Appetite 176 (2022) 106128

Contents lists available at ScienceDirect

Appetite
journal homepage: www.elsevier.com/locate/appet

‘Even if you don’t pay attention to it, you know it’s there’: A qualitative
exploration of adolescents’ experiences with digital food marketing
Gastón Ares a, *, Lucía Antúnez a, Carolina de León b, Florencia Alcaire a, Leticia Vidal a,
Virginia Natero c, Tobias Otterbring d, e
a
Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n. CP 91000.
Pando, Canelones, Uruguay
b
Intendencia de Montevideo, Montevideo, Uruguay
c
Departamento de Alimentos, Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
d
School of Business and Law, Department of Management, University of Agder, Universitetsveien 17, 4630 Kristiansand, Norway
e
Institute of Retail Economics, Regeringsgatan 60, 103 29, Stockholm, Sweden

A R T I C L E I N F O A B S T R A C T

Keywords: Adolescents are particularly vulnerable to digital food marketing. However, research on adolescents’ recall,
Social media awareness, and opinions of this type of marketing is still scarce. Accordingly, the present study aimed to conduct
Digital marketing an in-depth examination of adolescents’ experiences with digital food marketing. A convenience sample of 209
Food marketing
adolescents was recruited at two private educational institutions and a public health facility in Montevideo, the
Nutrition policy
Adolescence
capital city of Uruguay. Semi-structured group interviews were conducted, recorded in audio and transcribed.
The transcripts were analyzed using content analysis based on a deductive-inductive approach. Results showed
that participants were highly exposed to digital food marketing, as they all remembered having seen adver­
tisements, with those of fast-food restaurants and food-ordering apps being the most frequently mentioned.
According to the adolescents’ accounts, images, colors, music, oversized portions, product novelty, price pro­
motions and celebrities were the most memorable aspects of food advertisements. Participants recognized the
effect of advertisements on product awareness and wanting, and, to a lesser extent, on actual purchase and
consumption behavior. Factors that were thought to mediate the impact of digital marketing on food choice were
also identified. In the final part of the interviews, participants proposed strategies to reduce the effect of digital
marketing on their food choices, which included both regulatory approaches to reduce exposure to digital
marketing of unhealthy foods and behavior change communication. Together, the current findings provide in­
sights for the development of multifaceted strategies to reduce the effects of digital food marketing on the eating
habits of adolescents.

1. Introduction
Adolescence is a transformative life period, characterized by rapid
and profound biological and social changes (Perkovic, Otterbring,
Schärli, & Pachur, 2022; World Health Organization, 2017). Nutrition
during this phase is essential to achieve optimal growth and develop­
ment and sets the foundations for a healthy life during adulthood (Norris
et al., 2021). The available evidence suggests that the eating habits of
adolescents worldwide are far from optimal, as they do not consume
enough vegetables and fruits, and consume too much ultra-processed
products with excessive content of sugar, fat and sodium (ALjaraedah,
Takruri, & Tayyem, 2019; Christian & Smith, 2018; Enes, de Camargo, &
Justino, 2019; Neufeld et al., 2022). As a consequence of these eating
habits, micronutrient deficiencies persist in many places and the prev­
alence of overweight and obesity has largely increased worldwide,
amplifying the risk of premature mortality and non-communicable dis­
eases and compromising adolescents’ ability to achieve their full po­
tential (Appannah et al., 2015; Enes et al., 2019; Norris et al., 2021;
Patton et al., 2016; UNICEF, 2019).
This situation suggests the need to implement a multifaceted range of
strategies and interventions to promote healthier diets among adoles­
cents (Hargreaves et al., 2022). An improvement in the eating habits of

* Corresponding author.
E-mail address: gares@fq.edu.uy (G. Ares).

https://doi.org/10.1016/j.appet.2022.106128
Received 14 February 2022; Received in revised form 7 June 2022; Accepted 8 June 2022
Available online 16 June 2022
0195-6663/© 2022 Elsevier Ltd. All rights reserved.
G. Ares et al.
adolescents can have a positive effect on their health and wellbeing
during the life course, as well as on the health of their offspring
(Gluckman & Hanson, 2006). The eating habits of adolescents are
determined by the complex interaction of adolescents’ behaviors, their
personal food environments, external food environments and food
supply chains (Raza et al., 2020). In particular, external food environ­
ments have been increasingly recognized as key determinants of ado­
lescents’ eating habits (Fox & Timmer, 2020; Raza et al., 2020; UNICEF,
2019).
Food marketing is one of the factors of external food environments
that exerts a profound effect on adolescents’ food preferences and con­
sumption patterns (Boyland et al., 2016; Smith, Kelly, Yeatman, &
Boyland, 2019). The influence of marketing can be explained through a
hierarchy of effects model based on a series of chained stages, including
raising awareness of the existence of specific brands and products,
shaping favorable attitudes and preferences towards the promoted
products, and ultimately leading to purchase and consumption of such
products (Kelly, King, et al., 2015).
Most research on the effect of marketing on food choice has been
focused on television advertising, and to a lesser extent on food pack­
aging (Ares, Velázquez, Vidal, Curutchet, & Varela, 2022; Boyland et al.,
2016; Qutteina, De Backer, & Smits, 2019; Otterbring, Shams, Wästlund,
& Gustafsson, 2013; Smith et al., 2019). However, in the last decades,
the relevance of digital marketing has largely increased, motivated by
the growing popularity of social media platforms (Boyland et al., 2020;
Kannan & Li, 2017; Nöjd, Trischler, Otterbring, Andersson, & Wästlund,
2020; Radesky et al., 2020; World Health Organization, 2016). Digital
marketing can be defined as promotional activities delivered through
digital media that seek to maximize impact based on creative and/or
analytic methods (Montgomery & Chester, 2011). This type of market­
ing is characterized by its continuous availability, ubiquity and inter­
activity, which can make it more persuasive than other types of
marketing (Buchanan, Kelly, Yeatman, & Kariippanon, 2018; Kelly,
Vandevijvere, Freeman, & Jenkin, 2015). The relevance of digital
marketing has increased in the context of the COVID-19 pandemic, as
companies re-directed their strategies to online channels during social
distancing (Nielsen, 2020; Otterbring & Bhatnagar, 2022). Previous
research has shown that digital media are widely used to advertise
products with high content of sugar, fat and sodium using multiple
marketing techniques that promote interaction and engagement,
including promotions, advergames, celebrities, and user-generated
content (Antúnez, Alcaire, Brunet, Bove, & Ares, 2021; Buchanan,
Yeatman, Kelly, & Kariippanon, 2018; Freeman et al., 2014; Kelly,
Vandevijvere, et al., 2015; Qutteina, Hallez, Mennes, De Backer, &
Smits, 2019; Vassallo et al., 2018).
Adolescents are particularly vulnerable to digital food marketing
(Qutteina, De Backer, & Smits, 2019). Firstly, they are active users of
social media, which influence their relationships, identity, emotion
regulation, learning processes and ultimately their wellbeing (Shankle­
man, Hammond, & Jones, 2021). Secondly, adolescence is characterized
by an increased sensitivity to rewards, impulsive decision-making and
decreased inhibitory control, which may lead to unhealthy eating habits
(Lowe, Morton, & Reichelt, 2020). Finally, autonomy, agency and a
strong desire for uniqueness and social belonging during this life period
also encourage the adoption of unhealthy diets (Neufeld et al., 2022).
Despite its relevance, research on the topic has been scarce
(Kucharczuk, Oliver, & Dowdell, 2022; Qutteina, De Backer, & Smits,
2019; van der Bend, Jakstas, van Kleef, Shrewsbury, & Bucher, 2022). So
far, studies have shown that adolescents are frequently exposed to dig­
ital food marketing and that they are more likely to recall advertise­
ments of unhealthy foods compared to healthy foods or non-food items
(e.g., Baldwin, Freeman, & Kelly, 2018; Murphy, Corcoran,
Tatlow-Golden, Boyland, & Rooney, 2020). In addition, results from a
recent meta-analysis indicate an association between consumption of
unhealthy food and beverages and marketing exposure on social media
(Qutteina, Hallez, et al., 2019). However, an in-depth exploration of
2
Appetite 176 (2022) 106128
adolescents’ accounts and perceptions about digital food marketing is
still lacking. In addition, all the studies published on the topic have been
developed in western countries (Kucharczuk et al., 2022; Qutteina,
Hallez, et al., 2019), stressing the need to expand knowledge beyond this
geographic and cultural context. Insights on adolescents’ recall,
awareness, and opinion of digital food marketing can largely contribute
to policy making (van der Bend et al., 2022). The active engagement of
adolescents in the design of strategies to minimize the effect of digital
marketing on their food choices can contribute to increase their critical
awareness and self-efficacy (Merves, Rodgers, Silver, Sclafane, & Bau­
man, 2015).
1.1. Aims of the study and context
The aim of the present work was to explore adolescents’ experiences
with digital food marketing. Specifically, the following key objectives
were addressed: i) to explore the prevalence of digital food marketing
exposure among adolescents, ii) to examine adolescents’ perception of
digital food marketing and its influence on food choice, and iii) to
identify ideas posed by adolescents regarding how the effect of digital
marketing on food choice can be reduced.
The study was conducted in Uruguay, a high-income country located
in the South-eastern part of Latin America. Internet access is widespread
among the Uruguayan population. According to the most recent national
survey, 100% of adolescents between 14 and 19 years old had used
internet in the three months prior to the survey and 93% accessed
internet using a smartphone on a daily basis during 2019 (INE, 2019).
YouTube is one of the most popular websites among adolescents, being
accessed by 97% of adolescents aged between 14 and 19 years (INE,
2019). Social media use is highly prevalent among Uruguayan adoles­
cents regardless of their socio-economic status (INE, 2019; INJU, 2018),
with Instagram representing the most popular social network: 69.5% of
adolescents aged between 12 and 13 years and 84% of those aged 14–17
years have an Instagram account according to recent surveys (INJU,
2018). These data suggest that Uruguayan adolescents may be highly
exposed to digital food marketing. However, no studies have been
conducted in the country on the topic so far. The high prevalence of
adolescent overweight and obesity in the Uruguay –approximately 40%
according to the most recent estimates (ANEP, 2019; Estragó et al.,
2016; Pereyra & De León, 2016)– stresses the need to gather scientific
evidence about exposure to digital food marketing and its influence on
adolescents’ food choice.
2. Materials and methods
Given the exploratory nature of the study and the limited number of
studies investigating adolescents’ experiences with digital food mar­
keting, a qualitative approach based on group interviews was used.
Qualitative research contributes to an in-depth understanding of the
phenomenon of interest by capturing multiple views derived from
people’s individual experiences (Wu, Thompson, Aroian, McQuaid, &
Deatrick, 2016). Data collection was performed between November and
December 2021.
2.1. Participants
A convenience sample of adolescents was recruited at two private
secondary schools and a public health facility in Montevideo, the capital
city of Uruguay. These settings were selected to enable the recruitment
of adolescents from diverse socio-economic backgrounds. One of the
private high schools was located in a medium/high income neighbor­
hood and was targeted at adolescents with medium to high socio-
economic status. The other secondary school was located in one of the
areas of the city with the highest poverty rate and was targeted at ad­
olescents with low/medium to medium/high socio-economic status. The
public health facility was specialized in providing health care services
G. Ares et al. Appetite 176 (2022) 106128

