Date
Episode
032
Guest
Kelly Brownell, PhD

Children today are inundated with sophisticated marketing and ads online, particularly for unhealthy foods which can contribute to obesity and other negative health impacts. On this episode of Screen Deep, host Kris Perry is joined by food policy expert and leader in the fight against childhood obesity Dr. Kelly Brownell to discuss the ways in which this “toxic food environment” impacts children’s health and well-being. Dr. Brownell explores the addictive nature of highly processed and sugary foods and beverages, and draws parallels between the food and social media industries on how they prey on children’s vulnerabilities. He emphasizes the importance of policy solutions to help families cope with the powerful effect of food advertising on children’s health.

About Kelly Brownell

Kelly Brownell is Robert L. Flowers Professor Emeritus of Public Policy, Professor Emeritus of Psychology and Neuroscience, and Director Emeritus of the World Food Policy Center at Duke University. From 2013-2018 he served as Dean of the Sanford School of Public Policy at Duke. Dr. Brownell has been a member of Children and Screens’ National Scientific Advisory Board since 2022.

Prior to joining the faculty at Duke, Brownell was Director of the Rudd Center for Food Policy and Obesity at Yale University,  as well as the James Rowland Angell Professor of Psychology and a Professor of Epidemiology and Public Health.  While at Yale he also served as Chair of the Department of Psychology and as Head of Silliman College. Brownell was elected to membership in the National Academy of Medicine in 2006 and that same year was named as one of  Time magazine’s “World’s 100 Most Influential People.”  Among the honors for his work, he has received the Lifetime Achievement Award from the American Psychological Association, Graduate Mentoring Award from Yale, the James McKeen Cattell Award from the New York Academy of Sciences, the Distinguished Alumni Award from Purdue University, and the Lifetime Achievement Award from Rutgers University. Dr. Brownell has published 15 books and more than 350 scientific articles and chapters. He has served as President of several national organizations and has advised the White House, members of congress, governors, state attorneys general, world health and nutrition organizations, and media leaders on issues of nutrition, obesity, and public policy.

In this episode, you’ll learn:

    1. How screen use is linked to childhood obesity
    2. How daily exposure to large amounts of food advertising influences child and adolescent food choices and behaviors
    3. Why the food industry is incentivized to market unhealthy and addictive foods to children starting at young ages
    4. Why parents need support from policymakers and regulators to help protect children from the health effects of unhealthy online food marketing 
    5. The similarities between the food industry’s use of additives and the tobacco industry’s use of ingredients to manipulate desire and increase product appeal and dependence

Studies mentioned in this episode, in order of mention:

Robinson, T. N. (2001). Television viewing and childhood obesity. Pediatric Clinics of North America, 48(4), 1017-1025. https://doi.org/10.1016/S0031-3955(05)70354-0

Dietz, W. H., & Gortmaker, S. L. (2001). Preventing obesity in children and adolescents. Annual Review of Public Health, 22(1), 337-353. https://doi.org/10.1146/annurev.publhealth.22.1.337 

Robinson, T. N. (1999). Reducing children’s television viewing to prevent obesity: a randomized controlled trial. Jama, 282(16), 1561-1567. https://doi.org/10.1001/jama.282.16.1561

Harris, J. L., Schwartz, M. B., Brownell, K. D., et al. (2009). Cereal FACTS: Nutrition and Marketing Ratings of Children’s Cereals. Yale Rudd Center for Food Policy and Obesity. http://www.cerealfacts.org/media/Cereal_FACTS_Report.pdf 

  Harris, J. L., Schwartz, M. B., Ustjanauskas, A., Ohri-Vachaspati, P., & Brownell, K. D. (2011). Effects of serving high-sugar cereals on children’s breakfast-eating behavior. Pediatrics, 127(1), 71-76. https://doi.org/10.1542/peds.2010-0864

 Yokum, S., Gearhardt, A.N., Harris, J.L., Brownell, K.D. and Stice, E. (2014), Individual differences in striatum activity to food commercials predict weight gain in adolescents. Obesity, 22: 2544-2551. https://doi.org/10.1002/oby.20882

Brownell, K. D., Greenwood, M. R., Stellar, E., & Shrager, E. E. (1986). The effects of repeated cycles of weight loss and regain in rats. Physiology & behavior, 38(4), 459–464. https://doi.org/10.1016/0031-9384(86)90411-7

Brownell, K. D., & Rodin, J. (1994). Medical, metabolic, and psychological effects of weight cycling. Archives of internal medicine, 154(12), 1325–1330.

