The Association of Television Viewing With
Snacking Behavior and Body Weight of
Maria Thomson, MSc; John C. Spence, PhD; Kim Raine, PhD, RD; Lory Laing, PhD
Purpose. Investigate whether TV viewing and recognition of snack food advertisements
were associated with snack food consumption and the odds of being overweight or obese.
Design. Cross-sectional internet-based survey.
Setting. University of Alberta, Edmonton, Canada.
Subjects. Undergraduate university students aged 18 to 25 years (N 5 613).
Measures. Self-reported TV viewing, energy-dense snack consumption, snacking while
viewing TV, and body weight.
Analysis. Hypothesis testing was completed using multiple analysis of variance,
analysis of covariance, and logistic regression.
Results. Students reporting medium or high TV viewership snacked more frequently
while watching TV and recognized more advertising than students who were considered
low viewers. High viewers also reported more consumption of energy-dense snacks than low
viewers. Snacking frequency appeared to be related to TV viewing and place of residence,
but the association between snacking frequency and TV viewing was not accounted for by
advertising. Conversely, the association between TV viewing and consumption of energy-
dense snacks was accounted for by advertising recognition. Finally, male students (odds
ratio [OR], 2.78; 99% confidence interval [CI], 1.68–4.59) and medium (OR, 3.11;
99% CI, 1.37–7.08) and high (OR, 5.47; 99% CI, 1.97–15.16) TV viewers had higher
odds of being overweight or obese.
Conclusions. Associations were found among TV viewing, energy-dense snack
consumption, and snacking behavior, and between TV viewing and body weight status.
(Am J Health Promot 2008;22:329–335.)
Key Words: Diet, Advertising, Television, Food Habits, Obesity, Prevention
Research. Manuscript format: research; Research purpose: modeling/relationship
testing; Study design: nonexperimental; Outcome measure: behavioral, biometric;
Setting: home, school; Health focus: nutrition; Strategy: skill building/behavior
change; Target population: youth, adults; Target population circumstances:
The past few decades have witnessed
population-level changes in dietary in-
take trends in North America.1People
are increasingly eating more food away
from home,1consuming more soft
drinks,2,3and snacking more often.4,5
Since 1977, the average number of
snacks consumed in the United States
has increased significantly by approxi-
mately 24% to 32%.6Although the
energy density of snacks has remained
virtually unchanged, the sheer number
of snacks consumed has increased.
Snacks currently contribute an esti-
mated 25% of dietary energy and as
much as one-fifth of other dietary
nutrients.6Although fat intake has
decreased for all age groups in the
United States, the absolute and relative
proportion of fat from snacks has
increased throughout the same peri-
od.6Thus, for many, snacking is
becoming an important dietary com-
ponent and may be a factor in the
increasing prevalence of overweight
and obesity among North Ameri-
Changing population diet trends
have been accompanied by changes in
food advertising practices. Although
there are many media avenues through
which food messages are conveyed, TV
still receives the most attention and
highest advertising budgets from food
companies.9Content analyses show
that although the average time allot-
ment for TV commercials has not
changed, the average commercial
length has decreased, in effect dou-
bling the number of product expo-
sures.10,11At the same time, the food
marketing industry has increased and
Maria Thomson, MSc, is with the Department of Health Studies and Gerontology, University of
Waterloo, Waterloo,Canada. John C.Spence, PhD, iswiththeFaculty ofPhysical Education and
Recreation; Kim Raine, PhD, RD, is with the Centre for Health Promotion Studies; and Lory
Laing, PhD, is with the School of Public Health, University of Alberta, Edmonton, Canada.
Send reprint requests to John C. Spence, PhD, Faculty of Physical Education and Recreation, E-488
Van Vliet, University of Alberta Edmonton, Alberta, T6G 2H9 Canada; firstname.lastname@example.org.
This manuscript was submitted December 24, 2006; revisions were requested May 18, 2007; the manuscript was accepted for
publication June 3, 2007.
CopyrightE2008 by American Journal of Health Promotion, Inc.
