Children as consumers: advertising and marketing

Marketing and advertising support the U.S. economy by promoting the sale of goods and services to consumers, both adults and children. Sandra Calvert addresses product marketing to children and shows that although marketers have targeted children for decades, two recent trends have increased their interest in child consumers. First, both the discretionary income of children and their power to influence parent purchases have increased over time. Second, as the enormous increase in the number of available television channels has led to smaller audiences for each channel, digital interactive technologies have simultaneously opened new routes to narrow cast to children, thereby creating a growing media space just for children and children's products. Calvert explains that paid advertising to children primarily involves television spots that feature toys and food products, most of which are high in fat and sugar and low in nutritional value. Newer marketing approaches have led to online advertising and to so-called stealth marketing techniques, such as embedding products in the program content in films, online, and in video games. All these marketing strategies, says Calvert, make children younger than eight especially vulnerable because they lack the cognitive skills to understand the persuasive intent of television and online advertisements. The new stealth techniques can also undermine the consumer defenses even of older children and adolescents. Calvert explains that government regulations implemented by the Federal Communications Commission and the Federal Trade Commission provide some protection for children from advertising and marketing practices. Regulators exert more control over content on scarce television airwaves that belong to the public than over content on the more open online spaces. Overall, Calvert concludes, children live and grow up in a highly sophisticated marketing environment that influences their preferences and behaviors.     

The new threat of digital marketing

Because of their avid use of new media and their increased spending power, children and teens have become primary targets of a new "media and marketing ecosystem." The digital marketplace is undergoing rapid innovation as new technologies and software applications continue to reshape the media landscape and user behaviors. The advertising industry, in many instances led by food and beverage marketers, is purposefully exploiting the special relationship that youth have with new media, as online marketing campaigns create unprecedented intimacies between adolescents and the brands and products that now literally surround them.     

The relationship between television advertising, children's viewing and their requests to Father Christmas

OBJECTIVE: Children's letters to Father Christmas provide an opportunity to use naturalistic methods to investigate the influence of television advertising. METHODS: This study investigates the number of toy requests in the letters of children aged between 6 and 8 (n = 98) in relation to their television viewing and the frequency of product advertisements prior to Christmas. Seventy-six hours of children's television were sampled, containing over 2,500 advertisements for toys. RESULTS: Children's viewing frequency, and a preference for viewing commercial channels, were both related to their requests for advertised goods. Gender effects were also found, with girls requesting more advertised products than boys. CONCLUSION: Exploring the children's explicit understanding of advertising showed that children in this age group are not wholly aware of the advertisers' intent and that, together with their good recall of advertising, this may account for their vulnerability to its persuasive messages.     

Children, adolescents, and the media: health effects

The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.     

Prevalence of gallbladder stone disease in obese children and adolescents: influence of the degree of obesity, sex, and pubertal development

OBJECTIVES: The objective of the present study was to investigate the prevalence of gallbladder stone disease (GD) in a collective of obese children and adolescents and to assess the role of potential influencing factors such as the degree of obesity, sex, age, and pubertal development. METHODS: Four hundred ninety-three obese children and adolescents (body mass index standard deviation score [BMI-SDS] > 2.0p) aged 8 to 19 years (218 males, 275 females) were included in the study and underwent ultrasound for detection of GD. RESULTS: Gallbladder stones were detected in 10 of 493 (2.0%; 8 girls, 2 boys) subjects studied. None of the 95 prepubertal children examined were found to suffer from GD. Patients with GD were more severely obese (BMI-SDS 3.4 +/- 0.5 vs. 2.7 +/- 0.4; P < 0.001) and older (16.1 +/- 1.5 vs.13.9 +/- 2.0 years; P < 0.008) than children and adolescents without GD. CONCLUSIONS: Compared with published data for unselected children an adolescents, the prevalence of GD (2.0%) in obese children and adolescents, previously treated with diet for obesity, is high. Obesity and female sex appear even in children and adolescents to be risk factors for the development of GD. The occurrence of prepubertal GD is rare.     

Self-esteem, depression and anxiety among Swedish children and adolescents on and off cancer treatment

Self-esteem, depression and anxiety were investigated in 51 Swedish children and adolescents, 8-18 y, on (n = 16) and off (n = 35) cancer treatment. The self-report measures "I Think I Am" (ITIA), the Children's Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS) were used. Data were compared with data previously obtained by others for healthy Swedish children. Children and adolescents on treatment showed levels of self-esteem, depression and anxiety comparable to those of healthy children. However, children and adolescents off treatment reported higher depression and anxiety levels and lower psychological well-being and physical self-esteem than have been reported for healthy Swedish children. Seven children (14%) reported a high level of depression, six of whom were off treatment. The findings suggest that the period after treatment termination is characterized by a higher risk of psychosocial problems than is the actual treatment period.     