[Kris Perry]: Welcome to Screen Deep, the podcast where we decode young brains and behavior in a digital world. I’m your host, Kris Perry, Executive Director of Children and Screens.

Today, we’re taking a step back to look at the broader environment shaping children’s health and how the digital world fits into that picture. Joining me is Dr. Kelly Brownell, a psychologist and public policy expert whose work has helped define how we think about what we call the toxic food environment – the idea that children’s eating habits and health are shaped not only by individual choices, but also by the powerful systems, policies, and marketing forces around them. Dr. Brownell’s work speaks to the role of digital marketing in the poor health of American children, and he is a valuable member of the Institute’s National Scientific Advisory Board.

In this episode, we explore how digital media contributes to today’s food environment, what makes some children more susceptible to marketing than others, and what parents and policymakers can do to create healthier environments, both online and offline.

Welcome to Screen Deep, Kelly.

[Dr. Kelly Brownell]: Thanks very much, Kris. I have great admiration for the work you and your colleagues do and I’m delighted to be connected to it in the small way I am. So, it’s a real joy to be with you today.

[Kris Perry]: Me too. Kelly, we spend a lot of time on this podcast talking about how screen use is impacting child health and we’ve been hearing a lot about psychological health and brain level impacts from recent guests. I’m excited to talk to you today about a different kind of impact that media and screen use can have on child health – the choices they make about what food they put in their bodies and how that impacts their physical health in significant ways.

To kick us off, what do we know about the relationship between screen media use and childhood obesity? Is there evidence that these two are linked?

[Dr. Kelly Brownell]: There is, and the evidence goes back quite a long way. Researchers, many years ago, I mean, you can start to count it in the decades by now, looked at the amount of time people, children, were spending on screens and their likelihood of being overweight. Thomas Robinson at Stanford, William Dietz, Steven Gortmaker, a group of researchers studied this and found a pretty strong relationship. And that was right out of the gate many years ago, as I said. And subsequent research has shown the same thing.

So the more kids are on screens, the more likely they are to be eating an unhealthy diet and to have overweight as a problem. And, by the way, being overweight is only one of the biological consequences of eating an unhealthy diet, but later risk for heart disease and cancer and all sorts of things are in the mix. So, it’s not just obesity related, there’s a lot more going on than that.

[Kris Perry]: I’m glad you brought up those different biological impacts. Are there specific factors in screen use that seem to be more significantly linked to childhood obesity and other health outcomes?

[Dr. Kelly Brownell]: Well, let us count the ways. There is the obvious thing that children are being exposed to food marketing, and we can dive in deep to what that’s all about. There’s the physical inactivity that comes from being sedentary from the screen use. And then there’s whatever’s going on in a neurological way by absorbing all that information from the screen. So there are a lot of things going on that are steering children in a certain direction that’s not necessarily good for them.

[Kris Perry]: Are there different advertising techniques that food marketers use to encourage children to eat certain foods, whereas there may not be the same level of effort behind the marketing of healthy foods, for example?

[Dr. Kelly Brownell]: Oh my god, that’s not even close. How do you describe the amount of food advertising children are exposed to? Well, an avalanche, a tidal wave, a tsunami? You can pick whatever term you want, but boy, there is an awful lot of it. And it’s just thousands of messages over a period of a year that children are exposed to, almost all of it for unhealthy food.

You know, if you rewind the videotape, if there were such a thing anymore, rewind the videotape to when I was a boy, food advertising really just came in one form. I mean, there was a little bit of it here and there, but mainly it was Saturday morning cartoons and you were watching television advertisements. And all of that still exists, but now children are bombarded by it basically 24 hours a day. Any time they’re exposed to any media at all, they’re going to be getting advertisements for food. 

And so the amount of it, the sophistication of it, its ability to bypass parental oversight. Back when I was a boy it wasn’t a very fair fight that it was parents versus the advertisers. The advertisers would prevail almost always in that kind of a contest. And parents, of course, would be affected by the same type of advertising, but now it’s even harder because there’s so much more of it, it’s way more sophisticated, and it’s doing a lot of things biologically and psychologically to children that lead to unhealthy eating.

[Kris Perry]: So, children are influenced just like adults by celebrities or important characters in their life. We had a wonderful podcast about characters in children’s lives. We’ve also talked a little bit about parasocial relationships on the podcast. When it comes to kids and influencing their behavior, and their attachment to certain characters, I remember at a different point in time, I worked on an advertising campaign with a public broadcasting system on how to use those characters to encourage children to eat vegetables and fruit and they would be next to the oranges in the grocery aisle.

