Low Sugar Cereal Research Articles

Less Sugar and More Whole Grains in Infant Cereals: A Sensory Acceptability Experiment With Infants and Their Parents.

There is an urgent need to reduce sugar intake in early childhood. Commercial infant cereals are among the first solid foods introduced to infants at the beginning of the complementary feeding period in most countries. The aim of this study was to examine infants’ overall acceptability of low-sugar complementary cereals. To do so, a between-subjects experimental study with 165 parents and their infants aged 6–24 months was conducted where one group tested a high-sugar refined cereal (21 g/100 g), and the other a low-sugar cereal (<1 g/100 g) with 50% of whole grain, which represented a 95.2% decrease in sugar content. We found no significant differences between the two groups in terms of infants’ overall acceptability (infant’s reaction, estimated intake and relative intake). Importantly, infants’ reactions to high- and low-sugar cereals were not influenced by the time that infants had been consuming sweet cereals (15–25% sugar) before the experiment took place. In addition, parent’s overall liking and sensory evaluation (sweetness, color, taste, texture, and aroma) was positive and very similar in both groups. Overall, our findings show that it is feasible to reduce sugar content in infant cereals without sacrificing its sensory acceptability by infants and their parents. This represents a good opportunity for the infant food industry to adhere to current healthy and sustainable demands of lowering the sugar intake leading to important benefits in infants’ health, without compromising competitiveness in the market.

Foods Served in Child Care Programs Participating in the Child and Adult Care Food Program and Alignment with Program Meal Patterns

ObjectiveAssess Child and Adult Care Food Program (CACFP) program compliance with meal component requirements for children aged 3-5 years by program type, and describe foods and beverages most commonly served. DesignCross-sectional analysis of 1-week menu surveys during winter/spring 2017. SettingUS CACFP-participating child care programs. ParticipantsNationally representative multistage cluster sample of 664 programs: 222 child care centers, 247 Head Start programs, 195 family child care homes. Main Outcome Measure(s)Percentage of meals including required components; frequently served foods and beverages. AnalysisMean percentages; 2-tailed t tests; alpha = 0.05 significance level. ResultsMost breakfasts (97%), lunches (88%), and afternoon snacks (97%) included all required CACFP meal components. Most breakfasts included fruits (96%), but not vegetables; 16% included a meat/meat alternate. Most lunches (81%) included both fruits and vegetables. Afternoon snacks were mostly grains/breads (80%) and fruits (57%). Most frequently served foods included 1% unflavored milk and fresh fruits such as apples and bananas. Most menus limited juice, offered low-sugar cereal, and did not include flavored milk; very few menus included noncreditable foods with added sugar. Conclusions and ImplicationsMost CACFP meals provided required components, but there is room for improvement, particularly for increasing vegetables served and limiting foods high in added sugar and fat.

Dietary Correlates of Urinary Phthalate Metabolite Concentrations in 6-19 Year Old Children and Adolescents from NHANES

BACKGROUND AND AIM: Children are particularly vulnerable to phthalates, and food is one source of exposure. However, a comprehensive analysis that investigates exposure from food type and source has yet to be undertaken. We use reduced rank regression, a dimension reduction method, to identify dietary patterns associated with urinary phthalate metabolite concentrations in children in a large, US study with detailed data on dietary intake. METHODS: We used data from 2,402 participants 6-19 years old from the 2005-2010 National Health and Nutrition Examination Survey who had urinary phthalate metabolites measured by mass spectrometry. Participants recalled their diet during the 24 hours before urine collection. We quantified dietary intake and source (i.e., home-prepared vs. prepared away from the home) of 135 food groups. We used reduced rank regression to identify dietary patterns explaining variation in overall urinary concentrations of ∑di-2-ethylhexyl phthalate (DEHP) and seven phthalate metabolites, adjusting for urinary creatinine and sociodemographics. We also examined pairwise associations between food groups and phthalate concentrations. RESULTS:We identified eight dietary patterns that cumulatively explained 11.2% of variation in phthalates. The most variation was explained by a diet high in breakfast foods prepared away from home (e.g., bacon, low-sugar cereal, and reduced-fat milk). A one SD increment in adherence to the breakfast food dietary pattern was associated with an 11.3% higher monocarboxy-isononyl phthalate concentration (95% CI: 6.5, 15.9) and a 7.4% higher monobutyl phthalate concentration (95% CI: 3.0, 12.1). We observed some weak pairwise associations between food group intake and urinary phthalates (e.g., 0.1% [95% CI: 0.0, 0.2] higher DEHP per SD increment in milk intake). CONCLUSIONS:We identified dietary factors that may be sources of phthalate exposure or reflect lifestyle correlates. Diet and preparation location explained a small percent variation in phthalate concentrations, suggesting the need for more detailed information on food processing and packaging. KEYWORDS: food/nutrition, phthalates, children's environmental health, biomarkers of exposure

Effects of a Community-Based Pilot Intervention on Home Food Availability among U.S. Households.