for adolescents and enabled the recruitment of participants with low Table 1
socio-economic status. Questions included in the semi-structured interview guide used in the group
At each of the two high schools, all adolescents aged between 11 and interviews to explore adolescents’ experiences with digital food marketing. For
18 years were invited to take part in the study in order to provide them each of the main topics addressed in the interviews, the main and follow-up
with equal opportunities to participate. The institutions sent invitation questions are shown.
letters to the parents, who were asked to authorize their child’s partic­ Topic Main question Follow-up questions
ipation by signing an informed consent form. The parents were informed Social media use Do you use social media? Which social media
that the study aimed at exploring adolescents’ use of social media and its platforms?
influence on their eating habits. Only those adolescents whose parents Do you browse any
websites?
signed the informed consent form were invited to participate the day of
Which websites?
the study. At the health facility, adolescents aged 11 to 18 who attended Exposure to digital Do you remember having What products were
health checks accompanied by one of their parents were verbally invited marketing in general seen any advertisement on advertised?
to participate by one of the researchers. Informed consent forms were those social media platforms
signed by the parents. or websites?
Exposure of digital food Do you remember having What foods or
Adolescents were asked whether they wanted to participate or not. If
marketing seen any advertisement of beverages were
so, they were asked to provide their written assent. A total of 209 ado­ foods or beverages on those advertised?
lescents (56% female, 45% between 12 and 15 years old, 55% between social media platforms or Do you remember
16 and 18 years old) were included in the study. The number of ado­ websites? having seen any
influencer promoting
lescents recruited was not evenly distributed between sites given dif­
foods or beverages on
ferences in their characteristics and the recruitment strategy: 122 social media or
adolescents were recruited at the private high school from low/medium websites?
to medium/high socio-economic status, 81 adolescents were recruited at Perception of digital What do you remember What do you think
the private high school from medium to high socio-economic status, food marketing about the advertisements of about them?
foods and beverages?
whereas only 6 adolescents were recruited at the public health facility.
Perceived influence of Do you think the How?
After analyzing all the group interviews held at the three institutions digital marketing on advertisements you see on
described above, no new topics emerged and no major differences were food choice social media and websites
identified in adolescents’ views, which indicated that saturation was influence the foods and
beverages you consume?
reached (Carlsen & Glenton, 2011). For this reason, no additional data
Strategies to reduce the How do you think we could
collection was performed. influence of digital reduce the influence of
marketing on advertisements on social
2.2. Data collection adolescents’ food media and websites on the
choices food choices of adolescents?

A total of 46 group interviews were conducted: 25 at the private high

school from low/medium to medium/high socio-economic status, 18 at
the private high school from medium to high socio-economic status, and
3 at the public health facility. They were held in the adolescents’ own
classrooms during school time in their respective high school. In the case
of the health facility, the interviews were held in a multipurpose room.
First, the adolescents were explained that the study involved a group
discussion about their use of social media. They were asked to provide
their written assent to participate in the study, except for those above
legal age (18 years old), who were asked to provide written informed
consent. Then, they were divided in small groups composed of 2–7
participants. All the groups were composed of adolescents of the same
age (±1 year) and varied in their gender distribution, ranging from
groups composed exclusively by females, groups composed exclusively
by males and groups composed by both males and females. At the high
schools, the adolescents of each class were randomly divided in small
groups. The number of participants in each group was defined by the
number of adolescents in the class and the number of researchers
available for moderating the interview. At the health facility, two ado­
lescents were invited to join each group interview.
The group interview was moderated by a researcher, who asked
questions, moderated the group discussion, and encouraged the partic­
ipation of all adolescents that took part in the interview. A total of 5
researchers with previous experience in qualitative research carried out
the interviews. A semi-structured interview guide was used, which
included questions related to five main topics: i) social media use, ii)
exposure to digital marketing in general and digital food marketing in
particular, iii) perception of digital food marketing, iv) perceived in­
fluence of digital marketing on food choice, and v) strategies to reduce
the influence of digital marketing on adolescents’ food choices (Table 1).
The interview guide was developed based on a review of the literature
about food marketing. The group interviews, which lasted between 10
and 35 min (M = 19.0 min; SD = 4.8 min), were recorded in audio and
then transcribed. No identification of the participants in terms of gender
and age was considered at the transcription stage.
2.3. Data analysis
Content analysis was used to analyze the transcripts due to its reli­
ability, flexibility and data-driven nature (Bengtsson, 2016). The data
were analyzed manually using a deductive-inductive approach (Krip­
pendorf, 2004). First, the transcripts of the interviews were read by one
of the researchers to enhance familiarity with the data. A deductive
approach was used to decontextualize the data (Bengtsson, 2016). The
transcripts of the group interviews were broken down into segments,
corresponding to each of the five main topics addressed in the interview
guide. This was performed manually by one of the researchers, with
extensive experience in content analysis. Then, the researcher read all
the transcripts again, alongside the five main topics, to revise the coding
and recontextualize the data, while also ensuring that all information
relevant for the research objectives was retained in the selected seg­
ments. Categorization based on inductive coding was manually per­
formed by the same researcher. For each of the five topics, categories
were identified as they emerged when repeatedly examining the
transcripts.
The compilation step of the analysis involved four major steps: i)
revision of the coding, ii) tabulation and selection of quotes, iii) inter­
pretation, and iv) validity check. First, three researchers, who were
involved in the data collection, read the transcripts alongside the cate­
gorization developed by the researcher in charge of the coding. They
independently checked the coherence of the coding and suggested no
material changes. Once this validation step was completed, the writing
process began. Results for each of the five main topics were summarized
using tables. Quotes were selected and translated to English for illus­
trative purposes. In the text, the quotes are identified by the number of
group, the setting where it was conducted and the age range of the

