Can Pac-Man help kids make healthier choices?

One-third of American kids are overweight or obese. Obesity rates among kids have tripled in the past thirty years. Many experts blame not only the food environment we live in-comprised of endless opportunities to eat foods of minimal nutritional value-but also the massive bombardment of advertising our kids are exposed to, baiting them to consume these foods.

According to the Federal Trade Commission , the largest U.S. food and beverage companies spent about $1.6 billion (!) in 2006 marketing their products to kids-$492 million for soda ads alone-and I'm sure they wouldn't be spending this kind of money unless they saw real results.

Most parents are aware of how abundant junk food ads are on kids' TV programming, but ads lurk in every corner. Media consumption habits have changed, and marketers are keeping up as they find new ways to get their message to kids in new outlets, including social media, product placement in TV shows and movies, sports sponsorships, mobile phones and kids' favorite websites.

A recent article in the Archives of Pediatric and Adolescent Medicine reported on a study done by the Children's Digital Media Center at Georgetown University that examined how "advergames" (advertising that appears in computer games) affect kids' choices of snacks.

The Internet is a favorite pastime for many kids, and most major food and beverage websites have links to special pages designed exclusively for kids, many of them with fun digital games to play online. These games are a relatively inexpensive marketing tool, but are they effective in selling the product? Does playing a game affect food choices?

The Georgetown study included thirty low-income African American third- and fourth-graders from the Washington D.C. area. The researchers created two versions of a Pac-Man-type game, in which a digital character moves through a maze and eats or avoids the foods he encounters on his journey.

In the healthy-food version, the player was awarded 10 points for each nutritious snack eaten by Pac-Man, and penalized 10 points for every less-nutritious snack eaten by the digital consumer. In the less-healthy version, the player was awarded 10 points for each non-nutritious snack eaten by Pac-Man, and penalized 10 points for every nutritious snack he gobbled up. The foods featured in the game were a small banana and a small orange juice on the healthy side, and a small bag of chips and a small can of soda as the less-healthy options.

The kids were randomized to play one of the game versions or to act as the control. After completing the game-which took an average of less than 10 minutes-the kids were asked to select one food and one beverage from the foods that were featured in the game.

The results of this small study are very clear:


• Five of the ten kids who played the healthier version chose two healthy snacks, compared to only one kid making healthy choices from the unhealthy-snack game group.

• Four kids in the healthy-game version selected one healthy snack, compared to none in the less healthy game group.

• Only one kid who played the healthier game version chose no healthy snacks (he picked two unhealthy snacks) compared to nine out of the ten kids playing the unhealthy snack game group.


Ten minutes of exposure affected these kids' selections and they ate whatever snacks were being marketed by the advergame!

The authors, Tiffany Pempek and Sandra Calvert, write:

"Our findings also suggest that public concerns about online advergames that market less healthy foods and beverages to children are justified. Children selected and ate snacks that were of poor nutritional quality after exposure to the advergame that promoted less healthy foods and beverages. However, as demonstrated by this study, advergames may be used just as easily to promote healthier snacks, an approach recommended by the Institute of Medicine report as a way to help curb the obesity epidemic in the United States. In particular, because so many children play online games, health-promoting advergames can be part of a cost-effective social marketing campaign. Indeed, the children in this study reported liking our advergame. Our advergame had only 2 levels and lacked the "bells and whistles" of most commercial video games, indicating that even simple games can be effective in bringing about behavioral change. More sophisticated games with even more levels of challenge that are played over an extended time may yield even stronger effects." The journal also includes an advice for patients piece with their study report, in which parents are encouraged to moderate their kids' media use. Here are their recommendations: "Reduce Your Child's Media Use

• One way to reduce the impact of media on your child's nutrition choices is to reduce the time your child spends interacting with media. This can benefit your child by decreasing the unhealthy messages that media, such as television, can send, as well as giving more time for your child to do other healthy activities, such as playing outside or time spent with friends.

• Avoid having a television in your child's room or watching television during meals.

Media Literacy

• Media literacy means teaching young people how to understand and interpret advertisements.

• Parents can talk to their children about what advertisements they see and how that ad may influence their choices. This interaction helps children understand that not everything seen in the media is real and how media advertisements try to influence behaviors.

• There is evidence that media literacy may protect against some behaviors that the media promote, such as smoking.

Countermarketing

• This technique refers to promoting healthy messages through the media.

• Examples include advertisements for healthy foods and games that promote healthy behaviors."

As a parent, I've been attempting to find middle ground and a sensible way to minimize my kids' screen time while not forbidding it (and in that way inadvertently increasing its desirability).

I find that kids are quick to understand and develop some healthy skepticism when advertising techniques are explained to them. I remember the first ad I watched and explained to them: It was an ad for a cleaning product, featuring a joyful gorgeous mom cleaning a kitchen.
I asked them, "Why do you think she's so happy?" and we went through the possibilities, concluding that this woman looks so happy because she's an actress, and she's paid to look happy, and while this cleaning product may help you clean, it certainly doesn't make you happy or gorgeous. Indeed most moms (and dads) don't particularly enjoy cleaning-unless they're paid handsomely to do it on TV.

Taking junk-food ads apart isn't difficult-so many of them show kids gaining superpowers, having over-the-top fun, and are associated with sporting heroes and favorite cartoons, while the sad truth is these "eat less of" foods will give you less power, aren't much fun in the long run, and certainly have nothing to do with the admired basketball star or cartoon character.

But does explaining this take away the powerful repetitious visual message? I doubt we can completely undo the effect of advertising on our kids' preferences.

Do you have media guidelines in your home? How do you deal with your kids' exposure to ads? Please share!

Dr. Ayala

Read more from Dr. Ayala at http://herbalwater.typepad.com/

Follow Dr. Ayala on Twitter