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Responsiveness to healthy advertisements in adults: An experiment
assessing beyond brand snack selection and the impact of restrained
eating
Terence M. Dovey
a
,
*
, Tina Torab
a
, Dorothy Yen
b
, E.J. Boyland
c
, Jason C.G. Halford
c
a
Institute of Environment, Health &Societies, Department of Life Sciences, Marie Jahoda Building, Brunel University London, Uxbridge, UB8 3PH, United
Kingdom
b
Brunel Business School, College of Business, Arts and Social Sciences, Eastern Gateway, Brunel University London, Uxbridge, UB8 3PH, United Kingdom
c
Department of Psychological Sciences, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, United Kingdom
article info
Article history:
Received 6 October 2016
Accepted 15 January 2017
Available online 19 January 2017
Keywords:
Advertising
Restraint
Healthy eating
Food choice
abstract
The objective of this study was to explore the impact of different advertising messages on adults' snack
choice. Eighty participants (18e24 years old) were offered the choice between two snack packs following
exposure to one of three advertising conditions. The snack packs contained either healthy or high fat,
sugar or salt (HFSS) foods. Participants were exposed to commercials containing either non-food prod-
ucts, healthy food products or HFSS food products and their subsequent choice of snack pack was
recorded. The Dutch Eating Behaviour Questionnaire (DEBQ) was used to assess the impact of external,
restrained and emotional eating behaviour on snack pack selection following exposure to advertise-
ments. The majority of unrestrained participants preferentially choose the HFSS snack pack irrespective
of advertisement condition. In contrast, high restrained individuals exposed to the healthy eating
advertisement condition preferentially selected the healthy snack pack while those in other advertise-
ment conditions refused to take either snack pack. The healthy eating message, when distributed
through mass media, resonated with restrained eaters only. Exposure to healthy food adverts provoked
restrained eaters into choosing a snack pack; while exposure to other messages results in restrained
eaters refusing to take any foods.
©2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
1. Introduction
Television is a powerful method of mass communication and,
along with the internet, is the primary vehicle to deliver commer-
cial food and drink advertising to a mass audience (Boyland,
Harrold, Kirkham, &Halford, 2011; Kelly et al., 2010). As a result,
exposure to food advertisements has been proposed as an impor-
tant factor in influencing short-term food intake (Boyland et al.,
2016). Unsurprisingly, a number of narrative, systematic and
meta-analytic reviews have concluded that food advertising leads
to a greater preference for, and intake of, the products advertised.
What is interesting is that these same advertisements also increase
consumption of similar products in the same category. (e.g. Batada,
Seitz, Wootan, &Story, 2008; Boyland et al., 2016; Hastings et al.,
2003; Sixsmith &Furnham, 2010). This beyond-brand phenome-
non of the television advertisement suggests that when an indi-
vidual is exposed to commercials it primes the desire to eat all
foods within the same category (Bargh, 2006; Halford, Boyland,
Hughes, Oliveira, &Dovey, 2007; 2008). Despite regulations to
restrict the advertising for HFSS foods in many developed coun-
tries, people are still exposed to significantly more advertisements
for HFSS foods than products that promote high nutrient or low
calorie alternatives (Cairns, Angus, Hastings, &Caraher, 2013). This
presents a significant problem for health professionals attempting
to instil healthy eating programmes at the population level.
Due to the overwhelming presence of HFSS foods in media
advertising, little research has focused on advertising nutritious
foods with a healthy eating narrative and how these subsequently
impact on the viewers' eating behaviours. Exposure to healthy food
advertising results in small effect size increases in habitual fruit and
vegetable consumption (Liaukonyte, Rickard, Kaiser, Okrent, &
Richards, 2012; Pollard et al., 2008). Two competing perspectives
*Corresponding author.
E-mail address: terence.dovey@brunel.ac.uk (T.M. Dovey).