When you think about the kinds of food that marketers really want kids to eat, they don’t tend to be oranges and broccoli, right? It tends to be the more processed foods. Can you talk a little bit about the influencer, character, parasocial relationships, and how that is being used to influence children’s food decisions?

[Dr. Kelly Brownell]: There’s so much to be said about that. And I’ll tell you a story about some research we did when I was on the faculty at Yale University that addresses this very issue. But think, for example, of iconic images like Tony the Tiger, the Trix Rabbit, the bear that goes with Honey Crisp cereal, the leprechaun for Lucky Charms, Cap’n Crunch, you go on and on. And these are images that get burned into our brain at a very early age. And we associate them with fun, with luck, with good fortune, with being popular, all the sort of connections that the industry wants to make. But boy, do they start early, and the kids are exposed to this. I mean, sometimes well before they can even speak, they’re getting hit by these kind of messages. 

Now, the industry will say that they’re just trying to push around whether somebody picks our product over our competitor’s product – that the desire for a certain type of product, like, let’s say Frosted Flakes, or Raisin Bran, or sugar whatever – is set and that they just want to grab more of the share of the market, that’s why they use things like characters. Well, it turns out not to be true, that they drive desire for a category of products, not only theirs in particular. 

Now, why don’t the companies take those characters and associate them with healthier products? Because almost all the companies do have healthier products in their portfolio. Well, here’s the story. Back when I was on the faculty at Yale – I’m not there any longer. I’m at Duke University,  but I was at Yale for many years – and directed a center called the Rudd Center for Food Policy and Obesity that’s now at the University of Connecticut. That center continues to do amazing work on food marketing. So, we were funded by the Robert Wood Johnson Foundation, and this was work that was directed by Jennifer Harris, on looking at how much food marketing was being directed at kids, and what kind of foods were being marketed in particular. So the first category of food that Jennifer and her students took on to study were breakfast cereals and they published some really very powerful results on this.

What they found is that if you take breakfast cereals and rank order them in nutritional quality, and you put, let’s say, the worst products at the top of that list – the ones with the most sugar, the least fiber, et cetera – and then next to that, you put a list about what’s being marketed most aggressively to kids, those two lists overlap perfectly, almost. So the worst products are being marketed most aggressively to kids, that’s been established.

Now, why would the industry do that? Well, the industry, we were going to release the results of this research and tried to anticipate the industry’s response, which wasn’t too hard to do because they had written about these things and I’d seen them interviewed on panels and stuff and their basic argument is number one, that eating breakfast is a good thing. Well, that turns out to be true. Number two, that cereals are a good way to deliver nutrients – that also turns out to be true. But number three is that kids won’t eat the cereals unless they have sugar on them and, therefore, a thing can be as healthy as possible but it’s of no value to the child if they won’t eat it, so that’s why they put the sugar in it.

Okay, that’s what we call, as scientists, a testable hypothesis. Is that true or not? Well, we did a study to find out. Jennifer Harris did a randomized trial exposing kids to breakfast cereals and kids got to pour as much cereal in the bowl as they wanted. They got to add as much milk as they wanted. There was a sugar bowl on the side. If they wanted, they’d add sugar. And they could add fruit. The difference between the two conditions is that in one condition, children got a low sugar version of a cereal, like plain corn flakes, but in the other version, they got a high sugar version of the cereal. And what they found was a pretty predictable outcome – that when the kids were eating the low-sugar version of the cereal, they had a good nutrition profile for breakfast and they tended to sweeten it by adding fruit rather than sugar. So they got the nutrition boost from doing that. When they got the high-sugar version cereal, they ate way more and had a much worse nutrition profile. That’s why the companies put Tony the Tiger on the sugar-frosted version of the corn flakes, because kids will overeat that, their parents need to go back to the store more often, buy more boxes of the cereal – they just sell more. So, it’s pretty clear what’s going on there. 

And so, the marketing landscape basically comes down to a few basic fundamentals. Overwhelm children with messages to eat these foods – you promote the least healthy foods because those are the ones that children will overeat and parents will buy more, and could create addictive processes we can talk about – and then you cash in. And that’s done without regard for the health of the children because, if you were regarding the health of the children, you would push the better cereals in your portfolio, which get marketed to children almost not at all.

