How much junk would a preteen munch if a preteen lacked TV?

It's hard to quantify, but ponder this: American children ages 8 to 12 see an average of 21 food ads a day on TV alone, or more than 7,600 a year.

	Lake Fong, Post-Gazette Carolyn Abramowich, 5, left, watches TV with her sister Katie, 10, after school at their Ohio Township home. Click photo for larger image.

Candy and snacks get the most air play (34 percent), followed by fast food, cereal, sodas, dine-in and delivery restaurants and other soft drinks.

All other foods, including fruits and vegetables, grains, dairy, water and juice, bring up the rear. And food ads outnumber fitness and nutrition messages by 50 to 1.

The numbers come from a study released today by the Kaiser Family Foundation, which combined a content analysis of TV ads with previously reported data on children's viewing habits.

The report, "Food for Thought: Television Food Advertising to Children," comes amid growing recognition that the nation must address its alarming rate of childhood obesity, which has tripled for adolescents since 1976 and doubled among 6-to-11-year-olds.

"I have patients, 12 and 13 years old, who have never tasted plain water. They've always drunk either juice or pop," said Dr. Silva Arslanian , director of the Weight Management and Wellness Center at Children's Hospital of Pittsburgh.

"You're fighting two devils," she said -- children are watching too much TV, a sedentary activity that expends little energy, and the TV they're watching is driving them to unhealthful food.

Parents have a major role to play in resisting the trend, she said, but many are over-stressed, and all the food commercials make their job that much harder.

The Kaiser study found that half of all ads shown during children's programs are for food, making it by far the top product aimed at under-18 viewers.

The most common sales pitches are based on taste (34 percent), followed by fun, toys or contests and claims that the product is "unique" or "new." Only 2 percent emphasize health or nutrition.

Tweens (ages 8 to 12) see the most food ads, according to the report. Teens (13 to 17) see slightly fewer -- 17 a day, or roughly 6,000 a year. Younger children (3 to 7) see the fewest -- 12 a day, or 4,400 a year -- because they watch less TV overall, mostly on networks such as PBS (with no commercials) and Disney (which only advertises its own products).

The three commercial children's cable networks -- ABC Family, Cartoon Network and Nickelodeon -- run the most food ads (8.8 per hour, lasting 3.5 minutes and comprising 32 percent of their ad time). By contrast, ABC, NBC, CBS and Fox aired about half that number (almost two minutes per hour or 13 percent of their ad time).

Furthermore, a fifth of the ads aimed at kids included a push to a Web site; 19 percent offered a toy or other premium; and 11 percent had a tie-in to a children's TV or film character.

Moms like Susan Abramowich of Ohio Township say they feel outgunned.

"I'm always battling the kids [ages 12, 10 and 5] to make healthy choices and not to get taken in by advertising," said Ms. Abramowich, who avoids taking her children to the supermarket because of their ad-driven demands.

"They want everything they see on TV, every new gimmick and all very processed. Yogurt used to be a healthy snack, but now they have it with crushed Oreos and Butterfingers, so it's less healthy. Plain mac and cheese doesn't cut it anymore. They want the SpongeBob kind.

"They see anything on TV or being sold by a celebrity as coming from a place of authority," she continued. "Being a working mom, I don't know if it's out of guilt and wanting to make them happy, but if SpongeBob is going do it, I give in a little bit more than I used to. It's very difficult to compete."

The full study is available online at www.kff.org. Its authors are Dr. Walter Gantz, Dr. Nancy Schwartz and James R. Angelini, all of Indiana University, and Victoria Rideout, director of the Kaiser Family Foundation's program for the study of entertainment media and health.

The foundation portrayed the study as the largest ever conducted on TV food advertising to children. It looked at all types of programming that children watch, not just the shows that are made specifically for kids. The researchers sampled more than 1,600 hours of TV content, including 8,854 commercials targeting children.

The report offers no plan of action. Its purpose, Ms. Rideout said, is to provide an accurate picture of the current landscape and draw a baseline for measuring change in the years ahead.

"We have 9 million obese children in this country. That has very serious consequences for them, their families and the health care system," said Ms. Rideout.

As policy makers look at different ways to address the problem, she said, "their decisions should be made on the basis of accurate data."

One point of particular interest, she noted, is that tweens see more food commercials than any other age group.

"This is an age where kids have a little of their own money, more time away from parents and more opportunity to make their own choices about food," she said. "The food industry and policy makers are probably going to want to focus on them, to see how any changes in advertising affect this age group."

Politicians, the Federal Trade Commission, medical organizations and child advocates have been calling for curbs on food advertising to children, from voluntary guidelines all the way up to government bans such as those enacted last year by Great Britain. That country now bars child-targeting ads for foods that are high in fat, salt and sugar. It also stopped the use of celebrities, licensed characters and promotional offers.

But federal regulation in this country is unlikely, at least in the near future.

"Policy makers here are eager to see food advertising for children change, but they're not interested in mandating that by legislation yet," said Ms. Rideout. "They're looking to the industry to do it voluntarily. This study will help assess what happens on a voluntary basis over the next couple of years."

The food industry has sought to head off government intervention in various ways -- emphasizing healthier foods in ads aimed at children, introducing smaller snack packages, cutting down on or eliminating trans fats from their ingredients, replacing some junk foods in school vending machines with lower-calorie products.

Self-regulation has "moved the needle forward, but only a little," says Dr. Donald Shifrin , chairman of the American Academy of Pediatrics public policy committee. Four months ago, that body called on Congress to ban junk-food ads from children's programming.

"Our mission is the optimal health of children, so we set the bar fairly high," said Dr. Shifrin, clinical professor of pediatrics at the University of Washington School of Medicine in Seattle.

"We say the best thing is if kids don't see these ads at all, but we know they're not going away, so it makes sense to say, can the ads be altered to reflect healthier fare?"

Ms. Abramowich wonders the same thing. "I would like to see more balance," she said.

But Dr. Arslanian doubts that voluntary steps and public education will make a dent in the problem without more controls on advertising.

"The media is full of information about obesity," she said. "We as health care providers spend endless hours trying to educate people. Is the rate going down? No, it's not.

"It's hard to change behavior unless there are consequences. Everyone who wants to advertise unhealthy foods, let's tax them heavily and put the tax to treatment of obesity. Maybe for every one unhealthy food ad there should be two for fruits or vegetables. Or the ad would say the person biked a mile before having the candy bar.

"Twenty to 30 years ago, the smoking situation was like this, with endless ads on TV about how cool it is to smoke. Now that's changed completely. I believe that some day the same will be true with food, but not until the government takes a strong stand like it did with tobacco."