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NHS Direct Health News

NHS Choices: Behind the headlines   + / -  
last updated: Tue, 28 Jun 2016 20:17:38 GMT

 Tue, 28 Jun 2016 15:30:00 GMT Is 'Disney Princess culture' a bad influence on young girls?

"Disney princesses such as Elsa from Frozen can damage young girls' body esteem," the Daily Mail reports – inaccurately.

The study the news comes from actually found a more complex pattern of influences on both girls and boys.

Disney Princesses™ – from Elsa all the way back to Snow White – have become both cultural icons and a multibillion-dollar industry in terms of films, toys and costumes sales.

But concerns have been expressed that "princess culture" could lead to body esteem issues in young girls, as Disney Princesses tend to be slim, pretty, and often with an improbably small waist.

Researchers talked to both parents and children to assess what types of influences exposure to princess culture may have.

They found a link between young girls watching more princess media, identifying with princesses, and playing with princess toys over a year, and higher levels of female gender stereotypical behaviour.

One of the ways this manifested was in a preference for playing with dolls and tea sets over action figures and tool sets.

Despite media reports, princess exposure was not associated with poor body image in girls. But it did affect boys, who had higher self-esteem, as they apparently identified with the various dashing young male leads.

It may be a good idea to show your daughters that there are alternative role models and other things they can aspire to – such as being a doctor, scientist, engineer, pilot or astronaut, to name a few.

Where did the story come from?

The study was carried out by researchers from Brigham Young University, Texas Tech University and Linfield College in the US, and was funded by the Women's Research Initiative.

It was published in the peer-reviewed journal Child Development.

The media reporting was generally accurate, but many of the headlines were misleading. Both the Mail and The Guardian stated that princess culture damaged girls' self-esteem.

The study actually found no effect on girls' self-esteem. The lead author suggested that a study with a longer follow-up period may find a detrimental effect, but this remains to be seen.

The study's limitations were also not discussed in the media reporting. For example, it found links, but couldn't prove cause and effect, or provide new evidence on whether the effects on boys and girls were good or bad.

The implications of the study were provided by the authors based on other evidence and insight.

What kind of research was this?

This longitudinal study looked at how Disney Princess media and merchandise might affect young children's gender-specific behaviour, body image and positive social behaviour (such as helping others).

TV, film and other media play a large and influential role in shaping young children's expectations about their own gender, particularly in young girls.

Disney Princess films like Frozen represent an extremely popular and profitable source of influence on young girls, but contain idealised images of princesses.

The study says that the Disney Princess industry generated more than US billion in global sales in 2012.

This study investigated whether there was any link between the amount of exposure to Disney Princesses – through film, merchandise, clothing and more – and gender-specific behaviour, body image and social behaviour over the course of about a year.

This study type can't prove cause and effect, as there are many other sources of gender role influence and expectation.

Parents, teachers, friends, music videos and social media are just some strong additional factors that are part of the social pressure that shapes gender norms in different societies.

What did the research involve?

The researchers studied 198 girls and boys aged from 3 to 6.5 years from four US schools.

They started by taking baseline measurements of their gender-related behaviour, tracked their exposure to Disney Princess material over a year, and tested them again for any changes.

The children's teachers and parents provided most of the information, but there was also a toy test for the children.

The adults filled in questionnaires to establish their children's exposure to Disney Princesses: the amount of time spent watching TV, and information revealing its potential effect on their gender-stereotypical behaviour, body image and social behaviour.

The gender-stereotypical behaviour assessment involved a toy preference task. Children were given toys and asked to sort them into boxes of which they liked to play with a lot, a little, or not at all.

Some toys were female gender-stereotyped (such as a doll or a tea set), others male gender-stereotyped (action figure or tool set) and some neutral (puzzle or paint set), giving an idea of their preferences.

Body image was rated by the children's parents using a survey asking for agreement or disagreement with statements like, "My child likes his or her body", "My child would like to be thinner", "My child talks about his or her weight often", and "My child wishes he or she were better looking".

Social behaviour was assessed by asking parents how social their child was – for example, how often their child is helpful to their friends.

Parental gender-stereotypical behaviour – for example, whether parents encouraged their children to conform to accepted gender norms of behaviour – was also assessed to see how much this was having an influence.

What were the basic results?