[Kris Perry]: That business model that you just laid out that they’re using to sell sugary cereal is not that different from the business model that the platforms are using to capture our attention. The more sensational and addictive the content, the more we consume it, and the worse we feel. So, it’s kind of a really, really interesting analogy that you just drew between the food marketing world and the platform social marketing world.

[Dr. Kelly Brownell]: It becomes a double whammy, doesn’t it?

[Kris Perry]: Yes.

[Dr. Kelly Brownell]: That you’re using an addictive method of communication to push a product that has addictive properties. And boy, the outcome’s not very pretty, is it?

[Kris Perry]:  Well, there are many poor outcomes, but also what troubles me almost more than these near-term problems around eating too much and spending too much money and not getting the nutritional benefit you need is the long-term consequences of starting to eat a certain kind of food at a young age that you become very attached to, both emotionally and physically, and that it’s hard to stop wanting that. It’s very hard to override those desires as you get older. So, I was going to ask you a little bit about what can parents do? I mean, you mentioned that researchers have measured how much food marketing kids see in the media. Can you tell us how much they’re seeing on a daily or weekly basis on average and what techniques parents could use to mitigate and reduce the amount of exposure kids have to this kind of advertising?

[Dr. Kelly Brownell]: You reminded me of something really interesting that I’m hoping to talk about as a bit of a detour. You talked about these advertisements creating wanting – we want the foods, and that that wanting can take place over a period of many years and can begin early. What about when wanting becomes needing? And what happens when you cross some biological threshold where your body starts sending out signals when you don’t have it? And it’s not just that you like it, it’s that you need it. And that’s the classic addiction paradigm. And so, you know, people – I’m not saying food is heroin, by any means, but if somebody takes heroin, you know, they take it, it feels good, but at some point it hijacks the biology of the body and you need it and you are in big trouble if you don’t have it. And the question is does food create that same sort of a process and does it go from liking, wanting, to needing? And if that transition takes place, what does that mean for policy, for litigation? There are a whole lot of interesting consequences. And you can imagine how parents would feel if that sort of thing is happening to the brains and the biology of their children, and it’s being done intentionally. That, you know, you can imagine what kind of feelings that would produce.

Okay, so, how much marketing is there? Well, there’s a ton. So the average child is now seeing somewhere around 10 or 11 advertisements for unhealthy food per day, and that’s just on television. And children are spending a lot of screen time, but not on a television, and they’re getting bombarded with messages coming at them that way. It’s much harder to quantify what children are seeing in the social media. But if it were only television advertising and it were only 10 a day, think about how many that is over the course of a year. Is there any message children are getting 10 times a day? I mean, do your homework, or be a nice person, or don’t steal from your peers, or be kind. There’s nothing else that I know of that they’re being told that many times a day. And not only are they hearing the message, but it’s with these compelling characters, and wonderful stories, and music, and celebrities, and influencers, all these kind of things. It’s very hard for those not to have impact. 

So, it’s a big, big problem, and parents are having trouble competing with this. Even the most intrepid parents who really pay attention to this have trouble because they just can’t monitor the social media all the time. Their children are seeing games. An example would be, you know, a game where you move candy around a board, or you’re doing something with fast food and you earn points. And these games can be very engaging for children. And then, of course, there’s the influencer thing and the conflicts of interest embedded in that.

So it’s the same message, which is to eat junk food, over and over and over again. And so what can parents do? It’s hard to know. I mean, you can do the knee-jerk response to that, limit screen time and try to provide a healthy food environment at home, try to immunize your children against these messages by letting them know that the companies are preying on them and all that kind of stuff. But it’s just not a fair fight. And counting on parents to counteract this is the thumb and the dike problem. You just can’t do it. So parents need help, and they need help from government. And that can take the form of administrative, legislative, or litigative changes. And all those things need to be done, I think.

[Kris Perry]: Yeah, I mean, I can think of some policies where, say, at the school level, you can’t have certain kinds of vending machines anymore, or soda, or the school meal program has to conform to certain criteria. I can see at that more local level there have been some real attempts to change what we’ve been feeding kids.

I remember growing up, my mom would never let us have any sugary cereal ever. It was like her mission in life was that we wouldn’t have it. And I remember liking Grape-Nuts, which made me a really, like, a weird kid, but they were so good. If I ever had a Froot Loop, I would never have eaten the Grape-Nuts. So, you know, if you don’t know, it’s easier.