3
G. Ares et al.
participants. The interpretation of the results was focused on the man­
ifest content to ensure that the interpretation stayed as close as possible
to the original meaning expressed by the adolescents. Quantification of
the frequency of mention of the categories related to the topics “social
media and internet use” and “exposure to digital marketing” was per­
formed to estimate their relative importance. The final step of the
compilation process involved a validity check by an additional
researcher, who read the original transcripts and the results to assess
their reasonability (Bengtsson, 2016).
3. Results
3.1. Social media and internet use
Social media use was highly prevalent and regarded as a typical
activity among adolescents (e.g., "It’s kind of weird that someone of our
generation does not use social media"). Only two of the 209 participants
did not use social media, whereas the rest stated that they frequently use
two or more social media platforms. Instagram and WhatsApp were the
most frequently mentioned platforms (mentioned in all the interviews),
followed by TikTok and Twitter (mentioned in 39 and 35 of the in­
terviews, respectively). Youtube, Facebook, Snapchat, Discord, Pinter­
est, Reddit, iFunny, Telegram, and Liker were also mentioned but less
frequently. Entertainment, communication and keeping updated were
identified as the motives underlying the use of social media platforms.
3.2. Exposure to digital food marketing on social media and websites
All adolescents answered affirmatively when asked if they had seen
advertisements on social media or websites. They referred to the wide­
spread prevalence of advertising using expressions such as “a lot", “too
much", “all the time" and “many". They mentioned that the number of
advertisements they see on social media is increasing and identified
Instagram and YouTube as the platforms where they see the largest
amount of advertisements.
“All the time, all the time they are showing up. For example, you are
viewing a story on Instagram and an ad appears out of nowhere, or you
are browsing, and an ad appears.” (Group 31, high school from me­
dium to high socio-economic status, 16–17 years old)
"YouTube harasses me. Before, there was only a little sign next to the
video but now it shows up before you even start the video, it shows two
ads, not one, and until they are finished, it doesn’t allow you to see the
video.” (Group 32, high school from medium to high socio-economic
status, 16–17 years old)
Participants stated that they had seen advertisements of a broad
range of products and services. Food and clothing were the most prev­
alent categories: they were spontaneously mentioned in 29 and 27 of the
group interviews, respectively. Other frequent categories were apps
(mentioned in 19 group interviews), movies and songs (10 group in­
terviews), cosmetic and personal care products (9 group interviews),
websites (9 group interviews), and electronic appliances (8 group
interviews).
When prompted to remember food advertisements, all adolescents
indicated that they had seen them on social media or websites. The most
frequently mentioned advertisements corresponded to fast-food restau­
rants both from major chains and small businesses (e.g., “I usually see
advertisements of hamburger places, which promote themselves a lot and
make offers and all that kind of fast food, and a lot of food videos and so on"
(Group 33, high school from medium to high socio-economic status,
16–17 years old), “In general, from large companies but other small bars and
restaurants also appear" (Group 12, high school from medium to high
socio-economic status, 16–17 years old), “They are not always famous
places, there are also places that you do not know much about, entrepreneurs"
(Group 38, high school from low/medium to medium/high socio-
4
Appetite 176 (2022) 106128
economic status, 14–15 years old)), and food ordering websites/apps
promoting fast food (e.g., “Pedidos Ya1" (Group 9, health facility, 12–13
years old), “I see a lot of advertisements from PedidosYa1 and Rappi2, but
mostly PedidosYa. The ones from PedidosYa always show junk food, burgers
with bread, cheese and French fries" (Group 1, high school from low/me­
dium to medium/high socio-economic status, 12–13 years old)). These
advertisements were mentioned in 44 of the 46 group interviews. Ref­
erences to advertisements of pre-packaged ultra-processed products
were less frequent than those from fast food restaurants, being
mentioned in 25 group interviews. In particular, adolescents mentioned
advertisements of sweetened beverages (soft drinks and flavored water),
savory snacks, sausages, energy drinks, and confectionary.
Most participants described the food advertised on social media and
internet websites as “fast food" and “junk food" and stressed that ad­
vertisements of healthy foods were not frequent as they are less profit­
able. Some participants remembered having seen advertisements of
foods they regarded as healthy, such as fruits, vegetables, sushi, and
vegan food. However, they described the advertisements as less
appealing than those of junk food.
"From my point of view, everything I see is junk food. A burger, a mila­
nesa3, a pizza. A salad is never shown." (Group 34, high school from
low/medium to medium/high socio-economic status, 16–17 years
old)
"Healthy foods hardly appear. You can see some salads but almost
nothing. They show what generates the most profit, what is sold the most.”
(Group 13, high school from low/medium to medium/high socio-
economic status, 14–15 years old)
"Sometimes what appears to me are vegan foods but I’m not interested in
vegan." (Group 2, high school from low/medium to medium/high
socio-economic status, 12–13 years old)
"I’ve also seen advertisements of small businesses that have healthy food,
but they aren’t as appealing as the ones from McDonald’s." (Group 24,
high school from medium to high socio-economic status, 15–16 years
old)
Participants also remembered having seen influencers promoting
foods and beverages on YouTube, TikTok and Instagram. Energy drinks,
fast-food restaurants, soft drinks, and flavored water were the most
frequently mentioned product categories. The also referred to collabo­
rations between influencers and companies to launch specific products,
such as coffee beverages or energy drinks.
"Energy drinks. There was a moment when all YouTubers were promoting
a drink. I don’t remember its name, Boom or something like that. In their
posts, they always appeared with a can of the drink. They were doing a
tutorial, nothing related, but still, the can was in front of the camera."
(Group 36, high school from low/medium to medium/high socio-
economic status, 16–17 years old)
"There is an energy drink, Bang, that have appeared to me on TikTok.
They use half famous TikTokers to promote the drink and I guess young
people like us go and drink it." (Group 33, high school from medium to
high socio-economic status, 16–17 years old)
"Celebrities are paid to promote products, you know? A streamer named
Auronplay did a Halloween event with Fanta to promote the new drink.”
(Group 3, high school from low/medium to medium/high socio-
economic status, 12–13 years old)
2
A food ordering app available in Uruguay.
3
A traditional Uruguayan dish. It is a thin layer of meat (usually beef or
chicken) dipped in egg and dredged in breadcrumbs, which is fried or, less
frequently, baked.
G. Ares et al. Appetite 176 (2022) 106128

"Most of the time they promote products related to what they do, but Table 2
sometimes they promote food. For example, coffee from Starbucks. Taylor Categories identified in the content analysis for the two themes related to ado­
Swift launched a coffee with Starbucks to advertise the brand." (Group lescents’ perception of food advertisements seen on social media and websites.
15, high school from medium to high socio-economic status, 14–15 For each category, examples of the quotes provided by participants (n = 209) in
years old) the group interviews are shown.
Theme Category Example of quotes
The participants also stated that their friends or acquaintances, as
well as famous people, sometimes upload food pictures, mainly when Memorable aspects of Images "What is striking is how they plate
the advertisements the food, how they present it. It is
eating out or when eating something uncommon. Other participants also the first thing you see and then you
mentioned that some of their friends upload posts to promote small see the details. They purposely put
businesses. more cheese on the side." (Group
38, high school from low/
"My friends also upload pictures at restaurants eating burgers." (Group medium to medium/high socio-
34, high school from low/medium to medium/high socio-economic economic status, 17–18 years
status, 16–17 years old) old)
"The images more than anything
"I follow famous people, like Maluma, Karol G, Anuel. In their stories, else, how they present the food.
they post yummy food I don’t even know." (Group 28, health facility, Burgers with a pile of meat with
cheddar dripping." (Group 34,
15–16 years old) high school from low/medium to
medium/high socio-economic
"Sometimes athletes upload posts of the foods they eat, like their routine."
status, 16–17 years old)
(Group 6, high school from low/medium to medium/high socio- "Everything is amazing, that’s how
economic status, 12–13 years old) they show it to you. All the food is
delicious. It looks yummy." (Group
"Not just influencers. Sometimes friends of yours who help ventures, for 25, high school from low/
example vegan food, promote food. There are people who upload ’this medium to medium/high socio-
person makes vegan food’ and tag that person. If you go to the profile, you economic status, 15–16 years
can see the food that they sell." (Group 25, high school from low/ old)
"For an advertisement they had tied
medium to medium/high socio-economic status, 15–16 years old) all the ingredients with a thread,
and they dropped it. It was perfect.
It is done by food artists, as they
3.3. Perception of digital food marketing call them.” (Group 29, high
school from medium to high
Adolescents were asked what they remembered about the adver­ socio-economic status, 15–16
tisements they have seen on social media and websites. The character­ years old)
Colors “They make it eye-catching. They
istics of the images featured on the advertisements were the most have several colors." (Group 45,
memorable aspect. As shown in Table 2, participants stated that foods high school from low/medium to
are shown in a very appealing way and stressed the production tech­ medium/high socio-economic
niques used to take pictures or shoot videos. The colors of the adver­ status, 17–18 years old)
"I also remember the colors.
tisements and the use of catchy songs were identified as additional
Everything has very striking colors.
factors contributing to the attentional capture and memorability of the For example, McDonald’s has
advertisements. Participants indicated that they tend to remember ad­ yellow, red.” (Group 32, high
vertisements featuring oversized portions and novel products (Table 2). school from medium to high
Finally, participants referred to aspects of the advertisements used to socio-economic status, 16–17
years old)
convey specific associations and to marketing techniques such as price Music “They have catchy songs." (Group
promotions and references to celebrities, such as football players 2, high school from low/medium
(Table 2). to medium/high socio-economic
Adolescents had a wide range of reactions towards the advertise­ status, 12–13 years old)
"I remember the McDonald’s song.
ments they had seen on social media and websites (Table 2). The most
The ad ends and it says ‘ta ra ta ta."
frequent reaction towards advertisements was negative: participants (Group 31, high school from
described them as annoying and intrusive as they tend to appear too medium to high socio-economic
often when they use Instagram and YouTube and do not allow them to status, 16–17 years old)
watch media content or browse a website to search for information. Oversized portions "The size, that they show you that
the hamburger has 3 layers or 4
However, other participants had a positive reaction towards advertise­ layers and all the ingredients that it
ments and regarded them as informative as they allow them to become has." (Group 19, high school from
aware of new places or products (Table 2). medium to high socio-economic
Advertisements were described as attention grabbing, catchy and status, 14–15 years old)
Novelty "Most as they are so repetitive, I
tempting, as they usually feature desirable foods in an appealing way.
don’t look at them anymore. Unless
However, a few adolescents stated that they sometimes find the adver­ it’s something new, something
tisements showing an excessive amount of food gross or disgusting. special. I am intrigued to know
Interestingly, most participants stated that advertisements were what it is like. It makes me want to
deceitful as the images do not resemble the actual products (Table 2). know what the difference is with the
others.” (Group 16, high school
Some adolescents also indicated that advertisements usually emphasize from low/medium to medium/
the positive aspects of the products but do not include any reference to high socio-economic status,
their negative health consequences. In this sense, a few participants 14–15 years old)
recognized that they do not usually perform a critical appraisal of the Aspects of the ad “Those of Coke that tell you about a
content used to special moment or a special
food pictures shown on the advertisements when they see them on social
convey associations moment with Coca Cola, as if
media (Table 2). One of the adolescents explicitly stated that adolescents
(continued on next page)
tend to ignore the negative health consequences of some of the foods

