Improving breakfast patterns of portuguese children—an evaluation of ready-to-eat cereals according to the European nutrient profile model

Rito, Ana Isabel; Dinis, Ana; Rascôa, Carla; Maia, António João; Martins, Inês de Carvalho; Santos, Mariana; Lima, João; Mendes, Sofia; Padrão, Joana; Stein-Novais, Camila

doi:10.1038/s41430-018-0235-6

Cited by 25 publications

(35 citation statements)

References 26 publications

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“…The current study reports that a large proportion of child-orientated REBCs are less healthful; similar concerns have been reported by others [9,19,24,26]. The larger proportion of less healthful REBCs observed in the Latin American countries may be due to the lower protein and fibre combined with higher sugar content.…”

Section: Discussionsupporting

confidence: 89%

“…Similar findings are reported for REBCs in Guatemala [12], Mexico [8] and Ecuador [13]. However, there is a well-established body of evidence that consistently highlights concerns about the nutritional quality of REBCs and yoghurts marketed to children, in particular the high sugar content, while other nutrients of concern are fat, sodium, protein and fibre [9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27]. In the UK, REBCs and yoghurts contribute to 15% and 16% of free sugar intake in children aged 1.5-10 years, respectively [11].…”

Section: Introductionsupporting

confidence: 75%

“…High sugar content of REBCs has been previously reported in several countries [9,19,26]. It is also known that REBCs targeting children are higher in total sugar than REBCs targeting adults [24]. However, a direct comparison of sugar content in REBCs between countries with different policies aiming to promote heathier food environments that include a sugar reduction policy is lacking.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…The intake of ready-to-eat cereals at breakfast time has increased over the last decades (40,41) . Actually, ready-to-eat cereals are one of the most frequent breakfasts among children and adolescents (42) . Ready-toeat cereals are not a Mediterranean food and most important they are non-compliant with the European nutrient profile model, especially regarding sugar content (42,43) .…”

Section: The Ninth Questionmentioning

confidence: 99%

An update of the KIDMED questionnaire, a Mediterranean Diet Quality Index in children and adolescents

Altavilla

Caballero

2019

Public Health Nutr.

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Objective:The KIDMED questionnaire was published in 2004 to evaluate adherence to the Mediterranean diet (MD) in children and adolescents. In the last 14 years, several respected official dietetics and health organizations have recommended appropriate dietary habits, including eating whole grains and consuming whole fruit rather than fruit juice. We propose an update of the KIDMED questionnaire.Design:Based on the scientific evidence, the present commentary suggests some changes to the KIDMED questionnaire.Results:We suggest deleting ‘or fruit juice’ from the first question of the questionnaire, rewording the question as ‘Takes a fruit every day’, and assigning a positive value of +1. We suggest adding ‘whole-grain’ to the eighth question of the questionnaire, rewording the question as ‘Consumes whole-grain pasta or whole-grain rice almost every day (5 or more times per week)’, and assigning a positive value of +1. Further, we propose to add ‘whole cereals or whole grains’ to the ninth question of the questionnaire, reword the question as ‘Has whole cereals or whole grains (whole-meal bread, etc.) for breakfast’, and assign a positive value of +1.Conclusions:The present commentary examines some signs of a paradigm shift about fruit juice and whole grains after the development of the KIDMED questionnaire. The changes are of paramount importance in order to make the questionnaire an updated tool to evaluate adherence to the MD.

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“…Excessive salt intake is associated with an increased risk of obesity-partially due to poor diets that are high in both energy and salt, such as regular consumption of breakfast cereals [14] and highly processed foods [10]. Another reason for this association may be that consumption of salty foods stimulates thirst and increases fluid intake, thereby increasing the consumption of sugar-sweetened beverages, which can further fuel obesity [15].…”

Section: Introductionmentioning

confidence: 99%

Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education—The Eat Mediterranean Program

et al. 2020

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High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention—a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools’ food handlers training. EM (2015–2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3–21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (−23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals’ sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance.

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Improving breakfast patterns of portuguese children—an evaluation of ready-to-eat cereals according to the European nutrient profile model

Cited by 25 publications

References 26 publications

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

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

An update of the KIDMED questionnaire, a Mediterranean Diet Quality Index in children and adolescents

Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education—The Eat Mediterranean Program

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