Research report

Perceptions and choices of Brazilian children as consumers offood productsAC Mazzonetto GMR FiatesNutrition Post Graduate Program (Programa de Poacutes-graduaccedilatildeo em Nutriccedilatildeo) Nutrition in Foodservice Research Group (Nuacutecleo de Pesquisa de Nutriccedilatildeo emProduccedilatildeo de Refeiccedilotildees ndash NUPPRE) Federal University of Santa Catarina (Universidade Federal de Santa Catarina ndash UFSC) Florianoacutepolis Brazil

A R T I C L E I N F O

Article historyReceived 21 December 2012Received in revised form 7 March 2014Accepted 27 March 2014Available online 31 March 2014

KeywordsChildrenFood choicesConsumerFocus groupsQualitative researchAlceste

A B S T R A C T

In order to identify childrenrsquos perceptions about food choices and their behavior as consumers andinfluencers of food purchases 16 focus groups were conducted with 71 students aged 8ndash10 years Tran-scriptions were submitted to lexical analysis using the Alceste software The initial contextual unit brokedown into 1469 elementary contextual units 84 of which were retained in the descending hierarchicalclassification Results from the larger and more specific classes are reported here Children were stu-dents from public schools where energy-dense nutrient-poor (EDNP) food consumption was severely re-stricted but these foods were still bought by the children themselves or requested from their parentsTelevision shows and advertisements motivated food consumption in general and consumption of EDNPfoods was associated with social events and eating outside the home Situations that emphasize the plea-sure and satisfaction of not eating according to food guidelines are being addressed by traditional edu-cational strategies directed at the individual Appealing to the senses and employing visual stimuli to getto the affective component of childrenrsquos attitudes seems to be an alternative tool for promoting healthyeating instead of the traditional approach based on recommendations and restrictions

copy 2014 Elsevier Ltd All rights reserved

Introduction

Childrenrsquos eating habits are determined among a variety offactors by food preferences Energy dense nutrient poor (EDNP) foodsare easily incorporated into food preferences (Birch 1999) Becauseof their sweet taste fruits are also considered tasty and thereforeare more easily accepted by children vegetables on the other handtend to be rejected on the grounds of being sour or bitter and havingunpleasant textures (Kroslashlner et al 2011) Therefore vegetable con-sumption needs to be stimulated in order to become a learned pref-erence (Dovey Staples Gibson amp Halford 2008)

Taste food marketing and brand recognition by children havebeen related to their preference for energy dense nutrient poor foods(Cairns Angus Hastings amp Caraher 2012 Cornwell amp McAlister2011) The situation led a number of countries to develop some kindof control strategy to restrict food advertising to children (Hawkesamp Lobstein 2011)

Parents influence childrenrsquos preferences by making different kindsof foods available in the home environment while children influ-ence parentsrsquo choices by requesting specific food items (Birch 1999Cooke 2007 McNeal 2000 Patrick amp Nicklas 2005) Children rec-ognize trips to the supermarket as opportunities to influence family

purchases and to have their preferences taken into considerationPrevious research indicates that parents do consider their chil-drenrsquos opinions at the time of purchase even when the child hasasked beforehand and has not accompanied them (Kelly Turner ampMcKenna 2006 Marshall OrsquoDonohoe amp Kline 2007 Wilson amp Wood2004)

Besides acting as influencers children are also recognized asprimary consumers since they are able to make independent pur-chases with their own money Also preferences formed in child-hood are often retained in adulthood (McNeal 2000) Asaccomplished consumers children are the target of a wide rangeof promotional channels such as television internet magazinescomic books and gifts Television is still the most popular promo-tional channel and the high frequency of commercials is said to exerta direct effect on childrenrsquos food preferences and purchase behav-ior The most common categories of food products promoted to chil-dren are sugared breakfast cereals soft drinks savory snacksconfectionery and fast foods (Cairns et al 2012) and these are thesame food groups that children tend to either buy for themselvesor request from their parents (Marshall et al 2007 Olivares et al2011 Oumlzgen 2003 Wilson amp Wood 2004) A similar situation hasbeen identified in Brazil (Fiates Amboni amp Teixeira 2008)

Brazil with over 195 million inhabitants has the largest popu-lation of any South American nation 50 million (233) are chil-dren from 0 to 14 years 844 of them living in urban areas In 2010the average monthly household income for of urban families was

Corresponding authorE-mail address gifiatesccsufscbr (GMR Fiates)

httpdxdoiorg101016jappet2014030280195-6663copy 2014 Elsevier Ltd All rights reserved

Appetite 78 (2014) 179ndash184

Contents lists available at ScienceDirect

Appetite

journal homepage wwwelseviercom locate appet

around 2400 Brazilian reais (euro1040) and food expenditures ac-counted for about 20 of consumer spending (Brasil 2011) Accord-ing to National Surveys of Family Budgets the household availabilityof fruits and vegetables is low while the availability of processedsugary and fatty foods has been increasing (Brasil 2004 Brasil2010a) Such availability appears to affect food intake by childrenaccording to data obtained in 2008 by the Brazilian Food and Nu-trition Surveillance System Approximately half of the 26000 chil-dren aged 5ndash10 years who were investigated had eaten sweetschocolates cream-filled cookies crackers or packaged salty snackson at least three occasions during the week preceding the surveyMeanwhile only 3 in 10 children had eaten fruit and 1 in 10 hadeaten vegetables on a daily basis (Brasil 2009) Moreover nationaldata indicate that approximately one-third of Brazilian children areoverweight (Brasil 2010b)

The aim of the present study was to identify Brazilian chil-drenrsquos perceptions about their behavior as food buyers and asinfluencers of food purchases and about the motivators behind theirfood choices Qualitative approaches are recommended to under-stand human behaviors including in children since they value par-ticipants and their perceptions They can also highlight behavioraspects that quantitative methods fail to identify (Krueger amp Casey2009 Pope amp Mays 1995) Nevertheless it can be difficult for theanalyst to avoid a tendency to privilege those comments that conformto his or her personal expectations (Dransfield Morrot Martin ampNgapo 2004) In 1986 a software called Alceste was developed inorder to assist in data analysis and interpretation helping to over-come such limits Alceste could be described as a combination oftextual and statistical analysis The different word categories are gen-erated automatically by the software not by the researcher thus in-creasing the objectivity of the process and reducing human influence(Guerrero et al 2009 Reiner 1986) To our knowledge Alceste hasso far not been employed in food and nutrition research with chil-dren The use of the software enabled analysis of focus group tran-scriptions employing lexical analysis what constitutes a ratherinnovative approach

Method

This research is part of a larger study with an intergenerationalapproach approved by the Human Research Ethics Committeeof the Federal University of Santa Catarina (protocol 114010)and prepared in accordance with the ethical standards laid downin the 1964 Helsinki Declaration (World Medical Association2000)

Subjects

The study was conducted in Florianoacutepolis capital of Santa Ca-tarina state in the southern region of Brazil All 10 municipal schoolsdesignated exclusively for children enrolled in the first four ele-mentary school grades were included The schools did not have can-teens and bringing snacks from home was actively discouraged byschool management All the schools benefited from the NationalSchool Meal Program Since the development of independent con-sumer skills and persuasion and negotiation strategies appears moreclearly from the age of 8 onwards (John 2008 McNeal 2000) thiswas the age group chosen for the present study

Eight school principals agreed to participate and all 8- to 10-year-old students from the respective schools were invited ndash fromboth morning and afternoon classes All children who handed signedconsent forms on the designated day participated in the focus groupsSocioeconomic data were obtained from the childrenrsquos registra-tion cards

Focus groups

Sixteen focus groups were conducted including children of bothsexes who studied in the same classes and were of approximatelythe same age (average variation of 1 year) Each group had amaximum of six children The groups were led by a previouslytrained moderator and the discussions were recorded on two digitalrecorders An observer was responsible for annotating nonverbal ex-pressions and adding these to the transcripts

Semi-structured script

A semi-structured script following the stages suggested byKrueger and Casey (2009) was developed to guide the group dis-cussions Three focus groups were conducted in order to test thescript and the results were not considered in the analysis The scriptwas slightly modified after obtaining feedback from the pilot testIt was composed of two blocks of questions the first about moti-vations for eating energy-dense nutrient-poor (EDNP) foods and foreating fruits and vegetables and the second about behavior as buyersand as influencers of food purchases Pictures of fruit and veg-etables and of EDNP foods were used to stimulate discussion EDNPfoods included those with high levels of sugar fat and salt that wereprohibited from being sold at school cafeterias in Santa Catarina state(Santa Catarina 2001) and those most advertised to and pur-chased by children (Cairns et al 2012 McGinnis Gootman amp Kraak2006) These were sweets salty snacks fried snacks soft drinksartificial juices ldquofast foodrdquo and sugary flakes

Data analysis

After verbatim transcription of the recordings from the 16 focusgroups the moderator reviewed the transcripts assembled themto form a single corpus and organized them according to Alcestesoftware (ALCESTE V45 Image Toulouse France) requirementsAlceste was used to assist in data analysis and interpretation