0890-1171/08/$5.00 + 0
May/June 2008, Vol. 22, No. 5 329
intensified its targeting of youth po-
pulations in an attempt to influence
current and future consumer beha-
viors.12Thus, poor population dietary
habits may in part be related to TV
exposure of children,13adolescents,14
and young adults.15
The transition from adolescence to
adulthood has been shown to be
a period of adoption for many nega-
tive health behaviors including in-
creases in smoking and alcohol use
and decreases in physical activity and
fruit and vegetable consumption.16–19
However, limited information is avail-
able on the possible associations be-
tween food advertising exposure and
snacking behaviors among young
Cultivation analysis is a useful theo-
retic framework for assessing media
effects.20Originating in studies of TV
violence, cultivation analysis posits that
heavy TV viewers are more likely to
perceive the world in terms of the ideas
and values that are consistent with ‘‘TV
reality’’ than are light viewers.21,22In
contrast, light viewers are less exposed
to ‘‘TV reality’’ and are more likely to
draw on other sociocultural influences
to create their own world views.22,23
The present exploratory study concep-
tualized ‘‘TV reality’’ as depicting
a particular TV diet in which no food
was considered a ‘‘bad food.’’ It was
hypothesized that heavy TV viewing
would be associated with higher levels
of energy-dense (ED) snack consump-
tion, greater recognition of TV adver-
tising, increased likelihood of snacking
while viewing TV, and higher levels of
To facilitate access to a large sample
of young adults, an e-mail recruitment
protocol and web-based survey were
used with students at the University of
Alberta in Edmonton, Canada. Follow-
ing procedures recommended in the
was collected through an Internet-
based 22-item questionnaire developed
from a variety of previously validated
survey instruments.26–29With the ap-
proval of the University of Alberta
Health Research Ethics Board, we
obtained a random list of 5000 student
e-mail addresses from the University of
Alberta Computing and Networking
Services office. Solicitation e-mails,
containing a link to the web-based
survey, were sent out twice to the
students over a 2-week period in March
2005. Upon clicking the link provided,
students were automatically redirected
to the survey, and informed consent
was requested. All surveys were com-
pleted and collected anonymously.
The services of Academic Technologies
for Learning, a university-based service,
were contracted for assistance with web
site creation, maintenance, and data
A key feature of the web-based survey
was the fact that participants could not
return to previously completed sec-
tions. Because it was thought that
participants may have been inclined to
answer the snack food consumption
section differently in light of the TV
viewing and advertising sections in the
latter part of the survey, each survey
component was treated as a separate
section requiring the participant to
submit completed answers to load the
The study sample was drawn from
the population of students aged 18 to
25 years attending the University of
Alberta. In total, 613 students enlisted,
resulting in a response rate of 13%;
64% were female, and the mean
participant age was 20.8 (SD, 1.9).
Comparisons of sex and age distribu-
tions suggest that the sample demo-
graphics are representative of the total
population of university students
Television Viewing. Television viewing
was assessed by asking participants to
estimate the total number of hours
viewed on 1 average weekday and 1
average weekend day. These answers
were then summed to yield a weekly
total. In accordance with the American
Academy of Pediatrics30TV viewing
classification system, participants were
categorized as high viewers if they
watched §4 hours of TV per day and
as low viewers if they watched ,1 hour
of TV per day.
Snack Food. A modified version of
a food frequency questionnaire creat-
ed by Block et al.26was used to quantify
the amount of snack food participants
consumed in a typical week. Snacking
was defined as the consumption of any
food item that is not a meal. In total,
12 snack categories were created. Sev-
en were considered ED snack choices
(e.g., salty snacks, soft/fruit drinks,
candy, baked goods and ice cream/
frozen yogurt, salted meats, and snack
bars), and 5 were considered healthy
snack choices (e.g., fruit, dairy, vege-
tables, nuts, and breads/rolls/bis-
cuits). The scores for each snack
category ranged from 0 (never ate the
snack) to 4 (consumption exceeded
five times in 1 week). The categories
were summed to create two separate
Participant Demographics in Comparison With the Distribution for the
Study Sample (N = 613) University Population (N = 24,442)
330American Journal of Health Promotion
scores: healthy snacks and ED snacks.
