A systematic review and meta‐analysis of the effect of digital game‐based or influencer food and non‐alcoholic beverage marketing on children and adolescents: Exploring hierarchy of effects outcomes

Abstract

SummaryVideogame livestreaming platforms are an emerging form of digital media, popular with young people, where users watch gaming influencers play videogames. Food and non‐alcoholic beverage (hereafter: food) brands have a substantial presence on these platforms, yet no studies have examined the impact of this food marketing on young people. This systematic review and meta‐analysis examined the evidence (quantitative or mixed‐method) for a relationship between exposure to digital game‐based or influencer food marketing, and food‐related (brand awareness, attitudes, preferences, purchase, and consumption), and post‐consumption (weight, body mass index [BMI], and dental caries) outcomes in young people (≤18 years). Twenty‐three databases were searched in March 2021. Twenty‐two studies met the inclusion criteria, of which 20 were included in the quantitative synthesis. Meta‐analyses indicated food marketing was associated with more positive attitudes and greater preferences (OR = 1.74, p < 0.001 [95%CI: 1.355, 2.232]), and increased consumption (SMD = 0.37, p < 0.001 [95%CI: 0.219, 0.529]). Narrative synthesis indicated that food marketing may increase brand awareness but not pester intent, although data were limited. Evidence suggests that there is a relationship between exposure to food marketing via influencers and digital gaming media, and several food‐related outcomes. This is the first quantitative synthesis to demonstrate these relationships; this work has implications for food marketing policy.