Article Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial -- -- Abstract OBJECTIVES: To examine the impact of social media influencer marketing of foods (healthy and unhealthy) on children’s food intake. -- -- METHODS: In a between-subjects design, 176 children (9–11 years, mean 10.5 ± 0.7 years) were randomly assigned to view mock Instagram profiles of 2 popular YouTube video bloggers (influencers). Profiles featured images of the influencers with unhealthy snacks (participants: n = 58), healthy snacks (n = 59), or nonfood products (n = 59). Subsequently, participants’ ad libitum intake of unhealthy snacks, -- -- unhealthy snacks) were measured. RESULTS: Children who viewed influencers with unhealthy snacks had significantly increased overall intake (448.3 kilocalories [kcals]; P = .001), and significantly increased intake of unhealthy snacks -- -- .001), and significantly increased intake of unhealthy snacks specifically (388.8 kcals; P = .001), compared with children who viewed influencers with nonfood products (357.1 and 292.2 kcals, respectively). Viewing influencers with healthy snacks did not significantly affect intake. -- -- significantly affect intake. CONCLUSIONS: Popular social media influencer promotion of food affects children’s food intake. Influencer marketing of unhealthy foods increased children’s immediate food intake, whereas the equivalent marketing of healthy foods had no effect. Increasing the promotion of -- -- healthy foods on social media may not be an effective strategy to encourage healthy dietary behaviors in children. More research is needed to understand the impact of digital food marketing and inform appropriate policy action. -- -- Studies have revealed that broadcast food advertising strongly influences children’s eating behavior. The Internet is now well established as a food-marketing platform, and young people spend considerable time on social media, including engaging with the activity -- -- established as a food-marketing platform, and young people spend considerable time on social media, including engaging with the activity of influencers. What This Study Adds: -- -- What This Study Adds: Acute experimental exposure to influencers promoting unhealthy foods on social media increases children’s immediate intake of unhealthy foods, -- social media increases children’s immediate intake of unhealthy foods, but the same influencers promoting healthy foods does not have a beneficial effect on children’s choices or intake of those foods. -- -- engaging and entertaining media content, which actively encourages children to share these experiences with peers.^26^,^27 Social media have also bred a new form of celebrity: online influencers with huge fanbases^28 and whose opinions can affect those of their -- fanbases^28 and whose opinions can affect those of their subscribers.^29 Brands seek promotional relationships with influencers because of their reach and the trust that followers have in them.^30 -- because of their reach and the trust that followers have in them.^30 Influencers often engage in food-marketing activity on social media by featuring brands and products in their content, and it is not yet clear if this affects eating behaviors in the young people exposed. Recent -- -- psychological models suggest that reactivity to food cues is moderated by message factors, including the level of integration of food cues.^31 Because of the embedded nature of food cues in influencer media content, children’s awareness of the marketing may be low and the effects potentially more powerful than for television, on which even -- -- of a character increases the probability of imitating the character’s action. Therefore, exposure to an admired media character, such as an influencer, holding a food product may encourage these behaviors in children.^34 Exposure to traditional celebrity endorsement of HFSS foods in television commercials has been shown to increase children’s -- -- preference for and intake of these products,^35^,^36 with less robust findings seen for healthy foods.^37^–^39 Children report viewing influencers to be more trustworthy than traditional celebrities,^40 possibly because of increased feelings of familiarity.^41 To date, the -- possibly because of increased feelings of familiarity.^41 To date, the impact of influencer marketing of food on children’s eating behavior has not been researched. -- -- has not been researched. Our aim in this study was to examine the impact of social media marketing of snack foods, via influencers’ Instagram profiles, on children’s ad libitum snack intake. It was hypothesized that (1) children exposed to the social media marketing of snack foods (healthy -- -- In a between-subjects design, participants were randomly assigned to 1 of 3 influencer-marketing conditions: healthy food marketing, unhealthy food marketing, and nonfood marketing (control). Within each condition, -- food marketing, and nonfood marketing (control). Within each condition, the mock Instagram profiles of 2 popular influencers (1 man, 1 woman) were viewed on a laptop computer. Counterbalancing of participants to -- were viewed on a laptop computer. Counterbalancing of