Prevention of rickets and vitamin D deficiency in infants, children, and adolescents

Rickets in infants attributable to inadequate vitamin D intake and decreased exposure to sunlight continues to be reported in the United States. There are also concerns for vitamin D deficiency in older children and adolescents. Because there are limited natural dietary sources of vitamin D and adequate sunshine exposure for the cutaneous synthesis of vitamin D is not easily determined for a given individual and may increase the risk of skin cancer, the recommendations to ensure adequate vitamin D status have been revised to include all infants, including those who are exclusively breastfed and older children and adolescents. It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. The current recommendation replaces the previous recommendation of a minimum daily intake of 200 IU/day of vitamin D supplementation beginning in the first 2 months after birth and continuing through adolescence. These revised guidelines for vitamin D intake for healthy infants, children, and adolescents are based on evidence from new clinical trials and the historical precedence of safely giving 400 IU of vitamin D per day in the pediatric and adolescent population. New evidence supports a potential role for vitamin D in maintaining innate immunity and preventing diseases such as diabetes and cancer. The new data may eventually refine what constitutes vitamin D sufficiency or deficiency.     

Exposure to food advertising on television among US children

OBJECTIVE: To examine exposure to food advertising on television (TV) among children aged 2 through 11 years. DESIGN: Weighted examination of the distribution of national advertisements (ads) using TV ratings data. SETTING: National ads from 170 top-rated TV shows viewed by children aged 2 through 11 years from September 1, 2003, through May 31, 2004. PARTICIPANTS: Sample of 224,083 ads. MAIN OUTCOME MEASURES: Television nonprogram content time was assessed across 6 mutually exclusive categories that included food products, non-fast food restaurants, fast food restaurants, other products, public service announcements, and TV promotions. Food advertising was assessed according to 7 food categories--cereal, snacks, sweets, beverages, fast food restaurants, non-fast food restaurants, and other food products--and then examined across more detailed categories. RESULTS: In 2003-2004, 27.2% and 36.4% of children's exposure to total nonprogram content time and product advertising, respectively, was for food-related products. Similar distributions were found by race. Cereal was the most frequently seen food product, making up 27.6% of all food ads. Comparisons with previous studies suggest that, over time, food ads account for a smaller share of the product ads seen by US children. CONCLUSIONS: Children aged 2 through 11 years are exposed to a substantial amount of food advertising through TV, but the dramatic increase in childhood obesity rates during the past few decades was not mirrored by similar changes in food advertising exposure. However, we found evidence of a very recent (2000-2005) upward trend in the amount of exposure to food advertising on TV among US children.     

Children, adolescents, and television

As we have indicated, children's television has either a documented or probable effect on a variety of health-related behaviors in children and adolescents in the United States. Studies of cognitive development indicate that television provides a stimulus for learning and that children learn from television. The adverse effects of television appear related to both the time spent watching television and the content of the programs that are viewed. The reviewed observations suggest that a variety of initiatives are warranted to alter the time children spend watching television, the content of programs, and the types of programs for children and adolescents that are produced and broadcast. These initiatives require the development of effective techniques and materials for counseling parents, as well as continued political and legislative activities at the local and national level. We must promote the conviction that time spent in activities other than television viewing will provide our children with the values necessary to understand and interact with an increasingly complex world. Effective governmental action on behalf of children to change television will require a reaffirmation and enforcement of the Public Interest Standard. For half a century, the broadcast media have been licensed to use the airwaves in the public interest. The diversity and magnitude of the adverse effects of television on the health of children strongly suggest that the use of television has not been in the public interest. Although cable television offers multiple alternatives, less than 60% of American households receive cable. Broadcast television still represents the only alternative for 40% of American children. Substantial regulatory change by the current administration is unlikely. Therefore, legislative activity to mandate broadcast practices responsive to the needs of children appears the most appropriate national approach.     

On intimacy, sexual activities and exposure to sexual abuse among children and adolescents with mobility impairment

AIM: The aim was to describe experiences of intimacy and sexual activity and exposure to sexual abuse among children and adolescents with mobility impairment, and to relate these experiences to socio-demographic data, disability characteristics and well-being. METHODS: This study included semi-structured interviews with 141 children and adolescents aged 7-18 years with mobility impairment. Interpersonal experiences of intimacy and sexuality, socio-demographic data, disability characteristics and well-being were registered. RESULTS: About half of the children and adolescents in the study had been in a boy- or a girlfriend relationship, and about a fifth had an ongoing relationship. Of the adolescents, 15% had at least one experience of a sexual relationship. Whereas no particular sexual dysfunction was reported, 15% had concerns about their future sexual activities, presumably related to mobility impairment. A history of sexual abuse was reported by 7% in the age cohort of 13-18 years. The socio-demographic and disability-related features had a marginal influence on the experiences of intimacy and sexual activities. CONCLUSION: Several aspects of sexual health are not fully realized for children and adolescents with impaired mobility, and there is a need for specialized sexual health care services to protect the sexual rights of this group.     

