title: The extent and nature of digital food marketing via videogame livestreaming platforms and its impact on eating behaviour and health in young people
Creators: name: Evans, Rebecca
Publisher: name: University of Liverpool Repository
Year: 2023

description: Background
The global rate of overweight and obesity among children and adolescents is on the rise. This is a significant public health concern, as overweight and obesity are strongly associated with several non‐communicable diseases. The modern food environment is ‘obesogenic’ in that it promotes the (over)consumption of HFSS foods. Indeed, HFSS food makes up over two‐thirds of a UK adolescent’s total daily energy intake. One key environmental factor thought to be driving poor diet and overconsumption in adolescents is the pervasive and persuasive marketing of HFSS food. While there is considerable evidence that HFSS food marketing via traditional media (e.g., TV) negatively impacts young people’s food‐related behaviours, evidence is less comprehensive in relation to digital media. This lack of evidence is particularly notable regarding videogame livestreaming platforms – a growing form of digital media where individuals can broadcast or watch streamed videogame footage and communicate with streamers and viewers via a live chat. The top videogame livestreaming platforms globally are Twitch (77% of the market share by hours watched), YouTube Gaming (15%), and Facebook Gaming Live (7%). Videogame livestreaming platforms are popular with young people and present an opportunity for brands seeking to engage with this demographic. Policy action is reliant on robust evidence of the prevalence and effects of this marketing. Therefore, there is a clear need to examine the extent, nature, and impacts of marketing via videogame livestreaming platforms on young people’s eating behaviour and health.
Aims
1. To investigate the extent and nature of digital food marketing via videogame livestreaming platforms.
2. To examine the impact of this marketing on eating behaviour and health in young people.
Methods
Multiple rigorous methods were used in this thesis, and all studies were preregistered. In Chapter 3, content analysis methods were used to examine food cues on Twitch displayed by influencers likely to be popular with adolescents. We examined their exposure (e.g., display type, duration) and power (e.g., presentation) using a WHO protocol. In Chapter 4, we used systematic review and meta‐analytic methods to examine the evidence for a relationship between exposure to digital game‐based or influencer food marketing, and food‐related (brand awareness, attitudes, preferences, purchase, and consumption), and post‐consumption (weight, BMI) outcomes in young people (≤18 years). In Chapter 5, we used questionnaire methods (cross‐sectional) and structural equation modelling to explore direct and indirect associations between adolescents’ recall of food marketing on the top videogame livestreaming platforms, and relevant attitudinal, behavioural (purchase, consumption), and health (BMI) outcomes. In Chapter 6, we used a lab‐based between‐subjects randomised controlled trial to explore associations between HFSS food marketing via a mock Twitch stream and subsequent marketed and overall snack intake. We also examined the impact of attentional bias and inhibitory control in relation to branded food cues on intake.
Results and Discussion
Adolescents are likely exposed to extensive HFSS food marketing on Twitch, the leading videogame livestreaming platform. Food cues (2.6/hour, 20 minutes/cue) were predominantly HFSS (70.7%), branded (80.5%), energy drinks (62.4%), and not accompanied by an advertising disclosure (97.7%). Forms of influencer (e.g., product placement, 44% of food cues), and digital game‐based techniques (e.g., looping banners, 40.6% of food cues) were common, and several adolescent‐appealing features (e.g., tie‐ins, logos, offers, slogans) were used (Chapter 3). Influencer and digital game‐based food marketing influence young people’s eating behaviour. Digital game‐based marketing was associated with more positive attitudes and greater preferences toward marketed food brands and products (twice as likely to prefer). Additionally, influencer and digital game‐based marketing were associated with increased HFSS food consumption (~37 additional kcals). Evidence was lacking for awareness, purchase, and post‐consumption effects (Chapter 4). Food marketing via videogame livestreaming platforms is associated with adolescents’ eating behaviour. Recall of HFSS food marketing was associated with more positive attitudes towards HFSS foods, and in turn purchase and consumption of marketed HFSS foods. Neither purchase nor consumption were associated with BMI (Chapter 5). Acute exposure to HFSS food marketing in a mock Twitch stream was not associated with adolescents’ immediate consumption. Exposure to a single static banner food advert (versus exposure to equivalent non‐food marketing) was not associated with subsequent marketed or overall snack kcal intake. Additionally, attentional bias and inhibitory control in relation to branded food cues did not impact subsequent intake. However, greater habitual use of videogame livestreaming platforms was associated with increased marketed snack intake (Chapter 6).
Conclusions and Implications
This thesis provides important new information on the extent, nature, and impacts of HFSS food marketing via videogame livestreaming platforms on young people’s eating behaviour and health. Findings suggest that young people are likely exposed to extensive HFSS food marketing on videogame livestreaming platforms, and this marketing is presented using a range of powerful techniques and features. Additionally, this marketing appears to impact young peoples’ eating behaviours. However, more research on long‐term exposure, and the impacts of different advertising placements on videogame livestreaming platforms (and their combined effect) is needed. Although many users of videogame livestreaming platforms appreciate the presence of food brands on these platforms, and believe they help to support their favourite streamers, they are likely unaware of the potential impacts on their eating behaviour. These findings build on existing knowledge, provide a basis for additional research, and could help to inform public health policy deliberations in this area.