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Many factors influence children's food choices: where they eat; what their friends and siblings eat; what parents eat and drink and bring into the house; what is served at school; and, of course, what they like.

But if you are a parent, would you want your children's food and beverage choices determined by manufacturers whose primary goal is to make money by getting them hooked on products of questionable nutritional value? The issue is of particular importance now that rates of childhood obesity are soaring throughout the country, influenced in no small way by commercial interests.

Too Much Sugar on TV...

Last month, the Center for Science in the Public Interest, a Washington-based advocacy group, gave a grade of F to 95 of 128 food and entertainment companies for their policies - or lack thereof - on marketing to children. This despite the Children's Food and Beverage Advertising Initiative started in 2006 by the Better Business Bureau, in which 16 major food and restaurant companies, representing about 80 percent of television food advertising expenditures, announced they would not market foods to children under 12 if they did not meet the companies' own nutritional standards.

Unfortunately, there's the rub. What a company like Kellogg's regards as an acceptable amount of sugar in a serving of breakfast cereal may not be what a nutrition-wise parent would choose. The cutoff adopted by Kellogg's is 12 grams (3 teaspoons of sugar), which would keep them from promoting Cocoa Krispies (14 grams of sugar in a one-cup serving) to children. But Frosted Flakes, with 11 grams, could still be advertised in venues where children 6 and older will see them. (The company does not aim advertising at children under 6.)

Also, since each company sets its own guidelines, what applies to Kellogg's might not apply to products made by General Mills or Post.

"Despite the industry's self-regulatory system, the vast majority of food and entertainment companies have no protections in place for children," said Margo G. Wootan, the center's nutrition policy director. In the center's analysis of marketing to children, [PDF] released last November, the highest grade, a B-plus, went to the candy maker Mars, which does not market to children under 12 and avoids other gimmicks that attract them.

"If companies were marketing bananas and broccoli, we wouldn't be concerned," Dr. Wootan said. "But instead, most marketing is for sugary cereals, fast food, snack foods and candy. And this junk-food marketing is a major contributor to childhood obesity."

Furthermore, the analysis showed, although 64 percent of food companies that advertise to children at least have some sort of marketing policy, only 24 percent of restaurants and 22 percent of entertainment companies have any policy guiding advertising to children.

In a study released in March 2007 [PDF], the Henry J. Kaiser Family Foundation noted that children ages 2 to 7 see an average of 12 televised food ads a day, or 4,400 a year, and children 8 to 12 see an average of 21 a day - more than 7,600 a year. For teenagers, the numbers are 17 a day, or more than 6,000 a year. Fully half of all ad time on children's shows is for food, the foundation reported.

"Most of the food ads that children and teens see on TV are for foods that nutritionists, watchdog groups and government agencies argue should be consumed either in moderation, occasionally or in small portions," the group found. "Of the 8,854 food ads reviewed in the study, there were no ads for fruits or vegetables targeted at children or teens."

In case you are wondering, several studies have demonstrated that television ads do indeed have an effect - and not a good effect - on what children eat, and how much. In one study of 548 students at five public schools near Boston, published in 2006 in The Archives of Pediatric and Adolescent Medicine, researchers found that for each additional hour of television viewing, the children consumed an additional 167 calories, especially the calorie-dense, low-nutrient foods frequently advertised on television.

...and at the Movies

Now, a new study suggests, it's time to attend to more subtle promotions of questionable foods, beverages and eating establishments that appear in movies popular among children and adolescents. "Movies," the authors stated, "are a potent source of advertising to children, which has been largely overlooked."

The study, published in March in the journal Pediatrics, analyzed brand placements for foods, beverages and eateries depicted in the top 20 box-office hits for each year from 1996 to 2005. Of the 138 movies analyzed, 49 percent were rated PG-13, 20.5 percent were PG and 7.5 percent were G.

"We found that a surprising proportion of movies that were targeted to children and adolescents featured brand appearances," the authors wrote. Although Coca-Cola and Pepsi have long-standing commitments not to advertise their products on children's television, the researchers found that "sugar-sweetened beverage products from these companies regularly appeared in movies, especially those rated for children and adolescents."

Of the 1,180 brand placements identified, 26 percent of the food placements were for candy and other confections and 21 percent for salty snacks; 76 percent of the beverages were sugar-sweetened drinks, and two-thirds of the restaurants were fast-food places. The researchers found that "soft drinks, chips and fast-food brands dominated PG-rated and PG-13-rated movies."

The authors, led by Lisa A. Sutherland of Dartmouth Medical Center, found an average of 8.6 brand placements per movie, and concluded that most were "for energy-dense, nutrient-poor foods or product lines."

An Insidious Effect

Lest you doubt these brand placements influence young eating habits, the appearance of Reese's Pieces in the movie E.T. the Extra-Terrestrial resulted in a sharp increase in sales in the three months after the movie's release in 1982.

"Movie product placement is on a par with subliminal advertising, yet it has been largely ignored by those who study the impact of marketing on children," the authors wrote.

The authors expressed particular concern about the influence of brand placements in movies rated PG and PG-13 on older children and teenagers, "who are gaining independence with respect to their food choices." They noted that this "provides a likely avenue by which brand loyalty and product preference can be built."

What can you do? I wouldn't dare suggest passing up a wonderful movie like E.T. But just as parents and others have objected to sugary drinks sold in schools and, to a lesser effect so far, to foods advertised on children's television, it may be time to make your feelings known to movie producers about how brand placements are harming the health and increasing the weight of America's children.