Alceste conducts lexical analysis using the descending hierar-chical classification method It is based on calculations made aboutthe concurrence of words in segments of text with the aim of syn-thesizing and organizing essential information in a textual data-base (Dransfield et al 2004 Guerrero et al 2009) It operates inthe following five stages (1) Text segmentation and word codingthe corpus is segmented into elementary units of context (EUCs)which are text segments that contain a characteristic idea The wordsare classified using an internal dictionary (2) Lemmatization thewords are reduced to their radicals and classified as ldquoanalyzablerdquo(nouns verbs adjectives adverbs etc) or ldquosupplementaryrdquo (prepo-sitions pronouns etc) (3) Definition of a contingency table ofldquoanalyzablerdquo reduced forms and elementary units of context (EUCs)(4) Top-down hierarchical classification analysis performed to obtainstable classes and their significant words (tested by chi-square) (5)Class description to aid interpretation

Following these analyses the software generates a report Thesignificant vocabulary of each class that is the words which givesense to the classes was selected based on the concomitant occur-rence of the following criteria (1) Higher than average frequency(17 times) of occurrences in the corpus (2) Class association de-termined by a chi-square value (χ2) above 384 (gl = 1 indicating thatthe reliability of association between the word and the class is greaterthan 95) Elementary Units of Contexts (EUCs) significantly asso-ciated to the classes were also identified based on a chi-square valueabove 384 EUCs are segments of text that contain a characteristicidea or a meaning The same researcher responsible for conduct-ing the focus groups interpreted the results based both on the sig-nificant words and on the significant EUCs of each class The chi-square value associating words and EUCs to the classes enabled the

180 AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

interpretation of the classesrsquo meanings allowing the researcher tograsp the ideas that define each of them To understand the contentof the classes the researcher must locate the significant words ofeach class on the significant EUCs

Results

In total 71 children (average age of 954 years DP = 069) par-ticipated in the study and 42 were girls (59) All of them lived withtheir mothers and two-thirds of them lived with both parents Theaverage age of the mothers was 36 years (DP = 747) and of thefathers 39 years (DP = 677) Eighty percent of families had an averagemonthly income of up to 2040 Brazilian reais (euro 88700) at the timethe data were collected Approximately half of the mothers (51)and fathers (55) had less than 11 years of education More thanhalf of the children lived less than 2 km from school It was notedthat there was a food retail point near each of the eight schools

The corpus submitted for lexical analysis was composed of aninitial contextual unit that broke down into 1469 elementary unitsof context (EUCs) Of these 1221 (84) were retained in the de-scending hierarchical classification This result is considered satis-factory as it was expected that at least 75 of the EUCs would beclassified The corpus was divided into four classes Figure 1 illus-trates this division and indicates the percentage of the corpus thateach class represents and the number of EUCs that compose eachof them It also indicates the characteristic words of each class inorder of decreasing frequency

Classes 1 and 4 are larger and together they account for 73 ofthe corpus Moreover they are the most specific classes High speci-ficity is desirable since it indicates that the classesrsquo themes are absentor rarely appear in the others Low specificity indicates that thethemes are shared among the classes For these two reasons ndash greater

size and specificity ndash the present article explores and discusses thecontent dealt with in Classes 1 and 4

These two classes (to be described later) include reports of chil-dren in two different roles In the first children appear as active in-dividuals who choose buy and exercise autonomy They also makerequests negotiate with and influence their parents In Class 4 chil-dren appear as individuals who are influenced and have their choicesguided by different factors Examples of characteristic words andelementary units of context (EUCs) associated with the classes(χ2 ge 384) are reported to facilitate understanding The character-istic words are italicized in the text and the characteristic EUCs arepresented in Table 1

Class 1 ndash Choosing what to buy children as buyers and as influencersof food purchases

This class was organized around two verbs buy and ask The verbbuy appeared when the purchase of food by children and theirparents was discussed with the help of the verb ask to make senseof childrenrsquos actions of requesting and negotiating the purchase ofproducts

The results of this class revealed childrenrsquos active role in influ-encing family food choices and making independent food pur-chases Different nouns complement this meaning As demonstratedby the words money monthallowance work have earn and keep chil-dren had financial resources and mentioned means of obtainingthem The words mother father sister and brother identify the peopleinvolved in the buying and influencing processes Mother and fatherare those responsible for family purchases and for bringing homerequested foods Farmersrsquo market minimart supermarket home andschool characterize the specific food retail points and the locationof such points of purchase Farmersrsquo market appeared as a place fre-

Class 1 contained 45 class 2 16 class 3 11 and class 4 28 of the EUCs in stable classes

I like (260 116) donrsquot (202 9) lettuce (77 283) tomato (76 260) I eat (57 16) carrot (54 245) salad (50 137) onion (44 200) I put (27 57) rice (23 69) beans (23 69) potato (19 46) I love (19 22)

Juice (121 373) I like (88 22) drink (81 137) apple (73 245) natural (69 248) fruit (61 39) banana (51 130) orange (44 179) sandwich (44 89) grape (35 139) soft drink (34 82) strawberry (33 77) pineapple (31 129) cheese (29 90) take (28 33) watermelon (23 85) bread (23 24) juice in a box (20 87) kiwi (19 87) water (19 34)

I eat (239 36) to eat (212 128) people (99 18) doesmakes (90 5) want (72 80) healthy (47 53) popcorn (38 50) I think (38 8) candysweet (3711) good (34 10) ice cream (32 7) health (3032) French fries (30 28) hamburger (28 14) hot dog (27 31) makes you fat (25 42) TV (23 29) movie (22 46) I see (22 14) time (20 26) lookinglook (20 16)

buy (558 287) mother (383 111) I go (184 43) thing (17719) I ask(164 116) house (153 17) father (13857) money (84 83) I earn(8048) chocolate (766) candy (7116) minimartsupermarket (60 51)brothersister(53 34) I have (53 12) bring (47 31) a lot (43 10)monthallowance (41 20) cookie (38 4) cereal (35 11) I domake (339) gum (31 24) yogurt (28 16) works (27 21) school (26 7) junkfood (24 10) aunt (22 9) chocolate egg (21 21) farmerrsquos market (205) I keep (18 13)

Class 3

Class 2

Class 4

Class 1

Fig 1 The dendrogram (from top-down hierarchical cluster analysis) and the major associated words (frequency gt17 and χ2 gt 384) the four classes from the original re-cordings of the 16 focus groups

181AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

quented by mothers where fruits vegetables and homemade foodsare bought Supermarket indicates the place frequented by the family(including the children) where EDNP foods and other foods in generalwere bought Children also identified minimarts stores located nearhome and school as places where they made independent pur-chases either alone or accompanied by friends or siblings There-fore places of independent purchases could differ from places offamily purchases In both cases the associated words were choco-late candy gum cookie and junk food

Class 4 ndash Children choosing what to eat influences on food choices

The words that define this class are eat and want Childrenrsquos per-ceptions about the food items discussed in the focus groups re-vealed what circumstances and reasons motivated them to eat suchfoods

The words good and seelook were related to foodsrsquo sensory at-tributes in terms of taste and sight Good was associated to the pleas-ant taste of certain foods that satisfy the senses and stimulate thedesire to eat them Besides taste good appearance and presenta-tion appeared as influences while undesirable appearance reducedthe desire to eat some foods The verbs see and look were also men-tioned in comments about television (TV) Not only food advertise-ments but also TV programs were mentioned as stimuli for the desireto eat all kinds of foods not only EDNP

The term healthy was repeatedly mentioned in sentences statingwhich foods were good or bad for onersquos health Although health prop-erties appeared in the comments motivations to consumption weremore significantly linked to the previously mentioned taste and ap-pearance characteristics Regarding EDNP foods children stressedhealth hazards such as make you fat and mentioned occasional con-sumption (a long time ago) Eating hamburger hot dog chickennuggets French fries popcorn and ice cream were associated withleisure activities such as going to the movies

Discussion

Results evidenced and organized childrenrsquos perceptions abouttheir food choices and their behavior as consumers According tothe analysis children shopped independently in local minimarts neartheir homes and schools and influenced their parentsrsquo purchases atthe supermarket Bought and requested items were EDNP foods notavailable at school In fact it has been reported that limiting access

to any given food stimulates the desire to eat it (Patrick amp Nicklas2005 Savage Fisher amp Birch 2007) The presence of food retail pointsnear home or school has also been related to childrenrsquos food intake(Skidmore et al 2009) In Brazil a study which analyzed productssold to children at points of sale near their schools found that thecheapest and most available products were those rich in trans fatsresulting in a greater availability of EDNP foods at a lower cost(Silveira Kliemann Silva Colussi amp Proenccedila 2012)

Parents were indicated as responsible for family food pur-chases mostly at Farmersrsquo markets and supermarkets Only the latterthough were characterized by children as places where they couldinfluence their parents to buy EDNP foods It is true that supermar-kets provide a large array of EDNP foods with sophisticated mar-keting strategies employed by the industry (Hawkes 2008 Monteiro2009 Popkin 2006) But since they also provide fruits and veg-etables strategies to promote healthy eating could also be presentFor instance an experiment that linked brands and characters withfruits and vegetables found that the strategy can be useful to stim-ulate childrenrsquos consumption (Keller et al 2012)

Television was mentioned as a motivator for the desire to eat allkinds of foods not only EDNP ones This was an interesting findingsince televisionrsquos influence (especially from advertising) on chil-drenrsquos preference for such foods has been widely reported (Marshallet al 2007 Mehta et al 2010) Television advertisements usuallyfocus on pleasant experiences of taste affection reward and comfortwhich is exactly the same approach chosen by the food industry topromote EDNP foods (Gomes 2007) Alternatively the same ap-proach could be adopted by nutrition campaigns for promotinghealthy choices instead of the usual focus on nutrients health main-tenance and a reduction of the risk of disease