Temporal artery temperature measurements in healthy infants,children, and adolescents

A noninvasive temporal artery thermometer that uses arterial heat balance technology has been compared to rectal and ear thermometry and is available in the marketplace. This study was undertaken to establish mean temperatures and temperatures 2 standard deviations above the mean for healthy infants, children, and adolescents. Temperatures were measured in healthy patients 0 to 18 years of age using a noninvasive temporal artery thermometer. Temperatures were measured in 2,346 patients. Mean temperatures and temperatures 2 standard deviations above the mean were: 37.1 degrees C (38.1 degrees C) for 383 infants 0 to 2 months; 36.9 degrees C (37.9 degrees C) for 860 children 3 to 47 months; 36.8 degrees C (37.8 degrees C) for 680 children 4 to 9 years; and 36.7 degrees C (37.8 degrees C) for 423 adolescents 10 to 18 years. There were no significant differences in temperatures in white compared to African-American children, children with or without perspiration on their forehead, or between measurements taken on the left compared to the right side of the forehead. This study provides information about temporal artery temperatures in healthy infants and children that can serve as a basis for interpreting temperature measurements in ill children when the same instrument is used.     

Referrals, diagnoses, and neuropsychological findings in an outpatient sample of German children and adolescents with brain dysfunction

Although the necessity of outpatient neuropsychological rehabilitation of neurologically impaired children and adolescents is widely accepted, outpatient services, however, are scarcely supplied. Furthermore, there are only a few analyses of the requirement of such services for children and adolescents. This investigation presents the results of an empirical analysis of referral sources, referral diagnoses, demographic characteristics, and neuropsychological findings for an outpatient neuropsychological utilization sample of children and adolescents with brain dysfunction. Finally, suggestions for the further development of adequate rehabilitation programmes are discussed.     

Plasmodium vivax malaria in children and adolescents - epidemiological, clinical and laboratory features

OBJECTIVE: Evaluation of epidemiological, clinical and laboratory features of Plasmodium vivax malaria in children and adolescents. METHODS: This study was carried out in the Malaria Program of the Evandro Chagas Institute (Belém, Pará), from January 1995 to November 1996. 100 children and adolescents with the diagnosis of P. vivax malaria (thick blood film) were randomly enrolled. A protocol was created to assess epidemiological, clinical and laboratory parameters of this pathology. RESULTS: Malaria occurred in both sexes, and had a prevailing incidence among adolescents (37%). Most of the children and adolescents (92%) had been infected in the State of Pará. Autochthonous cases in the metropolitan area of Belém accounted for 34 % of the sample. Primary infection was seen in 80% of the patients. Fever was the major onset clinical symptom (88%). A history of typical febrile paroxysm was recorded in only 25% of the casuistic. In the first day of treatment (D0) fever (97%), chills (91%), pallor (85%), splenomegaly (46%) and hepatomegaly (29%) were some of the clinical features observed. Pallor (clinical signal) was found to be significantly (p=0.0004) associated with anemia (hemoglobin rate). There was a high significant negative correlation (p=0.0001) between delay of diagnosis (mean 12,5 days) and hemoglobin values. Regarding parasitological examination, just children and adolescents with positive results to hookworms were significantly (p=0.0133, p=0.0075) more anemic than those who had a positive parasitological examination to other helminths and/or protozoa species. CONCLUSIONS: Malaria affected children and adolescents from both sexes. An emphasis on epidemiological and clinical data is an important tool to the precocious diagnosis of the disease. Delay on diagnosis made anemia worse.     

Dietary calcium, saturated fat, fiber and vitamin C as predictors of forearm cortical and trabecular bone mineral density in healthy children and adolescents

Diet, weight–bearing physical activity (WPA) and daylight hours spent outdoors (DE) were related to bone mineral density in the distal (BMDd) and ultradistal (BMDud) forearm of 495 healthy children (8–11 years) and adolescents (11–17 years). BMD was assessed by single photon absorptiometry. Using multiple regression, BMDd was predicted by saturated fat and BMDud by fiber in children. In adolescents, BMDd was predicted by saturated fat and vitamin C, and BMDud by calcium and vitamin C. WPA and DE were not related to BMD. In conclusion, our results showed that current intake of calcium, saturated fat, fiber and vitamin C were positively associated with forearm BMD in children and adolescents. These associations depended on age and bone type. If our findings are verified, dietary recommendations, especially when aimed at young people, may have to be reconsidered.     

