Evaluating the Nutritional Content of Children's Breakfast Cereals in Australia

Product promotional strategies in supermarkets and their effects on sales: A case study of breakfast cereals and drinks in New Zealand

AIMS

To examine the frequency of promotions on breakfast cereals and drinks in a major New Zealand supermarket chain, determine the healthiness of promoted versus non-promoted products, and quantify the effects of promotions on sales.

METHODS

Weekly data on product promotions and sales were collected in six Auckland supermarkets for 198 breakfast products over 12 weeks. The healthiness of products was determined using the Health Star Rating system, and the effect of promotions on sales was estimated using linear mixed models.

RESULTS

On average, 47% of breakfast products in a given week were promoted using on-shelf tickets, 12% in weekly mailers, and 9% via promotional displays. The healthiness of promoted and non-promoted breakfast products was comparable. In relation to weekly sales of non-promoted products, all three promotional strategies had substantial (2 to 2.5 times higher sales) and statistically significant (P < 0.001) effects on product sales.

CONCLUSION

Promotions are frequently used and effective at increasing sales. Marketing strategies focusing solely on promoting healthier products could be an important nudging strategy to improve the healthiness of supermarket food purchases.

Nutritional value of child-targeted food products: results from the Food Quality Observatory

OBJECTIVE

To characterise the nutritional quality of food products targeted to children, we aimed: (1) to determine if the nutritional composition of child-targeted food products is different from those for the general population and (2) to verify differences in the nutrient content of child-targeted food products between three selected food categories.

DESIGN

The present study is part of the work conducted by the Food Quality Observatory, created in 2016 in the province of Quebec (Canada). Ready-to-eat (RTE) breakfast cereals (n 331), granola bars (n 310) and yoghurts and dairy desserts (n 380) were the food categories analysed.

SETTING

Nutritional values and all packaging information were obtained by purchasing every product available in supermarkets, grocery stores and specialty grocery stores. Free sugars were manually differentiated from total sugars for each product. Products were classified according to two targeted consumer groups: children or general population.

RESULTS

The nutrient profile of RTE breakfast cereals, granola bars and yoghurts and dairy desserts targeted to children differed from that of products intended at the general population. Child-targeted RTE breakfast cereals had the least favourable nutritional composition, with significantly higher content of carbohydrates, total sugars, free sugars and Na compared with breakfast cereals for the general population as well as child-targeted granola bars and yoghurts and dairy desserts. All child-targeted products analysed contained free sugars.

CONCLUSIONS

The current study supports the relevance to further regulate marketing to children on food product packages to ensure that such marketing is not present on food products with poor nutritional quality.

Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake

Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children's diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)-the nutrient profile model of the World Health Organization's Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)-in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs' reformulation on the nutritional quality of Portuguese children's diets. In total, 78 RTECs intended for children were assessed and two scenarios-current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)-were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.

A Fit-for-Purpose Nutrient Profiling Model to Underpin Food and Nutrition Policies in South Africa

South Africa (SA) is facing a rising prevalence of obesity and diet-related chronic diseases. The government is seeking to develop effective, evidence-based policy measures to address this. A well-designed, fit-for-purpose nutrient profiling model (NPM) can aid policy development. The aim of this study was to develop a fit-for-purpose NPM in SA. Steps included: (1) determining the purpose and target population; (2) selecting appropriate nutrients and other food components to include; (3) selecting a suitable NPM type, criteria and base; and (4) selecting appropriate numbers and thresholds. As part of the evaluation, the nutritional composition of packaged foods containing nutritional information (n = 6747) in the SA food supply chain was analyzed, a literature review was undertaken and various NPMs were evaluated. Our findings indicated that it is most appropriate to adapt an NPM and underpin regulation with a restrictive NPM that limits unhealthy food components. The Chile 2019 NPM was identified as suitable to adapt, and total sugar, saturated fat, sodium and non-sugar sweetener were identified as appropriate to restrict. This NPM has the potential to underpin restrictive policies, such as front-of-package labelling and child-directed marketing regulations in SA. These policies will support the fight against obesity and NCDs in the country.

Measuring the Healthiness of Ready-to-Eat Child-Targeted Cereals: Evaluation of the FoodSwitch Platform in Sweden

BACKGROUND

Childhood obesity is a major public health issue. The increase in the consumption of foods with poor nutritional value, such as processed foods, contributes to this. Breakfast cereals are often advertised as a healthy way to start the day, but the healthiness of these products varies greatly.

OBJECTIVE

Our main objective was to gather information about the nutritional characteristics of ready-to-eat breakfast cereals in Sweden and to investigate the healthiness of products targeted at children compared to other cereals by use of the FoodSwitch platform. A secondary objective was to evaluate the alignment between the Keyhole symbol and the Health Star Rating.