5
G. Ares et al. Appetite 176 (2022) 106128

Table 2 (continued ) Table 2 (continued )

Theme Category Example of quotes Theme Category Example of quotes

special or magical moments would medium/high socio-economic

only happen if there was Coke, if status, 15–16 years old)
you were drinking a Coke." (Group Catchy "The ads catch your attention, they
31, high school from medium to want to catch you.” (Group 30,
high socio-economic status, high school from low/medium to
16–17 years old) medium/high socio-economic
"They include people cooking to status, 15–16 years old)
inspire confidence. In the ads of “They are annoying but they kind
McDonald’s Signature line there of catch your attention." (Group 5,
were people cooking to give the idea high school from low/medium to
that it was something homemade." medium/high socio-economic
(Group 25, high school from status, 12–13 years old)
low/medium to medium/high Tempting "They show you a burger, a pizza,
socio-economic status, 15–16 something that tempts you."
years old) (Group 24, high school from
Price promotions "Things that tempt you. Like Rappi1 medium to high socio-economic
that shows you an offer “A burger status, 15–16 years old)
for 200 pesos" for you to go." "I skip them but they make me
(Group 22, high school from hungry.” (Group 2, high school
medium to high socio-economic from low/medium to medium/
status, 14–15 years old) high socio-economic status,
"Discount coupons or any offer they 12–13 years old)
have." (Group 29, high school Disgusting “Yesterday I saw an advertisement
from medium to high socio- from Mostaza3, which is a burger
economic status, 15–16 years restaurant, showing a huge
old) hamburger covered in cheddar.
"They almost always tell you that it Sometimes instead of catching your
is at a high price and they lower it to attention they are disgusting."
another price.” (Group 11, health (Group 29, high school from
facility, 12–13 years old) medium to high socio-economic
Celebrities “When Tony Pacheco2 and Chino status, 15–16 years old)
Recoba2 are shown in a Deceitful "They show you amazing
McDonald’s advertisement. That is hamburgers and nowhere you go
a marketing strategy that helps they are like that. They are always
them. Soccer people are struck by either smaller, or they do not look
it." (Group 25, high school from the same. That is why you also do
low/medium to medium/high not pay that much attention to the
socio-economic status, 15–16 ads. You know they aren’t 100%
years old) real." (Group 29, high school
Opinion about the Annoying "Horrible. Annoying. Sometimes from medium to high socio-
advertisements they are very constant and economic status, 15–16 years
annoying. Besides, they always old)
show you the same ad" (Group 8, "It’s not even real food, it’s actually
high school from low/medium to plastic. But when I see them, I don’t
medium/high socio-economic think ‘Oh, this is plastic’. I don’t
status, 12–13 years old) stare for long. It is not something
"YouTube is full of ads and it is that I stop to analyze.” (Group 24,
annoying. Fewer ads would be high school from medium to high
better.” (Group 18, high school socio-economic status, 15–16
from medium to high socio- years old)
economic status, 14–15 years "They show tasty foods, but they
old) don’t always tell the truth. They say
Intrusive “Sometimes it is too much, and it is that foods are 100% natural,
intrusive. Sometimes you are healthy, and they are full of
watching something, and it appears chemicals, for example" (Group
in the middle of a video. On a 11, health facility, 12–13 years
website you are going to look for old)
information, an advertisement “Ads disguise products. For
appears that covers almost the example, Coke is bad for the body,
entire screen” (Group 32, high you see the ad and maybe it makes
school from medium to high you want to drink." (Group 38,
socio-economic status, 16–17 high school from low/medium to
years old) medium/high socio-economic
Informative “For me, ads from small places that status, 17–18 years old)
make tasty food are good. They are "The ad shows you how they grill
tasty, cheap and perhaps they are the meat, the oil, the juices. It seems
not so well known, and you always the best thing ever. It looks like a
end up going to the same places. It is work of art, a movie about how
actually good to know those small they make the burger. They sell
businesses." (Group 43, high something amazing and then you
school from low/medium to think it does not have any effect on
medium/high socio-economic your body." (Group 32, high
status, 17–18 years old) school from medium to high
"They are useful to get to try socio-economic status, 16–17
something different." (Group 30, years old)
high school from low/medium to
Notes: 1 Food ordering app; 2 Uruguayan football player; 3 Fast food restaurant.