Contents lists available at ScienceDirect
Appetite
journal homepage: www.elsevier.com/locate/appet
http://dx.doi.org/10.1016/j.appet.2017.01.015
0195-6663/©2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Appetite 112 (2017) 102e106
have been offered concerning how the change in behaviour
following exposure to healthy food advertisements operates. The
first perspective suggests a simple manipulation effect, whereby
the healthy food advertisement operates by directly increasing
positive attitudes towards healthy eating habits within the
viewer(s) (Dixon, Scully, Wakefield, White, &Crawford, 2007). The
alternative perspective extends fromthe work of Bruner (1957) and
suggests that the healthy advertisement achieves behaviour change
through goal directed attention (Brunner, &Siegrist, 2012). Within
this socio-cognitive domain, the television advertisement only
reaches those people who have already instilled the healthy eating
narrative.
The limited data exploring the impact of healthy advertisements
appears to support both an attitude change and goal directed
attention interpretation. Studies exploring attitude change
following exposure to health-related campaigns have found small
to moderate effects in line with the changes in diet (Emery et al.,
2012). Specific goal-directed motivations following exposure to
healthy advertisements have also been observed in children. Chil-
dren with low levels of food neophobia decrease consumption of
the HFSS items at a subsequent snack opportunity, but do not shift
to healthier options (Dovey, Taylor, Stow, Boyland, &Halford, 2011).
Overall, susceptibility to changes in food intake in children
following exposure to media advertisements is known to be
dependent on other characteristics such as weight status (Halford
et al., 2008) and impulsivity (Folkvard, Anschutz, Nederkoorn,
Westerik, &Buijzen, 2014). Similar goal-directed motivated obser-
vations in response to television advertisements have not been
identified in adults (Anschutz, Engels, Becker, &van Strien, 2009).
This has led some authors to conclude that older age groups are not
susceptible to changes in eating behaviour following exposure to
television advertisements (Boyland et al., 2016). However, when
paradigms include food choice (Harris, Bargh, &Brownell, 2009)or
offers foods that are similar to those advertised (van Strien,
Herman, &Anschutz, 2012) subsequent changes in eating behav-
iour have been observed in adults.
The measurement of total caloric intake following exposure to
food advertisements fails to consider the purpose of the food
advertisement. The intention of a food advertisement is to famil-
iarise the viewer with the product and help them better achieve
their purchasing objectives (Resnik &Stern, 1977). In children,
increased caloric intake following exposure to food advertisements
may operate in a similar manner to any other external food cue.
This beyond brand effect observed in children (Halford et al., 2007;
2008) may stem from children's lack of understanding about the
intention of the food advertisement, leading to a global/category-
specific increase in food intake following exposure to television
programming (Hastings et al., 2003). In adults who are aware of an
advertisements intention, observed changes or reactivity to expo-
sure may only occur when the core advertisement message and the
viewer's current goals are aligned (see Bargh, 2006; Papies, 2016 for
reviews). Therefore, it is reasonable to suggest that factors such as
cognitive restraint, emotional eating and external eating may have
a significant role in responsiveness to healthy advertisements.
Focus on the negative impact of food advertisement has negated
the potential impact that this medium may have for positive
behaviour change. Further investigation regarding the impact of
healthy food advertisement on food choice is warranted. The aim of
the current paper was to investigate the impact of food advertise-
ments (both healthier and HFSS) on eating behaviour in adults. We
hypothesized that participants would be more likely to choose
healthy snacks following the congruent food advertisements and
are expected to choose HFSS snacks after exposure to HFSS food
adverts. A second aim was to investigate the role of individual
differences in eating-related characteristics and their interaction
with food advertisements on subsequent food choice. We believed
that individual differences as measured by high/low external, re-
straint and emotional eating status will have an impact on partic-
ipants' food choice after exposure to advertisements.