Resistance training, skeletal muscle and growth

Resistance training in youth and its effectiveness, possible effect on growth and safety considerations, has received considerable public and scientific attention in recent years. Although few early studies questioned the usefulness of resistance training in children, numerous recent studies have demonstrated its effectiveness in both children and adolescents. Nevertheless, the optimal intensity and volume of training for youths of different ages requires further study. The increase in strength following resistance training in youths, especially in prepubertal children, is believed to be due mainly to neural adaptations and only minimally, if at all, to muscle hypertrophy. Few studies have examined the long-term effect of resistance training on growth. The few which have, found that, contrary to the common misconception that resistance training may retard growth. Scientific evidence indicates that resistance training results in increased serum IGF-I and that there is no detrimental effect on linear growth. Finally, numerous studies have demonstrated that with appropriate supervision and precautions, resistance training can be safe and effective for children and adolescents.     

Schistosomiasis: Impact on childhood and adolescent growth,malnutrition, and morbidity

Schistosomiasis affects more than 200 million individuals residing in developing countries. The majority of those infected are children and adolescents because of high exposure to infective water and low levels of acquired immunity. Lack of sanitary human waste disposal, vector control, and regular antiparasitic treatments create conditions leading to endemic infection levels in many regions. Because of the impact of schistosomiasis on nutrient loss and dietary intake, the energetic demands for growth and development are not met. Short-term decreases in nutritional status and long-term delays in size for age have been observed in many different cross-sectional and longitudinal studies in all three major schistosome species. Infected children have reduced weight for height, skinfold thickness, and, in some cases, height for age compared with uninfected peers. Because of the many other influences on malnutrition in children in developing countries, randomized designs have provided the best causal evidence of the negative influence of schistosomiasis on nutritional status, size for age, hemoglobin and iron-deficiency anemia, and cognitive function. In these short-term randomized studies, infected children treated with antischistosomal drugs show increases in skinfold thickness, weight, hemoglobin levels, and cognition relative to the untreated children. Schistosomiasis infection at all levels of intensity exerts detrimental effects on growing children. The burden of disease from schistosomiasis must be broadened conceptually and operationally to include disturbances in nutritional status, growth, and cognitive function among children and adolescents. Copyright © 2000 by W.B. Saunders Company     

Excess of weight,but not underweight,is associated with poor physical fitness in children and adolescents from Castilla-La Mancha,Spain

We estimated the prevalence of underweight, overweight and obesity of children and adolescents from Castilla-La Mancha region (Spain), applying the new International Obesity Task Force (IOTF) 2012 criteria, and analysed differences in physical fitness components in relation to weight status. The sample was 2,330 schoolchildren aged 6–17 years. We measured height and weight, calculated body mass index (BMI) and assessed physical fitness using four tests included in the EUROFIT battery. Differences in physical fitness components across BMI categories, by sex, were calculated using ANOVA models. In children aged 6–11 years, 4.9 % were underweight, 26.7 % overweight and 11.0 % obese; in adolescents aged 12–17 years, 6.4 % were underweight, 16.7 % overweight and 5.8 % obese. Overall, overweight and obesity were associated with worse physical fitness but students in the underweight category did not score worse than their normal weight counterparts on fitness tests. Conclusion: Childhood obesity in Spain remains a public health problem. Our results show low physical fitness levels in overweight/obese children and adolescents and low levels of handgrip strength in underweight adolescents compared with normal weight subjects. Exercise programmes must be tailored to the specific needs of the subjects according to the different weight status.     

Early childhood development: A comparative study of beliefs held by adolescents, medical students and mothers

Abstract This study examined beliefs about the normal development of preschool children held by adolescents, medical students and mothers. A consistent pattern was identified, with adolescents estimating that young children can do the least, medical students'estimations lying between those of adolescents and mothers, and mothers estimating that the children can do the most. In addition, medical students were found to change their beliefs during the time that they participated in their paediatric teaching programme. It is suggested that paediatricians and other child health professionals take into account the varying beliefs held by different groups in the community when providing advice or teaching about early child development.     

Early childhood development: a comparative study of beliefs held by adolescents, medical students and mothers

This study examined beliefs about the normal development of preschool children held by adolescents, medical students and mothers. A consistent pattern was identified, with adolescents estimating that young children can do the least, medical students' estimations lying between those of adolescents and mothers, and mothers estimating that the children can do the most. In addition, medical students were found to change their beliefs during the time that they participated in their paediatric teaching programme. It is suggested that paediatricians and other child health professionals take into account the varying beliefs held by different groups in the community when providing advice or teaching about early child development.