Sensory attributes were frequently mentioned by children as mo-tivators for ingestion Visually appealing presentations have beenfound to have a strong effect on fruit consumption and also play acrucial role in childrenrsquos decisions about whether or not to eat veg-etables (Heath Houston-Price amp Kennedy 2011 Jansen Mulkensamp Jansen 2010 Kroslashlner et al 2011)

EDNP food brands were grouped with terms such as health andfat and children mentioned trying to avoid frequent ingestion ofthese Nevertheless consumption of such foods was associated withleisure activities birthday parties and eating out in the companyof relatives and friends Such situations are often regarded as in-appropriate occasions for eating fruits and vegetables (KirbyBaranowski Reynolds Taylor amp Binkley 1995) and promote the

Table 1Examples of Elementary Units of Context (EUCs) associated (χ2 ge 384) to Classes 1 and 4

From Class 1 (composed of 545 EUCs) χ2

I eat a lot of cereal my father buys in the supermarket chocolate too but I have to control myself otherwise I eat the whole bar 19When my mother has some money left gives me 2 or 3 bucks I have a piggy bank where my father puts coins and sometimes I get an allowance from

my mother too18

I go to the minimart in front of my house and I buy a chocolate bar then I share with my sister 13I always earn a penny from my father then I go buy a lollipop 12My mother buys what we need and sometimes I ask for gum and chocolate chocolate I always ask for and she gives me 12Near [school] there is a minimart and sometimes I buy cookies and things I do not keep my money because I buy candy 11I spend normally junk food really I go out with my friends we go to the minimart and I buy lollipop candy gum chocolate 9When there is a farmersrsquo market my mom goes buy fruit 7

From Class 4 (composed of 347 EUCs) χ2

I think [fruit] is very tasty has a very delicious taste cool when it is very hot and it makes us healthy 30I see a child eating a hamburger on TV and it makes me want 26I only eat nuggets and French fries on Saturdays I havenrsquot eaten French fries in a long time because otherwise they make you fat 26[Fruits] are good and are good for your health They are quite healthy and when I look at them a lot in the supermarket it makes me want to eat them 21It makes me want to eat it seeing it all pretty like that There are some pretty salads that make me want to eat them we think it is good 17I eat hamburgers at fast food restaurants and at the mall and I eat popcorn at home and when I go to the movies 15They are good [EDNPs] The hard thing is that they are not healthy but they are delicious When we are going to watch a movie I eat popcorn 13Sometimes I turn on the TV and it is showing a culinary recipe things like that so it makes me want to eat fruit 11It makes me not want to eat when itrsquos dirty at the Farmersrsquo market and everyone picks it up with their hands when it is spoiled 7

182 AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

choice of EDNP foods (Warren Parry Lynch amp Murphy 2008) Foodpreferences and sensory attributes tend to predominate over nu-tritional knowledge at the time of making food choices ndash the factof knowing what is good or bad for onersquos health is not a strongenough factor to induce good eating habits (Fitzgerald Heary Nixonamp Kelly 2010 Warren et al 2008)

Therefore one can argue that when faced with an environmentwhere EDNP foods are widely available strongly advertised and so-cially desirable children cannot be expected to make consciouslyinformed healthy food choices (Cohen 2008) Stimuli directed at pro-moting healthy eating habits need to be available in all places andsituations namely those identified in the present study Future re-search could focus on testing different strategies appealing to thesenses in strategic places and situations as an effort to increase theconsumption of fruits and vegetables

The use of focus groups enabled the observation of interac-tions behaviors and attitudes that would not have been possiblewith interviews or surveys Regarding data analysis the chosenapproach has its strengths and weaknesses Use of the Alcestesoftware reduces the chances of researcher bias and theneed for complex triangulation methods On the other handas this approach does not require exhaustive reading ofthe corpus it can lead to a distancing between the researcher andthe textual material For this reason it seems best that the sameresearcher responsible for conducting the focus group also be re-sponsible for organizing the textual material and interpreting theresults Also as the method emphasizes a collective representa-tion it is not possible to identify or analyze important but minorinsights

Conclusion

This study was conducted with a group of students from publicschools where EDNP food consumption was severely restricted Thesewere exactly the foods most bought by the children and requestedfrom their parents Supermarkets places where EDNP foods arewidely available and made attractive to consumers due to sophis-ticated marketing strategies were recognized as places where greaterinfluence could be exerted by the children over their parentsrsquo foodshopping Television advertisements and shows appeared as strongmotivators for food ingestion in general not only EDNP foods Con-sumption of EDNP foods was associated with social events and eatingout a situation that emphasizes the pleasure and satisfaction of noteating according to food guidelines Consumption of EDNP is beingfacilitated by a number of factors that cannot be properly ad-dressed by traditional strategies directed to the individual Appeal-ing to the senses and employing visual stimuli to influence theaffective component of childrenrsquos attitudes seems to be a possiblealternative for the promotion of healthy eating Such an approachcould be adopted by social marketing campaigns applied to TV showsand advertisements and also supermarkets Educational strate-gies focused on the sensory and pleasure aspects of ingesting healthyfoods such as fruits and vegetables could help to change the ob-served situation

References

Birch L L (1999) Development of food preferences Annual Review Nutrition 1941ndash62

Brasil (2004) Pesquisa de orccedilamentos familiares 2002ndash2003 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2002aquisicaoaquisicaopdf

Brasil (2009) Anaacutelise dos registros do consumo alimentar no SISVAN Web Availablefrom httpnutricaosaudegovbrdocsboletimSisvanconsumo_alimentar_sisvan_webpdf

Brasil (2010a) Pesquisa de orccedilamentos familiares 2008ndash2009 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE (Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_aquisicaopof20082009_aquisicaopdf)

Brasil (2010b) Pesquisa de orccedilamentos familiares 2008ndash2009 Antropometria e estadonutricional de crianccedilas adolescentes e adultos no Brasil Rio de Janeiro IBGE(Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_encaapof_20082009_encaapdf)

Brasil (2011) Censo Demograacutefico 2010 Caracteriacutesticas da populaccedilatildeo e dos domiciacuteliosResultados do universo Rio de Janeiro IBGE (Available from httpwwwibgegovbrenglishestatisticapopulacaocenso2010caracteristicas_da_populacaoresultados_do_universopdf)

Cairns G Angus K Hastings G amp Caraher M (2012) Systematic reviews of theevidence on the nature extent and effects of food marketing to children Aretrospective summary Appetite 62 209ndash215

Cohen D A (2008) Obesity and the built environment Changes in environmentalcues cause energy imbalances International Journal of Obesity (2005) 32(7)S137ndashS142

Cooke L (2007) The importance of exposure for healthy eating in childhood Areview Journal of Human Nutrition and Dietetics 20 294ndash301

Cornwell T B amp McAlister A R (2011) Alternative thinking about starting pointsof obesity Development of child taste preference Appetite 56 428ndash439

Dovey T M Staples P A Gibson E L amp Halford J C (2008) Food neophobia andldquopickyfussyrdquo eating in children A review Appetite 50(2ndash3) 181ndash193

Dransfield E Morrot G Martin J F amp Ngapo T M (2004) The application of atext clustering statistical analysis to aid the interpretation of focus groupinterviews Food Quality and Preference 15(5) 477ndash488

Fiates G M R Amboni R D M C amp Teixeira E (2008) Comportamento consumidorhaacutebitos alimentares e consumo de televisatildeo por escolares de Florianoacutepolis ReviewNutrition 21(1) 105ndash114

Fitzgerald A Heary C Nixon E amp Kelly C (2010) Factors influencing the foodchoices of Irish children and adolescents A qualitative investigation HealthPromotion International 25(3) 289ndash298

Gomes F S (2007) Fruits and vegetables Technical recommendations versus socialconstructs Review Nutrition 20(6) 669ndash680

Guerrero L Guardia M D Xicola J Verbeke W Vanhonacker FZakowska-Biemans S et al (2009) Consumer-driven definition of traditionalfood products and innovation in traditional foods A qualitative cross-culturalstudy Appetite 52(2) 345ndash354

Hawkes C (2008) Dietary implications of supermarket development A globalperspective Development Policy Review 26(6) 657ndash692

Hawkes C amp Lobstein T (2011) Regulating the commercial promotion of food tochildren A survey of actions worldwide International Journal of Pediatric Obesity6(2) 83ndash94

Heath P Houston-Price C amp Kennedy O B (2011) Increasing food familiaritywithout the tears A role for visual exposure Appetite 57(3) 832ndash838

Jansen E Mulkens S amp Jansen A (2010) How to promote fruit consumption inchildren Visual appeal versus restriction Appetite 54(3) 599ndash602

John D R (2008) Stages of consumer socialization The development of consumerknowledge skills and values from childhood to adolescence In C P HaugtvedtP M Herr amp F R Kardes (Eds) Handbook of consumer psychology (p 1273) NewYork Taylor amp Francis Group

Keller K L Kuilema L G Lee N Yoon J Mascaro B Combes A L et al (2012)The impact of food branding on childrenrsquos eating behavior and obesity Physiologyand Behavior 106(3) 379ndash386

Kelly J Turner J J amp McKenna K (2006) What parents think Children and healthyeating British Food Journal 108(5) 413ndash423