2. Method
2.1. Participants
A sample of eighty participants (38 female and 42 male) aged
18e24 years (M ¼20.86, SD ¼1.33) were recruited through op-
portunity sampling around a London university campus and a West
London Community Centre. The vast majority of the sample were
either staff or students at the university and had a healthy body
mass index (BMI) with 63 participants falling into the lean category
and 17 in the overweight category (M ¼23.19, SD ¼3.19). BMI was
not a significant factor in snack pack selection (
c
2
(3) ¼5.23;
p¼0.12) and did not interact with the three DEBQ subscales (all
p>0.1). Participants were randomly allocated to the three adver-
tisement conditions. Twenty-five participants were exposed to
advertisements for HFSS food, 26 participants were exposed to the
healthy food advertisements and 29 participants were exposed to
non-food advertisements (which did not contain any references to
food). The only exclusion criteria for the study were individuals
who reported any form of food allergy or subsequently reported not
liking any of the foods in either of the snack packs.
3. Materials
The current experiment was given full ethical approval from the
Brunel University London School of Life Sciences ethics board. A
between-subject design was used in this study, with the dependent
variable of ‘snack pack choice’used to measure behaviour change.
Participants were exposed to one of three advertisement types
(HFSS, healthy, or neutral/non-food products). Eating-specific in-
dividual differences of restraint, emotional and external eating
were assessed through the Dutch Eating Behaviour Questionnaire
(DEBQ) and acted as independent variables.
Snack Packs. Participants had a choice of two snack packs at the
end of the experiment. One snack pack included nutritious (natural
ingredient) food items such as a banana, an organic granola bar and
dry fruit raisins. The HFSS snack pack consisted of 5 hero/celebra-
tion chocolates, a pack of ready salted Walker's crisps and a choc-
olate muffin. Previous studies have used snacks to assess food and
calorie intake in adults and children following exposure to food
advertisements (Halford, Gillespie, Brown, Pontin, &Dovey, 2004;
Harris et al., 2009). The composition of products included in the
study was determined through pilot testing. It was important that
the foods in the healthy snack pack were perceived to be healthy by
the potential participants and would constitute a suitable alterna-
tive to the HFSS. Although the final selection of the healthy snack
packs contained food items that had high glycaemic indices, these
were all considered natural food items in the pilot testing phase. In
general, the public believe that foods low in fat, sugar and salt are
healthy; with fat and/or calories being the principal decision-
making criteria for what is considered healthy (Chen, Legrend, &
Sloan, 2006; Kang, Jun, &Arendt, 2015). Therefore, the differenti-
ating factor designating the snack pack as healthy or not was based
on perceived fat content. The healthy snack pack contained foods
low in fat/salt, while the HFSS snack pack comprised of foods high
in fat/salt.
Television Stimuli/Advertisements. Eight well known adverts
were imbedded into an episode of ‘Friends’(VideoPad Video Editor
Free version 4.23). The first condition contained advertisements for
HFSS and two non-food advertisements these were: Dior J'adore
T.M. Dovey et al. / Appetite 112 (2017) 102e106 103
(The future is Gold advertisement); Pringles (Cancion Anuncio
advertisement); Azzaro pour homme (Ian Somerhalder advertise-
ment); and Dairy Milk (Cadbury's Yes Sir I Can Boogie advertise-
ment). The second condition contained advertisements for healthy
food and two non-food advertisements these were specifically:
Dior J'adore (The future is Gold advertisement); Nakd Bars (Make
the Switch- Why Nakd Bars are Good advertisement); Azzaro pour
homme (Ian Somerhalder advertisement); and Organic Food Mar-
ket (Midwest whole foods market commercial: food from a happy
place) advertisements. Finally, condition three employed non-food
adverts to provide a non-food advertisement control condition.
These included: Dior J'adore (The future is Gold advertisement);
Easy Jet (Europe by Easyjet advertisement); Azzaro pour homme
(Ian Somerhalder advertisement); and Andrex Toilet Roll (The
Guide Dog Appeal). The inclusion of the same non-food adver-
tisement at the beginning of each condition prevented participants
guessing which condition they were in through an obvious
collection of food/neutral advertisements. Advertisements did not
promote any of the products within the snack packs. In addition, all
conditions contained the same non-food related adverts to simu-
late a typical commercial break and to mask the purpose of the
study. All advertisement segments were embedded into the middle
of the Friends episode and lasted for 2 min ±10 s depending on
condition. The episode lasted for 22 min and was interrupted after
12 min for the commercial break. The delay between the end of the
exposure to the television advertisements and snack pack selection
was roughly 10 min. Following selection of the snack pack, partic-
ipants were asked to complete a short questionnaire.