The highest scores possible for the
healthy and ED snacks were 20 and 28,
Advertising Recall. Advertising recall was
measured by 10 fill in the blank
questions that required the participant
to either finish the advertising slogan
or name the product for various
televised ED snack food items. The
products and their associated slogans
were chosen from recent television
programming to ensure their currency.
To do this, an abbreviated content
analysis of Canadian television pro-
gramming was performed. Ten hours
of television programming were exam-
ined for a period of 1 week during
January 11 to January 17, 2005. Based
upon the 2004 TV Times Reader’s
Choice Awards,31the top-rated pro-
grams from 10 program categories
were recorded for 1 hour each. Pro-
gram categories included situation
comedy, daily talk show, drama, sports,
news, late-night talk show, animated
series, daytime soap opera, reality
series, TV movie, and game show.
If the program was only 30 minutes, it
was recorded twice in the same week.
All jingle and product tag lines used in
the survey were derived from this
analysis. The same snack classification
used in the food frequency question-
naire was used to identify ED snack
advertisements. Fast food advertise-
ments were included in the ED snack
food count because it is possible that
these foods are consumed both in
replacement of and in addition to
Snacking Frequency. Snacking frequency
was assessed by one question: ‘‘How
often do you snack while watching
television?’’ Responses were measured
using a five-point Likert scale ranging
from ‘‘never’’ to ‘‘everyday.’’
Body Weight Status. Based on self-
reported height and weight, the body
mass index (BMI) of each participant
was calculated.32These measures were
reported using either the International
System of Units (kg/m) or the US/
Imperial scale (pounds/inches).
Demographics. Participants were asked
to report their age, sex, and place of
residence. Residence was measured by
asking participants to indicate whether
they currently resided in on- or off-
campus housing. Research has shown
that socioeconomic status (SES) is an
influential factor in population food
consumption patterns and bodyweight
status.33–35Because our sample con-
sisted of young adults attending uni-
versity, we assumed that SES would
not vary greatly within the sample,
and thus it was not measured or
All analyses were conducted with the
SPSS 13.0 statistical computing soft-
ware (SPSS Inc, Chicago, Ill). Descrip-
tive statistics, including Pearson corre-
lations, were calculated for all
variables. Hypothesis testing was com-
pleted using multiple analysis of vari-
ance (MANOVA), analysis of covari-
ance (ANCOVA), and logistic
regression. Significant interactions
were followed up with analyses of
simple effects and post hoc contrasts.
Due to extreme nonnormality and
skewness in the data, a square-root
transformation was performed on
the TV viewing variable so that it
could be treated as a continuous vari-
able in the correlation analysis. Be-
cause of the numerous statistical tests
conducted, an a of .01 was adopted for
It was expected that approximately
28% of participants would be high TV
viewers and 15% would be low TV
viewers.36,37Distributions in the cur-
rent sample approached expected dis-
tributions with 18% and 20% of par-
ticipants reported as high and low
viewers, respectively. Approximately
30% of participants reported consum-
ing soda and snack bars more than
once per week. Twenty-five percent
reported a similar intake of salty snacks
and baked goods, and 18% consumed
as much candy. Less than 6% of
participants reported consuming
salted meats or ice cream and frozen
yogurt more than once per week. In
terms of BMI, 28% of respondents
were overweight (21%) or obese (7%),
66% were normal weight, and 6% were
Television Viewing and
According to the correlation matrix
in Table 2, TV viewing (square-root
transformed) was related to snacking
frequency (r 5 .56), slogan recognition
(r 5 .24), and ED snack consumption
(r 5 .20). A two (male or female) by
three (high, medium, or low TV
viewing) factorial MANOVA was con-