Kirby S D Baranowski T Reynolds K D Taylor G amp Binkley D (1995) Childrenrsquosfruit and vegetable intake Socioeconomic adult-child regional and urban-ruralinfluences Journal of Nutrition Education 27(5) 261ndash271

Kroslashlner R Rasmussen M Brug J Klepp K I Wind M amp Due P (2011)Determinants of fruit and vegetable consumption among children andadolescents A review of the literature Part II Qualitative studies The InternationalJournal of Behavioral Nutrition and Physical Activity 8 112

Krueger R A amp Casey M A (2009) Focus groups A practical guide for applied research(4th ed) Thousand Oaks CA Sage Publications

Marshall D OrsquoDonohoe S amp Kline S (2007) Families food and pester powerBeyond the blame game Journal of Consumer Behaviour 6(4) 164ndash181

McGinnis J M Gootman J A amp Kraak V I (2006) Food marketing to children andyouth Threat or opportunity Washington DC The National Academies Press

McNeal J U (2000) Children as consumer of commercial and social productsWashington DC Pan American Health Organization

Mehta K Coveney J Ward P Magarey A Spurrier N amp Udell T (2010) Australianchildrenrsquos views about food advertising on television Appetite 55(1) 49ndash55

Monteiro C A (2009) Nutrition and health The issue is not food nor nutrients somuch as processing Public Health Nutrition 12(5) 729ndash731

Olivares S Lera L Mardones M A Araneda J Bustos N Olivares M A et al (2011)Food promotion and food preferences in Chilean school age children fromdifferent socioeconomic levels Archivos Latinoamericanos de Nutricion 61(2)163ndash171

Oumlzgen Ouml (2003) An analysis of child consumers in Turkey International Journal ofConsumer Studies 27(5) 336ndash380

Patrick H amp Nicklas T A (2005) A review of family and social determinants ofchildrenrsquos eating patterns and diet quality Journal of the American College ofNutrition 24(2) 83ndash92

183AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

interpretation of the classesrsquo meanings allowing the researcher tograsp the ideas that define each of them To understand the contentof the classes the researcher must locate the significant words ofeach class on the significant EUCs

Results

In total 71 children (average age of 954 years DP = 069) par-ticipated in the study and 42 were girls (59) All of them lived withtheir mothers and two-thirds of them lived with both parents Theaverage age of the mothers was 36 years (DP = 747) and of thefathers 39 years (DP = 677) Eighty percent of families had an averagemonthly income of up to 2040 Brazilian reais (euro 88700) at the timethe data were collected Approximately half of the mothers (51)and fathers (55) had less than 11 years of education More thanhalf of the children lived less than 2 km from school It was notedthat there was a food retail point near each of the eight schools

The corpus submitted for lexical analysis was composed of aninitial contextual unit that broke down into 1469 elementary unitsof context (EUCs) Of these 1221 (84) were retained in the de-scending hierarchical classification This result is considered satis-factory as it was expected that at least 75 of the EUCs would beclassified The corpus was divided into four classes Figure 1 illus-trates this division and indicates the percentage of the corpus thateach class represents and the number of EUCs that compose eachof them It also indicates the characteristic words of each class inorder of decreasing frequency

Classes 1 and 4 are larger and together they account for 73 ofthe corpus Moreover they are the most specific classes High speci-ficity is desirable since it indicates that the classesrsquo themes are absentor rarely appear in the others Low specificity indicates that thethemes are shared among the classes For these two reasons ndash greater

size and specificity ndash the present article explores and discusses thecontent dealt with in Classes 1 and 4

These two classes (to be described later) include reports of chil-dren in two different roles In the first children appear as active in-dividuals who choose buy and exercise autonomy They also makerequests negotiate with and influence their parents In Class 4 chil-dren appear as individuals who are influenced and have their choicesguided by different factors Examples of characteristic words andelementary units of context (EUCs) associated with the classes(χ2 ge 384) are reported to facilitate understanding The character-istic words are italicized in the text and the characteristic EUCs arepresented in Table 1

Class 1 ndash Choosing what to buy children as buyers and as influencersof food purchases

This class was organized around two verbs buy and ask The verbbuy appeared when the purchase of food by children and theirparents was discussed with the help of the verb ask to make senseof childrenrsquos actions of requesting and negotiating the purchase ofproducts

The results of this class revealed childrenrsquos active role in influ-encing family food choices and making independent food pur-chases Different nouns complement this meaning As demonstratedby the words money monthallowance work have earn and keep chil-dren had financial resources and mentioned means of obtainingthem The words mother father sister and brother identify the peopleinvolved in the buying and influencing processes Mother and fatherare those responsible for family purchases and for bringing homerequested foods Farmersrsquo market minimart supermarket home andschool characterize the specific food retail points and the locationof such points of purchase Farmersrsquo market appeared as a place fre-

Class 1 contained 45 class 2 16 class 3 11 and class 4 28 of the EUCs in stable classes

I like (260 116) donrsquot (202 9) lettuce (77 283) tomato (76 260) I eat (57 16) carrot (54 245) salad (50 137) onion (44 200) I put (27 57) rice (23 69) beans (23 69) potato (19 46) I love (19 22)

Juice (121 373) I like (88 22) drink (81 137) apple (73 245) natural (69 248) fruit (61 39) banana (51 130) orange (44 179) sandwich (44 89) grape (35 139) soft drink (34 82) strawberry (33 77) pineapple (31 129) cheese (29 90) take (28 33) watermelon (23 85) bread (23 24) juice in a box (20 87) kiwi (19 87) water (19 34)

I eat (239 36) to eat (212 128) people (99 18) doesmakes (90 5) want (72 80) healthy (47 53) popcorn (38 50) I think (38 8) candysweet (3711) good (34 10) ice cream (32 7) health (3032) French fries (30 28) hamburger (28 14) hot dog (27 31) makes you fat (25 42) TV (23 29) movie (22 46) I see (22 14) time (20 26) lookinglook (20 16)

buy (558 287) mother (383 111) I go (184 43) thing (17719) I ask(164 116) house (153 17) father (13857) money (84 83) I earn(8048) chocolate (766) candy (7116) minimartsupermarket (60 51)brothersister(53 34) I have (53 12) bring (47 31) a lot (43 10)monthallowance (41 20) cookie (38 4) cereal (35 11) I domake (339) gum (31 24) yogurt (28 16) works (27 21) school (26 7) junkfood (24 10) aunt (22 9) chocolate egg (21 21) farmerrsquos market (205) I keep (18 13)

Class 3

Class 2

Class 4

Class 1

Fig 1 The dendrogram (from top-down hierarchical cluster analysis) and the major associated words (frequency gt17 and χ2 gt 384) the four classes from the original re-cordings of the 16 focus groups

181AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

quented by mothers where fruits vegetables and homemade foodsare bought Supermarket indicates the place frequented by the family(including the children) where EDNP foods and other foods in generalwere bought Children also identified minimarts stores located nearhome and school as places where they made independent pur-chases either alone or accompanied by friends or siblings There-fore places of independent purchases could differ from places offamily purchases In both cases the associated words were choco-late candy gum cookie and junk food

Class 4 ndash Children choosing what to eat influences on food choices

The words that define this class are eat and want Childrenrsquos per-ceptions about the food items discussed in the focus groups re-vealed what circumstances and reasons motivated them to eat suchfoods

The words good and seelook were related to foodsrsquo sensory at-tributes in terms of taste and sight Good was associated to the pleas-ant taste of certain foods that satisfy the senses and stimulate thedesire to eat them Besides taste good appearance and presenta-tion appeared as influences while undesirable appearance reducedthe desire to eat some foods The verbs see and look were also men-tioned in comments about television (TV) Not only food advertise-ments but also TV programs were mentioned as stimuli for the desireto eat all kinds of foods not only EDNP

The term healthy was repeatedly mentioned in sentences statingwhich foods were good or bad for onersquos health Although health prop-erties appeared in the comments motivations to consumption weremore significantly linked to the previously mentioned taste and ap-pearance characteristics Regarding EDNP foods children stressedhealth hazards such as make you fat and mentioned occasional con-sumption (a long time ago) Eating hamburger hot dog chickennuggets French fries popcorn and ice cream were associated withleisure activities such as going to the movies

Discussion

Results evidenced and organized childrenrsquos perceptions abouttheir food choices and their behavior as consumers According tothe analysis children shopped independently in local minimarts neartheir homes and schools and influenced their parentsrsquo purchases atthe supermarket Bought and requested items were EDNP foods notavailable at school In fact it has been reported that limiting access

to any given food stimulates the desire to eat it (Patrick amp Nicklas2005 Savage Fisher amp Birch 2007) The presence of food retail pointsnear home or school has also been related to childrenrsquos food intake(Skidmore et al 2009) In Brazil a study which analyzed productssold to children at points of sale near their schools found that thecheapest and most available products were those rich in trans fatsresulting in a greater availability of EDNP foods at a lower cost(Silveira Kliemann Silva Colussi amp Proenccedila 2012)

Parents were indicated as responsible for family food pur-chases mostly at Farmersrsquo markets and supermarkets Only the latterthough were characterized by children as places where they couldinfluence their parents to buy EDNP foods It is true that supermar-kets provide a large array of EDNP foods with sophisticated mar-keting strategies employed by the industry (Hawkes 2008 Monteiro2009 Popkin 2006) But since they also provide fruits and veg-etables strategies to promote healthy eating could also be presentFor instance an experiment that linked brands and characters withfruits and vegetables found that the strategy can be useful to stim-ulate childrenrsquos consumption (Keller et al 2012)