  • As expected, girls had a lot more princess exposure than boys in terms of watching more princess media and identifying with princesses. For example, more than 61% of girls played with Disney Princess toys at least once a week, compared with about 4% of boys.
  • But for boys and girls, princess exposure was linked to higher female gender-stereotypical behaviour on the toy preference task, as well as others measuring a similar thing. This wasn't the case for male gender-stereotypical behaviour, body image or social behaviour.
  • Watching more princess media, identifying with princesses and playing with princess toys over the course of a year predicted stronger female gender-stereotypical behaviour at the end of the study, irrespective of the starting level.
  • Gender behaviour was a three-way interaction between the child's gender, their parents and fictional princesses for girls, but not for boys.
  • High exposure to princesses predicted higher body esteem in boys and more social behaviour.
  • Contrary to what may have been expected, engagement with princesses was not associated with poor body esteem in girls. And a related finding suggested that higher positive body image scores at the start of the study made it less likely that girls would engage in a lot of princess media and merchandise a year later.

How did the researchers interpret the results?

The researchers concluded that, "This study shows that engagement with Disney Princesses can be limiting, as young girls especially are more likely to embrace traditional female stereotypes both concurrently and longitudinally.

"However, there were also some potential positive benefits for boys, including better body esteem and higher levels of prosocial behavior when parents discussed the media with their children." 


This study shows an association between young girls watching more princess media, identifying with princesses and playing with princess toys over a year, and higher levels of female gender-stereotypical behaviour.

One of the ways this manifested was in a preference for playing with dolls and tea sets over action figures and tool sets.

The study found princess exposure was linked to higher levels of female gender-stereotypical behaviour, such as toy preference, but doesn't actually tell us if this is a bad thing.

Much of the media reporting, and quotes from the authors of the study, suggest ideas about why this might be bad – which may be true – but this conjecture isn't based on this particular study.

Also, identifying with princesses may have been expected to result in poor body image in girls, but this doesn't seem to have been the case.

As the researchers said: "Although there is nothing inherently wrong with expressing femininity or behaving in a gendered manner, stereotypical female behavior may potentially be problematic if girls believe that their opportunities in life are limited because of preconceived notions regarding gender."

They went on to state girls should not "avoid the types of exploration and activities that are important to children learning about the world in order to conform to stereotypical notions about femininity".

The study attempts to isolate the effects of princesses against a complex background of social gender influences from parents, friends, social media, schools and others.

This isn't the most realistic thing to do, as these influences are not isolated in the real world – they act together. Nonetheless, the nature of science is to study one thing in detail to attempt to assess its specific influence.

Although the study found a link, it can't prove cause and effect. On the one hand, children might have been influenced by princesses to prefer dolls and aspire to traditionally female stereotypes.

But the other explanation is that these preferences were already there, and these children sought out princesses more than others because they matched their underlying preferences.

Job opportunities for princesses are somewhat thin on the ground these days. So, to boost the chance of your daughter living happily ever after, it may be a good idea to highlight the wide range of opportunities and vocations that exist for women in modern society. 

Links To The Headlines

Why Frozen's Elsa can harm young girls' self-esteem: Fictional characters 'promote negative female stereotypes'. Daily Mail, June 27 2016

Disney princesses contribute to 'body esteem' issues among young girls, finds study. The Guardian, June 27 2016

Links To Science

Coyne SM, Linder JR, Rasmussen EE, et al. Pretty as a Princess: Longitudinal Effects of Engagement With Disney Princesses on Gender Stereotypes, Body Esteem, and Prosocial Behavior in Children. Child Development. Published online June 18 2016

 Mon, 27 Jun 2016 15:35:00 GMT Children's plastic toys can 'harbour viruses for hours'

"Plastic toys 'can harbour nasty viruses for hours, raising risk of infection'," the Mail Online reports. New research suggests that enveloped viruses, which have a protective shell, may survive on toys for up to 24 hours.

This laboratory study aimed to assess virus survival on a plastic toy at 22C and two different humidity levels – 40% (similar to indoor levels) and 60%.

Researchers used a virus called bacteriophage Φ6, which is harmless for humans. It acts as a useful "surrogate virus" for research, as its structure is similar to common causes of viral infection, such as the influenza virus.

The study found that viral survival was significantly less at the lower humidity – at two hours, virus survival had reduced by 99.9%. At high humidity, it took 24 hours to reduce by 99%.

Children's toys – particularly shared ones like in daycare centres and hospitals – have often been implicated in spreading infection during outbreaks. However, this study can't provide all the answers. For example, it can't inform us about the survival of other bacteria and viruses (e.g. tummy bugs spread hand-to-mouth), or whether viral survival may be the same on other surfaces.

What is probably most useful is the standard hygiene measure of ensuring that your child washes their hands regularly, after playing, after using the toilet and before eating.

Employees in settings where toys are likely to be shared should also be aware of the importance of regularly cleaning the toys.


Where did the story come from?

The study was carried out by researchers from Georgia State University, Atlanta, US. It was funded by a grant from the university, and the authors declare no conflict of interest. The study was published in the peer-reviewed Pediatric Infectious Disease Journal.