Questionnaires. Participants were initially asked a short series
of questions concerning their demographics (e.g. age, sex, known
food allergies), Individual differences in eating behaviour were
measured with the DEBQ (van Strien, Frijters, Bergers, &Defares,
1986). The DEBQ is a 33-item questionnaire and consists of three
sub-scales eexternal (e.g. If you walk past the baker do you have a
desire to buy something delicious?), restrained (e.g. If you have put
on weight, do you eat less thanyou usually do?), and emotional (e.g.
Do you have a desire to eat when you are upset?) eating. Partici-
pants responded to the items by completing Likert scales that
ranged from 1 (seldom) to 5 (very often). Total scores for each
subscale were calculated based on average per item responses. The
DEBQ has been widely used in appetite research and has high
reliability, internal consistency and validity for predicting food
intake in a variety of experimental paradigms. In the current study,
the mean ±standard deviation scores for the three DEBQ subscales
were: external ¼3.4 ±0.47, restraint ¼2.5 ±0.90 and
emotional ¼2.3 ±0.72 eating.
Median split was used to categorise participants as high or low
on each of the DEBQ subscales. The median score for the sample on
the restraint subscale of the Dutch Eating Behaviour Questionnaire
(DEBQ) was 2.4. This led to the sample being split between high
(n ¼39) and low (n ¼41) restraint scorers. Although sex did not
play any significant part in the experimental analysis (
c
2
(3) ¼1.7 2;
p¼0.63), females did report significantly higher restraint scores
than males (t(79) ¼3.15; p ¼0.0 02). This led to a slight sex dif-
ference in the final group allocation of restraint with females ac-
counting for a higher proportion of the high restraint scoring group
(females n ¼24; males n ¼15) compared to low scorers (females
n¼14; males n ¼27). It was deemed appropriate to measure both
males and females in this analysis, as the primary objective was to
measure the impact of healthy food adverts on adults' food selec-
tion similar to past research (e.g. van Strien et al., 2012).
3.1. Procedure
The general procedure of the study was explained to the
participants on entry and they were encouraged to seek clarifica-
tion of any component they did not understand. Participants were
invited to attend a standard experimental cubicle situated in a
university building between 2pm and 4pm on a specific working
day at a prearranged and mutually suitable time. All of the partic-
ipants reported eating lunch prior to attending their session and
were not hungry. All participants were tested in isolation in a quiet
room free from external disturbances. The two snack packs were
situated behind them and were in the environment throughout the
test. All testing took place between December 2014 and March
2015.
To avoid bias, participants were informed that they were to take
part in a pilot study to assess the suitability of a television program
to alter their mood. All participants were then informed that they
were placed in the ‘comedy’condition whereby they would be
required to watch a well-known episode of ‘Friends’. Participants
then completed a consent form. Following viewing of the television
episode, participants were asked for their opinions on the program
and offered the choice of a 'thank you' snack pack. Participants were
informed that the packs were left over from a conference held on
site this morning and were made fresh that day. The snack packs
were presented in labelled creates with their contents listed on the
front and each pack was in clear resealable sandwich bag. Once the
participants had made their selection, they were asked to complete
the questionnaires. At the end of the questionnaires, participants
were debriefed revealing the true aim of the experiment.
