TikTok Food Ads and Calorie Intake

Overseen By Krystle Tsai

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: NYU Langone Health

Disqualifiers: Age, Ethnicity, TikTok usage, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

100 Participants Needed

Trial Summary

What is the purpose of this trial?

Randomized and controlled experimental study to evaluate how influencer food ads on TikTok affect calorie purchases among youth (ages 10-13). Participants will be randomized to one of two conditions: (1) seeing an influencer with food or (2) seeing an influencer without food. Participants will complete a 15-minute survey in which they will be randomized to one of two conditions and view and rate TikTok influencer ads associated with their condition. Then they will complete a food purchasing task in which they will shop in an online store that will display six food items and six beverages. Finally, they will answer demographic questions (e.g., self-reported height and weight) and view a debriefing summary that describes the full purpose of the study.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment TikTok Food Ads and Calorie Intake?

Research shows that food advertising, especially for unhealthy foods, can significantly influence children's eating preferences and increase calorie intake. Studies have found that exposure to food ads, particularly those not permitted for children's advertising, can lead to higher consumption of unhealthy foods, suggesting that TikTok food ads may similarly impact calorie intake. ^{1 2 3 4 5}

Is it safe for humans to participate in a clinical trial involving TikTok food ads?

The research does not provide specific safety data for TikTok food ads, but it highlights concerns about the influence of food advertising on children's eating habits and potential impacts on body image and eating behaviors. ^{1 6 7 8 9}

How does the TikTok Food Ads treatment differ from other treatments for calorie intake?

This treatment is unique because it focuses on the impact of social media food advertisements, specifically on TikTok, on calorie intake, rather than using traditional dietary or pharmaceutical interventions. It explores how exposure to food-related content on TikTok can influence eating behaviors, which is a novel approach compared to standard treatments that typically involve dietary changes or medication. ^{1 6 9 10 11}

Research Team

Marie Bragg, PhD

Principal Investigator

NYU Langone Health

Eligibility Criteria

This trial is for non-Latino White or Black/African American youths aged 10-13 who use TikTok daily and can read and speak English. It's not open to those who don't meet these specific age, racial, language, and social media usage criteria.

Inclusion Criteria

Identify as only non-Latino White or only Black/African American

Report that they log into TikTok at least once daily

Read and speak English

Exclusion Criteria

I meet all the listed criteria for the study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Survey and Ad Viewing

Participants complete a 15-minute survey and view TikTok influencer ads associated with their randomized condition

1 day

1 visit (virtual)

Food Purchasing Task

Participants complete a food purchasing task in an online store and answer demographic questions

1 day

1 visit (virtual)

Follow-up

Participants are monitored for any additional feedback or reactions post-study

1-2 weeks

Treatment Details

Interventions

• TikTok Ads - With Food
• TikTok Ads - Without Food

Trial Overview The study examines the impact of food-related ads by influencers on TikTok versus non-food-related ads on young people's calorie purchases. Participants will be randomly assigned to view one type of ad, then choose food items in a simulated online store.

Participant Groups

Group I: TikTok Influencer Ads without Food Experimental Treatment 1 Intervention

Participants randomized to view TikTok influencers' posts without food will view 4 ads associated with their condition and 2 filler ads, all of which are presented in counterbalanced order. They will report their reaction to the ads using the icons available on the TikTok platform (i.e. like, comment, or share). After viewing all of the TikTok ads, youth participants will complete the virtual snack selection task where they will see a virtual vending machine. All items will cost $2. Participants will be asked to select one snack and one beverage from the vending machine. After the snack selection task, participants will review the TikTok ads again and complete survey questions.

Group II: TikTok Influencer Ads with Food Experimental Treatment 1 Intervention

Participants randomized to view TikTok influencers' posts with food will view 4 ads associated with their condition and 2 filler ads, all of which are presented in counterbalanced order. They will report their reaction to the ads using the icons available on the TikTok platform (i.e. like, comment, or share). After viewing all of the TikTok ads, youth participants will complete the virtual snack selection task where they will see a virtual vending machine. All items will cost $2. Participants will be asked to select one snack and one beverage from the vending machine. After the snack selection task, participants will review the TikTok ads again and complete survey questions.

Who Is Running the Clinical Trial?

NYU Langone Health

Lead Sponsor

Trials

1,431

Recruited

838,000+

Findings from Research

A study analyzing 360 videos and posts from popular influencers on TikTok, YouTube, and Instagram found that 24% contained food and beverage cues, with 77% of these cues being non-permitted for children's advertising according to WHO guidelines.

Notably, the non-permitted food and beverage cues were four times more likely to be branded and received significantly more positive descriptions and likes, highlighting the need for stricter regulations on influencer marketing targeting children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promotion of Food and Beverages by German-Speaking Influencers Popular with Adolescents on TikTok, YouTube and Instagram. Winzer, E., Naderer, B., Klein, S., et al.[2023]

A study involving 172 children aged 3 to 7 showed that exposure to television-style advertisements for healthy foods significantly increased their intake of healthy options like fruits, vegetables, and whole grains, with three exposures leading to an increase of up to three portions.

In contrast, children who viewed advertisements for toys consumed less healthy foods, highlighting the potential of targeted healthy food advertising to counteract the negative effects of traditional advertising for unhealthy foods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Manipulated exposure to television-style healthy food advertising and children's healthy food intake in nurseries. von Nordheim, L., Blades, M., Oates, C., et al.[2022]

Television advertising significantly influences children's food choices and intake, particularly promoting foods high in fat, salt, and sugar (HFSS).