The Mail article may suggest that this study has directly shown that viruses on plastic toys lead to infection, which isn't the case. As is so often the case, its headline verges on scaremongering. This study had a valuable purpose, but its results weren't conclusive.

These criticisms aside, the body of the article was largely accurate and informative.


What kind of research was this?

This was a laboratory study aiming to assess the survival of viruses on plastic toys in different environmental conditions.

The researchers explain how toys may transmit viruses to children, particularly shared toys in daycare centres, hospitals and doctors' waiting rooms. They go on to say how many cross-sectional studies have assessed the presence of viral DNA or RNA, but it's difficult to tell whether actual enveloped viruses are present and how long they survive.

This study aimed to assess an enveloped virus that infects and replicates within Pseudomonas bacteria – a virus called bacteriophage Φ6, which has similar characteristics to influenza. Enveloped viruses have a protective shell, so they can survive longer on external environments, such as objects and surfaces.

The researchers looked at its survival on non-porous plastic toys in different conditions.


What did the research involve?

The researchers incubated the Pseudomonas bacteria with the bacteriophage Φ6 virus in the lab. They cut up a disinfected plastic toy (a squeaking frog) into 1cm2 pieces and put the culture onto them.

They then incubated for 24 hours, some at 22C and 40% humidity, and others at 22C and 60% humidity. They assessed virus survival over the 24 hours.


What were the basic results?

Over 24 hours, there was a 99% reduction (2log10) in the number of infective viruses when incubated at 60% humidity. The number had already halved by 8 hours (1log10).

There was a significantly increased rate of decline at 40% humidity. There was a 3log10 decline at two hours, and 6.8log10 decline by 10 hours.

Log10 is a reference to measurements on the logarithmic (log) scale, which is a useful method of talking about very large numbers and very small numbers at the same time (in this case, viral load).


How did the researchers interpret the results?

The researchers conclude: "a lipid-enveloped virus [a virus with a protective shell] can survive on the surface of a nonporous children's toy for hours at indoor temperature and relative humidity levels, and the relative humidity level affects how rapid the inactivation is".



This laboratory research assessed the survival of a single type of bacteria-infecting virus on a plastic toy at 22C and two different humidity levels.

The bacteriophage Φ6 virus was chosen to be representative of influenza and other enveloped viruses, and indicated how they would survive under the same conditions. Certain characteristics of the bacteriophage, though, make it easier to study than the actual viruses.

The 40% humidity was meant to be typical of indoor environments. The researchers found that even at this humidity, it may take up to two hours to achieve a 99.9% reduction in levels of infectious virus – similar to previous findings about the rate of inactivation of the flu virus on non-porous surfaces. High humidity was associated with even longer viral survival.

However, this study is limited as it doesn't address many other issues, such as:

  • viral decline at other temperatures – combined with these and other humidity levels
  • survival of other types of non-respiratory viruses – or bacteria – on plastic toys, such as gastrointestinal viruses and bacteria that are spread hand-to-mouth, like norovirus or E.coli bacteria; whether the viral levels detected here at different time-points would directly lead to infection in a child if they were to touch the object is unknown
  • levels of viruses and bacteria on environmental surfaces all around us – for example doors and door handles, tables, work surfaces, taps, etc – all of which children would equally come into contact with
  • the effect of disinfecting or cleaning the items

Toys and children's play equipment has previously been linked to transmission of viruses during outbreaks. In environments such as nurseries, daycare, hospitals or surgeries where toys are shared, regular cleaning and/or disinfection of the items may be beneficial in helping to limit the spread of infection.

However, what is probably most useful is ensuring that your child washes their hands regularly, after playing, after using the toilet and before eating.   

Links To The Headlines

Are your child's TOYS making them sick? Plastic toys 'can harbour nasty viruses for hours, raising risk of infection'. Mail Online, June 27 2016

Links To Science

Bearden RL, Casanova LM. Survival of an Enveloped Virus on Toys. Pediatric Infectious Disease Journal. Published online May 3 2016

 Fri, 24 Jun 2016 15:30:00 GMT Broccoli compounds may help combat chronic diseases

"Eating broccoli could lower your risk of having coronary heart disease, type 2 diabetes and several types of cancer, a new study suggests," the Daily Mail reports.

But there is little hard evidence to back up this claim – the study it reports on involved plants, not humans.

Phenols, which are compounds found in broccoli and other cruciferous vegetables, have been linked for years to a lower risk of heart disease, certain cancers, type 2 diabetes and asthma.

They are thought to play a part in reducing oxidative stress – cell damage caused at the molecular level – and inflammation in cells, although the way they do this is unclear.

Because of their potential health-giving properties, plant scientists would like to produce fruits and vegetables with higher levels of phenols.