4. Results
The overall multinomial logistic regression model for predicting
snack pack selection (chose the healthy snacks, the HFSS snacks,
took both snacks, or refused to take any snack pack) by exposure to
different advertisement types (non-food, high fat/sugar, healthy)
and sample differentiation by restraint status (high/low) was sig-
nificant (
c
2
(15) ¼31.25; p ¼0.008). This result was confirmed by
the Pearson (
c
2
(6) ¼8.093; p ¼0.23) and Deviance (
c
2
(6) ¼9.95;
p¼0.13) 'goodness of fit' tests. This difference was caused by the
high restrained individuals preferentially selecting the healthy
snack pack following the healthy advertisements (B ¼2.93,
Exp(B) ¼0.54, 95% CI 0.004e0.64, p ¼0.02) and tended to refuse
both snack packs following other conditions. Low restrained in-
dividuals, irrespective of advert condition, tended to take the HFSS
snack pack (B ¼1.44, Exp(B) ¼4.23, 95% CI 1.18e15.22, p ¼0.027) or
took both snack packs (B ¼1.68, Exp(B) ¼5.35, 95% CI 1.18e24.75,
p¼0.032).
In order to follow up on the eating behaviour attributes of
restrained, emotional and external eating, a Welch's one-way
analysis of variance was employed. This analytic procedure was
adopted due to violations in homogeneity of variance. Assessment
of the impact of the subscales of the DEBQ revealed that only dif-
ferences between high/low restrained scores were significant.
Therefore, emotional (F(3,79) ¼1.61; p ¼0.19;
h
2
¼0.17) and
external (F(3,79) ¼1.11; p ¼0.34;
h
2
¼0.04) eating were not
considered further. There was a significant difference in restraint
score based on the snack pack selection (Welch's F(3,38) ¼4.73;
p¼0.007). This difference was due to individuals who refused to
take either snack pack being significantly more restrained than
those who selected the HFSS snack pack (p ¼0.007) or both
(p ¼0.018). The mean restraint scores for the participants who took
the different snack selections were: both snacks
(mean ¼2.05 ±standard deviation 0.52); High fat/sugar
(2.11 ±0.58); healthy (2.56 ±0.95); refusal to take either snack pack
(3.01 ±1.08).
T.M. Dovey et al. / Appetite 112 (2017) 102e106104
5. Discussion
The focus of this study concerned the interaction between food
choice (healthy or HFSS snack pack, or no snack pack) and food
advertisement exposure (i.e., healthy/HFSS food ads). We hypoth-
esized that participants were more likely to choose healthy snacks
following the healthy food adverts and to choose HFSS snacks after
exposure to HFSS food adverts. This hypothesis was only partially
supported. Participants snack pack selection altered after exposure
to different advertisements and was influenced by their restrained
status. For the majority of participants, there was an increased
likelihood that they would choose HFSS snack pack irrespective of
advertisements they were exposed to. Therefore, when given an
option of a free snack pack, the majority of participants tended to
prefer to follow their hedonic food choice. The data here does not
contradict that of van Strien et al. (2012). Within the current
paradigm, food choice was the dependent variable. In van Strien's
study, total caloric intake operated as the measured variable. Both
findings can co-exist with external eaters eating more in response
to concurrent HFSS food advertising and restrained eaters' subse-
quent food choice can alter in response to healthy advertisements.
The fact that past research and the current data have found mul-
tiple modes of action, suggests that television advertisements can
operate on multiple levels indicative of a complex stimulus. It was
also hypothesized that external, restrained and emotional eating
will have an impact on participants' food choice after being exposed
to food advertisements. Consistent with our hypothesis, high re-
straint status led to selecting the healthy snack pack following
exposure to healthy advertisements.
Previous research has indicated two competing perspectives on
the responsiveness to healthy advertisements may exist, either 1)
healthy advertisements provide a defence against over consuming
HFSS foods (Lemnitzer, Jeffery, Hess, Hickey, &Stroud, 1979;
Scammon &Christopher, 1981) or 2) healthy advertisement is
ineffective (Goldberg &Gorn, 1979; Goldberg, Gorn, &Gibson,
1978; Lemnitzer et al., 1979). The data collected here appear to
support that healthy food advertisements have a limited impact on
the general population's food choice when measured in isolation. .