6
G. Ares et al.
they frequently consume.
"Many times we ignore that they are bad for us and we continue
consuming the same things. We are very capable of canceling that thought
and saying ‘what I’m consuming is not good for me’ and we eat it any­
way." (Group 37, high school from medium to high socio-economic
status, 16–17 years old)
3.4. Perceived influence of digital marketing on food choices
When asked about the effect of digital marketing on their food
choice, participants mainly referred to awareness and wanting. Partici­
pants stressed that the content of the advertisements tends to be stored
in their memory, even if they try to skip it or not pay attention to it. This
makes them aware of the existence of specific products or fast-food
restaurants.
"You see it, it catches your attention, and it stays in your mind. Even if you
don’t pay attention to it, you know it’s there." (Group 39, high school
from low/medium to medium/high socio-economic status, 17–18
years old)
"I generally ignore all the ads. I don’t pay much attention to them, but they
still stay blurry in my memory. Even if I skip them, I know they are there."
(Group 40, high school from low/medium to medium/high socio-
economic status, 17–18 years old)
One of the most frequent reactions discussed by adolescents was
related to craving and temptation. However, they stressed that most of
the times they do not actually end up consuming the advertised
products.
"You see someone serving a Sprite or something like that and it makes you
want to drink but you aren’t going to run out to buy it." (Group 37, high
school from medium to medium/high socio-economic status, 16–17
years old)
"You open Instagram and you say ’how hungry I am!’ but you end up
eating what is in your house, you are not going to buy what you see, at
least me. It can tempt you, but you never go and buy that burger.” (Group
26, high school from medium to high socio-economic status, 15–16
years old)
Regarding the effect of digital marketing on actual purchase or
consumption, most participants described the effect of digital marketing
as small or non-existent. Some participants indicated that they consume
fast food and soft drinks but did not recognize an effect of digital mar­
keting on their decisions to do so (e.g., “I already consumed those products
before. It’s not that I consume them because of the ads" (Group 31, high
school from medium to medium/high socio-economic status, 16–17
years old). However, others recognized that the advertisements they see
on social media and websites influence their choices and described
specific situations where they bought or consumed the advertised foods
or beverages. Many of them stressed that the effect is neither immediate
nor rational.
"Yes, the ads of small burger places do influence me. Sometimes I’m trying
to decide what to order and an ad appears.” (Group 41, high school
from medium to high socio-economic status, 17–18 years old)
"Many times, maybe you see an ad, 4 months go by, you go to McDonald’s
for X or Y and, it’s not that you remember the ad, but it’s like it is written
in your head and you say ’well, I’m going to try this’, unconsciously
sometimes we do that." (Group 37, high school from medium to high
socio-economic status, 16–17 years old)
"It stays recorded in the unconscious and it influences us. Then, we don’t
think that we saw it in an advertisement and that is why we bought it. It’s
not like you see the ad and you’re already buying a combo or something,
it’s like it stays there. It appears so many times and when you go to the
7
Appetite 176 (2022) 106128
store you order what you saw because you can’t think of any other op­
tion.” (Group 32, high school from medium to high socio-economic
status, 16–17 years old)
Some of the adolescents who answered negatively when asked
whether the advertisements they see on social media influence their
food choices or not, subsequently described specific situations where
they were influenced by an advertisement (e.g., “The other time we got
together with another friend, and we ordered McDonald’s through Ped­
idosYa. We didn’t know PedidosYa before" (Group 17, high school from
low/medium to medium/high socio-economic status, 14–15 years old),
“I check what’s on the posters [to decide]. I always order the same thing. The
only time I was influenced by an ad was when McDonald’s launched the “fan
burger" because it has like 400 slices of cheese" (Group 7, high school from
low/medium to medium/high socio-economic status, 12–13 years old)).
Other participants stated that being aware of new products from specific
restaurants can influence their decisions if they go to that particular
place.
"It does not affect me. I do not care. If they give it to me, I’d take it, but I
wouldn’t buy it. If, by chance, I go to that place I might choose that one
because I know it from Instagram." (Group 20, high school from low/
medium to medium/high socio-economic status, 14–15 years old)
"It isn’t like you see the ad and say "I need to go right now". If, by chance,
you go, you say ’I’m going to try it’." (Group 42, high school from
medium to high socio-economic status, 17–18 years old)
Diverse views on the effect of the promotional activities conducted
by influencers on social media were identified. Some participants said
that influencers do not have any effect on their choices, whereas others
stressed that they have a large effect on their own food choices or those
of friends or acquaintances.
"Everyone wants to consume it just because an influencer is consuming it
or advertising it. I’ve seen many YouTubers and TikTokers that recom­
mend a mango energy drink, everyone recommends it. All the TikTokers,
YouYubers, Instagramers. It’s not available here but if it were, I would try
it because everyone is advertising it." (Group 22, high school from
medium to high socio-economic status, 14–15 years old)
"I see a celebrity with a meal, and I go and buy it because it’s the closest I
can ever be to that celebrity. I feel like Toretto drinking Corona, I don’t
know." (Group 33, high school from medium to high socio-economic
status, 16–17 years old)
Digital marketing was regarded as the most effective type of adver­
tising to target adolescents due to the relevance of social media in their
lives and the fact that they do not frequently watch TV (e.g., “Much more
people see an ad on Instagram compared to a billboard on top of a building or
an ad on TV" (Group 34, high school from low/medium to medium/high
socio-economic status, 16–17 years old), “Young people do not watch so
much TV, so the commercials are no longer useful" (Group 21, high school
from medium to high socio-economic status, 14–15 years old)). Differ­
ences among platforms were discussed. A few adolescents perceived
advertising on Instagram accessible to everyone, stressing that it enables
small businesses to promote themselves (e.g., “Instagram seems so much
better to me because anyone can promote things. In addition, you can become
very well-known very quickly on Instagram because everyone uses it" (Group
22, high school from medium to high socio-economic status, 14–15
years old)). On the contrary, advertising on YouTube was described as
more expensive and only accessible to large companies (e.g., “On
Instagram you get to see small companies, entrepreneurs. On YouTube, ads
are from bigger brands, chains, like Coke" (Group 19, high school from
medium to high socio-economic status, 14–15 years old)).
In the group discussions, participants referred to a series of factors
that mediate the effect of digital marketing on their food choices
(Table 3). Product-related factors were the most frequently discussed as
participants stressed that the influence of advertisements strongly
G. Ares et al.
Table 3
Factors that mediate the impact of digital marketing on the food choice of ad­
olescents, identified by adolescents in the group interviews (n = 46). For each
category, examples of the quotes provided by participants (n = 209) are shown.
Category Examples of quotes
Product category "If it’s an advertisement for a delicious burger, it’ll make you
crave and then you’ll go and ask for it." (Group 19, high
school from medium to high socio-economic status, 14–15
years old)
"It depends on the food.” (Group 8, high school from low/
medium to medium/high socio-economic status, 12–13
years old)
“There are things that seem yummy, and you go." (Group 5,
high school from low/medium to medium/high socio-
economic status, 12–13 years old)
Novelty "No, because the ads I’ve seen promote foods that I’ve already
tried, like Pepsi." (Group 5, high school from low/medium
to medium/high socio-economic status, 12–13 years old)
"If I’ve already tried it, I would say no, but if I haven’t tried it I
can indulge myself. It’s like something innovative, it’s
something you’ve never seen." (Group 2, high school from
low/medium to medium/high socio-economic status,
12–13 years old)
"If it is something new, it attracts your attention the most. You
stay to look at it. When you have the chance of buying
something, it comes to your mind." (Group 30, high school
from low/medium to medium/high socio-economic status,
15–16 years old)
"As most ads are so repetitive I don’t look at them anymore.
Unless it’s something new, something special. I am intrigued to
know what it is like. It makes me want to know what the
difference with the rest is.” (Group 16, high school from
low/medium to medium/high socio-economic status,
14–15 years old)
Degree of exposure “It’s like PedidosYa1. It sends you ads all the time. I would
probably have no idea about if it weren’t for the ads I see all the
time." (Group 41, high school from medium to high socio-
economic status, 17–18 years old)
"For me, if a burger appears two or three days in a row, at some
point you are going to order it because you get tempted."
(Group 22, high school from medium to high socio-
economic status, 14–15 years old)
"It may be because it’s something that is there all the time, if
you are in social media all the time and advertisements are
always showing up, you are going to pay at least a little bit of
attention." (Group 29, high school from medium to high
socio-economic status, 14–15 years old)
Content of the "If the ad catches my attention, I may end up buying the
advertisement product." (Group 14, high school from medium to high
socio-economic status, 14–15 years old)
“I have a 10-year-old cousin who is obsessed with a TikToker.
She has to be 24/7 at Starbucks. She uploads 24 photos at
Starbucks because she is obsessed with that girl who uploads
videos promoting Starbucks, and as she likes it so much she has
to be at Starbucks all day." (Group 8, high school from low/
medium to medium/high socio-economic status, 12–13
years old)
"Sometimes you go because of the ads. If you see a 2x1 with a
tremendous offer, you think about it twice." (Group 19, high
school from low/medium to medium/high socio-economic
status, 14–15 years old)
"Burger King had a promotion, a deal that said two double
cheeseburgers and bacon for $299." (Group 27, health
facility, 15–16 years old)
"It catches your attention when you see someone famous."
(Group 22, high school from low/medium to medium/high
socio-economic status, 14–15 years old)
"Coupons make you want to go because it is so cheap. Also they
say that the offer is just for today, so I have no other option."