This study looked at a type of broccoli bred specifically for high phenol content, and mapped which genes and gene sequences were most consistently linked to high phenol production.

However, the study also showed variation between the levels of phenol in different growing conditions, across different years. That suggests it's not as simple as tweaking genes – environmental factors also influence phenol content.

Despite the Mail's headline to the contrary, no type of "genetically tweaked" broccoli has been tested on animals, let alone humans.

Broccoli and other types of green vegetables are recommended as part of a healthy diet, but this study does not provide evidence the vegetable directly reduces the risk of these chronic diseases.  

Where did the story come from?

The study was carried out by researchers from the University of Illinois and the International Institute of Tropical Agriculture in Tanzania, and was funded by the Hatch Multistate Project.

It was published in the peer-reviewed journal, Molecular Breeding.

The Mail focuses on the old news that phenols in broccoli are linked to a lower risk of certain diseases, which was first reported in studies during the 1990s and 2000s.

The reporting is confused and poorly focused. The point of the new study – the researchers' hopes they may be able to breed vegetables with higher levels of phenols – is mentioned, but not in the headline or first few paragraphs.

The fact that this story seems to champion the idea of genetically enhanced broccoli also seems at odds with the newspaper's often-stated editorial policy against so-called "Frankenstein foods": genetically modified, or GM, foods.

What kind of research was this?

This is a plant-breeding study that used molecular and genetic markers to identify certain traits.

The potential health benefits of phenolic compounds found in fruit and vegetables have been extensively studied.

The biological pathways involved in the production of phenols within plants are also quite well understood.

This study aimed to better understand the genetics associated with the production of the highest phenol levels, as well as the environmental factors that could influence this.

The ultimate aim is to breed plants that could be most beneficial for human health.    

What did the research involve?

Researchers crossed two types of broccoli – one alabrese-type and one black broccoli, both of which had high levels of phenols – to create a new hybrid.

They grew it from seed on three different years in different states. During the growing season, they harvested broccoli florets at different points in the plant's growth, freeze-dried and ground them, then used chemical tests to determine their levels of phenols.

The researchers had bred the experimental broccoli with genetic markers, so they could map specific "candidate genes" to see which were most consistently associated with plants that had higher levels of phenols.

They then analysed the results to see what patterns emerged from the interplay of environment and genes.

What were the basic results?

In brief, the researchers found phenol levels varied in the broccoli both within the same year and between different years, suggesting that factors such as the amount of light and the temperature affected the plants' phenol production.

They also identified three candidate genes that played a key role in the early stages of phenol production, which occurred consistently across different years and growing environments.

How did the researchers interpret the results?

The researchers said the results showed that "both genetic and environmental factors play a significant role" in the amount of phenol produced by a plant.

They say the "complex regulatory network" of factors that affect whether specific genes activate phenol production "may at first glance appear to hinder the ability of breeders or growers to enhance phenolic compound accumulation".

However, they go on to say similar work with tomatoes show it may be possible.

They admit that "substantial environmental effects … are a challenge", but suggest that controlled environments such as greenhouses may enable growers to target optimal conditions for growing phenol-rich vegetables.


The "news" that broccoli may protect against some types of disease because they have high levels of phenol compounds is nothing new. We've known about the link between diets rich in phenolic compounds and the lower risk of heart disease since 1995.

This study looks instead at the mechanisms within broccoli plants that regulate how much phenol a plant produces.

Perhaps unsurprisingly, this varies a lot and seems to be affected both by the plant's genetic make-up and the environmental conditions in which it is grown.

The research may help food growers to increase the amount of phenol compounds in vegetables – including veg other than broccoli – using breeding programmes, genetic modification or controlled growing conditions, such as greenhouses.

However, this research is just one step on the pathway to that. More research will be needed to put these tentative findings into practice.

Also, this study does not involve people and in itself provides no direct evidence that eating large amounts of broccoli – high phenolic or otherwise – will directly influence your risk of cancer, heart disease, diabetes or any other chronic diseases.

Anyone wanting to increase the phenol content in their diet can do so by eating not just broccoli, but many other fruits and vegetables, including green vegetables, tomatoes, beans, berries and stone fruits.

Better still, why not try growing some in your garden or allotment? For more info, read some tips for growing your own fruit and vegetables

Links To The Headlines

Why broccoli really IS a superfood: Compounds in the veg lower the risk of cancer, heart disease and diabetes. Daily Mail, June 24 2016

Links To Science

Gardner AM, Brown AF, Juvik JA. QTL analysis for the identification of candidate genes controlling phenolic compound accumulation in broccoli (Brassica oleracea L. var. italica). Molecular Breeding. Published online June 11 2016


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