# Impact of changing restaurant advertising on weight gain and disparities

> **NIH NIH U54** · DANA-FARBER CANCER INST · 2022 · $53,379

## Abstract

Summary. Obesity is associated with 13 cancers and up to 11% of cancer in the United States is associated 
with excess body mass index (BMI). Evidence suggests that the food environment is associated with obesity 
risk, which affects one third of adults. Restaurants are an important component of the food environment. Onethird of Americans will eat at a fast food restaurant on a typical day. Restaurant sales have steadily increased 
over the past 5 decades; in 2015 restaurants spent $6.3 trillion in advertising (more than 100 times the NIH 
budget). Advertisements for unhealthy items are often targeted towards those at higher risk for obesity, and 
unhealthy food retail outlets, like fast food restaurants, are more densely located in low-income and minority
communities. Therefore, the restaurant environment may more negatively impact low-income and racial 
minority populations. To date, research on the relationship between restaurant advertising and obesity risk has 
largely focused on children. Available studies are limited by cross-sectional data (limiting identification of 
causal relationships). To address these knowledge gaps, we will combine multiple data sources to create a 
unique, objective measure of local per capita restaurant advertising (adapting an approach we previously 
developed). This will be derived from local-level quarterly restaurant advertising spending from Kantar Media 
for the 100 top revenue generating restaurants in the U.S. and the annual physical addresses for all locations 
from each restaurant chain from AggData. We will test associations of restaurant advertising per capita with 
population weight gain using objectively measured BMI data for 2.3 million people (in 217 counties across 40 
states and the District of Columbia, including 9 of the 10 most populous U.S. counties) from athenahealth. We 
will test whether this relationship is mediated by advertising exposure using data from Neilson Ad Intel. The 
overall objective is to leverage national data and provide a much-needed understanding of how exposure to 
changes in local restaurant advertising impacts adult weight gain and disparities. We propose two specific 
aims: 1) examine changes in chain restaurant advertising expenditures from 2012 to 2016 and test whether 
those changes vary by income and race/ethnicity and 2) estimate the associations between chain restaurant 
advertising and weight gain among U.S. adults, by race and SES and whether this relationship is mediated by 
the level of exposure to advertising. We will use a set of econometric techniques to assess whether these 
relationships are causal. We hypothesize that increases in restaurant advertising per capita were larger in 
areas with higher concentrations of racial/ethnic minority and low-income populations and that greater 
exposure to restaurant advertising will be associated with higher weight gain, particularly for low-income and 
racial/ethnic minority populations and those with higher ad...

## Key facts

- **NIH application ID:** 10490382
- **Project number:** 5U54CA156732-12
- **Recipient organization:** DANA-FARBER CANCER INST
- **Principal Investigator:** Briana Joy Kennedy Stephenson
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $53,379
- **Award type:** 5
- **Project period:** 2010-09-27 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10490382

## Citation

> US National Institutes of Health, RePORTER application 10490382, Impact of changing restaurant advertising on weight gain and disparities (5U54CA156732-12). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10490382. Licensed CC0.

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