for a national department store. And during the viewing all kids were given graham cracker treats and Bugles.
What the researchers reported was that eating in the absence of hunger, or EAH, was greater for those who watched the Bugles commercial. "Children exposed to food advertisements consumed, on average, [127 calories] more during the EAH phase than children exposed to the nonfood advertisements," who ate 97 calories worth of snacks.
With that as its linchpin, the study concluded that "exposure to TV food advertising as presented in a typical children’s TV program had an acute effect on cued eating among preschool-age children. Reducing a young child’s exposure to food advertisements is thus an actionable way to reduce the priming and reinforcement of obesogenic dietary behaviors during a critical period of child growth."
But given the potential confounding factors below, we're not so sure that's the case.
To begin with, the healthy snack was made available to ensure that the kids were full before TV viewing. The kids may say they're full, but maybe they aren't. And how can the researchers know for sure, as they readily admit: "Self-reported satiety ratings among young children," the study states, "are likely limited and should be cautiously interpreted." And can we reliably know whether 2-year-olds are full? Can this be observed with any accuracy, or can they accurately understand and convey this to researchers?
In addition, the study utilized a small sample size, just 60 kids. And it was conducted with kids from only Vermont and New Hampshire who were "mostly white, affluent rural kids, which may make the results less relevant to the broader population of U.S. children," as noted by a report in Reuters.
Moreover, Dr. Emond's team also screened for so many factors -- "Eligibility included English fluency, absence of food allergies and dietary restrictions, absence of health conditions or medication use that may affect appetite, willingness to participate in a 1-hour study, lack of familiarity with Bugles corn snacks, and no known previous exposure to Bugles advertisements" -- that it calls into question how the results can be meaningfully applied to the 2-to-5 age population at large.
And finally, it's hard to overlook a bit of hedging in the study's findings, where in at least two instances researchers retreated slightly from making a declarative statement by invoking the word "may."
“Young children average up to three hours of TV viewing a day,” Dr. Emond told Reuters. "If kids are exposed to food ads during that time, they may unconsciously overconsume snacks which can lead to extra weight gain.”
And in the paper's conclusion, we're told this: "Findings suggest that food advertisement exposure may encourage obesogenic-eating behaviors among the very young."
So given these questions, what should concerned parents take away from this research? First off, with young kids in this age group, the recent recommendation from the American Academy of Pediatrics is that parents should watch TV with their kids. And for the very youngest, as we reported last month, "those 1 1/2 to 2 years of age could watch high-quality TV programs, but accompanied by parents so they can explain what their child is watching. Kids aged 2 to 5 should be limited to one hour of screen use daily."
At the same time, parents should be aware that TV ads might influence very young kids, so use your discretion about whether to distract your child's attention from them when they appear.
While it seems logical that watching a particular, on-screen behavior might encourage the very young and impressionable to copy it, this study presents more than a few uncertainties that prevent us from becoming true believers.