Television was mentioned as a motivator for the desire to eat allkinds of foods not only EDNP ones This was an interesting findingsince televisionrsquos influence (especially from advertising) on chil-drenrsquos preference for such foods has been widely reported (Marshallet al 2007 Mehta et al 2010) Television advertisements usuallyfocus on pleasant experiences of taste affection reward and comfortwhich is exactly the same approach chosen by the food industry topromote EDNP foods (Gomes 2007) Alternatively the same ap-proach could be adopted by nutrition campaigns for promotinghealthy choices instead of the usual focus on nutrients health main-tenance and a reduction of the risk of disease

Sensory attributes were frequently mentioned by children as mo-tivators for ingestion Visually appealing presentations have beenfound to have a strong effect on fruit consumption and also play acrucial role in childrenrsquos decisions about whether or not to eat veg-etables (Heath Houston-Price amp Kennedy 2011 Jansen Mulkensamp Jansen 2010 Kroslashlner et al 2011)

EDNP food brands were grouped with terms such as health andfat and children mentioned trying to avoid frequent ingestion ofthese Nevertheless consumption of such foods was associated withleisure activities birthday parties and eating out in the companyof relatives and friends Such situations are often regarded as in-appropriate occasions for eating fruits and vegetables (KirbyBaranowski Reynolds Taylor amp Binkley 1995) and promote the

Table 1Examples of Elementary Units of Context (EUCs) associated (χ2 ge 384) to Classes 1 and 4

From Class 1 (composed of 545 EUCs) χ2

I eat a lot of cereal my father buys in the supermarket chocolate too but I have to control myself otherwise I eat the whole bar 19When my mother has some money left gives me 2 or 3 bucks I have a piggy bank where my father puts coins and sometimes I get an allowance from

my mother too18

I go to the minimart in front of my house and I buy a chocolate bar then I share with my sister 13I always earn a penny from my father then I go buy a lollipop 12My mother buys what we need and sometimes I ask for gum and chocolate chocolate I always ask for and she gives me 12Near [school] there is a minimart and sometimes I buy cookies and things I do not keep my money because I buy candy 11I spend normally junk food really I go out with my friends we go to the minimart and I buy lollipop candy gum chocolate 9When there is a farmersrsquo market my mom goes buy fruit 7

From Class 4 (composed of 347 EUCs) χ2

I think [fruit] is very tasty has a very delicious taste cool when it is very hot and it makes us healthy 30I see a child eating a hamburger on TV and it makes me want 26I only eat nuggets and French fries on Saturdays I havenrsquot eaten French fries in a long time because otherwise they make you fat 26[Fruits] are good and are good for your health They are quite healthy and when I look at them a lot in the supermarket it makes me want to eat them 21It makes me want to eat it seeing it all pretty like that There are some pretty salads that make me want to eat them we think it is good 17I eat hamburgers at fast food restaurants and at the mall and I eat popcorn at home and when I go to the movies 15They are good [EDNPs] The hard thing is that they are not healthy but they are delicious When we are going to watch a movie I eat popcorn 13Sometimes I turn on the TV and it is showing a culinary recipe things like that so it makes me want to eat fruit 11It makes me not want to eat when itrsquos dirty at the Farmersrsquo market and everyone picks it up with their hands when it is spoiled 7

182 AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

choice of EDNP foods (Warren Parry Lynch amp Murphy 2008) Foodpreferences and sensory attributes tend to predominate over nu-tritional knowledge at the time of making food choices ndash the factof knowing what is good or bad for onersquos health is not a strongenough factor to induce good eating habits (Fitzgerald Heary Nixonamp Kelly 2010 Warren et al 2008)

Therefore one can argue that when faced with an environmentwhere EDNP foods are widely available strongly advertised and so-cially desirable children cannot be expected to make consciouslyinformed healthy food choices (Cohen 2008) Stimuli directed at pro-moting healthy eating habits need to be available in all places andsituations namely those identified in the present study Future re-search could focus on testing different strategies appealing to thesenses in strategic places and situations as an effort to increase theconsumption of fruits and vegetables

The use of focus groups enabled the observation of interac-tions behaviors and attitudes that would not have been possiblewith interviews or surveys Regarding data analysis the chosenapproach has its strengths and weaknesses Use of the Alcestesoftware reduces the chances of researcher bias and theneed for complex triangulation methods On the other handas this approach does not require exhaustive reading ofthe corpus it can lead to a distancing between the researcher andthe textual material For this reason it seems best that the sameresearcher responsible for conducting the focus group also be re-sponsible for organizing the textual material and interpreting theresults Also as the method emphasizes a collective representa-tion it is not possible to identify or analyze important but minorinsights

Conclusion

This study was conducted with a group of students from publicschools where EDNP food consumption was severely restricted Thesewere exactly the foods most bought by the children and requestedfrom their parents Supermarkets places where EDNP foods arewidely available and made attractive to consumers due to sophis-ticated marketing strategies were recognized as places where greaterinfluence could be exerted by the children over their parentsrsquo foodshopping Television advertisements and shows appeared as strongmotivators for food ingestion in general not only EDNP foods Con-sumption of EDNP foods was associated with social events and eatingout a situation that emphasizes the pleasure and satisfaction of noteating according to food guidelines Consumption of EDNP is beingfacilitated by a number of factors that cannot be properly ad-dressed by traditional strategies directed to the individual Appeal-ing to the senses and employing visual stimuli to influence theaffective component of childrenrsquos attitudes seems to be a possiblealternative for the promotion of healthy eating Such an approachcould be adopted by social marketing campaigns applied to TV showsand advertisements and also supermarkets Educational strate-gies focused on the sensory and pleasure aspects of ingesting healthyfoods such as fruits and vegetables could help to change the ob-served situation

References

Birch L L (1999) Development of food preferences Annual Review Nutrition 1941ndash62

Brasil (2004) Pesquisa de orccedilamentos familiares 2002ndash2003 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2002aquisicaoaquisicaopdf

Brasil (2009) Anaacutelise dos registros do consumo alimentar no SISVAN Web Availablefrom httpnutricaosaudegovbrdocsboletimSisvanconsumo_alimentar_sisvan_webpdf

Brasil (2010a) Pesquisa de orccedilamentos familiares 2008ndash2009 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE (Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_aquisicaopof20082009_aquisicaopdf)

Brasil (2010b) Pesquisa de orccedilamentos familiares 2008ndash2009 Antropometria e estadonutricional de crianccedilas adolescentes e adultos no Brasil Rio de Janeiro IBGE(Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_encaapof_20082009_encaapdf)

Brasil (2011) Censo Demograacutefico 2010 Caracteriacutesticas da populaccedilatildeo e dos domiciacuteliosResultados do universo Rio de Janeiro IBGE (Available from httpwwwibgegovbrenglishestatisticapopulacaocenso2010caracteristicas_da_populacaoresultados_do_universopdf)

Cairns G Angus K Hastings G amp Caraher M (2012) Systematic reviews of theevidence on the nature extent and effects of food marketing to children Aretrospective summary Appetite 62 209ndash215

Cohen D A (2008) Obesity and the built environment Changes in environmentalcues cause energy imbalances International Journal of Obesity (2005) 32(7)S137ndashS142

Cooke L (2007) The importance of exposure for healthy eating in childhood Areview Journal of Human Nutrition and Dietetics 20 294ndash301

Cornwell T B amp McAlister A R (2011) Alternative thinking about starting pointsof obesity Development of child taste preference Appetite 56 428ndash439

Dovey T M Staples P A Gibson E L amp Halford J C (2008) Food neophobia andldquopickyfussyrdquo eating in children A review Appetite 50(2ndash3) 181ndash193

Dransfield E Morrot G Martin J F amp Ngapo T M (2004) The application of atext clustering statistical analysis to aid the interpretation of focus groupinterviews Food Quality and Preference 15(5) 477ndash488

Fiates G M R Amboni R D M C amp Teixeira E (2008) Comportamento consumidorhaacutebitos alimentares e consumo de televisatildeo por escolares de Florianoacutepolis ReviewNutrition 21(1) 105ndash114

Fitzgerald A Heary C Nixon E amp Kelly C (2010) Factors influencing the foodchoices of Irish children and adolescents A qualitative investigation HealthPromotion International 25(3) 289ndash298

Gomes F S (2007) Fruits and vegetables Technical recommendations versus socialconstructs Review Nutrition 20(6) 669ndash680

Guerrero L Guardia M D Xicola J Verbeke W Vanhonacker FZakowska-Biemans S et al (2009) Consumer-driven definition of traditionalfood products and innovation in traditional foods A qualitative cross-culturalstudy Appetite 52(2) 345ndash354

Hawkes C (2008) Dietary implications of supermarket development A globalperspective Development Policy Review 26(6) 657ndash692

Hawkes C amp Lobstein T (2011) Regulating the commercial promotion of food tochildren A survey of actions worldwide International Journal of Pediatric Obesity6(2) 83ndash94

Heath P Houston-Price C amp Kennedy O B (2011) Increasing food familiaritywithout the tears A role for visual exposure Appetite 57(3) 832ndash838

