|Year : 2018 | Volume
| Issue : 3 | Page : 220-225
Content analysis of sugar portrayal in online newspapers of Delhi, India
Shivam Kapoor1, Swati Jain1, Vikrant Mohanty1, Aswini Y Balappanavar1, Puneet Chahar2
1 Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
2 Department of Public Health Dentistry, Manav Rachna Dental College, Faridabad, Haryana, India
|Date of Submission||01-May-2018|
|Date of Acceptance||11-Jun-2018|
|Date of Web Publication||6-Aug-2018|
Dr. Shivam Kapoor
Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, MAMC Campus, BSZ Marg, New Delhi - 110 002
Source of Support: None, Conflict of Interest: None
Background: The role of sugars on health and specifically on oral health is well evident in scientific literature. However, information regarding sugar portrayal in print media is quite limited. Objectives: To determine “Sugar Portrayal” in English newspapers (online version), a 1-year media content analysis of newspaper stories from Delhi (India) was conducted. Methods: Media content analysis was conducted by an online search for news stories in the two most popular Delhi English newspapers for daily and their Sunday equivalents. A total of 3648 newspaper articles and opinion pieces appearing over a period of 1 year (October 1, 2015, until September 30, 2016) were retrieved after entering selected “keywords.” The articles were reliably coded for overall frame and type of article. The data were entered in MS Excel and analyzed using SPSS version 21 (IBM Inc., Chicago, IL, USA). Results: It was inferred that the print media generally advertise sugar recipes and industry, invariably in state-wide context with either a negative or neutral slant. Although there was mention regarding benefits as well as harmful effects in the news stories, yet coverage often lacked detailed health information. Conclusions: The current study found out that there was relatively wider state-wide coverage of sugar, with very narrow focus on public health facts. More accurate information would permit the individuals to make more informed decisions regarding their own behavior.
Keywords: Content analysis, India, newspapers, printed media, sugars
|How to cite this article:|
Kapoor S, Jain S, Mohanty V, Balappanavar AY, Chahar P. Content analysis of sugar portrayal in online newspapers of Delhi, India. J Indian Assoc Public Health Dent 2018;16:220-5
|How to cite this URL:|
Kapoor S, Jain S, Mohanty V, Balappanavar AY, Chahar P. Content analysis of sugar portrayal in online newspapers of Delhi, India. J Indian Assoc Public Health Dent [serial online] 2018 [cited 2021 May 17];16:220-5. Available from: https://www.jiaphd.org/text.asp?2018/16/3/220/238594
| Introduction|| |
Health is multidimensional and encompasses a variety of domains. It is an attribute of individuals rather than environments, i.e., through aggregate measures of sociobehavioral factors, diet, lifestyle, habits, and so on.
A paradigm change is evident from communicable diseases to the rising number of noncommunicable diseases (NCDs). The most important risk factors being high blood pressure, inadequate consumption of fruit and vegetables, overweight or obesity, physical inactivity, etc. Many of these factors are closely related to diet. NCDs are closely interlinked to oral diseases which are recognized as a worldwide epidemic through sharing common risk factors (e.g., excess sugar consumption and tobacco use).,
A dynamic relation exists between sugar intake in the diet and oral health. Sugars and other fermentable carbohydrates in diet, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH, resulting in tooth demineralization., The two-way relationship between diet and oral health is well documented in scientific literature and the same needs to be available to the general population.
The WHO too recognizes the understanding of the social determinants of health among the general public as the significant tool toward health literacy capable of changing the concepts toward the right direction at grass-root level. The media can play a central role in promoting the knowledge of health as well as shaping our understanding of medicine and science in general. Research has shown that “print media's dissemination of health information is important in shaping public beliefs and behavior.”, Print news in particular can be seen as an integral source of public policy and being available in all languages and accessible to all communities; newspapers enjoy a wide readership. This becomes further relevant in a culturally diverse country like India.
The exponential growth of the Internet and the increased reliance on digital information have revolutionized online newspapers, with the advantage of wider accessibility and ease of availability. In such a scenario, content analysis of the print media can be a viable tool to assess the nature of health-related information being published and available at the population level. Content analysis is a research tool used to determine the presence of certain words or concepts within texts or sets of texts. Researchers quantify and analyze the presence, meanings, and relationships of such words and concepts, and then make inferences about the messages within the texts, the writer(s), the audience, and even the culture and time, of which these are a part. This would further help in understanding the basic mindset of the masses for a particular health condition depending on the nature of the information available.