ducted with snacking frequency, slogan
recognition, ED snack consumption,
and healthy snack consumption as
dependent variables. Based upon Pil-
lai’s criterion, the combined depen-
dent variables were significantly related
to TV viewing (F[8, 1208] 5 25.36, p ,
.0005, g25 .14) but not to sex (F[4,
603] 5 1.88, p 5 .11, g25 .01) or their
interaction (F[8, 1208] 5 0.90, p 5 .52,
g25 .01). When the results for the
dependent variables were considered
separately, significant differences
were observed for snacking frequency
(F[2, 1210] 5 114.48, p , .0005,
g25 .27), slogan recognition
(F[2, 1210] 5 11.94, p , .0005,
g25 .04), and ED snack consumption
(F[2, 1210] 5 7.92, p , .0005,
g25 .03). Follow-up simple contrasts
revealed that medium TV viewers
recognized more slogans (mean, 9.60;
SD, 3.26) and snacked more often
while watching TV (mean, 2.97; SD,
0.99) than low TV viewers (mean, 8.68;
SD, 3.15 and mean, 1.81; SD, 0.87,
respectively). High TV viewers recog-
nized more slogans (mean, 10.79; SD,
3.38), snacked more often while
watching TV (mean, 3.77; SD, 0.99),
and consumed more ED snacks (mean,
11.16; SD, 3.97) than low TV viewers
(mean, 8.68; SD, 3.15; mean, 1.81; SD,
0.87; M, 9.29; SD, 3.42, respectively).
Slogan Recognition and
Two 2 3 2 between-group ANCOVAs
were conducted to assess whether
slogan recognition accounted for the
relationship between TV viewing and
snacking frequency or TV viewing
and ED snack consumption. The
independent variables were TV
viewing (low, medium, and high)
and residence (on campus and off
campus). Sex was not included as
an independent variable because
it was not related to either snacking
behavior in the previous set of
May/June 2008, Vol. 22, No. 5331
analyses. Preliminary checks were
conducted to ensure that no violation
of the assumptions of normality, ho-
mogeneity of variances, or homogene-
ity of regression slopes existed. After
we adjusted for slogan recognition,
significant main effects of TV viewing
(F[2, 605] 5 60.29, p , .0005, g25
.17) and place of residence (F[1, 605]
5 8.95, p 5 .003, g25 .02) were
observed for snacking frequency.
Specifically, high TV (meanadj, 3.53)
and medium TV (meanadj, 2.84)
viewers reported higher snacking
frequency than low TV viewers
(meanadj, 1.76) and students living off
campus (meanadj, 2.91) snacked at
a higher rate than those living on
campus (meanadj, 2.51). No significant
interaction was found for snacking
frequency. After we adjusted for
slogan recognition (F[1, 605] 5 6.98,
p , .008, g25 .01), no significant
interaction or main effects were
observed for ED snack consumption;
suggesting that slogan recognition
accounted for much of the relation-
ship between TV viewing and ED snack
Body Weight Status
In a hierarchic logistic regression
analysis, body weight status (under-
weight/normal weight vs. overweight/
obese) was regressed on age, sex,
residence, TV viewing, snacking fre-
quency, slogan recognition, and ED
snack consumption. A test of the full
model with all eight predictors (two for
TV viewing) against a constant-only
model was statistically reliable
(x2 [8, N 5 606] 5 57.74, p , .0001).
The variance explained in body weight
status, according to Cox and Snell and
Nagelkerke R square statistics, was
between 9% and 13%, respectively
(22log likelihood 5 661.53). Table 3
shows regression coefficients, Wald
statistics, odds ratios (OR), and 99%
confidence intervals (CI) for each of
the predictors. Sex (OR, 2.78; 99% CI,
1.68–4.59), medium TV viewing (OR,
3.11; 99% CI, 1.37–7.08), and high TV
viewing (OR, 5.47; 99% CI, 1.97–15.16)
were associated with body weight sta-
tus, indicating that male students and
medium and high TV viewers had
higher odds of being overweight or
obese than female students or low TV
viewers. Considering the small de-
creases in the Wald statistic for TV
viewing from step 2 to step 3 (Table 3)
and the fact that none of the snacking
variables were significant predictors of
body weight status, it appears that
snacking behavior may have partially,
but not significantly, mediated the
association between TV viewing and
body weight status.
