Fast Food Facts: Q&A with the Yale Rudd Center for Food Policy & Obesity

Nov 5, 2013, 10:26 AM

In 2012 alone, the fast food industry spent $4.6 billion to advertise mostly unhealthy products, with many of those ads specifically targeting children and teens. A new report, Fast Food FACTS 2013, examined 18 of the nation’s top fast-food restaurants, following up on a 2010 report to see how the food selection and advertising landscapes have changed. And while there have been some positive developments—healthier sides and beverages are available in most kids’ meals—the findings indicate there is still a very long way to go.

Detailed findings from the report, which was supported by a grant from the Robert Wood Johnson Foundation, will be presented today at the American Public Health Association’s (APHA) annual meeting in Boston.

>Read more on the Fast Food FACTS 2013 report.

NewPublicHealth spoke with Jennifer Harris, the Yale Rudd Center for Food Policy & Obesity’s director of marketing initiatives and lead author of the report, and Marlene Schwartz, the Center’s director, about their findings and how fast food advertising continues to impact our nation’s youth.

NewPublicHealth: Has any progress been made in the nutritional quality of fast food kids' meals?

Jennifer Harris: There have been a lot of changes in kids’ meals over the past three years and a lot of it has been good. Most of the restaurants have added healthy sides and healthy beverages to their kids’ meals. Now it’s possible to get a fairly healthy kids’ meal at most of the restaurants we looked at. But the problem is it’s kind of like finding a needle in a haystack. Almost all of the meals they offer are high in fat, sugar or sodium.

Marlene Schwartz: The odds of you getting the healthy combination when you go are extraordinarily low. For every healthy combination, there are roughly 250 unhealthy combinations.

Harris: The other thing is that a lot of the chains still don’t really have healthy main dishes. Chicken nuggets, burgers—those are the norm at most fast-food restaurants and those are not healthy choices. At some you can get a grilled chicken wrap or something that is healthy, but it’s not typical.

Schwartz: The interesting thing is that in our last report we looked at about 3,000 kids’ meal combinations, and there were just over a dozen that were healthy. What happened this time is that they increased the number of options, so there were more than 5,000 possible combinations, but the chances of finding a healthy choice are the same. It’s still 0.4 percent.

NPH: How have fast-food menus changed since your first report?

Harris: The kids’ meals have added all these options, including healthy options. But the main menus have also increased enormously, and the percentage of healthy options hasn’t changed. There’s been a lot of attention to fast-food companies trying to offer healthier choices, responding to consumer demand for healthy options. But at the same time they’re doing that they’re also increasing their unhealthy options. So unless you’re really motivated to get the healthy option, chances are people going to fast-food restaurants are still getting the unhealthy ones.

NPH: How much are fast-food companies marketing to young people? How are they targeting them?

Harris: They’re marketing to them a lot. Fast food is the most advertised product to children and teens. Kids, even preschoolers, see almost three ads per day for fast food on television, and teens see almost five ads per day. On the positive side, we’re seeing less advertising targeted directly to children. McDonald’s and Burger King have traditionally been the biggest advertisers to kids and their numbers are going down. But what’s happening is that most restaurants are advertising more to all age groups and they’re advertising in programming that everyone watches, family type programming. So kids are seeing more of those ads.

We’ve talked about this before as collateral damage. Most of the restaurants aren’t directly targeting children, but they’re not trying to protect them from their advertising, and so the kids are exposed to a lot of it. And then there are a lot of restaurants specifically targeting teens. Taco Bell is one of them. Starbucks is another one. Some of the Burger King products, such as their value menus, are being marketed to teens as well.

NPH: What about online or social media advertising?

Harris: A lot of the companies have discontinued their child-targeted websites. So Dairy Queen had one that was discontinued. Burger King had a popular one that was discontinued. They’ve replaced it, but it hasn’t gotten a lot of traffic. McDonald’s took down two of their sites, including one that had targeted preschoolers. There are fewer kids visiting fast food sites overall, but the number of teens visiting them is going way up. The ones getting the most visits are pizza sites where you can go online and actually order. Interestingly, a lot of the pizza companies’ mobile sites are some of the most popular sites we looked at.

In social media, which we know is really popular with teens, it was hard to calculate the percent increase in Facebook fans and Twitter followers because they were in the thousands. Again, Starbucks is by far the most popular restaurant on social media. McDonald’s and Subway both had huge increases in social media. They appear to be focusing more on that.

NPH: What kind of impact, if any, does self-regulation seem to be having?