The role of sugars on health and specifically on oral health is well established even by the WHO. Accordingly, it has been suggested that limiting the intake of free sugars to <10% and 5% of total energy intake,, is part of a healthy diet. Such information should ideally be readily available to masses through print and electronic media to comply with the concept of health promotion.
In a previous study, the extent of media-based public health (PH) advocacy versus pro-industry messaging regarding sugar-sweetened beverages (SSBs) in all mainstream British newspapers was conducted. It was observed that SSBs were frequently published in mainstream British print newspapers.
However, limited literature exists on the content analysis of Indian Daily newspapers. No previous studies have been found that analyzed the sugar portrayal in Indian newspapers. Hence, the present study was conducted with an aim to analyze the “Sugar Portrayal” in two English newspapers (online version) for 1 year. This would further help in analyzing the concept-tilting facts available through mass media.
| Methods|| |
The news media can highlight and frame certain aspects and play a role in steering policymakers for decision-making. On these grounds, the present study employed conceptual content analysis for two leading English newspapers (online version): Hindustan Times (newspaper 1) and Times of India (newspaper 2), with top circulation in Delhi. Delhi is the national capital territory and the most populous urban agglomeration in India, 2nd largest urban area in the world, and ranks 10 in literacy rate in India as per the Census 2011.,
Data extraction strategy
A standardized extraction method using the selected keywords was prepared and the newspapers were searched retrospectively [Figure 1]. The data set included all the articles retrieved after entering the selected keywords: “Sugar,” “Sugars” OR “Sweet,” OR “Sweetness” for the time period of October 1, 2015, until September 30, 2016. Only articles containing these exact words were included in the analysis. A pilot study was conducted for 10 days screening articles that featured in 1-month period (October 1, 2015, until October 31, 2015). This helped in mapping out the focus areas; henceforth, the core variables were enlisted [Table 1]. A codebook was developed as an adaptation of Eckler et al.
The various variables were categorized and coded as discussed by the two authors. The frequency of appearance of each coding was analyzed using a frequency count. The unit of analysis was the news story.
The headlines, subhead, and text of all articles were analyzed descriptively. The full text of each article was reviewed by SK and SJ for the emerged study variables over a period of 2 months. Cohen's κ across all themes was 0.82, representing a substantial agreement. Disagreements (if any) were resolved by discussion between the two authors.,,
Articles were excluded if they were duplicates (articles published around the same time, with the same number of words in the same publication and duplicating text) or only had a passing mention to the selected keywords. A total of 1896 (newspaper 1) and 1752 (newspaper 2) stories were collected which represented the whole universe (news stories/editorials) for the specified 1-year time period. As the content analysis employs a census approach, the sampling variation is 0.
A total of six main coding categories were formed and analyzed: (1) appearance of keywords, (2) regional news coverage, (3) theme, (4) news format, (5) pitch of event, and (6) public health cue.
Appearance of keywords
It includes appearance of keywords in (1) headline, (2) subhead, (3) text, and (4) combination.
Regional news coverage
The geographic place in which the story's event, issue, feature, or editorial took place was categorized as follows: (1) local (the news story occurred in the local town in which the newspaper is located), (2) state (occurred in the state, i.e., Delhi in which the newspaper resides), (3) national (occurred anywhere else in India except for Delhi), (4) international (occurred outside of India).
The principal subject that centered the news story was subcategorized into six heads: (1) health benefits of refined sugar; (2) harmful health effects of refined sugar; (3) sugar addiction; (4) sugar restrictions; (5) sugar pricing; and (6) others. Coding preferred a hierarchical order by examining the headline first, subhead, and text afterward. For instance, if the headline was about ‘'Sweets can help you stay in shape’' (Times of India, November 15, 2015), the ‘'Health benefits of refined sugar” topic was selected. In cases where the headline was ambiguous and the examiner was unsure which topic to code, henceforth, the first sentence (and no more than the first paragraph) of the story was taken into consideration.
The news format coverage was primarily classified as: (1) event/issue, i.e., a story that is happening currently or recently happened; (2) feature was defined as a special story or article that is not “the current talk of the town,” but was distinguished by writing style; and (3) editorial included opinions/letter to the editor/briefings/commentaries.