METHODS

The FoodSwitch app is a mobile health (mHealth) tool used to present nutrition data and healthier alternative products to consumers. Ready-to-eat breakfast cereals from the largest Swedish grocery retailers were collected using the FoodSwitch platform. Products were defined as targeting children if they presented features addressing children on the package.

RESULTS

Overall, information on 261 ready-to-eat cereals was examined. Of this total, 8% (n=21) were targeted at children. Child-targeted cereals were higher in sugar (22.3 g/100 g vs 12.8 g/100 g, P<.001) and lower in fiber (6.2 g/100 g vs 9.8 g/100 g, P<.001) and protein (8.1 g/100 g vs 10.5 g/100 g, P<.001). Total fat (3 g/100 g vs 10.5 g/100 g, P<.001) and saturated fat (0.8 g/100 g vs 2.6 g/100 g, P<.001) were also lower. No difference was found in salt content (P=.61). Fewer child-targeted breakfast cereals displayed an on-pack Keyhole label (n=1, 5% vs n=53, 22%; P=.06), and the mean Health Star Rating value was 3.5 for child-targeted cereals compared to others (mean 3.8, P=.07). A correlation was found between the Keyhole symbol and the Health Star Rating.

CONCLUSIONS

Ready-to-eat breakfast cereals targeted at children were less healthy in terms of sugar and fiber content compared to products not targeted at children. There is a need to improve the nutritional quality of child-targeted cereals.

A Cross-Sectional Audit of Nutrition and Health Claims on Dairy Yoghurts in Supermarkets of the Illawarra Region of New South Wales, Australia

Health and nutrition claims are used by consumers to guide purchasing decisions. In consequence, monitoring and evaluation of such claims to ensure they are accurate and transparent is required. The aim of this study was to investigate the use of nutrition and health claims on dairy-yoghurt products within select Australian supermarkets and assess their compliance with the revised Food Standards Code (FSC). Nutrition, health, and related claims on yoghurt products were assessed in a cross-sectional audit of five supermarkets in the Illawarra region of New South Wales. Claim prevalence, type, and compliance were assessed and products were compared against current rating measures. A total of n = 340 dairy yoghurt products were identified. Most products (97.9%) carried at least one nutrition and/or health claim, with nutrition-content claims (93.9%) the most prevalent. Most products (n = 277) met the nutrient profiling scoring criterion; while 87.9% of products did not carry the health star rating. Almost all claims surveyed (97.4%) were compliant with the FSC. Health and nutrition claims are highly prevalent across yoghurt categories, with the majority of these compliant with regulations. The ambiguity surrounding the wording and context of claims challenges researchers to investigate consumers’ interpretations of health messaging within the food environment.

Back in Time for Breakfast: An Analysis of the Changing Breakfast Cereal Aisle

Breakfast cereal improves overall diet quality yet is under constant scrutiny with assertions that the category has not improved over time. This study aimed to comprehensively analyse the category of breakfast cereals, the nutritional values, and health claims across eight distinct sub-categories at four time points (2013, 2015, 2018, and 2020). An audit of products from four major supermarkets in metropolitan Sydney (Aldi, Coles, IGA, and Woolworths) collected ingredient lists, nutrition information, claims and Health Star Rating (HSR) for biscuits and bites; brans; bubbles, puffs, and flakes; granola and clusters; hot cereal flavoured; hot cereal plain; muesli; breakfast biscuits. The median (IQR) were calculated for energy, protein, fat, saturated fat, carbohydrate, sugars, dietary fibre, and sodium for comparisons over time points by nutrient. Data from 2013 was compared with 2020 (by sub-category and then for a sub-section of common products available at each time point). Product numbers between 2013 (n = 283) and 2020 (n = 543) almost doubled, led by granola and clusters. Whole grain cereals ≥ 8 g/serve made up 67% of products (↑114%). While there were positive changes in nutrient composition over time within the full data set, the most notable changes were in the nutrition composition of cereals marketed as the same product in both years (n = 134); with decreases in mean carbohydrate (2%), sugar (10%) and sodium (16%) (p < 0.000), while protein and total fat increased significantly (p = 0.036; p = 0.021). Claims regarding Dietary Fibre and Whole Grain doubled since 2013. Analysis of sub-categories of breakfast cereal assisted in identifying some changes over time, but products common to both timeframes provided a clearer analysis of change within the breakfast category, following introduction of HSR. Whole grain products were lower in the two target nutrients, sodium and sugars, and well-chosen products represent a better choice within this category.