Responsiveness to healthy food advertisements in adults was only
observed in restrained individuals. This may explain the null results
and small effects observed in previous healthy advertisement
studies (Liaukonyte et al., 2012; Pollard et al., 2008). This novel
finding offers some additional complexity underlying the impact of
healthy food advertisements. Although the intention of the healthy
food advertisement was to alter food choice in the viewer, these
data suggest that it only appeals to those for whom the advertise-
ment message is salient (Bargh, 2006). This finding mirrors those of
Fishbach, Friedman, and Kruglanski (2003), who suggested that
goal congruent diet-relevant cues in individuals concerned about
dieting increased selection of healthy foods. Restrained individuals
are by definition either engaging in dieting or are attempting to
weight maintain (Witt, Ketterman, &Lowe, 2013). The message
portrayed in the healthy food advertisement appears to resonate
with the restrained eater and alters their habitual food choice. The
habitual choice of restrained individuals was to decline to take
either healthy or HFSS snack pack. The implication of this result
would be that the healthy food advertisement stimulates food
choice in high restrained individuals and may constitute a net in-
crease in food intake. This was the first study to uncover the
responsiveness of adults to healthy food advertisements. Therefore,
there are some limitations that need to be highlighted prior to of-
fering definitive conclusions. In order to hide the nature of the
study from the participants, in line with similar studies on adults, a
between-subject design was implemented. Future studies may
wish to build on this finding by specifically exploring the impact of
healthy food advertisements on restrained individuals through
more subtle methods or specific inclusion criteria. Specifically, it is
important to understand how the restrained eater is primed by the
healthy advertisement message. Analysis of paired word associa-
tions will likely reveal if the healthy message is specifically primed
or is indirectly primed as an associated triggering the restrained
process. To ensure thatthe healthy message is primed by restrained
eating it would be worth replicating this finding by recruiting in-
dividuals who score in the top quartile on this DEBQ subscale rather
than splitting the sample based on median scores, as well as in a
widest possible range of ages.
Another key limitation of the field, as well as the study, was the
need to consider the perception of the healthy, rather than
considering a snack pack that is nutritionally balanced. It would
appear that the perception of what is healthy is complex and the
general public consider a variety of factors when ascribing the term
'healthy' to a product (Tudoran, Olsen, &Dopico, 2009). The defi-
nition of the term healthy may have specific resonance with the
rule governed behaviour of restraint. Additional conceptualisations
of 'healthy' food exploring other nutrient targets (e.g. low in sugar)
may uncover different outcomes. The robustness of the impact of
restraint on responsiveness to healthy food advertisements merits
further testing. Based on this limitation, it cannot be concluded that
there is not a complex tridirectional relationship between advert
type, restraint status and the food offered.
The final limitation of the findings was that food in this para-
digm was free. Usually, the advertisement intends to make the
viewer buy the product. This component of the process was not
considered within the current paradigm as it was not the integral to
the hypothesis. It would be expected that the impact of a single
advertisement episode on food choice would be further limited if
the participant was offered a choice of items to purchase. However,
the impact of paying for food items would need to be substantiated
in further research before definitive conclusions concerning the
impact of healthy advertisements can be fully understood. It is not
possible to conclude from these data if other multimedia messages
or media would have a similar effectof television advertisements. It
would be of value to explore the similarities and differences be-
tween all screen based advertisements to fully understand the
generalisation of our findings to other platforms.
Despite the limitations noted, this study has significant
strengths that provide additional insight into the impact of adver-
tisements on adults. What the paradigm loses in sensitivity, it al-
lows for a more valid measure of the impact of an advertisement. By
expressly measuring food choice rather than food intake, allows for
an assessment of the impact of the advertisement that reflects its
intention. Although total caloric intake or food choices in an ad
libitum snack are valid dependent variables, food choice provides
insight about how the participant responds to the advertisement
directly. Moreover, food choice allows for more direct attributes
between exposure to the food advertisement and subsequent
behaviour.
To conclude, responsiveness to healthy food advertisements in
adults appears to be complex. Healthy food advertisements appear
to elicit a behavioural response in restrained eaters only. Exposure
to the healthy messages resonated with the restrained eaters and
made them select healthier foods when ordinarily they would
refuse to take a snack.
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