Low-Fat, No-Fat, and Sugar Free: An Examination of Children's Knowledge of Nutrition, Food Preferences, and Television Use

IntroductionRecent reports from the International Obesity Task Force indicated that in 2006, 22 million children worldwide under the age of five years were classified as obese or overweight. Furthermore, results from the 2003-2004 National Health and Nutrition Examination Survey indicated that an estimated 17% of children in the US between 2-19 years were overweight. What is known from empirical studies across disciplines is that multiple factors may be related to the likelihood of a child to be overweight or obese: genetics, lack of physical activity, and increased consumption of high-calorie, low-nutrition foods and beverages (1). Of importance here are factors that children cannot control-access or encouragement to participate in physical activities, access to healthy or unhealthy foods at home or at school, and a social or home environment that either promotes or discourages healthy eating and exercise. Along these lines, children and adolescents may presume that their parents are making responsible and healthy choices for them as it relates to food and physical activity (2), and probably will not spend a great deal of time analyzing the nutritional attributes of a specific food item (3). Children will either rely on parents to make good choices for them, or respond to terms on the products such as "low fat" or "low sugar", and they may not examine the actual nutritional content of the products themselves. A recent study published by the Institute of Medicine of the National Academies (IOM report) indicated that the current practices for food marketing put children at a health risk because dietary patterns begin early in childhood and are shaped by social, cultural and mediated factors, including television advertising. Furthermore, children may presume that the foods they receive at school in lunch or breakfast programs are also healthy and may not critically consider the nutritional attributes of the foods being served. Accordingly, this study examined 3rd-6th graders' television use, their knowledge of nutrition, their food preferences, and their food intake at home and at school in order to better assess which factors may prove more influential in shaping their overall knowledge about nutrition and health.Even though parents are responsible for the food children consume at home, many researchers suggest the media, especially advertising, influence children's purchasing behavior and food purchase requests (4). Certainly, as studies over the last decade have illustrated, food ads targeted toward children have often emphasized unhealthy options versus healthy options (5). They further report that in the ads targeted toward children, few health-related messages were found, but of the ones with some mention of health, the message was related to the food containing natural ingredients or that the food was low in calories.Studies more recently have examined the nutritional value of food served in public schools, suggesting that the school environment may be one source of a child's higher calorie diet. With the introduction of vending machines in schools and the shift to cheaper foods in bulk, the nutritional value of food served during the school day is questionable at best. Children, however, may not recognize the poor nutritional value of the foods they are consuming, especially if the food is coming from home or school. Children may further lack the awareness or understanding related to nutritional guidelines and may simply assume what they are eating is healthy. More sedentary lifestyles and changes in the home environment have also contributed to a shift in eating habits and behavior in the last few decades, especially in the foods children eat on a daily basis and their daily media diet.Roberts and Foehr report that the average child spends up to five hours a day with various media (6), and as reported in a more recent study, elementary aged children spent several hours a day watching television programs on the Disney Channel, Nickelodeon, and the Cartoon Network and spent additional time on the websites associated with those channels as well as websites targeted toward children (webkins. …