Overweight and obese children are especially affected, showing increased food intake and a stronger preference for unhealthy foods when exposed to these advertisements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Television advertising and branding. Effects on eating behaviour and food preferences in children. Boyland, EJ., Halford, JC.[2019]

In Spain, childhood obesity and eating disorders are significant public health issues, with obesity affecting 15% and eating disorders 12% of children, particularly in the 6-12 age group.

Food and beverage advertising on mobile devices significantly influences children's purchasing behavior, highlighting the need for regulation of these advertisements to promote better public health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food and Beverage Advertising Aimed at Spanish Children Issued through Mobile Devices: A Study from a Social Marketing and Happiness Management Perspective. Jiménez-Marín, G., Elías Zambrano, R., Galiano-Coronil, A., et al.[2020]

In a pilot study involving 41 Black adolescent females, exposure to racially-targeted food ads did not significantly affect caloric consumption compared to neutral ads, suggesting that these ads may not directly influence eating behaviors in this group.

However, there was a trend indicating that adolescents with obesity consumed nearly 240 kcal more than their non-overweight peers, hinting that they might be more vulnerable to the effects of racially-targeted food ads, warranting further research with a larger sample size.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of racially-targeted food marketing and attentional biases on consumption in Black adolescent females with and without obesity: Pilot data from the Black Adolescent & Entertainment (BAE) study. Cassidy, O., Tanofsky-Kraff, M., Waters, AJ., et al.[2023]

In a study of 400 popular child-oriented educational YouTube videos, 165 featured food and beverages, which were viewed over 1.1 billion times, highlighting their significant presence in children's media.

A concerning 67.4% of these videos showcased unhealthy foods, and over half (52.1%) included branded products, suggesting that these videos could influence children's dietary preferences without parents or educators being aware.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Food and Beverage Product Appearances in Educational, Child-Targeted YouTube Videos. Tsai, KA., Pan, P., Liang, C., et al.[2023]

From 2004 to 2009, daily exposure to TV food advertisements in South Korea decreased by 19%, but ads for full-service restaurants increased by 45.7%, indicating a shift in advertising focus.

Despite an overall decline in fast-food ads, local fried chicken franchise ads nearly doubled, becoming the most frequently seen fast-food ads by 2009, particularly among adolescents, highlighting the need for ongoing monitoring of food advertising trends.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trends in exposure to television food advertisements in South Korea. Han, E., Powell, LM., Kim, TH.[2019]

A study involving 597 children in the Netherlands and Spain found that playing an advergame promoting energy-dense snacks led to increased caloric intake, regardless of whether a 'protective' message was included.

The findings suggest that 'protective' messages may not effectively reduce unhealthy food consumption among children, highlighting the need for stricter regulations on food advertising to children, especially in online settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does a 'protective' message reduce the impact of an advergame promoting unhealthy foods to children? An experimental study in Spain and The Netherlands. Folkvord, F., Lupiáñez-Villanueva, F., Codagnone, C., et al.[2019]

A study analyzing 1,000 TikTok videos related to food, nutrition, and weight revealed that most content promotes a weight-normative view of health, potentially leading to disordered eating and body dissatisfaction among young users.

Less than 3% of the videos featured weight-inclusive perspectives, and the majority were created by white, female adolescents and young adults, highlighting a lack of expert voices in nutrition discussions on the platform.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Weight-normative messaging predominates on TikTok-A qualitative content analysis. Minadeo, M., Pope, L.[2022]

Over half (53%) of the food and beverage products approved for advertising on children's television did not meet federal nutrition recommendations, indicating a significant gap in the health standards for marketed products.

The study highlights the need for ongoing monitoring of food and beverage advertising to children to ensure that products align with established nutrition guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list. Schermbeck, RM., Powell, LM.[2019]

A study analyzing 100 TikTok videos tagged #WhatIEatInADay identified two main types of content: 'Lifestyle' videos, which promote clean eating and weight loss ideals, and 'Eating Only' videos, which focus on food consumption and often feature excessive eating.

Both types of videos may contribute to disordered eating behaviors among vulnerable youth, highlighting the need for further research on the impact of TikTok eating-related content on mental health and eating habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A reflexive thematic analysis of #WhatIEatInADay on TikTok. Davis, HA., Kells, MR., Roske, C., et al.[2023]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Promotion of Food and Beverages by German-Speaking Influencers Popular with Adolescents on TikTok, YouTube and Instagram. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Manipulated exposure to television-style healthy food advertising and children's healthy food intake in nurseries. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Television advertising and branding. Effects on eating behaviour and food preferences in children. [2019]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Food and Beverage Advertising Aimed at Spanish Children Issued through Mobile Devices: A Study from a Social Marketing and Happiness Management Perspective. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

The impact of racially-targeted food marketing and attentional biases on consumption in Black adolescent females with and without obesity: Pilot data from the Black Adolescent & Entertainment (BAE) study. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Food and Beverage Product Appearances in Educational, Child-Targeted YouTube Videos. [2023]

7. England pubmed.ncbi.nlm.nih.gov

Trends in exposure to television food advertisements in South Korea. [2019]

8. England pubmed.ncbi.nlm.nih.gov

Does a 'protective' message reduce the impact of an advergame promoting unhealthy foods to children? An experimental study in Spain and The Netherlands. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Weight-normative messaging predominates on TikTok-A qualitative content analysis. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Nutrition recommendations and the Children's Food and Beverage Advertising Initiative's 2014 approved food and beverage product list. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

A reflexive thematic analysis of #WhatIEatInADay on TikTok. [2023]