For example future research should investigate if

For example, future research should investigate if increased advertising literacy for children,
possibly via training or education, could increase the level of cognitive processing of the food
cues. This could foster children’s skepticism towards the advertisements and thereby possibly
decrease the cue-reactivity to such food cues. What is more, the extinction of a classical
conditioning relationship between food cues and subsequent intake seems to be successful
among adults following training [50], but this has not been studied in children. In summary,
intervention studies are needed to investigate the effectiveness of training or educational
programs in reducing susceptibility to food cues, disrupt progression of the incentive-
sensitization process, and ultimately protect children from overeating.
Conclusions
Evidence shows that food advertising affects eating behavior among children, but
more research is needed to examine individual susceptibility factors and the exact underlying
mechanisms. The proposed REFCAM provides a framework for (1) explaining the
relationship between exposure to advertised food cues and food behaviors and (2) guiding

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future research questions and intervention opportunities. Although companies assert their right
to freedom of commercial speech, restrictions of marketing efforts should be seriously
considered - especially those directed at children, because this marketing contributes to
childhood obesity [4,5]. In times of increasing childhood obesity rates and related rises in
health service utilization and costs, there is a need for public debate on advertising techniques
attempting to persuade children subconsciously. Reversing the trend of increased childhood
obesity will require both bold action by policymakers to restrict children’s exposure to
unhealthy food marketing and evidence-based interventions to help children defend
themselves against commercial messages promoting unhealthy food intake.

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Advertising Effect Process Incentive Sensitization Process
Figure 1 : Reactivity to Embedded Food Cues in Advertising Model (REFCAM)
Food Cues
Embedded in
Advertisements
Cue Reactivity:
Physiological
and
Psychological
Responses
Palatable Food
Intake
Message Factors: Level of
Integration of Food Cues
Individual Susceptibility
Factors: e.g. Impulsivity
and Attentional Bias

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Acknowledgements
Frans Folkvord drafted the manuscript, Doeschka J Anschütz, Emma Boyland, Bridget Kelly,
and Moniek Buijzen provided critical revisions and writing assistance. All authors proofread
the article and approved the final version of the manuscript for submission.
References

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[1] Nestle M. (Eds): Food Politics: How the food industry influences nutrition and health.
University of California Press; 2013.
[2] Klein N (Eds): No Logo . Picador; 2002.