Opportunities for Implementing Media Literacy Education as an Obesity Prevention Strategy in China

  • Yi-Chun (Yvonnes) ChenEmail author


This chapter discusses the importance of incorporating media literacy into school and nonschool settings to combat childhood obesity in China. This chapter begins with an introduction of the obesity epidemic and the rising medical costs associated with obesity-related illnesses. The author then explains how food marketing contributes to childhood obesity by discussing food advertising expenditures, types of food advertising, and persuasive tactics used in food marketing to attract children’s attention.

Although policies that restrict food marketing to children are strongly advocated in the USA to combat childhood obesity, the author argues that such policy solutions may not be easily adaptable in China due to a variety of structural barriers. Indeed, lax food marketing regulations in China, coupled with a lack of regulations that do not limit children’s exposure to food advertising, require integrating novel approaches—such as media literacy trainigns—into obesity prevention. In China, media literacy education has received burgeoning interests in school and nonschool settings. It offers a potential solution to addressing the childhood obesity crisis by asking critical questions to encourage reflections and by empowering children to produce media messages to counter the impact of food advertising.

Modeling after evidence-based health-promoting media literacy interventions, the author provides suggestions for media literacy strategies for obesity prevention. Because advertising often reflects cultural values, the author also argues the importance of incorporating such values into the critical analysis of food advertising and marketing activities.