Jansen E Mulkens S amp Jansen A (2010) How to promote fruit consumption inchildren Visual appeal versus restriction Appetite 54(3) 599ndash602

John D R (2008) Stages of consumer socialization The development of consumerknowledge skills and values from childhood to adolescence In C P HaugtvedtP M Herr amp F R Kardes (Eds) Handbook of consumer psychology (p 1273) NewYork Taylor amp Francis Group

Keller K L Kuilema L G Lee N Yoon J Mascaro B Combes A L et al (2012)The impact of food branding on childrenrsquos eating behavior and obesity Physiologyand Behavior 106(3) 379ndash386

Kelly J Turner J J amp McKenna K (2006) What parents think Children and healthyeating British Food Journal 108(5) 413ndash423

Kirby S D Baranowski T Reynolds K D Taylor G amp Binkley D (1995) Childrenrsquosfruit and vegetable intake Socioeconomic adult-child regional and urban-ruralinfluences Journal of Nutrition Education 27(5) 261ndash271

Kroslashlner R Rasmussen M Brug J Klepp K I Wind M amp Due P (2011)Determinants of fruit and vegetable consumption among children andadolescents A review of the literature Part II Qualitative studies The InternationalJournal of Behavioral Nutrition and Physical Activity 8 112

Krueger R A amp Casey M A (2009) Focus groups A practical guide for applied research(4th ed) Thousand Oaks CA Sage Publications

Marshall D OrsquoDonohoe S amp Kline S (2007) Families food and pester powerBeyond the blame game Journal of Consumer Behaviour 6(4) 164ndash181

McGinnis J M Gootman J A amp Kraak V I (2006) Food marketing to children andyouth Threat or opportunity Washington DC The National Academies Press

McNeal J U (2000) Children as consumer of commercial and social productsWashington DC Pan American Health Organization

Mehta K Coveney J Ward P Magarey A Spurrier N amp Udell T (2010) Australianchildrenrsquos views about food advertising on television Appetite 55(1) 49ndash55

Monteiro C A (2009) Nutrition and health The issue is not food nor nutrients somuch as processing Public Health Nutrition 12(5) 729ndash731

Olivares S Lera L Mardones M A Araneda J Bustos N Olivares M A et al (2011)Food promotion and food preferences in Chilean school age children fromdifferent socioeconomic levels Archivos Latinoamericanos de Nutricion 61(2)163ndash171

Oumlzgen Ouml (2003) An analysis of child consumers in Turkey International Journal ofConsumer Studies 27(5) 336ndash380

Patrick H amp Nicklas T A (2005) A review of family and social determinants ofchildrenrsquos eating patterns and diet quality Journal of the American College ofNutrition 24(2) 83ndash92

183AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

quented by mothers where fruits vegetables and homemade foodsare bought Supermarket indicates the place frequented by the family(including the children) where EDNP foods and other foods in generalwere bought Children also identified minimarts stores located nearhome and school as places where they made independent pur-chases either alone or accompanied by friends or siblings There-fore places of independent purchases could differ from places offamily purchases In both cases the associated words were choco-late candy gum cookie and junk food

Class 4 ndash Children choosing what to eat influences on food choices

The words that define this class are eat and want Childrenrsquos per-ceptions about the food items discussed in the focus groups re-vealed what circumstances and reasons motivated them to eat suchfoods

The words good and seelook were related to foodsrsquo sensory at-tributes in terms of taste and sight Good was associated to the pleas-ant taste of certain foods that satisfy the senses and stimulate thedesire to eat them Besides taste good appearance and presenta-tion appeared as influences while undesirable appearance reducedthe desire to eat some foods The verbs see and look were also men-tioned in comments about television (TV) Not only food advertise-ments but also TV programs were mentioned as stimuli for the desireto eat all kinds of foods not only EDNP

The term healthy was repeatedly mentioned in sentences statingwhich foods were good or bad for onersquos health Although health prop-erties appeared in the comments motivations to consumption weremore significantly linked to the previously mentioned taste and ap-pearance characteristics Regarding EDNP foods children stressedhealth hazards such as make you fat and mentioned occasional con-sumption (a long time ago) Eating hamburger hot dog chickennuggets French fries popcorn and ice cream were associated withleisure activities such as going to the movies

Discussion

Results evidenced and organized childrenrsquos perceptions abouttheir food choices and their behavior as consumers According tothe analysis children shopped independently in local minimarts neartheir homes and schools and influenced their parentsrsquo purchases atthe supermarket Bought and requested items were EDNP foods notavailable at school In fact it has been reported that limiting access

to any given food stimulates the desire to eat it (Patrick amp Nicklas2005 Savage Fisher amp Birch 2007) The presence of food retail pointsnear home or school has also been related to childrenrsquos food intake(Skidmore et al 2009) In Brazil a study which analyzed productssold to children at points of sale near their schools found that thecheapest and most available products were those rich in trans fatsresulting in a greater availability of EDNP foods at a lower cost(Silveira Kliemann Silva Colussi amp Proenccedila 2012)

Parents were indicated as responsible for family food pur-chases mostly at Farmersrsquo markets and supermarkets Only the latterthough were characterized by children as places where they couldinfluence their parents to buy EDNP foods It is true that supermar-kets provide a large array of EDNP foods with sophisticated mar-keting strategies employed by the industry (Hawkes 2008 Monteiro2009 Popkin 2006) But since they also provide fruits and veg-etables strategies to promote healthy eating could also be presentFor instance an experiment that linked brands and characters withfruits and vegetables found that the strategy can be useful to stim-ulate childrenrsquos consumption (Keller et al 2012)

Television was mentioned as a motivator for the desire to eat allkinds of foods not only EDNP ones This was an interesting findingsince televisionrsquos influence (especially from advertising) on chil-drenrsquos preference for such foods has been widely reported (Marshallet al 2007 Mehta et al 2010) Television advertisements usuallyfocus on pleasant experiences of taste affection reward and comfortwhich is exactly the same approach chosen by the food industry topromote EDNP foods (Gomes 2007) Alternatively the same ap-proach could be adopted by nutrition campaigns for promotinghealthy choices instead of the usual focus on nutrients health main-tenance and a reduction of the risk of disease

Sensory attributes were frequently mentioned by children as mo-tivators for ingestion Visually appealing presentations have beenfound to have a strong effect on fruit consumption and also play acrucial role in childrenrsquos decisions about whether or not to eat veg-etables (Heath Houston-Price amp Kennedy 2011 Jansen Mulkensamp Jansen 2010 Kroslashlner et al 2011)

EDNP food brands were grouped with terms such as health andfat and children mentioned trying to avoid frequent ingestion ofthese Nevertheless consumption of such foods was associated withleisure activities birthday parties and eating out in the companyof relatives and friends Such situations are often regarded as in-appropriate occasions for eating fruits and vegetables (KirbyBaranowski Reynolds Taylor amp Binkley 1995) and promote the

Table 1Examples of Elementary Units of Context (EUCs) associated (χ2 ge 384) to Classes 1 and 4

From Class 1 (composed of 545 EUCs) χ2

I eat a lot of cereal my father buys in the supermarket chocolate too but I have to control myself otherwise I eat the whole bar 19When my mother has some money left gives me 2 or 3 bucks I have a piggy bank where my father puts coins and sometimes I get an allowance from

my mother too18

I go to the minimart in front of my house and I buy a chocolate bar then I share with my sister 13I always earn a penny from my father then I go buy a lollipop 12My mother buys what we need and sometimes I ask for gum and chocolate chocolate I always ask for and she gives me 12Near [school] there is a minimart and sometimes I buy cookies and things I do not keep my money because I buy candy 11I spend normally junk food really I go out with my friends we go to the minimart and I buy lollipop candy gum chocolate 9When there is a farmersrsquo market my mom goes buy fruit 7

From Class 4 (composed of 347 EUCs) χ2

I think [fruit] is very tasty has a very delicious taste cool when it is very hot and it makes us healthy 30I see a child eating a hamburger on TV and it makes me want 26I only eat nuggets and French fries on Saturdays I havenrsquot eaten French fries in a long time because otherwise they make you fat 26[Fruits] are good and are good for your health They are quite healthy and when I look at them a lot in the supermarket it makes me want to eat them 21It makes me want to eat it seeing it all pretty like that There are some pretty salads that make me want to eat them we think it is good 17I eat hamburgers at fast food restaurants and at the mall and I eat popcorn at home and when I go to the movies 15They are good [EDNPs] The hard thing is that they are not healthy but they are delicious When we are going to watch a movie I eat popcorn 13Sometimes I turn on the TV and it is showing a culinary recipe things like that so it makes me want to eat fruit 11It makes me not want to eat when itrsquos dirty at the Farmersrsquo market and everyone picks it up with their hands when it is spoiled 7

182 AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

choice of EDNP foods (Warren Parry Lynch amp Murphy 2008) Foodpreferences and sensory attributes tend to predominate over nu-tritional knowledge at the time of making food choices ndash the factof knowing what is good or bad for onersquos health is not a strongenough factor to induce good eating habits (Fitzgerald Heary Nixonamp Kelly 2010 Warren et al 2008)

Therefore one can argue that when faced with an environmentwhere EDNP foods are widely available strongly advertised and so-cially desirable children cannot be expected to make consciouslyinformed healthy food choices (Cohen 2008) Stimuli directed at pro-moting healthy eating habits need to be available in all places andsituations namely those identified in the present study Future re-search could focus on testing different strategies appealing to thesenses in strategic places and situations as an effort to increase theconsumption of fruits and vegetables

