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In an article from 2011, United States Secretary of Agriculture, Tom Vilsacks stated, “The rise of childhood obesity has placed the health of an entire generation at risk” (2011). Research conducted has shown fast food to be a leading contributor to childhood obesity with close to one third of children consuming and demonstrating weight gain and risk of obesity (Holguin, 2004). The fast food industry stands accused of attempting to addict people, at an early age, to their food with a direct result of increased incidences of obesity. Much like the tobacco industry and smoking, there is debate whether responsibility lies with fast food or with individuals and their parents. There is strong evidence of fast food industries marketing correlating to childhood obesity.
Fast Food Proximity Easy access to fast food encourages consumption, replacing the traditional “afternoon snack” children would normally consume at home (Alviola, et al., 2004). A study conducted by Alviola, et al. found correlation between fast food proximity and childhood obesity rates (2004). The researchers used a varied approach to study 193 children between the ages of 11 and 14 years old in the state of Arkansas. The researchers studied the distance to fast food restaurants as a measurement, and found results suggesting that proximal exposure correlates to an increase in obesity levels. Specifically within a mile radius from a school, there is a statistically significant effect on the level of obesity rates (Alviola, et al., 2004). Another finding suggests a link to the time of discharge from school and time of last meal. Because lunch is often several hours before the end of the school day, many children will be hungry and are inclined to stop for fast food on their way home (Alviola, et al., 2004). The conclusions of the study demonstrated an increase of BMI by 0.08 – 0.14 points as measured by Body Mass Index (BMI) and the proximity to fast food for school-aged children (Alviola, et al. 2004). Still other studies question the link between obesity and fast food. A study conducted by the Patterson, Risby, & Chan (2012) did find that children who have fast food options on their way home from school had a greater than 33% increase in BMI compared to those children who do not have the option. The study measured the types and amounts of fast food purchased over several weeks and measured baseline and post study BMI of all participants. While they concluded that consumption of fast food did contribute to an increased BMI, when adjusted for age and gender, the significance becomes statistically insignificant.
Marketing and Television Influences Families may expose their children to healthy eating habits and may attempt to limit their snack and fast food options but those children still face the marketing influence of fast food. Fast food restaurants package meals specifically designed for children and offer incentives such as toys or enticements of playground activities within the restaurant. Fast food restaurants also buy television-advertising time during peak times when more children are watching. All of these examples instill a brand recognition and sense of reward for consuming their products (Chang & Nayga, 2009). In addition to advertising around programming, fast food marketing has found its way into many plotlines of children’s programming. In the UK and Ireland, a study found a total 1,155 food and beverage cues with sweet snacks and soda beverages accounting for 20% of those cues (Scully, et al., 2013). Both the U.S. studies and the UK and Ireland study demonstrate that the simple act of watching children’s television inundates children with overt and hidden fast food enticements.
A literature review by Henderson, Ward and Taylor discovered evidence of focused marketing to children by fast food restaurants and increased obesity (2009). They found children exposed to fast food advertising had their chances of obesity increase over 50% when compared to children with little or no exposure (Henderson, Ward, & Taylor, 2009). Another study found a link between decreased advertising and lowered obesity rates. Research conducted by Chou and Grossman in 2008 estimated the effects of television advertisement of fast food on adolescents. They utilized the 1979 Child-Young Adult National Longitudinal Survey of Youth and the 1997 National Longitudinal Survey of Youth to collect their research data of children across the United States. Through their research, they estimated that banning fast food advertisement during children’s programing would decrease of obesity rates by 14% – 18% (Chou & Grossman, 2008). Additionally, television viewing often accompanies poor food choices that are high calorie or high fat (Koplan, Liverman, & Kraak, 2005). This study by Koplan also found a link between playing video games and internet use with increased snacking. With the average child spending approximately seven hours per day playing video games, the chance for unhealthy eating significantly increases when compared to those who have limited viewing and playing times (Rubin, 2010). Controlling the amount of time children can play video games may have a positive effect on unhealthy eating and can free time for physical activity.
