Youth Exposure to Food and Beverage Marketing on Digital Media Platforms

Importance Youth are heavy users of digital devices, and digital media increasingly represents a source for unhealthy food marketing, which the World Health Organization highlights as a risk for poor diet and health. Objective To examine the extent and nature of youth exposure to food marketing on digital media across multiple platforms. Design, Setting, and Participants This cross-sectional study conducted from November 2024 to October 2025 used real-time screen capture data and surveyed screen use to estimate youth exposure to food marketing on digital media, including differences by sociodemographic characteristics. Content and nutritional analyses assessed marketed food categories, companies, and product healthfulness based on the Pan American Health Organization’s nutrient profile model (PAHO-NPM), as well as characteristics of marketing exposure. Participants included youth in the US aged 8 to 17 years. Exposure Food marketing on digital media. Main Outcomes and Measures Hours of smartphone and/or tablet device use per day and estimated median food marketing exposures per year among youth. Distribution of marketed food items by food category and company were analyzed, as was the percent exceeding the PAHO-NPM standard. Marketing exposures were reviewed by platform, source, and type. Results Participants included 1011 youth (median [IQR] age, 12 [10-15] years; 519 female [51.3%]; 511 aged 8-12 years; 500 aged 13-17 years). Participants reported spending a mean (SD) of 3.7 (1.9) hours per day using smartphones or tablets outside of school or homework activities. Estimated median number of food marketing exposures among youths was 3883 (IQR, 0-16 697) per year. Exposure was higher for adolescents vs children (10 107 [IQR, 0-26 205] per year vs 1427 [IQR, 0-7795] per year; P < .001), female vs male youths (8017 [IQR, 0-25 999] per year vs 2139 [0-9027] per year; P < .001), and youth with non–college-educated vs college-educated parents or guardians (5380 [IQR, 0-22 422] per year vs 3431 [IQR, 0-15 128] per year; P = .04). Exposure was higher but not significant for non-Hispanic Black vs White youth (6358 [IQR, 0-24 053] vs 3697 [IQR, 0-16 287]; P = .06). The largest food marketed categories were fast food (1983 of 6896 [28.8%]), sweets (1407 [20.4%]), and beverages (1384 [20.1%]). A total of 2437 of 2660 nonrestaurant food marketed items (91.6%) did not meet PAHO-NPM standards. A total of 4256 of 5154 food marketing exposures (82.6%) to youth were viewed on social media platforms (TikTok, 1565 of 5154 [30.4%] and YouTube, 1162 of 5154 [22.6%]). The majority of marketing exposures were paid (2703 of 5154 [52.4%]), 2261 (43.9%) were earned, and 190 (3.7%) were owned. Almost half (3231 of 6896 [46.9%]) of marketed food items were from Children’s Food and Beverage Advertising Initiative (CFBAI)–member companies. Conclusions and Relevance Results of this cross-sectional study suggest that youth exposure to unhealthy food marketing on digital media is high and differences exist across sociodemographic groups. Results that a substantial portion of exposure comes from nonpaid earned media and CFBAI-member companies highlights the complexities of and need for regulation.