The purpose of this study was to assess the effects of a pilot community-based behavioral intervention on the home food environment in U.S. households. Parents (21 females, 2 males; age = 36 ± 5.5 years; 78% Hispanic) of elementary school-aged children attended a 10-week dietary improvement behavioral intervention targeting an increase in fruit and vegetable consumption and a reduction in sugar intake. Home food availability of fruit, vegetables, and sugar-laden foods and beverages were assessed before and after the intervention using a modified version of the Home Food Inventory. Relative to baseline, the intervention resulted in significant increases in fruit availability (7.7 ± 3.2 items vs. 9.4 ± 3.1 items; p = 0.004) and low sugar cereal (2.3 ± 1.4 types vs. 2.7 ± 1.4 types; p = 0.033). There was a significant reduction in sugar-sweetened beverage availability (3.2 ± 1.9 types vs. 1.7 ± 1.3 types; p = 0.004). There was a significant increase in the number of households with accessible ready-to-eat vegetables and fruit, and a significant reduction in available prepared desserts, and candy (p < 0.01). There were no significant changes in the availability of vegetables and sugar-laden cereals. The current intervention resulted in positive changes in the home food environment. Further research to confirm these results in a randomized controlled trial is warranted.

Child-Oriented Marketing on Cereal Packaging: Associations With Sugar Content and Manufacturer Pledge

To assess sugar content and child-oriented promotional features on packaging among cereals manufactured by companies with varying Children's Food and Beverage Advertising Initiative (CFBAI) participation. Ready-to-eat dry cereals (n = 159) were purchased from southeastern US grocery stores in September 2018. Content analysis of 159 ready-to-eat dry cereal boxes, coded for sugar content and presence of 8 child-oriented features. Frequencies of each promotional feature and number of features per box, level of participation in CFBAI, and sugar content by serving and ounce. Chi-square tests of independence analyzed correspondence between measures of sugar content. Extent of features per box based on sugar content and CFBAI participation were assessed with analyses of variance (ANOVAs). Most cereals (81%) contained <13 g of sugar per serving, meeting the sugar content requirement for child-directed advertising. Cereals' sugar content classifications varied between sugar per serving and sugar per ounce metrics (P < .001). Among low-sugar per serving cereals, 28% were classified as moderate-sugar per ounce, whereas 55% of moderate-sugar per serving cereals had high-sugar per ounce. Games/activities and trade characters were especially common (62% and 49%, respectively), particularly on high-sugar per ounce cereals (P < .001, respectively). Child-oriented features were rare on low-sugar cereals and highest on cereals with higher sugar content per ounce produced by CFBAI-participating companies (F8,158 = 12.33, P < .001). Variable cereal-suggested serving sizes may contribute to consumers' misunderstanding of sugar content. CFBAI manufacturers continue to market cereals with high sugar to children. Food and beverage regulatory policy could be strengthened if CFBAI companies apply marketing pledges to brand mascots, adopt standardized metrics for sugar content, and limit added sugar content to the recommended <6 g/serving target used by the Special Supplemental Nutrition Program for Women, Infants, and Children program.

Do Brands Serve as Reliable Signals of Nutritional Quality? The Case of Breakfast Cereals

ABSTRACTOrganic and national brand manufacturers position their offerings as nutritious meals for adults and children. Do these brands serve as reliable signals of nutritional quality? To find an answer, this study analyzed a very popular, ready-to-eat breakfast cereal food category based on all the available data from 2011 (324 offerings) from a large UK grocery comparison website, mysupermarket.co.uk. The study shows that it is possible to find store and basic brand offerings that are almost identical to national brand offerings, but much cheaper and with less sugar (the main concern in cereal). Hedonic price regression analysis further confirms that brand and size explain most of cereal’s price variability, regardless of nutritional quality. The findings also reveal that low-sugar cereals are hard to find regardless of price, and almost all cereals targeted at children have high levels of sugar. A replication study (337 offerings in 2012) revealed that, on average, cereal sugar levels and prices increased, while nutritional value decreased.

Comparative Performance of NEMS‐S Surveys in Latino Corner Stores in the Greater Boston Area

BackgroundIn diverse areas, culturally‐sensitive tools may better assess the food environment associated with diet.ObjectiveTo determine the availability of healthy foods in Latino corner stores (bodegas) to elucidate its relationship with culture.Methods: Three bodegas were selected from low‐income urban areas in Somerville, MA by field enumeration. The reference Nutrition Environment Measures Survey for Stores (NEMS‐S) and a Guatemala NEMS‐S version were used to assess healthy food vs. regular food availability in bodegas. Both surveys were conducted in each bodega. Frequency and proportion of items were determined. Chi‐square tests assessed differences in availability by survey method across stores.Results: Bodegas have limited healthy foods as measured by the reference NEMS‐S. A greater availability of healthy foods in bodegas is indicated by the Guatemala NEMS‐S. All stores had 100% of the time, regular: milk, baked goods, soda, juice, chips, bread; diet soda; and 100% juice. Often, stores had skim milk, low‐sugar cereal, and wheat bread; but rarely, frozen dinners and low fat baked goods. Of the three vegetables added to the Guatemala NEMS‐S, at least one was available in two of the three stores; and of the six fruits added at least two were available in each store. No significant differences in availability by store were found.ConclusionsThe Guatemala NEMS‐S indicates a greater availability of healthy foods in bodegas than the reference NEMS‐S. Therefore, culture may impact food availability, as stores may cater towards specific ethnic populations. The existence of culturally‐specific stores needs consideration when creating healthy food policies.Funding: Tufts Undergraduate Research Fund

