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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assess how TikTok influencer ads, with and without food, influence children's calorie-based purchasing decisions. Participants will watch these ads and then select snacks and drinks from a virtual store. The goal is to determine if food in ads leads to higher calorie purchases. Children aged 10 to 13, who identify as non-Latino White or Black/African American, and use TikTok at least once daily, are ideal candidates for this trial. As an unphased trial, this study provides a unique opportunity to contribute to understanding social media's impact on children's food choices.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that TikTok is becoming a major platform for marketing unhealthy foods. Studies find that influencers often promote these foods, sometimes without clear disclosure. Although the research does not provide specific safety details about TikTok food ads, watching ads is generally safe. The main concern is how these ads might affect children's food choices, encouraging them to choose less healthy snacks. While there are no health risks from watching the ads, it is important to be aware of their potential influence on children's eating habits. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores the influence of TikTok ads on calorie intake, a relatively uncharted territory in understanding eating behaviors. Unlike traditional methods that focus on dietary education or restriction, this trial investigates how exposure to social media content, with and without food cues, affects snack choices. By examining the direct impact of engaging TikTok ads, researchers hope to uncover insights into how digital environments can shape our food preferences and decision-making processes, potentially leading to innovative strategies for promoting healthier eating habits among youth.

What evidence suggests that this trial's treatments could be effective in influencing calorie purchases among youth?

This trial will compare the effects of TikTok influencer ads with food to those without food. Research has shown that TikTok influencer ads about food can affect the number of calories young people purchase. Studies have found that these ads can lead children to eat more immediately after viewing them. TikTok is becoming a popular platform for promoting unhealthy foods, influencing how much kids eat right after watching the ads. Although these ads don't alter long-term eating habits, they do quickly increase the calories kids consume shortly after viewing. ^{1 2 4 6 7}

Who Is on the Research Team?

Marie Bragg, PhD

Principal Investigator

NYU Langone Health

Are You a Good Fit for This Trial?

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

I am between 10 and 13 years old.

Exclusion Criteria

I meet all the listed criteria for the study.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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 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]

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]

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]

Citations

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TikTok Food Ads and Calorie Intake Randomized and controlled experimental study to evaluate how influencer food ads on TikTok affect calorie purchases among youth (ages 10-13).

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9240823/

marketing of unhealthy food and non-alcoholic beverages ... Our study has shown that TikTok is an emerging source of unhealthy food marketing, including that created by users at the instigation of brands. Given TikTok's ...

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How TikTok Influencers Disclose Food and Beverage ... This study aimed to quantify how often TikTok influencers promote products from food and beverage brands and document the range of ways they disclose brand ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11504184/

Diet culture on TikTok: a descriptive content analysis - PMC To investigate how dieting is portrayed on TikTok and the potential implications for public health considering the effect of diet culture on eating ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S0277953623008298

The impact of social media influencers on health outcomes Influencer marketing of unhealthy foods had a statistically significant effect on increasing children's immediate energy intake, but no effect ...

6. healthyeatingresearch.org healthyeatingresearch.org/wp-content/uploads/2024/10/HER-Digital-Marketing-Report-2024.pdf

Evidence-Based Recommendations to Mitigate Harms from ... Evidence-Based Recommendations to. Mitigate Harms from Digital Food Marketing to Children Ages 2-17. Durham, NC: Healthy Eating Research, 2024.

7. washingtonpost.com washingtonpost.com/wellness/2023/09/13/dietitian-instagram-tiktok-paid-food-industry/

The food industry pays 'influencer' dietitians to shape your ... Registered dietitians are being paid to post videos that promote diet soda, sugar and supplements on Instagram and TikTok.