Abstract
Background: Governments have introduced legislative activities, such as restricting marketing to children of foods high in fat, sugar and/or salt, to curb the childhood obesity burden. In the European Region, the World Health Organization (WHO/Europe) has facilitated them with the development of the Nutrient Profile Model (WHO/Europe-NPM). Cyprus is the country with the highest childhood obesity rates in the Region. Nonetheless, it does not currently restrict marketing to children. The purpose of this study is to evaluate the composition of ready-to-eat-cereals (RTECs), a fat, sugar and/or salt dense food product category on the Cypriot market and to examine whether the marketing of these products to children should be permitted according to the WHO/Europe-NPM.
 Methods: Two hundred RTEC samples from four national food retailers were collected from March to April 2018. The samples were assessed for their nutritional quality with the use of the WHO/Europe-NPM and statistical comparisons were performed between child-targeted and non-child-targeted RTECs.
 Results: The average content of sugar and salt was significantly higher in “child-targeted” than in “non-child-targeted” RTECs. 87.3% of the “child-targeted” RTECs would not be permitted for marketing to children according to the WHO/Europe-NPM and 73.5% of the overall sample exceeded at least one of the WHO/Europe-NPM recommendations for fat, sugar and/or salt.
 Conclusions: In case of the implementation of any marketing restriction legislation domestically in the future, most of the RTECs currently sold in Cyprus would not be permitted to be marketed to children according to the WHO/Europe-NPM. Incorporating marketing restrictions in the health policy agenda and adopting the WHO/Europe-NPM may improve the childhood obesity rates in Cyprus.
Highlights
Childhood obesity is one of the most serious public health challenges of the 21st century (WHO 2018d), and has increased with alarming rates in the last decades, affecting more than 158 million children worldwide (Lobstein and Brinsden 2019)
Than in “non-child-targeted” RTECs. 87.3% of the “child-targeted” RTECs would not be permitted for marketing to children according to the WHO/Europe-NPM and 73.5% of the overall sample exceeded at least one of the WHO/Europe-NPM recommendations for fat, sugar and/or salt
In case of the implementation of any marketing restriction legislation domestically in the future, most of the RTECs currently sold in Cyprus would not be permitted to be marketed to children according to the WHO/Europe-NPM
Summary
Childhood obesity is one of the most serious public health challenges of the 21st century (WHO 2018d), and has increased with alarming rates in the last decades, affecting more than 158 million children worldwide (Lobstein and Brinsden 2019). RTECs are an important source of macro- and micro-nutrients, but they can be energy dense foods, high in fat, sugar and/or salt (HFSS). Governments have introduced legislative activities, such as restricting marketing to children of foods high in fat, sugar and/or salt, to curb the childhood obesity burden. In the European Region, the World Health Organization (WHO/Europe) has facilitated them with the development of the Nutrient Profile Model (WHO/Europe-NPM). Cyprus is the country with the highest childhood obesity rates in the Region. The purpose of this study is to evaluate the composition of ready-to-eat-cereals (RTECs), a fat, sugar and/or salt dense food product category on the Cypriot market and to examine whether the marketing of these products to children should be permitted according to the WHO/Europe-NPM
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