Obesity Food marketing Media literacy China Cultural dimensions 


  1. Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  2. Albers-Miller, N. D., & Gelb, B. D. (1996). Business advertising appeals as a mirror of cultural dimensions: A study of eleven countries. Journal of Advertising, 25, 57–70.CrossRefGoogle Scholar
  3. Arke, E. T., & Primack, B. A. (2009). Quantifying media literacy: Development, reliability and validity of a new measure. Educational Media International, 46, 53–65.CrossRefGoogle Scholar
  4. Aufderheide, P. (1993). Media literacy: A report of the national leadership conference on media literacy. Washington: Aspen Institutes.Google Scholar
  5. Austin, E. W., Chen, Y., Pinkleton, B. E., et al. (2006). Benefits and costs of channel one in a middle school setting and the role of the media-literacy training. Pediatrics, 117, 425–433.CrossRefGoogle Scholar
  6. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  7. Bickham, D. S., & Slaby, R. G. (2012). Effects of a media literacy program in the US on children’s critical evaluation of unhealthy media messages about violence, smoking and food. Journal of Children Media, 6, 255–271.CrossRefGoogle Scholar
  8. Buijzen, M., Schuurman, J., & Bomhof, E. (2008). Associations between children’s television advertising exposure and their food consumption patterns: A household diary survey study. Appetite, 50, 231–239.CrossRefGoogle Scholar
  9. CAA. (2007). Consultation on the legality of advertisements. Accessed 1 Dec 2014.
  10. Cairns, G., Angus, K., Hastings, G., et al. (2013). Systematic reviews of the evidence on the nature, extent and effects of food marketing to children: A retrospective summary. Appetite, 62, 209–215.CrossRefGoogle Scholar
  11. Center for Diseases Control & Prevention. (2012). Causes and consequences: What causes overweight and obesity? Accessed 1 Dec 2014.
  12. Chen, Y. (2013). The effectiveness of different approaches to media literacy in modifying adolescents’ responses to alcohol. Journal of Health Communication, 18, 723–739.CrossRefGoogle Scholar
  13. Chen, Y., Kaestle, C. E., Estabrooks, P., et al. (2013). US Children’s acquisition of tobacco media literacy skills: A focus group analysis. Journal of Children Media, 7, 409–427.CrossRefGoogle Scholar
  14. Cheng, T. O., & Ji, C. Y. (2008). Prevalence and geographic distribution of childhood obesity in China in 2005. International Journal of Cardiology, 131, 1–8.CrossRefGoogle Scholar
  15. Cheung, C. K., Xu, W. (2014). Promoting media literacy education in China: A case study of a primary school. International Journal of Adol Youth. Accessed 15 Nov 2015.
  16. China Media Monitor Intelligence. (2008a). China advertising facts (from front webpage). Accessed 1 Dec 2014.Google Scholar
  17. China Media Monitor Intelligence. (2008b). Advertising in China: A snapshot. A report prepared for China Forum Munich.…/Review_290908.pdf. Accessed 1 Dec 2014.
  18. Consumer International & the International Obesity Task Force. (2008). Recommendations for an international code of marketing of foods and non-alcoholic beverages to children. Accessed 1 Dec 2014.
  19. Consumers International. (2008). The junk food trap: marketing unhealthy food to children in Asia Pacific. Accessed 1 Dec 2014.
  20. Contento, I., Balch, G. I., Bronner, D. M., et al. (1995). The effectiveness of nutrition education and implications for nutrition education policy, programs, and research: A review of research. Journal of Nutrition Education, 27, 312–328.CrossRefGoogle Scholar
  21. Davis, B. (2013). Beijing endorses market role in economy: Economists express doubts after release of reform plan. Accessed 1 Dec 2014.
  22. Dietz, W. H., & Gortmaker, S. L. (1985). Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics, 75, 807–812.Google Scholar
  23. Evans, A. E., Dave, J., Tanner, A., et al. (2006). Changing the home nutrition environment: Effects of a nutrition and media literacy pilot intervention. Journal of Family & Community Health, 29, 43–54.CrossRefGoogle Scholar
  24. Folta, S. C., Golderg, J. P., Economos, C., et al. (2006). Food advertising targeted to school children: A content analysis. Journal of Nutrition Education and Behavior, 38, 244–248.CrossRefGoogle Scholar
  25. Freedman, D. S., Khan, L. K., Dietz, W. H., et al. (2001). Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics, 108, 712–718.CrossRefGoogle Scholar
  26. Freedman, D. S., Kettel, L., Serdula, M. K., et al. (2005). The relation of childhood BMI to adult adiposity: The Bogalusa Heart Study. Pediatrics, 115, 22–27.Google Scholar
  27. Freedman, D. S., Wang, J., Thornton, J. C., et al. (2009). Classification of body fatness by body mass index-for-age categories among children. Archives of Pediatrics and Adolescent Medicine, 163, 801–811.CrossRefGoogle Scholar
  28. Guo, S. S., & Chumlea, W. C. (1999). Tracking of body mass index in children in relation to overweight in adulthood. American Journal of Clinical Nutrition, 70, 145–148.Google Scholar
  29. Harris, J. L., Pomeranz, J. L., Lobsetin, T., et al. (2009). A crisis in the marketplace: How food marketing contributes to childhood obesity and what can be done. Annual Review of Public Health, 30, 211–225.CrossRefGoogle Scholar
  30. Harris, J. L., Sarda, V., Schwartz, M. B., et al. (2013). Redefining “child-directed advertising” to reduce unhealthy television food advertising. American Journal of Preventive Medicine, 44, 358–364.CrossRefGoogle Scholar
  31. Harrison, K., & Marske, A. L. (2005). Nutritional content of foods advertised during the television programs children watch most. American Journal of Public Health, 95, 1568–1574.CrossRefGoogle Scholar
  32. Hawkes, C. (2002). Globalization, diets and noncommunicable diseases. Marketing activities of global soft drink and fast food companies in emerging markets: a review. World Health Organization, Geneva.Google Scholar
  33. Hawkes, C. (2008). Agro-food industry growth and obesity in China: What role for regulating food advertising and promotion and nutrition labeling? Obesity Reviews, 9, 151–161.CrossRefGoogle Scholar
  34. Henderson, V. R., & Kelly, B. (2005). Food advertising in the age of obesity: Content analysis of food advertising on general market and African American Television. Journal of Nutrition Education Behaviour, 37, 191–196.CrossRefGoogle Scholar