participants to condition, and influencer order (man first or woman first), was conducted by using randomizer.org. Although a “food-cues only” condition would begin to disentangle whether effects on food intake are -- -- attributable to the endorsement of the food cue or just the food cue itself, this is not representative of how foods are marketed by social media influencers; therefore, this condition was not included in the study. -- -- Mock Instagram Profiles Two social media influencers were selected: a 26-year-old female YouTube video blogger (vlogger) and a 23-year-old male YouTube vlogger (names are not provided for reasons of copyright). Both feature in the -- -- followers on Instagram. Research suggests consumers respond differently to male and female celebrity endorsers,^43 and so children were exposed to mock Instagram profiles for both influencers (Supplemental Fig 2). Profiles consisted of the Instagram banner and 6 images (3 test and 3 -- Profiles consisted of the Instagram banner and 6 images (3 test and 3 filler) of the influencer holding a product. In test images, the products were snacks (unhealthy [eg, chocolate cookies] or healthy [eg, banana]) or branded nonfood items (control [eg, sneakers]). Snacks were -- -- major source of calories.^45 In filler images, the products were unbranded nonfood items. All images were obtained and edited (to create the healthy-condition stimuli) from influencers’ YouTube channels (Corel PaintShop Pro 9). -- -- 2010.^48 To control for potential effects on kcal food intake, children were asked to report liking of the mock Instagram profiles with a yes-or-no response and previous familiarity with the influencers by indicating the number of social media sites they had previously viewed them on. -- -- Participants were tested in a quiet room in their school, seated at a desk with a laptop computer and questionnaire. Children firstly completed the hunger rating VAS and then viewed each influencer’s Instagram profile on the laptop screen for 1 minute. Children were told to pay close attention to the profiles because they would later be -- -- Randomization checks were conducted for hunger, BMI, age, sex, ethnicity, liking of Instagram profiles, and previous exposure to the influencers by using a Welch 1-way analysis of variance. The conditions did not differ on the variables measured (all P > .05; Table 1). View this table: -- -- To examine which factors should be used as covariates, Pearson’s correlations were calculated. As shown in Table 2, hunger, previous influencer exposure, and liking of Instagram profiles were related to kcal intake and included as covariates in the analyses. Multivariate analysis of covariance measured the effect of the marketing-exposure -- -- Discussion This study quantifies the impact of influencer food marketing on children’s food intake. The results demonstrated that children exposed to marketing of unhealthy snacks increased their immediate overall kcal -- -- foods or fruit, have been shown to lead children to increase kcal intake in general.^20^,^21 Therefore, it was predicted that exposure to influencer food marketing that featured a food cue would produce similar effects in the current study. This effect was found for unhealthy cues but not healthy cues. As previously discussed, children -- -- marketing consumed more unhealthy foods compared with children in the other conditions. These findings are consistent with previous studies assessing the impact of digital marketing on intake of HFSS foods^17^,^56 and those demonstrating the effect of celebrity endorsement on intake of HFSS foods.^35^,^36 The medium effect size -- -- consumed 91 kcals more compared with those in the control condition. This is larger than the proposed energy gap and is the effect after acute exposure to social media influencer marketing only. Children’s additional kcal intake in response to acute food-marketing exposure is not compensated for at later eating occasions, and so marketing-driven -- -- This study had some limitations. First, all children were exposed to the same 2 influencers, and individual differences that may have moderated endorser effects, such as perceived similarity, familiarity, and likeability,^58 could not be considered. Just more than 40% of the -- -- moderated endorser effects, such as perceived similarity, familiarity, and likeability,^58 could not be considered. Just more than 40% of the sample had no previous exposure of the 2 influencers used in the current study but were included in the analysis. Including these -- current study but were included in the analysis. Including these children may have underestimated the impact of influencer food marketing. However, children are likely to spend much longer on social media sites^19 than occurred here and, as a result, be exposed to -- -- marketing. However, children are likely to spend much longer on social media sites^19 than occurred here and, as a result, be exposed to greater volumes of influencer food marketing.^59 In addition, Instagram encourages engagement with advertising by prompting users to “like” and share images.