Pitch of event
The fundamental philosophy amalgamated with the tone of the news which is presented to the readers was referred to as “Pitch of event.” The focus was on how the news story presented information for and against excessive sugar intake. There were four options: (1) “positive” for sugar restrictions/taxation/health benefits of reduced sugar intake/stories that supported additional education/sugar substitutes/anti-sugar policies, efforts/overall beneficial effects of optimum sugar in diet, etc.; (2) “negative” for sugar addiction and other harmful effects of sugar consumption; (3) “mixed impact” on readers was events or issues illustrating some good and some bad news in the same relation; and (4) “not specified” contained the other horde of news stories.
Public health cue
Initially, five categories were considered; however, during the course of the study, the two prime areas were identified and the rest were clubbed as “others.” Henceforth, the three types of cues to PH about sugar were health effects, financial aspects, and others. Health effects were the consequences related to sugar consumption (beneficial or harmful). Financial aspects covered economic expenses/burden due to PH problems at familial, community, city, state, or national levels. Others category comprised of PH comparing dietary sugar consumption within the states, nations, or worldwide; news stories drawing parallels for sugar industry to others (workers and working conditions); and sugar farming. PH cues were determined by probing each sentence of the news stories.
The reporting style could be helpful in influencing public policy; hence, the sensitivities grounded in reporting should be realized. Studies in the past have discussed that popular media can be imbalanced and miss out important information and may focus on advertising.,,, The present study attempted for descriptive analysis of the sugar portrayal in the newspapers and any such hypothesis regarding pro or anti sugar slant was not decided initially, since this was a descriptive study about the sugar portrayal. Thus, the articles were examined for the perspectives presented and the types of reasons or arguments presented either for or against the particular access issue portrayed in the news articles.
Chi-square test was conducted to draw comparisons between the two newspapers (P < 0.05). Statistical analyses were performed using SPSS version 21 software package (IBM Inc., Chicago, IL, USA).
| Results|| |
A total of 1896 articles from newspaper 1 and 1752 articles from newspaper 2 published during 1-year period were retrieved for content analysis. The analysis showed that keywords for the online search appeared in the headline for most of the articles (51.9%) followed by the text (35.2%) for newspaper 1; however, in newspaper 2, keywords were more likely observed in the text (83.9%). Regarding the regional coverage of the articles, mostly, the news published was from the local state in both the newspapers [43.7% and 44.4%, respectively, [Figure 2]. The international news coverage was found to be more in newspaper 2 (31.5%) as compared to newspaper 1 (14.8%), the difference being statistically significant [P < 0.001; [Figure 3].
|Figure 2: Appearance of keywords in the newspapers. Chi-square test, P < 0.001|
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|Figure 3: Regional coverage of “sugar” in print media. Chi-square test, P < 0.001|
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On assessing the theme of the news articles published concerning “Sugar and sweetness,” it was interesting to note that, in both the newspapers, majority of the articles discussed about sugar-containing recipes or sugar industries. Only 24.1% and 26.5% articles, respectively, in newspapers 1 and 2 highlighted the harmful effects of sugar and sugary products [P < 0.001; [Table 2].
Mostly, the articles in newspaper 1 were of editorial format (38.9%) in comparison to feature format [66.1%, P < 0.001; [Figure 4]. Regarding the pitch of the articles, it was observed that only 37% of newspaper 1 and 8.1% of newspaper 2 stories had a negative slant for the sugar and sugary products [Table 3]. During that period, most of the stories could not convey specific PH impact. Only 35.2% and 15.3% of the articles published in newspapers 1 and 2, respectively, highlighted the health effects/consequences of sugar intake, the difference being statistically significant [P < 0.001; [Table 4]. In addition, front page stories varied from 1.6% in newspaper 2 to 30.7% in newspaper 1.
|Figure 4: Story-type coverage of “sugar” portrayal. Chi-square test, P < 0.001|
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|Table 4: Public health cue regarding sugar portrayal in online newspapers|
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| Discussion|| |
Print media plays a pivotal role in enlightening the civic about what happens in the world. Health coverage contributes as one such area. Moreover, the appearance of the keywords in the headline or main text of the news articles highlights the connotation of the topic. Headlines play a huge role in the popularity of worthy content. Data from the present study revealed that majority of the articles had appearance of keywords in the headlines for newspaper 1 [Figure 2], which indicates the due importance given to the focus of topic “sugar and sweetness.” However, in newspaper 2, the headlines were only indicative of the content and did not clearly state the subject of the article. Such articles gain less attention from the readers and have limited outreach as far as focus of the article is concerned.