[Dr. Kelly Brownell]: Well Kris, look at the amazing person you became.

[Kris Perry]:  Yeah, it’s the Grape-Nuts, for sure.

But you did talk about immunization, which I like a lot because that gets into cognition, metacognition, and kids being able to use information about this marketing strategy to their own benefit. So if you know that this is how this works and this is meant to, in a sense, use you for profit, maybe you can make some higher level decisions in your own mind. Can you talk about some of those psychological mechanisms that the games and the experiences that companies use to advertise, and then how kids and parents can try to fend off some of that advertising for kids?

[Dr. Kelly Brownell]: Well, the companies have unbelievable amounts of money they devote to doing this. And they’re doing not only kind of market research and focus groups and testing messages and all those sort of sophisticated things, but they’re also funding neuroscience studies. So they’re really looking at what’s going on at the level of the neural circuitry in the brain. And as they become more sophisticated, the amount of bang they get per advertising dollar seems, to me, to have increased a lot.

You know, again, back when I was a boy and I was just seeing cartoon advertisements on television, advertising was a pretty blunt instrument. Everybody was getting the same ad, and now it gets highly targeted to individuals. You know, it’s not just that we’re watching the screens. They’re watching us and learning about us and then targeting messages to us in return. So the effectiveness goes way up and the cost goes way down when, say, a company can have a one-time investment in a game that they can then post on the web and it just sits there forever, they’re not having to pay every time it gets used. Or they can pay a very small amount of money to an influencer who then can talk about the product and these things then become viral and you can get many thousands of people following the influencers. And the companies are very wise at trying to get the greatest impact per dollar.

So again, how in the world can parents compete with this? Well, they can do their best. Now, one thing they can do – and this gets back to the immunization idea – back with tobacco, when the state attorneys general sued the tobacco industry, and what came from that was something called the “Master Settlement Agreement,” where the tobacco companies didn’t want these cases to go to trial, so they made a big settlement with the state AGs. I mean, many, many, many millions of dollars over many, many years. And that money got used for a lot of different things, but one of which was to create a public relations campaign called “the Truth Campaign.”

And the Truth Campaign was a series of advertisements that didn’t – and that were really very widely seen around the US – that didn’t talk about the dangers of smoking or even how it would give you dirty teeth or things like that. What it focused on was the manipulative, predatory behavior of the industry. So there would be ads, for example, showing a smoke-filled boardroom of these old, white men sitting around laughing at how they had been able to hook generations of people on cigarettes and it was things like that. And that campaign was very effective. I mean, data got collected over a period of years. It was very effective. And it wasn’t because they were preaching to people. They were just pointing out the behavior of the industry. People then got mad at the industry and felt, “Well, I don’t want to be duped by these people.” And so then they were less likely to smoke.

Something like that would be wonderful for the food industry, as well. And there are a few things afoot there that way. But if people can begin to find out the degree of manipulation of the food itself and of the marketing, they’re really going to get mad.

I mean, I’ll just give you a few quick examples, if you don’t mind. One is when you eat food, the way your body first senses it before you ever eat it, you’re looking at it or you’re smelling it. And that initial smell of the food becomes one of the drivers of how much you’re going to like it. The people that sell frozen foods are at a disadvantage because the odor gets locked in the food. So some of the companies are now chemically recreating a pleasant smell from that food and impregnating the wrapper to have it. So you pick up that frozen ice cream bar, you open it up, you get a whiff, and you’re smelling what you think is the ice cream bar, but it’s actually not. There are other enzymes that are getting added to food that basically pre-salivate it so you don’t have to go through that salivation process yourself, which is one of the signals of how much you’ve eaten and when it’s time to stop. And so you get these snack foods, for example, that go in your mouth and they dissolve almost instantly. It’s as if they melt in your mouth. And the reward substances that are going to the brain are delivered in a very effective, rapid way, but then they dissipate very rapidly, so you need more.

It’s exactly what the tobacco companies did. And it’s not surprising that this technology got transferred because there was a period of time when the tobacco companies owned the food companies. And it had an epigenetic effect – at least, from my point of view – on the food industry in terms of very finely tuning every sensory aspect of the food in order to create maximum pleasure from it. 

So when people start to find these things out, if you could do a public relations campaign and start to really show people the degree of the manipulation, they’re not going to like it. And I think it might help. At some age, children will become responsive to these kind of messages, and parents certainly will. So I think something like that might be in order.