(Group 46, high school from low/medium to medium/high
socio-economic status, 17–18 years old)
Age "When we were younger, we were easily influenced." (Group
46, high school from low/medium to medium/high socio-
economic status, 17–18 years old)
"Younger people are influenced much easier than us. For
example, I have a small cousin who is much easily influenced."
(Group 27, high school from medium to high socio-
8
Appetite 176 (2022) 106128
Table 3 (continued )
Category Examples of quotes
economic status, 15–17 years old)
"Maybe if we lived alone, it would influence us more. As I live
with my family, I am not going to convince them to buy. Maybe
if I were alone I would say ‘Oh, yes, yes’." (Group 29, high
school from medium to high socio-economic status, 17–18
years old)
"I can’t go out at 7 p.m. to buy food but if I had the opportunity,
maybe I would." (Group 14, high school from low/medium
to medium/high socio-economic status, 14–15 years old)
Personal habits "If you have a healthy habit, advertising doesn’t influence you.
You may say that you want to eat a burger but it will only be
once, you won’t eat it all the time." (Group 27, high school
from medium to high socio-economic status, 15–17 years
old)
"Maybe if you are a person who is used to [eating] junk food,
you see the ad and say ‘wow, how is it!’ and asks for it."
(Group 31, high school from medium to high socio-
economic status, 15–17 years old)
Personal environment "Pizza with mozzarella and Coke from a bar. You see the
number on the ad, and you call. I can’t call because I don’t
have money." (Group 9, health facility, 12–13 years old)
"If I have money and I see that a famous person ate something, I
go and buy it because I want to taste it as it is. Very seldom do I
have money." (Group 10, health facility, 12–13 years old)
"In our family we send each other the ads and we say ‘look at
this’ and we end up buying what I wouldn’t buy if I were
alone." (Group 29, high school from medium to high socio-
economic status, 15–17 years old)
"My mother prepares everything homemade but once in a
while, on a Friday, she is tired and I say ‘we can order food’
and we look for restaurants.” (Group 33, high school from
low/medium to medium/high socio-economic status,
16–17 years old)
Situational factors “Maybe if you are with many friends and you are deciding
what to eat and someone saw and ad of a burger, you end up
ordering that burger." (Group 24, high school from medium
to high socio-economic status, 15–16 years old)
"If I’m about to have dinner and I can order a burger, then it
would influence me. If I see it in the afternoon when I’ve
already eaten, it will make me crave [but] after a while I’ll
forget about it." (Group 38, high school from low/medium
to medium/high socio-economic status, 17–18 years old)
"It depends on when and who you are with. If I’m with friends
and the ad appears at 11 p.m., I end up looking and sometimes
we ask for something." (Group 32, high school from medium
to high socio-economic status, 16–17 years old)
"Maybe you didn’t have anything to eat at night. You see the ad
and say ‘wow! I want to eat this’ and you go and order."
(Group 19, high school from medium to high socio-
economic status, 15–17 years old)
Notes: 11
Food ordering app.
depends on the type of product being advertised. Special emphasis was
placed on product novelty, as participants stated that advertisements are
more likely to be persuasive if they promote a product they have not
tried before (Table 3). Regarding the characteristics of the advertise­
ment, participants stated that the more frequently they see an adver­
tisement, the more likely they are to be influenced by it, and they
referred to a food ordering app to exemplify this point. Besides, partic­
ipants mentioned specific aspects of the advertisement, including its
attentional capture, references to celebrities and influencers, as well as
price promotions and special offers.
Individual characteristics were also identified as moderators of the
effect of digital marketing on food choices (Table 3). Participants stated
that younger people, children and early adolescents, are more likely to
be influenced by advertisements as they have a lower ability to critically
assess the information they convey. According to this account, the effect
of digital marketing decreases with age but increases during late
adolescence due to increased independence. The youngest participants
stated that most of the times they are not able to make the food purchase
decisions on their own and that they would be more frequently tempted
G. Ares et al.
to order fast-food if they were older and lived alone. Habits and food
preferences were also identified as relevant moderators. As shown in
Table 3, participants stated that adolescents with a healthy diet and a
preference for healthy food are expected to be less influenced by digital
marketing than those who frequently consume the advertised products,
particularly junk food. Moreover, participants identified two charac­
teristics of their personal environment as moderators: household income
and the family environment (Table 3). Lack of financial resources
refrained some participants from buying the foods they see on social
media (Table 3), whereas the characteristics of the family environment
could facilitate or obstruct the capacity of digital marketing to influence
food choice. Finally, participants indicated that situational factors, such
as hunger state, day of the week, and time of the day, also moderate the
effect of digital marketing on their food choices (Table 3).
3.5. Strategies to reduce the effect of digital marketing on the food choices
of adolescents
In the last phase of the interview, participants were asked to discuss
their ideas about strategies to reduce the effect of digital marketing on
adolescents’ food choices. As shown in Table 4, most of the strategies
spontaneously raised by adolescents were related to marketing regula­
tions. They indicated that advertisements would have a lower effect on
their food choices if their prevalence was reduced, stressing the need to
reduce both the number of advertisements they are exposed to on social
media and websites and their frequency of appearance. In some of the
groups, participants went further and proposed banning advertising of
junk food (Table 4), which raised diverse opinions. Some participants
considered that banning advertising on social media would be positive
as adolescents would not be constantly exposed to unhealthy food ads,
which could lead to an improvement in their eating habits (e.g., “For me
it would be better because you wouldn’t be looking at food all the time. Social
media is entertainment. Time would pass and you wouldn’t be thinking about
food. Now you spend 2 h with the cell phone and half an hour you are seeing
advertising" (Group 38, high school from low/medium to medium/high
socio-economic status, 17–18 years old)). However, a few participants
regarded the implementation of marketing regulations as unfeasible due
to its impact on trade and lack of political commitment, as exemplified
in the following quote.
"It would be morally correct for the State to limit advertisements to only
the truth and not to allow those that are misleading or counterproductive
for the health of others. However, it is not convenient for the authorities,
and they prefer to promote trade. If we think about the health of the
population, it would be best to avoid misleading advertisements and foods
with contraindications." (Group 31, high school from medium to high
socio-economic status, 16–17 years old)
Other adolescents disagreed with the idea of banning advertising as
they thought that this would make them miss information about new
products or places. They expressed concerns about the ability of small
businesses to attract customers without advertisements on social media
and stated that marketing regulations would lead to job losses. In this
sense, some adolescents proposed regulating digital marketing only for
chains or large companies, so that small businesses could still advertise
themselves.
“People would not be informed. They wouldn’t know about new things."
(Group 8, high school from low/medium to medium/high socio-
economic status, 12–13 years old)
"It would actually put the job of many people at stake. By limiting the
advertising of certain places, less people would go there. We can say ’I
take out advertising and I encourage people to eat better’ but we would
also leave a lot of people without a job." (Group 43, high school from
1 (continued on next page)
An Uruguayan food ordering app.
9
Table 4
Categories identified in the content analysis of adolescents’ proposed strategies
to reduce the impact of digital marketing on food choice. For each category,
examples of the quotes provided by participants (n = 209) in the group in­
terviews are shown.
Category
Reducing the prevalence
Banning advertising
Making advertisements more
real
Making advertisements less
attractive
Banning price promotions
Appetite 176 (2022) 106128
Examples of quotes
"There are things that can keep you informed but
making them so repetitive at one point becomes boring.
Once it’s ok, but not all the time.”
“Advertisements should not appear all the time."
(Group 8, high school from low/medium to
medium/high socio-economic status, 12–13 years
old)
"Showing ads less frequently." (Group 10, health
facility, 12–13 years old)
"I think that it’s ok that food advertising exists but it
should not be so intrusive. Everywhere you go there is a
hamburger chasing you. The same happens with Coca
Cola. You wouldn’t see it so often, it wouldn’t be like
you open your eyes and you see it." (Group 37, high
school from medium to high socio-economic status,
16–17 years old)
"Removing the ads, that they no longer exist. They
should take them out because I don’t want to see them
anymore." (Group 8, high school from low/medium
to medium/high socio-economic status, 12–13
years old)
"Not allowing that type of advertising." (Group 44,
high school from low/medium to medium/high
socio-economic status, 17–18 years old)
"Sticking a little more to reality (…) Ads should not
tempt you with a hamburger that looks like 4 floors and
when you go the 4 meats are all crushed. They play with
us a lot; they fill our head telling us that it is going to be
an Eiffel Tower of meat. Advertising misleads and that
is something that could be changed so that it does not
influence so much." (Group 32, high school from
medium to high socio-economic status, 16–17 years
old)
"They should use more realistic pictures.” (Group 30,
high school from low/medium to medium/high
socio-economic status, 15–16 years old)
“They show perfect food in the pictures and in real life it
is not so perfect. They should make it more realistic,
without retouching." (Group 14, high school from
low/medium to medium/high socio-economic
status, 14–15 years old)
"To make ads less catchy for teenagers, not to make
them so close to them. I don’t know, if you are
promoting a package of Doritos, don’t include a group
of teenagers at a party eating because there you are
capturing a place, a situation, to which teenagers can be
attracted to." (Group 18, high school from low/
medium to medium/high socio-economic status,
14–15 years old)
"If they changed the advertisements for something that
