Trends in food and beverage television brand appearances viewed by children and adolescents from 2009 to 2014 in the USA.

OBJECTIVE
Public health experts raise concerns about marketing unhealthy products to young people through television (TV) product placements. Coca-Cola brand appearances (product placements) reached a substantial child and adolescent audience in 2008, but additional brands now sponsor popular programming. We aimed to quantify child and adolescent exposure to food and beverage appearances since 2008.

DESIGN
In 2015, we purchased Nielsen data on occurrences and child/adolescent exposure to food, beverage and restaurant brand appearances on US prime-time TV from 2009 to 2014, and analysed appearances by product category, company, brand and year. We compared exposure to appearances with exposure to traditional commercials for top brands.

SETTING
Nationally representative panel of approximately 20 000 TV-viewing households.

SUBJECTS
Children (2-11 years) and adolescents (12-17 years).

RESULTS
Exposure to food and beverage brand appearances peaked in 2012 and declined through 2014. Whereas full-calorie soda brands dominated before 2012, other sugary drink and quick-serve restaurant brands contributed over one-third of appearances viewed by children in 2013 and 2014. Nine hundred and fifty-four companies had brand appearances from 2009 to 2014, but just four were responsible for over half of exposures: The Coca-Cola Company, Dr Pepper Snapple Group, PepsiCo and Starbucks. Approximately half were viewed on reality TV programmes and one sitcom. Each year from 2009 to 2013, brand appearance exposure exceeded traditional advertising exposure for at least one brand.

CONCLUSIONS
Despite recent reductions in brand appearances viewed by young people, some unhealthy branded products continue to be marketed via this method. We suggest policy options to reduce child and adolescent exposure to such appearances.