[Kris Perry]: Well, the artificialness of it, which is a little bit where we are with technology, too, is just it gets to a point if it’s so artificial that we all may just decide we want to draw a line between real and artificial like we did with food.

Are some children more susceptible to the influence of the food advertising that you’ve described than other kids?

[Dr. Kelly Brownell]: I am assuming the answer to that is yes, but I don’t think there’s enough research to know. There could be both psychological vulnerability and biological vulnerability to these things, and those two things might intersect with one another. So my guess is that if you expose the population of American children to an avalanche of messages for unhealthy children, not every child is going to react the same. Now, the average child will react in the predicted way or else the companies wouldn’t spend money doing all that advertising. So it’s having an impact. But there are probably very few children on whom it has no impact at all. There are probably a lot for whom it has enormous impact.

But figuring out who those children are and whether something might be done to specifically protect them becomes kind of the next generation of potential research. I mean, my own feeling would be not to go down that road because – I mean, it’s okay to do that. It’s a very interesting question intellectually, but it sort of implies that there are some people who are not vulnerable to it and that the ones who are just might be psychologically deficient or weak-willed in some way and so it’s a personal responsibility problem rather than an input problem from the terrible environment. And I don’t think that’s a very healthy message to have. You should assume that most every child is being affected by this and that policy ought to reflect that.

[Kris Perry]: But you’re a policy guy. So you’re already thinking as far upstream as you can that, if there were differences among kids – that, as a policy matter, we want to do things at population level, at scale. So let’s think about what’s best for the majority. And then if there are subsets of kids that have different reactions, and we’ll address that next, but we haven’t even done that yet.

So in addition to specific differences among children, what about different developmental periods where children might be more vulnerable? And I’m thinking about your 2014 study that examined brain activity in adolescents in response to food commercials. Can you tell us more about those developmental period differences?

[Dr. Kelly Brownell]: That study was done by a group of researchers at the Oregon Research Institute and I was a collaborator on it, but other people did the main research. And since that time, there’s been some more research but not a ton. And so the amount we know about how children are responding neurologically to these kind of messages at different periods of their development just isn’t very well nailed down. So, I guess it would be helpful to know that. I mean, if you could figure out that children between the age of X and Y are especially vulnerable, then maybe you could rein in the marketing during that particular age. But the companies find workarounds. And no matter what kind of policy you put in, the companies are very good at finding ways to bypass it, circumvent it, undermine it, prevent it, stall it, do whatever they can. So something needs to be done pretty dramatic, I think, in order to offer a higher level of protection.

So I think you’re asking good questions. At what age are kids most vulnerable? What can parents do? Are there kind of messages to help people defend themselves against this sort of stuff? Those are all necessary roads to go down, there’s no question. But this is such a pernicious, overwhelming influence on children that something more than that has to be done. And I think government owes it to people to do something. And if it’s not going to be done through the regulatory side of government, like the Federal Trade Commission or other authorities that might be involved here, and if it’s not going to be done by legislators because the food industry is too powerful in their lobbying, then what’s left is litigation. And my sense is that’s probably going to be the most productive frontier.

[Kris Perry]: There is some movement on the litigation front right now around product design and the harms caused by – we’re talking about social media now, not food, but there are an amazing number of similarities in the way that they’ve strategized how to market.

Yesterday, I was in the Inner Harbor in Baltimore and the Domino Sugar Factory is there. And they were proud to announce that they process six million pounds of sugar per day. And I did think to myself, “I don’t – that doesn’t sound like a good thing at all.” And then you realize there’s sugar – we’ve come across this, too, that sugar is in everything. It’s in fast food, it’s in candy, it’s in bread, it’s in juice. It’s – children really, you know, whether – even when parents try as hard as they can or subjected to food with that’s enhanced with sugar and salt and other ingredients that create that same addiction we’re talking about here. And it reminds me that you were the first person who coined the phrase “yo-yo dieting” decades ago, that pattern of dieting and then gaining weight back and we know that social media use can significantly impact adolescent body image, especially through constant comparison to unattainable body ideals found on image-based social media platforms. Is screen media and social media contributing to yo-yo dieting and other intense dieting behaviors?