Studies have examined food intake
and caloric consumption in relation to
TV viewing among adults,15but few
have considered the role of snacking.
The current study specifically exam-
ined snacking in relation to TV viewing
and body weight status among young
adults. We found that university stu-
dents reporting medium or high TV
viewership snacked more frequently
while watching TV and recognized
more advertising than students who
were considered low viewers. High
viewers also reported more consump-
tion of ED snacks than low viewers.
Snacking frequency appeared to be
related to TV viewing and residence,
but the association between snacking
frequency and TV viewing was due to
advertising. However, advertising rec-
ognition did account for the associa-
tion between TV viewing and con-
sumption of ED snacks. In addition,
male students and medium and high
TV viewers had higher odds of being
overweight or obese.
The literature suggests two mech-
anisms of influence to explain the
relationship between TV viewing and
snacking and food consumption, that
is, (1) exposure to advertising will
stimulate a desire to consume a
particular product38–41and (2) TV
viewing provides an opportunity to
snack.37,42–46Results from the current
study support claims for both of these
potential pathways. Snacking frequen-
cy was related to the amount of TV
viewed, a relationship that was not
explained by advertising recognition.
Although high TV viewers reported
more ED snack consumption than
viewers of low levels of TV, it appears
that much of this relationship was
accounted for by advertising recogni-
tion. Thus, consistent with the tenets of
cultivation analysis,21the effect of TV
viewing on ED snack consumption may
work through the advertising viewed
on TV and the extent to which that
advertising is recognized and remem-
bered. Further research is needed to
expand on these preliminary findings
and compare advertising recognition
with specific product consumption.
Many studies have investigated the
relationship between TV viewing and
Intercorrelations for Snacking Behavior, TV Viewing, Slogan Recognition, and BMI
BMI indicates body mass index; and ED, energy dense.
* p , 0.01 (two-tailed).
332American Journal of Health Promotion
BMI with equivocal results.47–49For
instance, a recent meta-analysis con-
cluded that only a small relationship
exists between TV viewing and BMI
among children and youth.49In the
current study, medium and high levels
of TV viewing were significant predic-
tors of body weight status. The odds of
high TV viewers (i.e., §4 hours per
day) being overweight or obese were
approximately 5.5 times greater than
low TV viewers. Although the variance
explained by this model was small, it
does not discount the possibility of TV
viewing having an effect on popula-
tion-level BMI ratios. In addition, it is
possible that the relationship between
TV viewing and body weight is cumu-
lative and does not become large
enough to detect until adulthood. The
fact that none of the snacking beha-
viors or slogan recognition predicted
body weight status once TV viewing was
taken into account suggests that it may
be the sedentary behavior that results
from TV viewing, as opposed to sub-
sequent snacking, that leads to over-
weight and obesity.
Previous studies have postulated that
place of residence, especially in child
and adolescent populations, may play
a role in determining food choice and
food consumption patterns.33,50,51In
our study, residence was related to
snacking consumption with those stu-
dents living off campus reporting
higher levels of snacking than those
living on campus. This finding may be
indicative of the differential access to
snacks in different locations. Although
significant, the difference between the
groups was not large, probably reflect-
ing the fact that these young adults
have increased autonomy and are able
to acquire snack foods in whatever type
or quantity desired regardless of the
residential dietary milieu.
The current study had some limita-
tions that merit discussion. Due to the
cross-sectional design adopted, we
could only investigate associations or
group differences between variables;
questions of causality could not be
addressed. The use of self-reported
measures may have introduced partic-
ipant recall bias. However, the mea-
sures of TV viewing and snack food
consumption have been used in prior
research with positive results.26,27The
inclusion of a university sample may
have presented a bias because of the
higher education levels of participants.
For instance, the consumption of
healthy snacks in this sample was high.
This result may be reflective of the
higher SES of university students as
compared with the general population.