The link between obesity and advertising is apparent; television networks must act to address this growing problem. Leading the way, the Walt Disney Company in support of First Lady Michelle Obama’s “Let’s Move Campaign”, imposed a ban on “junk food ads” during prime-time children programming on all of its stations and affiliates. This made Disney the first network proactively lead the way towards decreasing advertising exposure (Barnes, 2012).
Parental Influence While there is a great deal of evidence supporting fast food’s proximity to schools and advertising techniques with an increase in childhood obesity, there is also evidence of parental influence as a contributing factor. The ease of serving fast food, as well as the satisfaction of their children’s desire makes it an appealing choice for some parents. In addition, children allowed television watching unsupervised, are exposed to fast food commercials, are also more likely to request fast food. A study of school age children in Taiwan revealed that parents who allow television viewing immediately after school, where there is increased fast food marketing, have children who are 20% higher at risk for obesity than parents that do not allow television watching (Chang & Nayga 2009).
Parental involvement is clearly the primary influence on their children’s health, but parents must be aware of food choices both inside and outside the home, while encouraging and rewarding healthy eating. Parents who make poor food choices and are sedentary create a perfect atmosphere for their children to become obese ("Childhood Overweight," 2012). It is not enough to allow participation in activity but parents should also make time to encourage and foster a healthy lifestyle. Parents whom add exercise as a family activity have children who are less obese and carry a healthy lifestyle into adulthood (“Childhood Overweight”, 2012). A study focused on the instance of childhood obesity as it relates to physical activity found that children who are encouraged to participate in 30 minutes of physical activity every day are 75% less likely to be obese to compared to those who are not as active (Koplan, Liverman, & Kraak, 2005). Another study by Neman and Burton in 2014 showed that sedentary life-styles and the decrease of physical activity in schools also had significant effects on increased obesity levels. They found that fast food was not the only contributing factor to increased obesity but found that those children also consumed sugared and fried snacks as well (Newman & Burton, 2014). Parents can also enforce healthy eating at school. While parents may enforce good food choices at home, it is sometimes difficult for children to make those choices while in school. Schools frequently offer soft drinks, high calorie snacks, and high fat food to students (Vilsack 2011). Parental involvement in food choices is also critical. If healthy choices are not available parents, should provide lunches from home and discourage buying snacks or other foods. However, the temptation of other foods may be overwhelming and children may opt to make poor food choices. Parents have a vested interest in working with their child’s school to ensure that healthy food choices are not only offered but encouraged, with limitations be placed on those that are high calorie and high fat. Parents can also work with their schools to increase physical activity during the school day. Competitive sports and physical fitness challenges can be an enjoyable way for children to stay active. Parents can also ensure these choices are available by volunteering to coach or chaperone activity times during the school day (Vilsack, 2011).
Conclusion
Parental and familial support allows for the best path to decreasing the instance of childhood obesity and helps those already obese to become healthier. Government and health experts may lobby for tighter controls on fast food restaurants and schools, but no matter the influence or the proximity, advertisement have the involvement of family support for both food choices and an active lifestyle are clearly the most important.
The elimination or reduction of fast food advertising and availability coupled with parental involvement with food choices can significantly decrease the prevalence of childhood obesity and subsequent adult levels of obesity. There is also a clear link to increased physical activity and a decrease in obesity. Television and video games often replace time for activities and contribute to furthering obesity through a sedentary lifestyle. The studies researched span a range of socio-economic, geographical, and ethnic diversity with the common findings of obesity rates increased with increased exposure to fast food advertising. Ultimately, parental involvement is the single greatest influence in their children’s health (Chang & Nayga, 2009). Supervising and limiting television and video games as well as enforcing healthy eating and snacking are the first step in battling the obesity epidemic. Television viewing also has a secondary effect of limiting physical activity among children. With the average child spending approximately seven hours per day playing video games, the chance for unhealthy eating significantly increases when compared to those who have limited viewing and playing times (Rubin, 2010).