Abstract A25: Evaluation of the food environment in rural towns in eastern Washington

Abstract Introduction: Hispanics are at increased risk for obesity, which places them at increased risk for a variety of health conditions, including cancer. Risk factors for both obesity and cancer include limited access to healthy affordable foods. This problem is especially prevalent in low-income communities such as rural towns. This study assessed the availability of healthful foods and food environment scores in two rural towns with large percentages of Hispanic residents in Eastern Washington State. Experimental Procedures: Store inventories were collected in 14 food stores (3 grocery and 11 convenience stores) from July-August 2013 using the Nutrition Environment Measures Survey. We recorded data on availability of a variety of fresh fruits, vegetables, whole grain bread, lean ground beef, low-fat hot dogs, baked or low-fat chips, and low sugar cereal. Food environment scores were generated for stores, which consisted of a composite score of availability of healthy food, quality, and price. Results: Convenience stores comprised 79% of food stores. Availability of specific healthful items differed between grocery and convenience stores with all the grocery stores (100%) selling at least 1 fresh fruit compared to 27% of the convenience stores. More grocery stores also had fresh vegetables (100% vs. 18%), whole grain bread (100% vs. 36%), lean ground beef (100% vs. 9%), low-fat hot dogs (100% vs. 9%), baked or low-fat chips (67% vs. 0%), and low sugar cereal (67% vs. 18%). Grocery stores, however, were slightly less likely to be stocked with 100% fruit juice (67% vs. 73%), while more stocked with diet soda (100% vs. 91%) than convenience stores. Out of a possible maximum food environment score of 62, grocery stores scored 29 while convenience stores scored 3.64. Conclusions: Convenience stores make up a large proportion of available food sources in rural towns and have limited stocks of healthful foods. The low food environment scores of both grocery and convenience stores are indication that stores have room for improvements. Increasing the variety of healthy food offerings in food stores could be the first step in improving the food environment in rural towns. Citation Format: Linda K. Ko, Cynthia Perry, Norma Mariscal, Edgar Rodriguez, Catherine Duggan, Mario Kratz, Beti Thompson. Evaluation of the food environment in rural towns in eastern Washington. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A25. doi:10.1158/1538-7755.DISP13-A25

Sugar as Part of a Balanced Breakfast? What Cereal Advertisements Teach Children About Healthy Eating

Marketing that targets children with energy-dense, nutrient-poor foods is a likely contributor to the childhood obesity crisis. High-sugar ready-to-eat cereals are the packaged food most frequently promoted in child-targeted food advertising on television. The authors combined content analysis of product nutritional quality and messages presented in cereal television advertisements with syndicated data on exposure to those ads. The analysis quantifies children's exposure to specific products and messages that appear in advertisements and compares it with adult exposure. Children viewed 1.7 ads per day for ready-to-eat cereals, and 87% of those ads promoted high-sugar products; adults viewed half as many ads, and ads viewed were equally likely to promote high- and low-sugar cereals. In addition, the messages presented in high-sugar ads viewed by children were significantly more likely to convey unrealistic and contradictory messages about cereal attributes and healthy eating. For example, 91% of high-sugar cereal ads viewed by children ascribed extraordinary powers to these products, and 67% portrayed healthy and unhealthy eating behaviors. Given children's vulnerability to the influence of advertising, the emotional and mixed messages used to promote high-sugar cereals are confusing and potentially misleading.

Low-sugar cereals encourage children to eat more fruit

Low-sugar cereals encourage children to eat more fruit

Effects of Serving High-Sugar Cereals on Children's Breakfast-Eating Behavior

To test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk. Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating. Researchers measured the amount and calories consumed of each food. In both conditions, children reported "liking" or "loving" the cereal they chose. Children in the low-sugar cereal condition consumed, on average, slightly more than 1 serving of cereal (35 g), whereas children in the high-sugar condition consumed significantly more (61 g) and almost twice the amount of refined sugar in total (24.4 vs 12.5 g). Milk and total calories consumed did not differ significantly between conditions, but children in the low-sugar condition were more likely to put fruit on their cereal (54% vs 8%) and consumed a greater portion of total calories from fresh fruit (20% vs 13%). Compared with serving low-sugar cereals, high-sugar cereals increase children's total sugar consumption and reduce the overall nutritional quality of their breakfast. Children will consume low-sugar cereals when offered, and they provide a superior breakfast option.