adolescents do not care about, they wouldn’t influence
them. For example, I’m interested in football. So, if
nothing about football appears, it doesn’t catch my
attention." (Group 35, high school from low/
medium to medium/high socio-economic status,
16–17 years old)
"Removing music, making ads boring." (Group 5, high
school from low/medium to medium/high socio-
economic status, 12–13 years old)
"Not allowing to show famous people or putting famous
people saying how disgusting it is or how bad it is for
you. I think many people would stop eating because
they say so. Once Ronaldo removed a bottle of Coke in
a press conference and millions of people stopped
drinking it.” (Group 30, high school from low/
medium to medium/high socio-economic status,
15–16 years old)
“Promotions shouldn’t appear anymore because you
see the ads saying “on sale” and maybe one day you
go." (Group 19, high school from medium to high
socio-economic status, 14–15 years old)
G. Ares et al.
Table 4 (continued )
Category
Including warnings on
advertisements
Advertising healthy foods
Communication and
educational campaigns
Personalized settings or ad
blockers
Examples of quotes
"Being honest with what you are selling, let’s say. Not
showing just how good it is, how healthy it is, that
people would have a nice time, but also that it will have
an effect on your health." (Group 36, high school
from low/medium to medium/high socio-economic
status, 15–16 years old)
"I think they could show what products really contain
and then people would become more aware. There are
many things that I know what they have but I still
consume them. Maybe if they told me all the time, I
would think about it a little more. As they do with
cigarettes, the package tells you that smoking gives you
cancer or cerebral palsy. That is because the
government forced companies to do it and now people
are aware. They could include something similar in the
ads.” (Group 43, high school from low/medium to
medium/high socio-economic status, 17–18 years
old)
“To put something like “One in as many people who
eats at Burger King develops diabetes” at the end of the
ad." (Group 8, high school from low/medium to
medium/high socio-economic status, 12–13 years
old)
"They should show the reality after consuming and
consuming all that. Like the do with cigarettes, right?
They show reality on the packages. They should show
you that you are going to end badly.” (Group 29, high
school from medium to high socio-economic status,
15–16 years old)
“Explaining what foods really have as it was recently
done with the excess of sugar, the new logo they put on
packages. It’s not good for companies but it’s something
they should do. Maybe something similar could appear
in the ads." (Group 44, high school from low/
medium to medium/high socio-economic status,
17–18 years old)
"Making more ads of healthy food." (Group 16, high
school from low/medium to medium/high socio-
economic status, 14–15 years old)
"Showing more healthy food. Showing fruit,
vegetables." (Group 5, high school from low/medium to
medium/high socio-economic status, 12–13 years) old)
"Showing easy recipes, like a grilled chicken, or those
potatoes that are easy to prepare. I don’t know, short
videos featuring a guy peeling potatoes, cooking them,
and so on. Very dynamic. They should explain you very
quickly, in 10 s. A nice picture, a short recipe, and
that’s it.” (Group 43, high school from low/medium to
medium/high socio-economic status, 17–18 years old)
“Fast food advertisements will always be there. It is
something that you cannot avoid. What you can do is
counteract it by informing people about the
consequences of frequent intake using other
advertisements or at educational institutions." (Group
43, high school from low/medium to medium/high
socio-economic status, 17–18 years old)
"Talking about the diseases you can get. Maybe you can
make people change their mind." (Group 30, high
school from low/medium to medium/high socio-
economic status, 15–16 years old)
"I think raising awareness about the risks of consuming
certain amounts of food or certain products is quite
important and can have an impact. If a lot of young
people were educated and knew how bad it really is,
maybe they would not be so easily influenced, and they
wouldn’t consume the first thing that is offered to
them.” (Group 37, high school from medium to high
socio-economic status, 16–17 years old)
“Tell Instagram that you are not interested." (Group
19, high school from medium to high socio-
economic status, 14–15 years old)
"If you find an advertisement that does not attract your
attention, you can report it so that it does not appear
again." (Group 43, high school from low/medium to
medium/high socio-economic status, 12–13 years
old)
10
Appetite 176 (2022) 106128
Table 4 (continued )
Category Examples of quotes
"Installing an ad blocker." (Group 29, high school
from medium to high socio-economic status, 15–16
years old)
low/medium to medium/high socio-economic status, 17–18 years
old)
"Small companies would be more impacted because they are not going to
be known. For these companies, the only way to become known is through
Instagram because they don’t even have a billboard outside their house, as
it is generally a house. Large companies would not be so impacted.”
(Group 19, high school from medium to high socio-economic status,
14–15 years old)”
I understand that there are fast food brands like McDonald’s and Burger
King that do not need it, but there are other smaller places that depend on
advertising because people know them thanks to the advertising on
Instagram. If you take it out, they could lose the possibility to keep selling."
(Group 37, high school from medium to high socio-economic status,
16–17 years old).
Participants also discussed a series of strategies to make advertise­
ments less attractive to adolescents (Table 4). The most frequently dis­
cussed approach was to require food companies to make their
advertisements more real by refraining from including food pictures not
resembling their actual products. Suggestions for removing other ele­
ments of the advertisements that attract their attention were also iden­
tified, such as attractive colors, music, celebrities, references to typical
activities adolescents perform in their daily life and price promotions
(Table 4).
The inclusion of warnings on the advertisements was regarded as
another potential strategy to reduce the effect of advertisements on
adolescents’ food choices. Participants stated that advertisements
should include information on the potential negative health conse­
quences of consuming the advertised products to enable informed de­
cisions and discourage adolescents from consuming them. When
discussing this strategy, adolescents referred to the warnings included
on tobacco packages and the Uruguayan nutritional warning regulation
which requires the inclusion of black octagons featuring the word
“Excess" followed by the corresponding nutrient (sodium, fat, saturated
fat, and sugar) on packaged foods (Table 4).
The last set of strategies discussed in the group interviews involved
behavior change communication to raise awareness, increase nutrition
knowledge and increase food skills, which would lead to a more critical
appraisal of advertisement and healthier food choices. As shown in
Table 4, such strategies included advertising healthy foods, the imple­
mentation of communication and educational campaigns on social
media and at formal educational institutions. In addition, some partic­
ipants proposed the use of ad blockers or the implementation of
personalized settings on social media to select the type of advertisements
social media users would like to see.
4. Discussion
An in-depth understanding of adolescents’ views on digital market­
ing of unhealthy foods is necessary for the development of compre­
hensive regulations aimed at protecting them from its harmful effects
(van der Bend et al., 2022; World Health Organization, 2016). In this
context, the present exploratory study contributes to the literature by
providing insights about the experiences of adolescents from a Latin
American country.
Results showed that participants were highly exposed to digital
marketing of fast food and ultra-processed foods (though to a lesser
extent for the latter food alternatives). Previous studies have reported
G. Ares et al.
that adolescents are frequently exposed to food marketing in social
media apps (Potvin Kent, Pauzé, Roy, de Billy, & Czoli, 2019), as well as
frequent social media usage in the marketing of energy-dense,
nutrient-poor foods and beverages (Antúnez et al., 2021; Folwarczny,
Otterbring, Sigurdsson, Tan, & Li, 2021; Freeman et al., 2014; Horta,
Rodrigues, & Dos Santos, 2018; Potvin Kent & Pauzé, 2018; Vassallo
et al., 2018). A recent experimental study found that advertisements of
unhealthy food evoked more positive reactions among adolescents and
were more easily recalled and more likely to be shared than advertise­
ments of healthy foods (Murphy et al., 2020).
According to participants, Instagram and YouTube were the main
sources of food advertisements, which matches the most popular plat­
forms for Uruguayan adolescents (INE, 2019; INJU, 2018). Exposure
occurred through advertisements that appeared prior to or between the
media content they consumed, as well as embedded within content
generated by celebrities or influencers. Instagram and YouTube provide
sophisticated intelligence analytics to target specific segments of users,
which are not publicly available (World Health Organization, 2016).
This poses challenges to the evaluation of adolescents’ exposure to and
engagement with digital marketing, as previously stressed by other re­
searchers (van der Bend et al., 2022; World Health Organization, 2016).
Advertisements of fast-food restaurants and food ordering apps were
most frequently remembered, whereas packaged ultra-processed foods
and beverages were much less prevalent. Within this last category,
however, advertisements of sweetened beverages and energy drinks
were mentioned. This result is aligned with previous research showing
that the content of advertisements of energy drinks and sweetened
beverages on digital platforms target young people by addressing their
desires, aspirations and socio-cultural values and practices (Brownbill,
Miller, & Braunack-Mayer, 2018; Buchanan, Yeatman, et al., 2018). Fast
food advertisements were also the most prevalent in an observational
study conducted with 7–16 year-old children and adolescents in Ottawa,
Canada (Potvin Kent et al., 2019). In addition, the food categories
depicted in the advertisements remembered by adolescents match re­
sults from other studied reporting products marketed through other
media formats (Kelly et al., 2010; Potvin, Dubois, & Wanless, 2012).
Participants also highlighted the power of digital food marketing.
Specifically, they identified a wide range of marketing techniques as
determinants of the memorability of advertisements, including attention
grabbing pictures of oversized unhealthy foods, attractive colors, catchy
music, novel products, celebrities, and price promotions. These tech­
niques have been previously reported in content analyses of digital food
marketing on Facebook and Instagram (Antúnez et al., 2021; Brownbill