Citations
Alviola, P., Nayga, Jr., R., Thomsen, M., Danforth, D., & Smartt, J. (2014). The effect of fast-food restaurants on childhood obesity: A school level analysis. Economics and Human Biology, 12, 110-119. doi: 10.1016/j.ehb.2013.05.001. Retrieved September 4, 2014, from http://www.sciencedirect.com/science/article/pii/S1570677X13000403

Barnes, B. (2012, June 04). Promoting nutrition, Disney to restrict junk-food ads. Retrieved October 10, 2014, from http://www.nytimes.com/2012/06/05/business/media/in-nutrition-initiative-disney-to-restrict-advertising.html?pagewanted=all&_r=0.

Chang, H., & Nayga, Jr., R. (2009). Television viewing, fast-food consumption, and children 's obesity. Contemporary Economic Policy, 27(3), 293-307. doi: 10.1111/j.1465-7287.2009.00157.x. Retrieved September 4, 2014, from http://onlinelibrary.wiley.com/doi/10.1111/j.1465-7287.2009.00157.x/abstract

Childhood overweight. (2012, January 1). Retrieved September 27, 2014, from http://www.obesity.org/resources-for/childhood-overweight.htm

Chou, S., Rashad, I., & Grossman, M. (2008). Fast-food restaurant advertising on television and its influence on childhood obesity. Journal of Law and Economics, 51(4), 599-618. Retrieved September 4, 2014, from http://www.jstor.org/stable/10.1086/590132

Henderson, J., Coveney, J., Ward, P., & Taylor, A. (2009). Governing childhood obesity: Framing regulation on fast food advertising in the Australian print media. Social Science & Medicine, 69(9), 1402-1408. doi: 10.1016/j.socscimed.2009.08.025. Retrieved September 4, 2014, from http://www.sciencedirect.com.ezproxy.snhu.edu/science/article/pii/S0277953609005449.

Holguin, J. (2004, January 5). Fast food linked to child obesity. Retrieved September 09, 2014, from http://www.cbsnews.com/news/fast-food-linked-to-child-obesity/

Koplan, J., Liverman, C. T., & Kraak, V. I. (2005). 8 Home. In Preventing childhood obesity: Health in the balance. Washington, D.C.: National Academies Press

Patterson, R., Risby, A., & Chan, M. (2012). Consumption of takeaway and fast food in a deprived inner London Borough: Are they associated with childhood obesity? BMJ Open, 2(3), 1-7. doi: 10.1136/bmjopen-2011-000402. Retrieved September 4, 2014, from http://bmjopen.bmj.com/content/2/3/e000402

Rubin, B. M. (2010, January 20). Young people spend 7 hours, 38 minutes a day on TV, video games, computer. Retrieved September 27, 2014, from http://articles.latimes.com/2010/jan/20/business/la-fi-youth-media21-2010jan21

Scully, P., Reid, O., Macken, A., Healy, M., Saunders, J., Leddin, D., ... O 'Gorman, C. (2014). Food and beverage cues in UK and Irish children - television programming. Archives of Disease in Childhood. doi: 10.1136/archdischild-2013-305430

Vilsack, T. (2011, May 25). Securing our future through our children 's health [Editorial]. The Huffington Post. Retrieved September 27, 2014, from http://www.huffingtonpost.com/gov-tom-vilsack/securing-our-future-throu_b_473363.html

Citations: Holguin, J. (2004, January 5). Fast food linked to child obesity. Retrieved September 09, 2014, from http://www.cbsnews.com/news/fast-food-linked-to-child-obesity/ Koplan, J., Liverman, C Scully, P., Reid, O., Macken, A., Healy, M., Saunders, J., Leddin, D., ... O 'Gorman, C. (2014). Food and beverage cues in UK and Irish children - television programming. Archives of Disease in Childhood. doi: 10.1136/archdischild-2013-305430 Vilsack, T

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