Influencing children: food cues in YouTube content from child and youth influencers.

Digital marketing of unhealthy foods is linked to childhood obesity. This study evaluated nutrient quality and creative strategies of food cues on social media, focusing on child/youth influencers, to inform the ongoing digital media regulatory debate. Using the WHO's Monitoring of Marketing of Unhealthy Products to Children and Adolescents protocol, 162 videos from seven child/youth influencers' YouTube accounts with German content (33.8 h) were analyzed, classifying foods and beverages as permitted or not based on the WHO Nutrient Profile Model. Two-thirds (67%) of the n = 901 food cues analyzed were not permitted for marketing to children, 30.4% were permitted, and 2.6% were miscellaneous. Chocolate had the biggest proportion (19.8%). Child-appealing food cues were significantly more likely to feature not permitted foods than permitted foods (91.1% vs. 71.9%, p < 0.001). Of branded foods, 46.5% were not permitted foods and 7.7% were permitted foods (p < 0.001), and of those with positive verbal attributions/reactions, 36.9% were not permitted foods, and 28.1% were permitted foods (p < 0.001). Similarly, compared to 36.9% of not permitted foods, only 28.1% of permitted foods were presented with positive verbal attributions/reactions (p < 0.001). Children are exposed to extensive appealing presentations of food not permitted for marketing to children via influencers on digital media. Policy makers need to become more active in monitoring and regulating this content.