et al., 2018; Horta et al., 2018; Jaichuen, Vongmongkol, Suphanchai­
mat, Sasiwatpaisit, & Tangcharoensathien, 2019; Vassallo et al., 2018).
Special emphasis should be placed on influencers, as their promotional
activities usually blur the lines between the content they generate and
commercial advertising (Kannan & Li, 2017). The relevance of influ­
encers has also been highlighted in previous studies focused on dieting
and alcohol (Hendriks, Wilmsen, van Dalen, & Gebhardt, 2020; Pilgrim
& Bohnet-Joschko, 2019).
Digital food marketing raised diverse opinions among the adoles­
cents. Constant exposure to advertisements received negative opinions
and was perceived as annoying and intrusive, as reported by a recent
qualitative study with Australian young adults (Molenaar et al., 2021).
However, other adolescents expressed positive reactions towards ad­
vertisements, as they regarded them as catchy, tempting and informa­
tive. Such positive views about food advertising have been reported in
previous studies conducted with adolescents (Harris et al., 2019; Mur­
phy et al., 2020).
The group discussions supported the cascade of effects that deter­
mine the influence of digital food marketing on eating habits (Kelly,
King, et al., 2015; van der Bend et al., 2022). Adolescents recognized the
effect of advertisements on product awareness and wanting, and, to a
lesser extent, on actual purchase and consumption behavior. In this
respect, it is worth highlighting that although some adolescents
11
Appetite 176 (2022) 106128
recognized that digital food marketing influences their food choices,
even if not immediately after exposure or consciously, others stated that
marketing does not have any influence on their behavior. This result can
be explained considering differences in the ability to acknowledge the
influence of marketing, as well as differences in susceptibility to
persuasion (Chang, 2017). Although empirical evidence on the influence
of digital marketing on food consumption is still scarce, recent studies
provide compelling evidence about the deleterious effects of digital
marketing of energy-dense, nutrient-poor foods and beverages on eating
habits (Baldwin et al., 2018; Buchanan, Kelly, et al., 2018; Qutteina, De
Backer, & Smits, 2019).
According to the adolescents interviewed in the current research, the
effect of digital marketing on food choice is affected by a series of factors
related to the advertised products, the characteristics of the advertise­
ments, individual characteristics, and situational factors. Novelty
emerged as a key mediator, as adolescents stressed that they are more
likely to be influenced by advertisements of novel products and res­
taurants. This matches the characteristics of decision making during
adolescence, particularly sensation seeking tendencies (Luna, Padma­
nabhan, & Geier, 2014; Neufeld et al., 2022). Another relevant factor
impacting the effect of marketing on actual food choice was age, as the
youngest participants reported not being in charge of food purchase
decisions. This matches the developmental changes experienced by ad­
olescents in their transition from childhood to adulthood, as they gain
independence and become actual consumers (Lowe et al., 2020; Val­
kenburg & Cantor, 2001). Further research should be conducted to
obtain a deeper understanding of the influence of digital food marketing
on adolescents’ eating habits and quantitatively assess the role of the
factors identified in the current work.
Regulatory approaches to reduce exposure to, and the persuasive
power of digital marketing of unhealthy foods were the most frequently
mentioned strategies spontaneously raised by adolescents to decrease
the effect of digital marketing on their food choices, in agreement with
expert recommendations (Boyland et al., 2020; Nyst, 2018; Tatlow-­
Golden & Garde, 2020; van der Bend et al., 2022; World Health Orga­
nization, 2016). Although banning digital marketing of unhealthy foods
was generally positively perceived, some adolescents raised concerns
over the effects of the regulation on small businesses and potential job
losses. Concerns over the potential negative economic consequences of
nutrition policies are frequent and have contributed to obstacles and
delays in their implementation (Ares, Antúnez, Cabrera, & Thow, 2021;
Dorlach & Mertenskötter, 2020; Julia & Hercberg, 2016; Thow, Abdool
Karim et al., 2021; Thow, Waqa, et al., 2021). In addition, the inclusion
of warnings on advertisements was also suggested as another potential
strategy to reduce the impact of digital food marketing. Experimental
research has shown that the inclusion of health warnings on advertise­
ments makes the potential harm of consuming the advertised products
more relevant in consumers’ minds (Grummon, Reimold, & Hall, 2021;
Hammond, 2011; Hammond, Acton, & Goodman, 2021).
The adolescents identified behavior change communication as yet
another possible approach to reduce the impact of digital marketing of
unhealthy foods on their eating habits. They suggested the use of social
media to advertise healthy foods, which matches the recommendations
provided by Uruguayan adolescents to promote healthier eating patterns
in a previous qualitative study (Ares, Antúnez, Alcaire, Vidal, & Bove,
2021). Based on the results from the present work, the development of
social media campaigns about healthy eating could involve celebrities to
maximize their impact. Supporting this notion, social media influencers
are increasingly included in public health campaigns to boost their
reach, despite the challenges associated with the identification of
influencers who may or may not have a conflict of interest (Jane Harris,
Atkinson, Mink, & Porcellato, 2021; Kostygina et al., 2020).
Finally, adolescents’ conceptualizations of food advertisements as
intrusive and deceitful suggest that the use of strategies to empower
adolescents to leverage their right to privacy and health could contribute
to reduce the effects of digital food marketing. Previous research has
G. Ares et al.
shown that interventions framing deceitful food marketing as incom­
patible with relevant values for adolescents can reduce the implicit as­
sociations raised by ads featuring fast food (Bryan, Yeager, & Hinojosa,
2019). Similar approaches have been reported to reduce the impact of
tobacco and alcohol advertising (Palmedo, Dorfman, Garza, Murphy, &
Freudenberg, 2017; Smith & Cooper-Martin, 1997). Adolescents’
empowerment on the topic can also contribute to increase political will
for action, increasing the odds of implementing digital marketing reg­
ulations (Cullerton, Donnet, Lee, & Gallegos, 2018; Russell, Lawrence,
Cullerton, & Baker, 2020). An interesting avenue for further research,
therefore, is the use of co-creation for empowering adolescents in the
development of strategies aimed at reducing the influence of digital food
marketing.
4.1. Strengths and limitations
The main strength of the present work is its novelty, as only a few
studies to date have explored adolescents’ experiences with digital food
marketing (Kucharczuk et al., 2022; Qutteina, De Backer, & Smits, 2019;
van der Bend et al., 2022). Thus, this study represents one of the first
in-depth examinations of adolescents’ views regarding digital food
marketing. An additional strength is the fact that the research was
conducted in Latin America, a region of the world which is usually un­
derrepresented in the academic literature (Henrich, Heine, & Nor­
enzayan, 2010a; 2010b).
Despite its novelty, the study is not free from limitations. Firstly, the
study involved a convenience sample of adolescents recruited at three
different settings in a single city (Montevideo, the capital city). Although
the sample was diverse in terms of age, gender and socio-economic
status, results cannot be generalized to the national context. In this
sense, adolescents from small Uruguayan cities may be less exposed to
marketing due to their lower geographical proximity to fast food outlets.
Secondly, due to its exploratory nature, the study did not assess the
influence of social-demographic characteristics of the adolescents, such
as age and gender, on their experiences with food marketing on social
media and websites. Further quantitative research is warranted to
identify socio-demographic variables that may moderate the impact and
persuasiveness of digital food marketing cues in predicting adolescents’
food choices (Chang, 2017). Another avenue for further quantitative
research is the evaluation of adolescents’ exposure to digital food mar­
keting and how it evolves over time. This type of study may contribute to
elucidate whether exposure to food advertisements in social media is
increasing or whether adolescents are becoming more aware of them.
Due to its qualitative nature, the study may not necessarily paint a
complete picture regarding the effect of digital food marketing on ad­
olescents’ actual food choices. Indeed, people are sometimes unaware of
the forces that shape their behavior, which means that self-reported
responses such as those provided during interviews cannot always be
used to draw accurate inferences on customers’ real, observable
behavior (e.g., Baumeister, Vohs, & Funder, 2007; Nisbett & Wilson,
1977; Otterbring, 2021). Moreover, food purchases often follow a
habitual pattern and can occur without careful consideration of the
factors that may guide such purchases (Dijksterhuis, Smith, Van Baaren,
& Wigboldus, 2005; Machín et al., 2020; Wood & Neal, 2009), meaning
that some of the sources that influence customers’ choice behavior may
operate beyond conscious awareness (Furst et al., 1996; Vadiveloo,
Morwitz, & Chandon, 2013; Williams & Poehlman, 2017).
5. Conclusions
The present research contributes to the growing body of evidence
about adolescents’ exposure to marketing of nutrient-poor, energy dense
foods on social media, both through paid advertisements and influencer-
generated content. Adolescents recognized the effect of digital food
marketing on awareness, wanting, product purchase and consumption.
These results provide additional evidence for the effect of digital
12
Appetite 176 (2022) 106128
marketing of unhealthy foods on adolescents’ eating habits, stressing the
need to implement multifaceted strategies to reduce the harmful con­
sequences emerging from marketing taking place online. Such strategies
should include digital marketing regulations and social media cam­
paigns to promote healthy eating developed based on adolescents’ own
input and ideas. Additional survey-based and experimental studies are
needed to quantify the effect of digital food marketing on adolescents’
food preferences and eating habits, and to test the mediating and
moderating factors of this marketing format statistically in the food
context.
Financial support
Funding was obtained from Comisión Sectorial de Investigación
Científica (Universidad de la República, Uruguay) and Espacio Inter­
disciplinario (Universidad de la República, Uruguay).
Ethical statement
Ethical approval was obtained from the Ethics committee of the
School of Chemistry of Universidad de la República (Uruguay) (Protocol
101900-000608-20).
Acknowledgements
Nelly Lepanto, Silvana López, and Virginia Cardozo are thanked for
their collaboration in data collection.
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