The use of focus groups enabled the observation of interac-tions behaviors and attitudes that would not have been possiblewith interviews or surveys Regarding data analysis the chosenapproach has its strengths and weaknesses Use of the Alcestesoftware reduces the chances of researcher bias and theneed for complex triangulation methods On the other handas this approach does not require exhaustive reading ofthe corpus it can lead to a distancing between the researcher andthe textual material For this reason it seems best that the sameresearcher responsible for conducting the focus group also be re-sponsible for organizing the textual material and interpreting theresults Also as the method emphasizes a collective representa-tion it is not possible to identify or analyze important but minorinsights

Conclusion

This study was conducted with a group of students from publicschools where EDNP food consumption was severely restricted Thesewere exactly the foods most bought by the children and requestedfrom their parents Supermarkets places where EDNP foods arewidely available and made attractive to consumers due to sophis-ticated marketing strategies were recognized as places where greaterinfluence could be exerted by the children over their parentsrsquo foodshopping Television advertisements and shows appeared as strongmotivators for food ingestion in general not only EDNP foods Con-sumption of EDNP foods was associated with social events and eatingout a situation that emphasizes the pleasure and satisfaction of noteating according to food guidelines Consumption of EDNP is beingfacilitated by a number of factors that cannot be properly ad-dressed by traditional strategies directed to the individual Appeal-ing to the senses and employing visual stimuli to influence theaffective component of childrenrsquos attitudes seems to be a possiblealternative for the promotion of healthy eating Such an approachcould be adopted by social marketing campaigns applied to TV showsand advertisements and also supermarkets Educational strate-gies focused on the sensory and pleasure aspects of ingesting healthyfoods such as fruits and vegetables could help to change the ob-served situation

References

Birch L L (1999) Development of food preferences Annual Review Nutrition 1941ndash62

Brasil (2004) Pesquisa de orccedilamentos familiares 2002ndash2003 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2002aquisicaoaquisicaopdf

Brasil (2009) Anaacutelise dos registros do consumo alimentar no SISVAN Web Availablefrom httpnutricaosaudegovbrdocsboletimSisvanconsumo_alimentar_sisvan_webpdf

Brasil (2010a) Pesquisa de orccedilamentos familiares 2008ndash2009 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE (Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_aquisicaopof20082009_aquisicaopdf)

Brasil (2010b) Pesquisa de orccedilamentos familiares 2008ndash2009 Antropometria e estadonutricional de crianccedilas adolescentes e adultos no Brasil Rio de Janeiro IBGE(Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_encaapof_20082009_encaapdf)

Brasil (2011) Censo Demograacutefico 2010 Caracteriacutesticas da populaccedilatildeo e dos domiciacuteliosResultados do universo Rio de Janeiro IBGE (Available from httpwwwibgegovbrenglishestatisticapopulacaocenso2010caracteristicas_da_populacaoresultados_do_universopdf)

Cairns G Angus K Hastings G amp Caraher M (2012) Systematic reviews of theevidence on the nature extent and effects of food marketing to children Aretrospective summary Appetite 62 209ndash215

Cohen D A (2008) Obesity and the built environment Changes in environmentalcues cause energy imbalances International Journal of Obesity (2005) 32(7)S137ndashS142

Cooke L (2007) The importance of exposure for healthy eating in childhood Areview Journal of Human Nutrition and Dietetics 20 294ndash301

Cornwell T B amp McAlister A R (2011) Alternative thinking about starting pointsof obesity Development of child taste preference Appetite 56 428ndash439

Dovey T M Staples P A Gibson E L amp Halford J C (2008) Food neophobia andldquopickyfussyrdquo eating in children A review Appetite 50(2ndash3) 181ndash193

Dransfield E Morrot G Martin J F amp Ngapo T M (2004) The application of atext clustering statistical analysis to aid the interpretation of focus groupinterviews Food Quality and Preference 15(5) 477ndash488

Fiates G M R Amboni R D M C amp Teixeira E (2008) Comportamento consumidorhaacutebitos alimentares e consumo de televisatildeo por escolares de Florianoacutepolis ReviewNutrition 21(1) 105ndash114

Fitzgerald A Heary C Nixon E amp Kelly C (2010) Factors influencing the foodchoices of Irish children and adolescents A qualitative investigation HealthPromotion International 25(3) 289ndash298

Gomes F S (2007) Fruits and vegetables Technical recommendations versus socialconstructs Review Nutrition 20(6) 669ndash680

Guerrero L Guardia M D Xicola J Verbeke W Vanhonacker FZakowska-Biemans S et al (2009) Consumer-driven definition of traditionalfood products and innovation in traditional foods A qualitative cross-culturalstudy Appetite 52(2) 345ndash354

Hawkes C (2008) Dietary implications of supermarket development A globalperspective Development Policy Review 26(6) 657ndash692

Hawkes C amp Lobstein T (2011) Regulating the commercial promotion of food tochildren A survey of actions worldwide International Journal of Pediatric Obesity6(2) 83ndash94

Heath P Houston-Price C amp Kennedy O B (2011) Increasing food familiaritywithout the tears A role for visual exposure Appetite 57(3) 832ndash838

Jansen E Mulkens S amp Jansen A (2010) How to promote fruit consumption inchildren Visual appeal versus restriction Appetite 54(3) 599ndash602

John D R (2008) Stages of consumer socialization The development of consumerknowledge skills and values from childhood to adolescence In C P HaugtvedtP M Herr amp F R Kardes (Eds) Handbook of consumer psychology (p 1273) NewYork Taylor amp Francis Group

Keller K L Kuilema L G Lee N Yoon J Mascaro B Combes A L et al (2012)The impact of food branding on childrenrsquos eating behavior and obesity Physiologyand Behavior 106(3) 379ndash386

Kelly J Turner J J amp McKenna K (2006) What parents think Children and healthyeating British Food Journal 108(5) 413ndash423

Kirby S D Baranowski T Reynolds K D Taylor G amp Binkley D (1995) Childrenrsquosfruit and vegetable intake Socioeconomic adult-child regional and urban-ruralinfluences Journal of Nutrition Education 27(5) 261ndash271

Kroslashlner R Rasmussen M Brug J Klepp K I Wind M amp Due P (2011)Determinants of fruit and vegetable consumption among children andadolescents A review of the literature Part II Qualitative studies The InternationalJournal of Behavioral Nutrition and Physical Activity 8 112

Krueger R A amp Casey M A (2009) Focus groups A practical guide for applied research(4th ed) Thousand Oaks CA Sage Publications

Marshall D OrsquoDonohoe S amp Kline S (2007) Families food and pester powerBeyond the blame game Journal of Consumer Behaviour 6(4) 164ndash181

McGinnis J M Gootman J A amp Kraak V I (2006) Food marketing to children andyouth Threat or opportunity Washington DC The National Academies Press

McNeal J U (2000) Children as consumer of commercial and social productsWashington DC Pan American Health Organization

Mehta K Coveney J Ward P Magarey A Spurrier N amp Udell T (2010) Australianchildrenrsquos views about food advertising on television Appetite 55(1) 49ndash55

Monteiro C A (2009) Nutrition and health The issue is not food nor nutrients somuch as processing Public Health Nutrition 12(5) 729ndash731

Olivares S Lera L Mardones M A Araneda J Bustos N Olivares M A et al (2011)Food promotion and food preferences in Chilean school age children fromdifferent socioeconomic levels Archivos Latinoamericanos de Nutricion 61(2)163ndash171

Oumlzgen Ouml (2003) An analysis of child consumers in Turkey International Journal ofConsumer Studies 27(5) 336ndash380

Patrick H amp Nicklas T A (2005) A review of family and social determinants ofchildrenrsquos eating patterns and diet quality Journal of the American College ofNutrition 24(2) 83ndash92

183AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

choice of EDNP foods (Warren Parry Lynch amp Murphy 2008) Foodpreferences and sensory attributes tend to predominate over nu-tritional knowledge at the time of making food choices ndash the factof knowing what is good or bad for onersquos health is not a strongenough factor to induce good eating habits (Fitzgerald Heary Nixonamp Kelly 2010 Warren et al 2008)

Therefore one can argue that when faced with an environmentwhere EDNP foods are widely available strongly advertised and so-cially desirable children cannot be expected to make consciouslyinformed healthy food choices (Cohen 2008) Stimuli directed at pro-moting healthy eating habits need to be available in all places andsituations namely those identified in the present study Future re-search could focus on testing different strategies appealing to thesenses in strategic places and situations as an effort to increase theconsumption of fruits and vegetables

The use of focus groups enabled the observation of interac-tions behaviors and attitudes that would not have been possiblewith interviews or surveys Regarding data analysis the chosenapproach has its strengths and weaknesses Use of the Alcestesoftware reduces the chances of researcher bias and theneed for complex triangulation methods On the other handas this approach does not require exhaustive reading ofthe corpus it can lead to a distancing between the researcher andthe textual material For this reason it seems best that the sameresearcher responsible for conducting the focus group also be re-sponsible for organizing the textual material and interpreting theresults Also as the method emphasizes a collective representa-tion it is not possible to identify or analyze important but minorinsights