[Dr. Kelly Brownell]: I’m assuming so, although I don’t have data to support it. But you can think about what children are seeing on the screens – lots of inducements to eat unhealthy food, which affects what they eat and therefore affects their body weight. At the same time, their body weights are being tugged upwards. They’re getting messages about being slimmer and trimmer and, you know, having the perfect male or female body. And all of these sort of things compete and kids are caught in the crossfire here. And it’s very sad and there are – there is just so much fallout from it. I mean, you have some people develop frank eating disorders – anorexia, bulimia, and things like that – which can be devastating to the life of somebody, especially, you know, a developing child and teenager and things. In other cases, there may not be an eating disorder, but the excess weight leads to teasing and bullying and social ostracism, not to mention the health consequences later on. It’s just a very bad kettle of fish that kids are exposed to these days. And it’s been true for a while, but it seems to be even more intense now.

So one of the consequences of this among some people are periods of weight loss followed by regain, what we called “yo-yo dieting,” or weight cycling. And we did a series of studies a number of years ago to find out what happens when people go through that. And, more or less, it comes to pass that the more one diets, the harder it becomes to diet later on, that your body responds to dieting as a type of starvation. And a smart body then will say, “Well, at some points I’m going to be starved and I’m going to try to slow down my metabolism. I’m going to try to conserve my energy stores. I’m going to do everything I can to prevent weight loss and then when I eat again, I’m going to regain as rapidly as possible.” This would make sense in an evolutionary way if starvation is actually what you were facing. And we don’t know whether the body doesn’t take dieting as a signal that you’re starving and create this defensive reaction that makes each bout of weight loss harder than the last and the likelihood of regain more rapid than the last.

And then, of course, there are the health consequences of these cycles of loss and gain because when you lose weight, your blood pressure changes, your blood sugar regulation changes, your lipids may change, a lot of things change. And then when you gain weight, the opposite occurs and those things tend to get worse. So the question is what’s the net effect of a bunch of these cycles of up and down? And from the research we and others did, it doesn’t appear to be good. And there seems to be a relationship between cardiovascular mortality, in particular, with those cycles of loss and gain. So anything that encourages or promotes these cycles of loss and regain are things that should be avoided.

[Kris Perry]: Evidence has come forward as a result of those recent lawsuits that I mentioned that social media companies are trying to recruit younger and younger users to their platforms despite knowledge that it’s unhealthy for them. Did the social media giants take a page out of the food marketing playbook when they realized that hooking them earlier creates brand attachment, dependency, future behavior?

[Dr. Kelly Brownell]: Yeah, those brand loyalties develop early. Here’s an example I like to use. If you ask the typical person, “Are you a Coke or a Pepsi person?” even people that are intentionally not drinking soda will always answer, immediately, which one they prefer. And if you ask people, “Can you tell the difference between the two?” almost everybody will say yes. When you actually do taste tests to see how many people can actually distinguish the difference, it’s not a lot. And it’s far less than believe that they can tell the difference.

So how does this come to be, Kris, that these two products, which are kind of indistinguishable to a lot of people, have such strong loyalty for one versus the other? Well, it’s all about the marketing. It’s which of these things was in your school. It’s which of these things was on the scoreboard on the football field. It’s which music celebrity or athlete endorsed them and you happen to like that. Or it’s what your family provided you. I mean, there are all these sort of things that imprint on you. But the earlier they get you, the better. The earlier it is to persuade you that these things are good because you don’t have the cognitive defenses if you’re very young. So striking early and trying to get kids as loyal customers where they imprint on a color of a logo or its shape or its name or its associations with celebrities or whatever, the better off you are. So the companies start really, really early.

[Kris Perry]: I mean, these forces that are creating this toxic food environment for children seem to be so big and so powerful. It can be difficult to really even feel hopeful about making it better. What gives you hope?

[Dr. Kelly Brownell]: Well, I’m hopeful, but first let’s talk about the word “toxic.” So I’ve been using the word “toxic” to discuss the food environment for a number of years, and it’s a pretty strong word. It sort of implies that if you’re in the presence of certain things, you’re going to get sick like a poison would make you sick. Well, as people are around the modern food environment, they get sick, they get heart disease and diabetes and obesity and cancers and all kinds of bad, bad stuff. 

And you could say, “Well, it’s just because people aren’t being responsible or pushing away from the table.” But as the modern American food supply gets replicated in country after country around the world, their rates of diet-related diseases start to look like ours. Well, are you prepared to argue that every country in the world is becoming less personally responsible? And at the same time we’re saying, “Well, people aren’t responsible about their food,” it turns out they’re being responsible in other areas of their life, like wearing seat belts and brushing and flossing and getting preventive exams. People are actually doing pretty well with these things, but in this particular arena, they’re not. So it’s just the overwhelming influence, manipulation by the companies and stuff like that that makes the environment toxic and when people are exposed to it, they get sick. So we need to create a different environment that promotes, rather than undermines, healthy eating. 

