Fans tuning in to nationally televised National Football League (NFL) games are bombarded with advertisements for snacks and meals loaded with calories, fat, and salt, a new analysis has found.

Among 102 food-related commercials recently aired during 10 NFL games, the advertised products contained a median of 490 kcal and 910 mg of sodium. Some of the advertised meals from fast-food chains, such as Panera Bread and Little Caesars, contained a whopping 1,400 kcal and exceeded the daily recommended allowance for sodium.

Senior investigator Paul J. Hauptman, MD (University of Nevada, Reno), pointed out that the NFL season runs for 17 weeks, plus playoffs, and games air 3 nights per week. Given the pervasiveness of the games and frequency of advertisements, dietary discussions can be individualized by delving into the patient’s viewing habits.

“It wouldn’t be wrong, based on these data, if you’re in a discussion with the patient to ask around the time of the Super Bowl or at the start of the NFL season: do you watch a lot of sports on television?” he told TCTMD. “’I just want to let you know that a lot of the foods that are advertised are really high in sodium.’”

Hauptman, along with lead investigator Lara Al-Zoubaidi (Saint Louis University, MO), emphasized that they are not making policy recommendations with these data, but instead are reminding physicians and patients about the importance of a healthy diet. “Poor dietary choices are maladaptive to both the primary and secondary prevention of various cardiovascular diseases and other chronic health conditions,” Al-Zoubaidi told TCTMD.

The new study, which was published today in JAMA Network Open, comes a little more than a week before an estimated 100 million Americans will tune in for Super Bowl LIX in New Orleans, LA.

I’m not saying that the individual doesn’t need to exert different forms of self-control and educate themselves, but we’re asking them to do an awful lot in an environment that’s really pushing the opposite. Maya Vadiveloo

Maya Vadiveloo, PhD, RD (University of Rhode Island, Kingston), chair of the American Heart Association’s Lifestyle Nutrition Committee, said the public perception is that Panera Bread is “healthier” than Burger King, so the sodium and calorie counts may surprise some people.

In terms of how to counteract the avalanche of advertising, Vadiveloo said there should be an effort to make people aware that these foods are being promoted to them without any consideration of the long-term impact on their health. Beyond the individual, she would like to see a restriction on the amount of advertising for unhealthy foods given the widespread availability and cheap prices.

The US dietary guidelines, as well as the AHA, currently recognize the importance of the food environment when it comes to making food choices, she added.

“It’s been a slow growth in how much emphasis is being put on the fact that our environment really shapes a lot of our food decisions and trying to reduce a little bit of the sort of finger wagging that we put on the individual,” she said. “I’m not saying that the individual doesn’t need to exert different forms of self-control and educate themselves, but we’re asking them to do an awful lot in an environment that’s really pushing the opposite.”

Nearly 3 g of Sodium in Single Meal

The most recent Dietary Guidelines for Americans recommend people consume less than 2,300 mg/day of sodium. The American Heart Association suggests a similar target, although they add that a daily target of 1,500 mg/day is probably ideal. US dietary guidelines recommend less than 10% of daily calories come from saturated fat.

For the study, Al-Zoubaidi and colleagues analyzed ads from games taking place September to November 2023. The ads ran for 15 to 20 seconds and included store-bought foods, such as chips and chocolate bars, as well as items from high-volume restaurant chains. The store-bought foods tended to be lower in calories, fat, and sodium content, but many were high in sugar.

Ads from Little Caesars, which ran the most during the study period, included items that contained 1,370 kcal, 76 g of fat, and 2,820 mg of sodium, on average. The items from Burger King had 1,284 kcal, 55 g of fat, and more than 1,500 mg of sodium, while Panera Bread’s advertised food contained 1,410 kcal, 76 g of fat, and 2,560 mg of sodium. There were also ads from Domino’s Pizza, Jersey Mike’s Subs, Papa John’s, Subway, Taco Bell, and Wingstop.

Total sodium content for all the ads ranged from 25 mg to 2,850 mg, while fat ranged from 3 g to 76 g. Calorically, the foods ranged from 87 to 1,410 kcal, and added sugars ran as high as 59 g.

Hauptman and Al-Zoubaidi said the results aren’t unexpected, noting that the nutritional information was easy to find online. Al-Zoubaidi pointed out, though, that some of the information, such as recommendations around the daily intakes of calories, fat, and sodium, could be buried in the fine print. Both researchers noted, though, that the frequency of ads for these unhealthy foods took them aback.  

To TCTMD, Vadiveloo said most people would be caught off guard by the amount of sodium in some of these advertised foods and noted that some changes have been proposed to make people more aware, at least at the grocery store. The US Food and Drug Administration is currently proposing “front-of-package” nutritional labeling about saturated fat, sodium, and added sugars on packaged foods. The intention is that consumers would see this information when they make purchasing decisions.

Whether package labels, or nutritional information accompanying advertising, would change behavior is an area of intense research at the moment, said Vadiveloo. “The pure informational pieces are relatively ineffective at behavior change, because it’s a lot of cognitive information for people to process and interpret and to know benchmarks at the time of making a food decision,” she told TCTMD.