Breakfast Habits of a Representative Sample of the Spanish Child and Adolescent Population (The ENALIA Study): Association with Diet Quality

The association between breakfast quality and total diet quality of children and adolescents ((1–17.9 years (n = 1570)) from the National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) was analyzed. Dietary information was collected using two non–consecutive one–day food diaries (1–10 years old) or two 24 h dietary recalls (>10 years). Breakfast quality index (BQI) and a variant of Nutrient Rich Foods index (NRF9.3) were calculated to assess the total diet quality. Children and adolescents who had breakfast on at least one day (n = 1561) were divided into two groups according to BQI: Worse Quality Breakfast (WQB) (BQI < 4 points (P66), n = 781) and Good Quality Breakfast (GQB) (BQI ≥ 4, n = 780). Younger children and those whose parents have university education presented higher BQI. GQB group had significantly higher intakes of micronutrients (vitamins A, D, C, B₁, B₂, B₆, niacin, folate, calcium, potassium, magnesium). Fewer GQB children exceeded the Acceptable Macronutrient Distribution Range for fat and had folate and calcium intakes below their estimated average requirement. Daily NRF9.3 was 496.2 ± 54.0, being higher in GQB (503.8 ± 50.6 vs. 488.6 ± 56.2, p < 0.001). Increasing the quality of breakfast increased the possibility of having a NRF9.3 higher than P₅₀ (OR: 1.893, CI: 1.549–2.315, p < 0.0001). Breakfasts have room for quality improvement in a high percentage of children. A higher quality breakfast is associated with a benefit in the quality of the total diet.

Sugar Content and Nutritional Quality of Child Orientated Ready to Eat Cereals and Yoghurts in the UK and Latin America; Does Food Policy Matter?

Ready to eat breakfast cereals (REBCs) and yoghurts provide important nutrients to children's diets, but concerns about their high sugar content exist. Food reformulation could contribute to sugar reduction, but policies across countries are not uniform. We aimed to compare the sugar content and nutritional quality of child-orientated REBCs and yoghurts in Latin American countries with the UK. In a cross-sectional study, nutritional information, marketing strategies, and claims were collected from the food labels and packaging of products available in Guatemala, Mexico, Ecuador and the UK. Nutritional quality was assessed using the UK Ofcom Nutrient Profiling System. In total, 262 products were analysed (59% REBCs/41% yoghurts). REBCs in the UK had a lower sugar content (mean ± SD) (24.6 ± 6.4) than products in Ecuador (34.6 ± 10.8; p < 0.001), Mexico (32.6 ± 7.6; p = 0.001) and Guatemala (31.5 ± 8.3; p = 0.001). Across countries, there were no differences in the sugar content of yoghurts. A large proportion (83%) of REBCs and 33% of yoghurts were classified as "less healthy". In conclusion, the sugar content of REBCs in Latin America is higher than those of the UK, which could be attributed to the UK voluntary sugar reduction programme. Sugar reformulation policies are required in Guatemala, Mexico and Ecuador.

Breakfast Choice Is Associated with Nutrient, Food Group and Discretionary Intakes in Australian Adults at Both Breakfast and the Rest of the Day

Breakfast choice is correlated with daily nutrient intakes, but this association may not be solely explained by the breakfast meal. We profiled breakfast consumer groups among Australian adults and compared the role that breakfast versus the rest of the day had on daily intakes of the Five Food Groups, discretionary foods, and nutrients. Breakfast groups were breakfast cereal consumers, non-cereal breakfast consumers, and breakfast skippers. One-day dietary recall data from the 2011⁻2012 National Nutrition and Physical Activity Survey were analysed (n = 9341, ≥19 years), as well as socio-demographic and anthropometric measures. Twelve per cent of adults were breakfast skippers, 41% were breakfast cereal consumers, and 47% were non-cereal breakfast consumers. Females were more likely to have a non-cereal breakfast than males, and the non-cereal breakfast was predominantly bread-based. Breakfast skipping decreased with age (p < 0.001), while breakfast cereal consumption increased with age (p < 0.001). Breakfast skippers were more likely to be male, had a lower socio-economic status, and lower physical activity levels (p < 0.001). Breakfast skippers had the highest mean body mass index (BMI) and waist circumference (p < 0.001), the lowest intake of wholegrain foods, fruits and vegetables, and the highest intake of discretionary foods (p < 0.001). Breakfast cereal consumers had the lowest mean BMI and waist circumference (p < 0.001) and had healthier diets at both breakfast and throughout the rest of the day. They were the most likely to meet the daily recommended serves for grain foods, fruit, dairy, and vegetables, had the highest wholegrain food intake, and the lowest discretionary intake (p < 0.001). Additionally, breakfast cereal consumers had the most favourable daily nutrient intakes, including the lowest added sugars intakes. Differences in daily diet between breakfast groups were attributed to differences in food choices both at breakfast and throughout the rest of the day.