Based on Canadian population data,52
a negative relationship exists between
fruit and vegetable consumption and
BMI. The low levels of overweight and
obesity found in this sample further
suggests that the reported healthy
snack consumption may be higher
than that of the general population.
Higher levels of SES may have attenu-
ated the link between healthy snacks
and television viewing because both of
these factors have been linked to diet
and consumption behaviors.50,53It is
not clear the extent to which these
results are generalizable to other Ca-
The use of self-reported height and
weight for the calculation of BMI is
a definite limitation of this study. In
comparison with objective measures,
people tend to underreport weight and
BMI and overreport height.54However,
when conducting surveys with large
Summary of Logistic Regression Analysis Predicting Body Weight Status (N = 606)
VariableB SE Wald Test OR 99% CI
Place of residence
Place of residence
Low TV viewing
Medium TV viewing
High TV viewing
Place of residence
Low TV viewing
Medium TV viewing
High TV viewing
CI indicates confidence intervals; ED, energy dense; OR, odds ratio; and SE, standard error.
May/June 2008, Vol. 22, No. 5333
samples, or over the Internet, it is
difficult to avoid the use of self-
reported measures of height and
weight. Numerous studies of college
students have used self-reported height
and weight55–57In terms of prevalence
of overweight and obesity, our findings
(28%) are similar to those of Huang et
al.,55who found that approximately
26.5% of University of Kansas students
were either overweight (21.6%) or
obese (4.9%). However, until correc-
tion factors are developed to increase
the accuracy of self-reports of height
and weight, the limitations of this
procedure will need to be continually
Because of the relatively large sam-
ple size, several of the analyses in our
study detected small effects as being
statistically significant that would not
have been detected with a smaller
sample. However, because the direc-
tion of the study results were consistent
with the proposed hypotheses and are
consistent with results from other
studies,6,13,48,58–60we do not believe
these findings are anomalies or irrele-
vant. That is, in spite of the limited
explanatory power of these models,
there does appear to be a positive
relationship among TV viewing,
advertising, and consumption of ED
snacks among Canadian university
A final limitation is the low survey
response rate of 13%. It is possible that
a self-selection bias was present. Per-
haps those students who answered the
survey were the same individuals who
felt most strongly about TV viewing,
snacking, or both. This would then
maximize the differences observed
between the highest and lowest view-
ers. However, because of the similarity
of sex and age distributions between
the sample and parent population
shown in Table 1; the expected pro-
portions of high, medium, and low TV
viewers; and the relatively large sample,
we are confident that the responses
were representative of the university
population. Not surprisingly, low re-
sponse rates (e.g., 0.24%–10%) have
been reported by others using Inter-
net-recruiting strategies.24,25,61Lack of
appropriate incentives, timing con-
flicts, and difficulty differentiating the
authenticity and legitimacy of invita-
tion e-mails from spam were suggested
reasons for these low rates of recruit-
The tenets of cultivation analysis
suggest that regular, long-term expo-
sure to TV and advertising will have an
effect on heavy viewers.21,23Each of the
hypotheses in this study were con-
structed on the assumption that high
TV viewing cultivates a ‘‘TV reality’’
that is associated with distinct differ-
ences in consumption and behavioral
patterns related to snacking as com-
pared with low viewing. Overall rela-
tionships were found among TV view-
ing, ED snack consumption, and
snacking behavior, and between TV
viewing and body weight status. Fur-
ther study is required to understand
the motivations for choosing specific
snacks in different populations and
how these motivations are influenced
Funding for the project was provided by the Canadian
Institutes for Health Research and the Heart and Stroke
Foundation of Canada. Kim Raine, PhD, RD, is supported
by a career award from the Alberta Heritage Foundation for
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SO WHAT? Implications for Health
Promotion Practitioners and
Television commercials are
a common method of advertising
food throughout the industrialized
world. Our research shows that
university students who watch
§4 hours of TV per day snack more
frequently while watching TV, rec-
ognize more advertising, and con-
sume more ED snacks than students
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