Childhood obesity is one of the greatest public health problems in Spain and thus one of the great challenges our society faces. In Spain, according to data from the ALADINO1 study conducted in 2015, the prevalence of overweight in children aged 6–9 years is 23.2%, and the prevalence of obesity 18.1%.

The question is, how did we get to this point? Our children lead increasingly sedentary lives, with limited physical activity and a pattern of consumption of unhealthy foods. The latter factor is one of the determinants of the obesity problem, and television advertisements may play a relevant role in it that should be analysed and controlled.2 In Spain, the literature regarding this subject is scarce, with salient studies like the one performed by Royo Bordonada et al.3 revealing the considerable exposure of Spanish children to food advertising in television.

In this work, we conducted an observational pilot study with the aim of analysing the advertisements broadcast on television in the reinforced-protection children's viewing time, focusing on the 4 main stations in Spain whose programming include advertisements (Telecinco, Cuatro, Antena 3 and La Sexta). This time is scheduled Monday through Friday from 8:00 to 9:00 AM and from 5:00 to 8:00 PM, and Saturdays and Sundays from 9:00 AM to noon. We analysed 5 days during April 2017 (3 weekdays, Saturday and Sunday), reviewing a total of 72h of programming (18h broadcast by each station).

In the period under study, we counted 797min of advertising (Table 1) broadcast during the protected children's viewing time (amounting to approximately 200min per station). We counted a total of 2,847 advertisements, of which 679 (23.8%) were food-related, with an average of 9.5 food-related advertisements per hour of broadcasting. We classified these advertisements into groups of similar nutritional characteristics based on a simplified adaptation of the food categories of the European nutrient profile model developed by the World Health Organization (Table 2). The food groups advertised most frequently in the 4 stations were beverages and infusions (22.9%, mainly sugary drinks), confectionery, snacks and desserts (21.8%) and dairy (16.2%). We found that both the proportion of food-related advertisements and the most frequently advertised food group changed significantly between stations, which could be related to the self-regulation process implemented by each of them.

Our results suggest that nearly half of the advertisements seen by children during the “protected children's viewing time” promote the consumption of calorie-dense, sugary and unhealthy foods. Since minors also watch television during midday and evening meals and those time bands are not subject to the same stringent regulation of advertising, it is likely that the overall exposure to food advertising is even higher. In Spain, measures have been introduced in recent years to counteract this phenomenon, such as the HAVISA Plan, which includes small captions in advertisements that promote healthy habits, but which has little weight in advertisement broadcasting; the PAOS Code, which promotes self-regulation and responsibility in food product advertising targeting children aged less than 12 years, and the NAOS strategy, an important initiative for the prevention of obesity that has been at play since 2005. To date, the overall impact of these initiatives has proven insufficient.4,5 Due to all of the above, we believe that paediatricians should alert both citizens and institutions of the potential risks of food-related advertisements that do not promote better dietary habits and are broadcast at sensitive times in a medium as influential as television.6