As school food services outsource more of their food preparation, the processed products they offer to schoolchildren are increasingly branded. There is legitimate concern that branding will make more indulgent foods even more attractive.1-3 Conversely, a promising question is whether branding can be used to promote healthier eating.4,5 Could branding more dramatically improve the attractiveness of less exciting—but healthier—foods?
After obtaining institutional review board approval at Cornell University and parental consent, 208 children (99 female) ranging from 8 to 11 years old were recruited from 7 ethnically and economically diverse schools in suburban and rural upstate New York. The study occurred during lunchtime on 5 consecutive days at each location. After selecting their lunch, children were individually offered an opportunity to select either an apple or a cookie. In total, there were 615 observations included in the analysis after eliminating absentee students, missing data, or miscoded observations.
On the first day of the study, both the apple and the cookie were offered without a sticker, as a pretest control. This enabled us to calibrate a baseline preference for each child. On the last day of the study, both the apple and cookie were offered without a sticker as a posttest control to help us determine if the presence of stickers on the apple had any carryover.
The remaining 3 days were intervention sessions that varied within schools. On one of the days, each child was offered a choice between an unbranded apple and a cookie that had a sticker of a familiar popular character (ie, Elmo) on it. On another day, each child was offered a choice between an unbranded cookie and an apple that had a sticker of the Elmo icon on it. On another day, each child was offered a choice between an unbranded cookie and an apple with a sticker of a character that was unfamiliar. On each day of the study, each child’s choice was unobtrusively recorded. Children were accustomed to knowing they could not take any lunch food home with them. The majority of children who selected a food ate at least a portion of the food. All analyses were performed using SPSS (version 24.0; SPSS Inc). The analysis compared the likelihood of a child selecting an apple in each experimental condition with the likelihood of them selecting an apple in the pretest condition. We used a generalized estimating equation model with a binomial distribution and a logit link with the repeated measures at the child level and a fixed effect for school and condition.
The preplanned comparison shows Elmo-branded apples were associated with an increase in a child’s selection of an apple over a cookie, from 20.7% to 33.8% (Wald χ2 = 5.158, P = .02) (Figure). Compared with this same unbranded pretest control condition, apple selection was not significantly associated with selection of the unbranded apples with control stickers (Wald χ2 = 0.945, P = .33), Elmo-branded cookies (Wald χ2 = 0.452, P = .50), or in the posttest condition (Wald χ2 = 2.661, P = .10). This may suggest that using stickers of familiar, popular characters on an apple could increase the selection of apples over cookies compared with the pretest control condition.
There is concern over what impact branded products in lunchrooms might have on children’s selection of food. In contrast, this study suggests that the use of branding or appealing branded characters may benefit healthier foods more than they benefit indulgent, more highly processed foods. Just as attractive names have been shown to increase the selection of healthier foods in school lunchrooms,6 brands and cartoon characters could do the same with young children.
Correspondence: Dr Wansink, Charles H. Dyson School of Applied Economics and Management, Cornell University, 475 Warren Hall, Ithaca, NY 14853 (wansink@cornell.edu).
Retraction: This article was retracted on October 20, 2017.
Retraction and Replacement: This article was retracted and replaced on September 21, 2017, to fix errors in the text, Figure, and end matter.
Published Online: August 20, 2012. doi:10.1001/archpediatrics.2012.999
Author Contributions: Dr Wansink had access to the data in the study and had responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Wansink, Just, and Payne. Acquisition of data: Payne. Analysis and interpretation of data: Wansink. Drafting of the original manuscript: Wansink, Just, and Payne. Critical revision of the replacement manuscript for important intellectual content: Wansink, Just, and Payne. Statistical analysis: Wansink. Obtained funding: Wansink. Administrative, technical, and material support: Payne. Study supervision: Wansink.
Conflict of Interest Disclosure: None reported.
Additional Contributions: We thank Jennifer Cole, MS, for help with study execution and data collection; Laura E. Smith, BS, and Josh Baylin, BS, for help with data collection; Mitsuru Shimizu, PhD, for the original data analysis; and Huy Tran, MS, for help with data analysis in this version of the manuscript.
Funding/Support: This study was supported by the Robert Wood Johnson Foundation through the Healthy Eating Grant Program.
Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Reproducible Research Statement: Data, analysis scripts, and output files used in this study are available at http://www.ciser.cornell.edu/ASPs/search_athena.asp?IDTITLE=2796.
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