Conclusion

This study was conducted with a group of students from publicschools where EDNP food consumption was severely restricted Thesewere exactly the foods most bought by the children and requestedfrom their parents Supermarkets places where EDNP foods arewidely available and made attractive to consumers due to sophis-ticated marketing strategies were recognized as places where greaterinfluence could be exerted by the children over their parentsrsquo foodshopping Television advertisements and shows appeared as strongmotivators for food ingestion in general not only EDNP foods Con-sumption of EDNP foods was associated with social events and eatingout a situation that emphasizes the pleasure and satisfaction of noteating according to food guidelines Consumption of EDNP is beingfacilitated by a number of factors that cannot be properly ad-dressed by traditional strategies directed to the individual Appeal-ing to the senses and employing visual stimuli to influence theaffective component of childrenrsquos attitudes seems to be a possiblealternative for the promotion of healthy eating Such an approachcould be adopted by social marketing campaigns applied to TV showsand advertisements and also supermarkets Educational strate-gies focused on the sensory and pleasure aspects of ingesting healthyfoods such as fruits and vegetables could help to change the ob-served situation

References

Birch L L (1999) Development of food preferences Annual Review Nutrition 1941ndash62

Brasil (2004) Pesquisa de orccedilamentos familiares 2002ndash2003 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2002aquisicaoaquisicaopdf

Brasil (2009) Anaacutelise dos registros do consumo alimentar no SISVAN Web Availablefrom httpnutricaosaudegovbrdocsboletimSisvanconsumo_alimentar_sisvan_webpdf

Brasil (2010a) Pesquisa de orccedilamentos familiares 2008ndash2009 Aquisiccedilatildeo alimentardomiciliar per capita Rio de Janeiro IBGE (Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_aquisicaopof20082009_aquisicaopdf)

Brasil (2010b) Pesquisa de orccedilamentos familiares 2008ndash2009 Antropometria e estadonutricional de crianccedilas adolescentes e adultos no Brasil Rio de Janeiro IBGE(Available from httpwwwibgegovbrhomeestatisticapopulacaocondicaodevidapof2008_2009_encaapof_20082009_encaapdf)

Brasil (2011) Censo Demograacutefico 2010 Caracteriacutesticas da populaccedilatildeo e dos domiciacuteliosResultados do universo Rio de Janeiro IBGE (Available from httpwwwibgegovbrenglishestatisticapopulacaocenso2010caracteristicas_da_populacaoresultados_do_universopdf)

Cairns G Angus K Hastings G amp Caraher M (2012) Systematic reviews of theevidence on the nature extent and effects of food marketing to children Aretrospective summary Appetite 62 209ndash215

Cohen D A (2008) Obesity and the built environment Changes in environmentalcues cause energy imbalances International Journal of Obesity (2005) 32(7)S137ndashS142

Cooke L (2007) The importance of exposure for healthy eating in childhood Areview Journal of Human Nutrition and Dietetics 20 294ndash301

Cornwell T B amp McAlister A R (2011) Alternative thinking about starting pointsof obesity Development of child taste preference Appetite 56 428ndash439

Dovey T M Staples P A Gibson E L amp Halford J C (2008) Food neophobia andldquopickyfussyrdquo eating in children A review Appetite 50(2ndash3) 181ndash193

Dransfield E Morrot G Martin J F amp Ngapo T M (2004) The application of atext clustering statistical analysis to aid the interpretation of focus groupinterviews Food Quality and Preference 15(5) 477ndash488

Fiates G M R Amboni R D M C amp Teixeira E (2008) Comportamento consumidorhaacutebitos alimentares e consumo de televisatildeo por escolares de Florianoacutepolis ReviewNutrition 21(1) 105ndash114

Fitzgerald A Heary C Nixon E amp Kelly C (2010) Factors influencing the foodchoices of Irish children and adolescents A qualitative investigation HealthPromotion International 25(3) 289ndash298

Gomes F S (2007) Fruits and vegetables Technical recommendations versus socialconstructs Review Nutrition 20(6) 669ndash680

Guerrero L Guardia M D Xicola J Verbeke W Vanhonacker FZakowska-Biemans S et al (2009) Consumer-driven definition of traditionalfood products and innovation in traditional foods A qualitative cross-culturalstudy Appetite 52(2) 345ndash354

Hawkes C (2008) Dietary implications of supermarket development A globalperspective Development Policy Review 26(6) 657ndash692

Hawkes C amp Lobstein T (2011) Regulating the commercial promotion of food tochildren A survey of actions worldwide International Journal of Pediatric Obesity6(2) 83ndash94

Heath P Houston-Price C amp Kennedy O B (2011) Increasing food familiaritywithout the tears A role for visual exposure Appetite 57(3) 832ndash838

Jansen E Mulkens S amp Jansen A (2010) How to promote fruit consumption inchildren Visual appeal versus restriction Appetite 54(3) 599ndash602

John D R (2008) Stages of consumer socialization The development of consumerknowledge skills and values from childhood to adolescence In C P HaugtvedtP M Herr amp F R Kardes (Eds) Handbook of consumer psychology (p 1273) NewYork Taylor amp Francis Group

Keller K L Kuilema L G Lee N Yoon J Mascaro B Combes A L et al (2012)The impact of food branding on childrenrsquos eating behavior and obesity Physiologyand Behavior 106(3) 379ndash386

Kelly J Turner J J amp McKenna K (2006) What parents think Children and healthyeating British Food Journal 108(5) 413ndash423

Kirby S D Baranowski T Reynolds K D Taylor G amp Binkley D (1995) Childrenrsquosfruit and vegetable intake Socioeconomic adult-child regional and urban-ruralinfluences Journal of Nutrition Education 27(5) 261ndash271

Kroslashlner R Rasmussen M Brug J Klepp K I Wind M amp Due P (2011)Determinants of fruit and vegetable consumption among children andadolescents A review of the literature Part II Qualitative studies The InternationalJournal of Behavioral Nutrition and Physical Activity 8 112

Krueger R A amp Casey M A (2009) Focus groups A practical guide for applied research(4th ed) Thousand Oaks CA Sage Publications

Marshall D OrsquoDonohoe S amp Kline S (2007) Families food and pester powerBeyond the blame game Journal of Consumer Behaviour 6(4) 164ndash181

McGinnis J M Gootman J A amp Kraak V I (2006) Food marketing to children andyouth Threat or opportunity Washington DC The National Academies Press

McNeal J U (2000) Children as consumer of commercial and social productsWashington DC Pan American Health Organization

Mehta K Coveney J Ward P Magarey A Spurrier N amp Udell T (2010) Australianchildrenrsquos views about food advertising on television Appetite 55(1) 49ndash55

Monteiro C A (2009) Nutrition and health The issue is not food nor nutrients somuch as processing Public Health Nutrition 12(5) 729ndash731

Olivares S Lera L Mardones M A Araneda J Bustos N Olivares M A et al (2011)Food promotion and food preferences in Chilean school age children fromdifferent socioeconomic levels Archivos Latinoamericanos de Nutricion 61(2)163ndash171

Oumlzgen Ouml (2003) An analysis of child consumers in Turkey International Journal ofConsumer Studies 27(5) 336ndash380

Patrick H amp Nicklas T A (2005) A review of family and social determinants ofchildrenrsquos eating patterns and diet quality Journal of the American College ofNutrition 24(2) 83ndash92

183AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184

Pope C amp Mays N (1995) Qualitative research Reaching the parts other methodscannot reach An introduction to qualitative methods in health and health servicesresearch British Medical Journal 311 42ndash45

Popkin B M (2006) Global nutrition dynamics The world is shifting rapidly towarda diet linked with noncommunicable diseases The American Journal of ClinicalNutrition 84 289ndash298

Reiner M (1986) Un logiciel drsquoanalyse lexicale Alceste Les cahiers de lrsquoAnalyse desDonnersquoes 4 471ndash484

Santa Catarina (2001) Dispotildee sobre criteacuterios de concessatildeo de serviccedilos de lanches ebebidas nas unidades educacionais localizadas no Estado de Santa Catarina Leindeg 12061 2001

Savage J S Fisher J O amp Birch L L (2007) Parental influence on eating behaviorConception to adolescence The Journal of Law Medicine and Ethics A Journal ofthe American Society of Law Medicine and Ethics 35(1) 22ndash34

Silveira B M Kliemann N Silva D P Colussi C F amp Proenccedila R P C (2012)Availability and price of food products with and without trans fatty acids in food

stores around lower- and medium-income elementary schools Ecology of Foodand Nutrition 52(1) 63ndash75

Skidmore P Welch A van Sluijs E Jones A Harvey I Harrison F et al (2009)Impact of neighborhood food environment on food consumption in children aged9ndash10 years in the UK SPEEDY (Sport Physical Activity and Eating behaviourEnvironmental Determinants in Young people) study Public Health Nutrition 13(7)1022ndash1030

Warren E Parry O Lynch R amp Murphy S (2008) lsquoIf I donrsquot like it then I can choosewhat I wantrsquo Welsh school childrenrsquos accounts of preference for and control overfood choice Health Promotion International 23(2) 144ndash151

Wilson G amp Wood K (2004) The influence of children on parental purchases duringsupermarket shopping International Journal of Consumer Studies 24(4) 329ndash336

World Medical Association (2000) Declaration of Helsinki Human subjects ethicalprincipals for medical research Journal of the American Medical Association 2843043ndash3045

184 AC Mazzonetto GMR FiatesAppetite 78 (2014) 179ndash184