The impact of food marketing advertisements on children and teens remains controversial, as evidenced by a U. S. Senate Hearing on September, 23, 2008, and several Federal Trade Commission reports (2006, 2008). Reviews by the Institute of Medicine and World Health Organization (WHO, 2003), Institute of Medicine (McGinnis, Gootman, & Kraak, 2005), and United Kingdom Food Standards Agency (Hastings, Stead, McDermott, Forsyth, MacKintosh, Rayner, et al 2003) conclude that although there is sufficient evidence linking television viewing overall to both consumption and adiposity, more research is needed into the links between advertising and consumption of high-caloric low-nutrient foods among children and teenagers. The need is particularly great for research on adolescents. The aim of the study is to disentangle the contributions of television viewing, food advertising, and pro-nutrition public service announcements (PSAs) to children's and adolescents' food consumption and health outcomes, controlling for factors identified in the literature as potential moderators of food marketing effects. We propose to examine the relationships using a novel approach - a multilevel analysis of differences in children's and adolescents' food consumption and health outcomes by the media markets in which they live, given that markets vary in the amounts of spending per capita on advertising for healthy and unhealthy foods and PSAs. This approach has been used to examine the impact of tobacco and alcohol advertising (e.g. Snyder et al., 2006) but not food marketing. We will conduct a multilevel analysis of four large national datasets that contain food consumption and health outcome data at the individual level, combined with industry data on the monetary value of advertising for particular products and PSAs per media market. Two cycles of the National Health and Nutrition Examination Survey contain consumption and health outcome data on children and teens. The Early Childhood Longitudinal Studies (ECLS-B and ECLS-K) contain food consumption and BMI data for children in preschool and 5th grade. The results should inform the debate about the effects of food marketing for unhealthy products on children. The study should also contribute to our understanding of the collective effect of existing PSAs and advertising for healthy food products, informing future efforts to promote good nutrition among children. PUBLIC HEALTH RELEVANCE: Prior research has established that television viewing relates to obesity, but it is not clear whether it is due to the advertising on television or some other factor of viewing television. The purpose of the proposed study is to understand how advertising affects the food choices and health status of children and adolescents. The answers are important to public health given the scope of the obesity epidemic among young people, and have the potential to inform future public health interventions and policy recommendations.