Harris: The two restaurants that participate in the Children’s Food and Beverage Advertising Initiative, McDonald’s and Burger King, have reduced their advertising on children’s television. And as I’ve said before they discontinued or reduced their child websites. So they’re doing what they’ve pledged to do. But the problem is that their pledges don’t cover non-children advertising. So they’ve increased advertising in other areas. Companies that don’t belong, such as Wendy’s and Subway, are actually targeting kids with their regular menu items on children’s television.

Also, the definitions of what’s included as child-directed advertising don’t really make sense. For example, McDonald’s advertises its Filet of Fish sandwich a lot on and, a Lego website. So you would think those would be counted as child-directed advertising and covered by their pledge, but if you look at the actual audience for those sites, they’re not covered. So there are lots of loopholes in those pledges. They work on the specific things they cover, but they don’t cover the majority of advertising.

Schwartz: The other program Jennifer talked about in the report is KidsLiveWell. Restaurants said they would offer at least one meal that would meet certain nutrition standards. Again, it’s this issue of they keep their promises but their promises are so limited it doesn’t really make a difference. So the restaurants do put exactly one meal on their menus that meets the standards, but if you look at the big picture, 97 percent of the meals don’t.

They just set the bar so low. Industry has made the definition of marketing to children so narrow and filled with loopholes that they still reach a lot of kids.

NPH: Are kids of different ages or races exposed to different amounts of advertising?

Harris: Exposure goes up with age. Teens are exposed to about 50 percent more of these ads than children are. Also, we know that black children and teens are exposed to about 60 percent more television ads than white children or teens. A lot of that is because they watch more television, but the difference is higher than you would expect based on television viewing. So it appears some restaurants are targeting black children.

One of the most disturbing findings in here is how much advertising on Spanish-language television has grown. The number of preschoolers viewing those ads has gone way up. It’s gone up more than the number of Hispanic children and teens who see the ads. Hispanic preschoolers are some of the biggest viewers of Spanish-language television—not children’s programming, but adult programming. All the research shows that advertising affects young children more because they don’t recognize it as biased and have no defense against it. And on top of that, Hispanic youth are more at risk for overweight and obesity-related diseases. All of that is a serious problem.

Hispanic preschoolers see 100 more fast-food ads on Spanish-language television over a year than Hispanic teens see.

NPH: What do you think parents should know about fast-food menus and marketing coming out of your report?

Harris: Parents of teenagers should know that fast food companies see their kids as an important target market and that they’re reaching them in ways that parents might not even know exist, such as mobile apps and social media. Teens are some of the biggest consumers of fast food, so it’s probably not a coincidence.

Schwartz: I think the thing that parents should do is really demand that fast food restaurants provide a significant number of healthy options. It’s not good enough to make it theoretically possible to come in and find a healthy meal. The odds should be in your favor—it should be easier to end up with a healthy kids’ meal than an unhealthy one. Parents have been misled by all of the public announcements from fast-food companies that they care about obesity and nutrition and are trying to improve the quality of their meals.

Harris: Or that the whole meal is healthy, not just the side of apples and the milk.

Schwartz: Right. The burger and chicken nuggets still don’t meet nutrition standards for healthy items for kids.

The other thing parents might be surprised to learn is that food companies consider their 12- and 13-year-olds to not be children anymore. And I think most parents would say that if your child’s in middle school they’re still a child. I think there needs to be a public outcry about the low age that has been set for protecting our kids, and the idea that you don’t need any additional protection at age 12, that you’re the same as an adult.

After age 12, companies can market anything they want to children, even if they are taking part in the industry’s self-regulation commitment. Middle-school-aged children are getting lost in the shuffle because they’re not covered by pledges. And I don’t think most parents realize that.

Harris: They’re also more independent, and have their own money and can go to restaurants on their own.

Schwartz: Exactly. Combining the lack of protection with greater independence is a problem, and the industry isn’t helping with this at all.

Harris: The website for our report,, does include tools to help parents pick healthy choices for their kids.

NPH: What are your recommendations for limiting the marketing of unhealthy foods and beverages to young people?

Marlene: Industry needs to have real standards for nutrition quality. It needs to have real standards on what counts as marketing to children and not have so many loopholes. It also should agree that the majority of kids’ meals should be healthy.

Menu defaults make a huge difference with this kind of thing. For instance, because McDonald’s switched from French fries as the default to a combination of French fries and apples as the default, most people get apple and fries. Changing the default changes what people buy.

Parents need to realize how much marketing kids are exposed to outside of parents’ awareness. Kids are being reached through social media and through apps. It’s not enough just to keep the television out of children’s bedrooms. Parents need to keep a much closer eye on what children are exposed to.

This commentary originally appeared on the RWJF New Public Health blog.