The regional news coverage is another parameter which creates impact on the readers. A balance of both national and international news coverage is required to upkeep the reader's interest. It was observed that majority of the articles in both the newspapers featured news stories pertaining to Delhi [Figure 3]. This could be due to the fact that we targeted the online version for Delhi specifically but not the editorials of the other Indian states. It could also be attributed to the culturally influenced Indian nation, wherein the regional diversity influences the readers' choice. Similar results have been reported by Chen that local (48.5%) and regional (25.6%) stories were far more popular than international stories (17%).
Newspapers have immense potential for influencing health awareness facts on diverse issues such as health and hygiene. The health effects of sugar and its products are well documented and understood among the health professionals, but in the present study, the focus of the articles was found to paint a blurred picture (such as recipes and sugar markets) [Table 2]. This was contrary to the findings of Paul and Singh, wherein almost 55.1% of the articles published were health related, and injury-related articles formed the bulk among the published health articles. The findings of the present study could be attributed to the keyword-specific research, which might have resulted in limited outcomes.
The format of most of the news articles was editorial type in newspaper 1 [Figure 4]. Editorial is a type of news story which is used to develop an argument about an issue and even sway readers' opinions. This is an encouraging finding as it depicts that the articles published had the clout to influence the readers' frame of mind. However, in newspaper 2, the articles were mostly a feature category. A feature article is more in depth than a traditional hard news article and uses various types of storytelling devices and details like that in novels. Feature stories are considered soft news and do not focus merely on the basic facts. This highlights the lack of understanding regarding the gravity of sugar effects on health. At least 17.4% and 15.3% of the articles published in newspapers 1 and 2, respectively, had a positive slant toward sugar portrayal [Table 3]. News that appears on newspaper front pages is intended to reach a wider audience and sticks with the readers for a longer period. In our study, the coverage was found to vary from 1.6% in newspaper 2 to 30.7% in Newspaper 1.
Majority of the articles (46.2% and 71.0%) that featured during this 1-year study period did not envision any significant PH cues regarding “sugar” [Table 4]. This highlights the limited role of the selected newspapers in escalating the existent knowledge base of the masses. Although this finding might be due to the limitation of the study, wherein only two online English newspapers were assessed, there were fewer PH stories that portrayed the beneficial role of sugar as “Sugar before a long run kills fatigue” (Times of India, December 02, 2015); “Sweets can help you stay in shape?” (Times of India, November 15, 2015). The exceptionally strong evidence establishing the causal relationship between sugars and dental caries,, featured in many editorials and opinions. However, there was a constant mention regarding “Sugar-free drinks are equally bad for your teeth” (Times of India, December 01, 2015).
Although the hotly debated issue of “whether a ‘fat' or ‘sugar' tax can be an effective mechanism” appeared in these newspapers (Times of India, December 28, 2015, and Hindustan Times, August 19, 2016), yet, the readers received bits and pieces as compared to the growing scientific evidence [Table 3].,, In addition, the lack of evidence on sugar addiction and the hostility toward its premature incorporation into the scientific literature were reflected in the passing coverage of “sugar addiction and addicts” stories (Hindustan Times, September 11, 2015). Media should take an initiative to inform people about the lesser known facts of sugar.
Some limitations of the study should be noted. First, it is limited to the online versions only of the two Delhi publications, so the results may not be representative of the bigger picture presented to the public. The articles were only scrutinized for content and not for authenticity of the information presented, as this not being our aim. The cues to PH were restricted to two main types broadly, which may not have captured other types that may be present. Further, multilingual longitudinal country-based qualitative analysis of both print and online media can remedy these limitations.
| Conclusions|| |
This is the first study to examine the content of newspaper articles addressing the sugar portrayal in Indian media. While the majority of newspapers pitched a neutral or negative slant focusing more on state-wide coverage, very few PH facts were discussed and features lacked detailed health information. Examining the articles presenting the sugary snapshot from media's point of view raises many questions on future endeavors such as: Is it a missed opportunity to educate public on healthy behaviors? Is PH media coverage creating significant impact on the masses, particularly around sugar habits and advocacy? As strongly entitled, “the most widely disseminated of all forms of literature,” are newspaper insights an effective health promotion strategy? Moreover, it is important for researchers not only to scrutinize media coverage, but also to work with journalists on the accuracy and appropriateness of the information cited, since this would permit the public to make more informed decisions regarding their own behavior. Further studies are also needed to look into the complex relationships between media and PH impact.