^30 This engagement allows direct communication between -- -- encourages engagement with advertising by prompting users to “like” and share images.^30 This engagement allows direct communication between influencers and followers, heightening feelings of familiarity and likeability^41 and enabling influencer marketing to reach not only followers but also followers’ wider social networks.^60 For this -- followers but also followers’ wider social networks.^60 For this reason, it would be interesting to explore effects of influencer marketing on those who do not follow the influencers’ online activity but may be recipients of their content via peers. Second, although children were asked to refrain from discussing the study with their -- -- cannot be drawn from these data, and future studies should be designed to explore this and the potential for longer-term effects. It would also be interesting to compare the potential influence of peers versus media influencers on children’s behavior. The findings of the current study may be used to inform the debates -- -- who viewed that 2 YouTube vloggers (those featured in the current study) were popular with children and had featured in HFSS marketing on Instagram. Both influencers have been nominated for the award for UK favorite vlogger at the 2015 Nickelodeon Kids’ Choice Awards, demonstrating their popularity with children.^62 The Advertising -- -- favorite vlogger at the 2015 Nickelodeon Kids’ Choice Awards, demonstrating their popularity with children.^62 The Advertising Standards Authority noted that <25% of both influencers’ Instagram followers were registered as <18 years old; therefore, the advertisement was deemed to not target children. At the time of -- -- followers were registered as <18 years old; therefore, the advertisement was deemed to not target children. At the time of writing, collectively, these influencers have just more than 15 million Instagram followers.^63 Using Instagram’s user demographics data, 3.75 million young people (13–17 years old) may have been exposed to this -- -- Instagram followers.^63 Using Instagram’s user demographics data, 3.75 million young people (13–17 years old) may have been exposed to this influencer HFSS food marketing. In addition, Instagram’s data do not include children <13 years old who use fake dates of birth^64; thus, this figure is likely to be a conservative estimate. The data presented -- -- Conclusions This study demonstrates that influencer marketing of unhealthy foods increased children’s immediate food intake of these foods, whereas -- increased children’s immediate food intake of these foods, whereas influencer promotion of healthy foods had no such effect. These findings are consistent with the literature on the impact of celebrity endorsement, which shows that the effects of HFSS food promotion are more robust than for healthy foods.^37 Childhood obesity remains a -- -- 4. Campbell NRC, 5. Johnston BC . Influence of unhealthy food and beverage marketing on children’s dietary intake and preference: a systematic review and meta-analysis of randomized trials. Obes Rev. -- -- 2. Kelly B, 3. McMahon AT, et al . Sustained impact of energy-dense TV and online food advertising on children’s dietary intake: a within-subject, randomised, crossover, counter-balanced trial. Int J Behav Nutr Phys Act. -- -- 1. Lee JE, 2. Watkins B . YouTube vloggers’ influence on consumer luxury brand perceptions and intentions. J Bus Res. 2016;69(12):5753–5760 OpenUrl -- -- 2. Cauberghe V, 3. Hudders L . Marketing through Instagram influencers: the impact of number of followers and product divergence on brand attitude. Int J Advert. 2017;36(5):798–828 -- -- 3. Valkenburg PM . Enhancing children’s vegetable consumption using vegetable-promoting picture books. The impact of interactive shared reading and character-product congruence. Appetite. 2014;73:73–80pmid:24216486 -- -- 41. ↵ 1. Gräve JF . Exploring the perception of influencers vs. traditional celebrities. In: Proceedings of the 8th International Conference on Social Media & Society; July 28–30, 2017; Toronto, Canada: 1–5 -- -- 4. Halford J, 5. Boyland E . Children’s exposure to food advertising: the impact of statutory restrictions [published online ahead of print October 30, 2017]. Health Promot Int. doi:10.1093/heapro/dax044pmid:29092014 -- -- 1. Kapitan S, 2. Silvera DH . From digital media influencers to celebrity endorsers: attributions drive endorser effectiveness. Mark Lett. 2016;27:553–567 -- -- 1. Augure 2. Launchmetrics . The state of influencer engagement: 2015. Available at: https://www.launchmetrics.com/resources/whitepapers/the-state-of-in fluencer-engagement-2015. Accessed July 12, 2018 -- -- Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial Message Subject (Your Name) has sent you a message from American -- -- Log in Citation Tools Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial Anna E. Coates, Charlotte A. Hardman, Jason C.G. Halford, Paul -- -- Share Social Media Influencer Marketing and Children’s Food Intake: A Randomized Trial Anna E. Coates, Charlotte A. Hardman, Jason C.G. Halford, Paul -- -- Cited By... * Child Social Media Influencers and Unhealthy Food Product Placement * Digital Advertising to Children