I’m optimistic. Even though what we’ve been saying is not very positive, there’s a lot afoot just recently that I’m very, very optimistic about. The social media lawsuits are one example of a positive change. Not only because they’re likely to be very helpful in their own right, but they signal something that government and the population is saying, “Enough,” that, “We need protection, these companies can no longer prey on us, and enough is enough. And it’s time to do something.” And I think that philosophy is finding its way into the food arena and others, as well. 

So now you have, for example, state attorneys general who are very interested in potential lawsuits against the food industry. Some of the initial actions are against particular parts of the food environment, like food dyes, but I think will likely, with time, expand into these broader categories of food like sugary beverages or breakfast cereals or ultra-processed foods overall and things like that. And I think this – those lawsuits and the public changes in attitude will embolden the legislators to get in there and do what needs to be done, like setting restrictions, creating oversight capability, taxing the unhealthy things and stuff like that. And I think more and more you’ll see that. 

And one thing I’m very happy about in the food arena is that it’s become surprisingly bipartisan. If you look at the people who are showing the necessary outrage against food industry behavior, you can’t predict somebody’s political interest or their party affiliation based on that because it’s people on all sides of the political spectrum who are really focusing on this now, which is a very positive sign. 

So hopefully things will happen and we’ll start to see progress. And I believe some tipping point has been reached and we’re going to see a lot of good things coming up in a short period of time.

[Kris Perry]: We didn’t talk about GLP-1s, but I do wonder if, when adults are able to control their food noise and some of the impulses that may have been triggered as children when they were eating highly processed foods and sugar, et cetera, that as adults, if their, say, their interest in different foods starts to emerge and they start to prepare different food for their family and it’s almost like – so now we have big pharma and the food industry. They’re going almost head-to-head here, too at this point in time and I think it’s just gonna be really interesting to watch how much the farm bill and other policy related to changes as appetites change, as people feel like they have more control over their food life, because that maybe hasn’t felt that way before. 

How did you come to do this work?

[Dr. Kelly Brownell]: Well, I began my career many years ago doing randomized trials for treating obesity. So we were randomly assigning groups of people to different medications or behavioral treatments or family interventions and the like. And I got frustrated with the poor results we were getting. And also, I began doing this work on yo-yo dieting that we talked about before and finding that that had negative consequences. So that led me to believe that these diet-related diseases needed to be prevented rather than treated. And once you start thinking about prevention, then children become important and the cascade of environmental influences, the upstream influences that are causing the downstream medical problems, really need to be addressed. And that’s where you get into policy and prevention and all that kind of thing. 

So I really made a turn many years ago and some friends of mine who were doing the treatments for obesity kept laboring at it decade after decade with very little in terms of reinforcing results. And then you know along come the GLP-1s, which change everything. So now there are treatments at work, but back then there weren’t. But it still doesn’t change the fundamental fact that you’d be way better off if these problems were prevented in the first place.

[Kris Perry]: Beyond the toxic food environment and childhood obesity, what’s most concerning to you when it comes to child health in the digital age? What do you think researchers should be studying most urgently?

[Dr. Kelly Brownell]: You know, it’s hard to know, Kris, because if you look at these things side by side – like, there’s the food and nutrition part of kids’ exposure to the digital environment, and then there’s the social interaction part of it, and the bullying, and things like that – there’s the physical activity effect, there’s the sleep effect. I don’t know how these things all stack up to one another. So I can’t really say how I’d rank order them, but what I would say is that the food environment’s pretty darn important. And, you know, it just affects so many areas of our health and well-being. And so much of this gets established early in life that, if there were actions taken to protect children from the bad messages they’re receiving in digital media regarding food, it would be a huge help to human health and well-being.

[Kris Perry]: Thank you, Kelly, for helping us understand how the environment surrounding children from food systems to digital media can shape their habits, preferences, and long-term health. And thank you to the audience for listening to Screen Deep today. 

For more about Kelly’s work, including his research on food policy and marketing, you can visit childrenandscreens.org. If this conversation resonated with you, please subscribe, share this episode, and visit childrenandscreens.org for more evidence-backed resources to help children thrive in a digital world. 

Until next time, I’m Kris Perry, reminding you that while technology shapes how children grow up, we all play a role in shaping the environments that help them thrive.

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