The authors thank the anonymous reviewers for their constructive comments and valuable suggestions.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Chatterji S, Ustün BL, Sadana R, Salomon JA, Mathers CD, Murray CJ. The Conceptual Basis for Measuring and Reporting on Health. GPE Discussion Paper No 45. Global Programme on Evidence for Health Policy. Geneva: World Health Organization; 2001. Available from: http://www.who.int/healthinfo/paper45.pdf
. [Last accessed on 2017 Apr 20].
Sheiham A, Watt RG. The common risk factor approach: A rational basis for promoting oral health. Community Dent Oral Epidemiol 2000;28:399-406.
Jin LJ, Lamster IB, Greenspan JS, Pitts NB, Scully C, Warnakulasuriya S, et al.
Global burden of oral diseases: Emerging concepts, management and interplay with systemic health. Oral Dis 2016;22:609-19.
Touger-Decker R, van Loveren C. Sugars and dental caries. Am J Clin Nutr 2003;78:881S-92S.
Lai WY, Lane T, Jones A. Sources and coverage of medical news on front pages of US newspapers. PLoS One 2009;4:e6856.
Paul S, Singh AB. Coverage of health-related articles in major local newspapers of Manipur. J Educ Health Promot 2016;5:3.
Elliott-Green A, Hyseni L, Lloyd-Williams F, Bromley H, Capewell S. Sugar-sweetened beverages coverage in the British media: An analysis of public health advocacy versus pro-industry messaging. BMJ Open 2016;6:e011295.
Eckler P, Rodgers S, Everett K. Characteristics of community newspaper coverage of tobacco control and its relationship to the passage of tobacco ordinances. J Community Health 2016;41:953-61.
Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960;20:37-46.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
Hellyer NE, Haddock-Fraser J. Reporting diet-related health issues through newspapers: Portrayal of cardiovascular disease and type 2 diabetes. Health Educ Res 2011;26:13-25.
Rachul C, Caulfield T. The media and access issues: Content analysis of Canadian newspaper coverage of health policy decisions. Orphanet J Rare Dis 2015;10:102.
MacKenzie R, Chapman S, Barratt A, Holding S. “The news is [not] all good”: Misrepresentations and inaccuracies in Australian news media reports on prostate cancer screening. Med J Aust 2007;187:507-10.
Abelson J, Collins PA. Media hyping and the “Herceptin access story”: An analysis of Canadian and UK newspaper coverage. Healthc Policy 2009;4:e113-28.
Habel MA, Liddon N, Stryker JE. The HPV vaccine: A content analysis of online news stories. J Womens Health (Larchmt) 2009;18:401-7.
Happer C, Philo G. The role of the media in the construction of public belief and social change. J Soc Pol Psychol 2013;1:321-36.
Leask J, Hooker C, King C. Media coverage of health issues and how to work more effectively with journalists: A qualitative study. BMC Public Health 2010;10:535.
Afshin A, Peñalvo JL, Del Gobbo L, Silva J, Michaelson M, O'Flaherty M, et al.
The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis. PLoS One 2017;12:e0172277.
Ahmed SH, Guillem K, Vandaele Y. Sugar addiction: Pushing the drug-sugar analogy to the limit. Curr Opin Clin Nutr Metab Care 2013;16:434-9.
Westwater ML, Fletcher PC, Ziauddeen H. Sugar addiction: The state of the science. Eur J Nutr 2016;55:55-69.
Zero DT. Sugars – The arch criminal? Caries Res 2004;38:277-85.
Park K. Park's Textbook of Preventive and Social Medicine. 23rd
ed. Jabalpur: Bhanot Publishers; 2013. p. 854.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3], [Table 4]