  35. Hindin, T. J., Contento, I. R., & Gussow, J. D. (2004). A media literacy nutrition education curriculum for Head Start parents about the effects of television advertising on the children’s food requests. Journal of the American Dietetic Association, 104, 164–169.CrossRefGoogle Scholar
  36. Institute of Medicine. (2005). Food marketing to children and youth: Threat or opportunity. Accessed 1 Dec 2014.
  37. Ji, M. F., & McNeal, J. U. (2001). How Chinese children’s commercials differ from those of the United States: A content analysis. Journal of Advertising, 30, 79–92.CrossRefGoogle Scholar
  38. Johnson, D. W., & Johnson, R. T. (1985). Nutrition education: A model for effectiveness, a synthesis of research. Journal of Nutrition Education, 17, 1–45.CrossRefGoogle Scholar
  39. Kelly, B., Halford, J. C. G., Boyland, E., et al. (2010). Television food advertising to children: A global perspective. American Journal of Public Health, 100, 1730–1736.CrossRefGoogle Scholar
  40. Kelly, B., Hebden, L., King, L. et al. (2014). Children’s exposure to food advertising on free-to-air television: An Asia-Pacific perspective. Health Promotion International (in press).Google Scholar
  41. Li, M., Dibley, M. J., Sibbritt, D. W., et al. (2010). Dietary habits and overweight/obesity in adolescents in Xi’an City, China. Asia Pacific Journal of Clinical Nutrition, 19, 76–82.Google Scholar
  42. Lim, S. S., & Nekmat, E. (2008). Learning through ‘prosuming’: Insights from media literacy programmes in Asia. Science Technology & Society, 13, 259–278.CrossRefGoogle Scholar
  43. Lin, C. (2001). Cultural values reflected in Chinese and American television advertising. Journal of Advertising, 30, 83–94.CrossRefGoogle Scholar
  44. Lobstein, T., & Dibbs, S. (2005). Evidence of a possible link between obesogenic food advertising and child overweight. Obesity Reviews, 6, 203–208.CrossRefGoogle Scholar
  45. Matheson, D. M., Killen, J. D., Wang, Y., et al. (2004). Children’s food consumption during television viewing. American Journal of Clinical Nutrition, 79, 1088–1094.Google Scholar
  46. McNeal, J. U., & Yeh, C. (1997). Development of consumer behaviour patterns among Chinese Children. Journal of Consumer Marketing, 14, 45–59.CrossRefGoogle Scholar
  47. Mueller, B. (2011). Dynamics of international advertising. New York: Peter Lang.Google Scholar
  48. Ng, M., Fleming, T., Robinson, M., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the global burden of disease study 2013. Lancet, 384, 766–781.CrossRefGoogle Scholar
  49. Pinkleton, B., Austin, E., Chen, Y., et al. (2012). The role of media literacy in shaping adolescents’ understanding of and responses to sexual portrayals in mass media. Journal of Health Communication, 17, 460–476.CrossRefGoogle Scholar
  50. Powell, L. M., Szcypka, G., & Chaloupka, F. G. (2007). Exposure to food advertising on television among children. Archives of Pediatrics and Adolescent Medicine, 161, 553–560.CrossRefGoogle Scholar
  51. Primack, B. A., & Hobbs, R. (2009). Association of various components of media literacy and adolescent smoking. American Journal of Health Behaviour, 33, 192–201.CrossRefGoogle Scholar
  52. Robinson, T. N., Borzekowski, D. L. G., Matheson, D. M., et al. (2007). Effects of fast food branding on young children’s taste preferences. Archives of Pediatrics and Adolescent Medicine, 161, 792–797.CrossRefGoogle Scholar
  53. Rudd Center for Food Policy & Obesity. (n.d.). Food marketing to youth. Accessed 1 Dec 2014.
  54. Tan, Q., Xiang, Q., Zhang, J., et al. (2012). Media literacy education in Mainland China: A historical overview. International Journal of Information and Education Technology, 2, 382–385.Google Scholar
  55. Tanner, A., Duhe, S., Evans, A., et al. (2008). Using student-produced media to promote healthy eating: A pilot study on the effects of a media and nutrition intervention. Science Communication, 30, 108–125.CrossRefGoogle Scholar
  56. Taveras, E. M., Sandora, T. J., Shih, M., et al. (2006). The association of television and video viewing with fast food intake by preschool-age children. Obesity, 14, 2034–2041.CrossRefGoogle Scholar
  57. Veerman, J. L., Van Beeck, E. F., & Barendregt, J. J. (2009). By how much would limiting TV food advertising reduce childhood obesity? European Journal of Public Health, 19, 365–369.CrossRefGoogle Scholar
  58. Wan, G., & Gut, D. M. (2008a). Media use by Chinese and US secondary students: Implications for media literacy education. Theory Into Practice, 47, 178–185.CrossRefGoogle Scholar
  59. Wan, G., & Gut, D. M. (2008b). Roles of media and media literacy education: Lives of Chinese and American adolescents. New Horizons in Education, 56, 28–41.Google Scholar
  60. Wang, Y., & Lobstein, T. (2006). Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity, 1, 11–25.CrossRefGoogle Scholar
  61. Wiecha, J. L., Peterson, K. E., Ludwig, D. S., et al. (2006). When children eat what they watch: Impact of television viewing on dietary intake in youth. Archives of Pediatrics and Adolescent Medicine, 160, 436–442.CrossRefGoogle Scholar
  62. Wiggins, J. (2007). Mars to axe child-targeted adverts. Accessed 1 Dec 2014.
  63. Withrow, D., & Alter, D. A. (2011). The economic burden of obesity worldwide: A systematic review of the direct costs of obesity. Obesity Reviews, 12, 131–141.CrossRefGoogle Scholar
  64. World Health Organization. (2003). Diet, nutrition and the prevention of chronic diseases. Geneva: World Health Organization.Google Scholar
  65. Yach, D., Stuckler, D., & Brownell, K. D. (2006). Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nature Medicine, 12, 62–66.CrossRefGoogle Scholar
  66. Zhang, L. (n.d.). Advertising in a new age of media: The rise of digital media will require traditional media platforms to restrategize and will open new opportunities for advertisers. Accessed 1 Dec 2014.
  67. Zhang, J., & Shavitt, S. (2003). Cultural values in advertisements to the Chinese X-generation: Promoting modernity and individualism. Journal of Advertising, 32, 23–33.CrossRefGoogle Scholar
  68. Zhao, W., Zhai, Y., & Hu, J. (2008). Economic burden of obesity-related chronic diseases in Mainland China. Obesity Reviews, 9, 62–67.CrossRefGoogle Scholar
  69. Zimmerman, F. J., & Bell, J. F. (2010). Associations of television content type and obesity in children. American Journal of Public Health, 100, 334–340.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Singapore 2016

Authors and Affiliations

  1. 1.William Allen White School of Journalism and Mass CommunicationsUniversity of KansasLawrenceUSA

Personalised recommendations