Ready-to-eat Cereal Research Articles

Evaluation of the nutritional quality of French children breakfasts according to the Breakfast Quality Score (BQS).

Breakfast meals provide essential nutrients and energy to children and adolescents. Based on recommendations from the International Breakfast Research Initiative (IBRI), the Breakfast Quality Score (BQS) was developed to assess breakfast nutritional value among the French adult population. However, its application to children remains unexplored. This study aimed to evaluate the BQS in assessing the nutritional quality of breakfasts consumed by French children aged 4-17 years. A total of 4,015 breakfasts, obtained from dietary recalls provided by 1,448 children participating in the French representative dietary survey (INCA3), were analyzed. As for adults, the performance of the BQS was tested through correlations with other nutritional indicators and comparison of nutrients and dietary components between tertiles of scores. The study examined the regularity of breakfast consumption and compared the BQS of children's breakfasts across socio-demographic modalities and breakfast categories distinguished by their primary grain component. Additionally, a predictive modeling using Partial Least Squares (PLS) regression identified influential INCA3 food groups. The majority of children consumed solid breakfasts regularly. Socio-professional category, household income and food insecurity influenced BQS, revealing contradictory disparities. Ready-to-eat cereal (RTEC) breakfasts had the highest BQS (73.5% for children and 73.1% for adolescent), while biscuits and viennoiseries scored the lowest (52% for children and 49.1% for adolescent). PLS highlighted RTECs, milk, and hot beverages (mainly containing chocolate milk) as being positively associated with BQS, while sweet beverages and viennoiseries were negatively associated. The study demonstrates the effectiveness of the BQS in assessing children's breakfast quality, with RTEC breakfasts showing the highest nutritional value. The findings provide insights into factors influencing breakfast nutritional quality and underscore the importance of promoting healthier breakfast choices among all children.

Ready-to-eat cereal consumption is associated with improved nutrient intakes and diet quality in Canadian adults and children across income levels.

Results from observational studies suggest ready-to-eat cereal (RTEC) consumption is associated with higher diet quality. In the United States, studies have shown that RTEC is an important contributor to nutrient intakes across income levels. However, it is unknown if this association varies by income level in the Canadian population. Given its affordability, RTEC may represent an important source of nutrients for lower-income individuals. This study evaluated the association of RTEC consumption with nutrient intakes and diet quality across household income levels in Canadian adults and children. Income and dietary data from 24 h dietary recalls were obtained from the 2015 Canadian Community Health Survey (CCHS)-Nutrition in 6,181 children (2-18 years) and 13,908 adults (19+ years). Diet quality was assessed with a modified Nutrient Rich Food Index (NRF) 9.3. Income levels were stratified into low, middle, and high based on family size, and data were analyzed by RTEC consumption and income level using multivariate linear regression adjusted for energy, age, and sex. Diet quality was greater in adult and child RTEC consumers across all household income levels. Children and adults consuming RTEC also had higher nutrient intakes, including shortfall nutrients such as calcium, dietary fiber, iron, magnesium, and vitamin D. RTEC provided <10% of energy intake, <4% of saturated fat intake, and <9% of total sugar intake across all ages and income levels, while also providing one-third of daily iron intake and at least 10% of daily intake of dietary fiber, thiamin, folate, and vitamin B6. RTEC consumption was associated with improved nutrient intakes and diet quality in adults and children across household income levels. Nutrient dense and affordable food choices, such as RTEC, may be a helpful strategy to improve the diet quality of Canadians, particularly those with a lower household income.

Measuring retail productivity: proposition of a new method for decision making

This paper proposes an elegant way of estimating retail productivity through a mathematical model inspired by FGLS multivariate linear regression, using the error equation obtained as a hidden variable estimator to be used as inferred efficiency. This methodology was applied to a dataset obtained from a leading ready-to-eat cereal (RTEC) manufacturer and demonstrated substantial results. Unlike conventional ordinary least squares (OLS) regressions, the proposed approach offers benchmarking information relative to the best-performing retailers, as opposed to the typical relative-to-average outcomes of regressions. Furthermore, in contrast to traditional data envelopment analysis (DEA), this methodology relies on the entire dataset to establish the efficiency index, thereby addressing limitations imposed by DEA and allowing for executive discretion and flexibility in the analysis.

Folate and vitamin B12 usual intake and biomarker status by intake source in United States adults aged ≥19 y: NHANES 2007–2018

BackgroundFolate and vitamin B12 are important biomarkers of nutritional status of populations. ObjectivesThis study aims to estimate folate and vitamin B12 usual intakes among United States adults and examine folate and vitamin B12 biomarker status by intake source. MethodsWe analyzed data for United States adults aged ≥19 y from National Health and Nutrition Examination Survey 2007–2018 (n = 31,128), during which time voluntary corn masa flour (CMF) fortification was started. Usual intake was estimated using the National Cancer Institute method. Folate intake included folate from natural foods and folic acid from 4 sources: enriched cereal grain products (ECGPs), CMF, ready-to-eat cereals (RTEs), and folic acid–containing supplements (SUP). Vitamin B12 intake was mainly from food and supplements. ResultsThe median natural food folate intake (222 μg dietary folate equivalents (DFE)/d) was below the estimated average requirement (EAR) of 320 μg DFE/d. The proportions of those who consumed folic acid from ECGP/CMF only, ECGP/CMF + RTE, ECGP/CMF + SUP, and ECGP/CMF + RTE + SUP were 50%, 18%, 22%, and 10%, respectively. Median usual folic acid intakes (μg/d) were 236 (IQR: 152, 439) overall and 134, 313, 496, and 695 in the ECGP/CMF only, ECGP/CMF + RTE, ECGP/CMF + SUP, and ECGP/CMF + RTE + SUP folic acid consumption groups, respectively. Overall, 2.0% (95% CI: 1.7%, 2.3%) of adults, all of whom used folic acid supplements, consumed greater than the tolerable upper intake level (UL) of 1000 μg/d folic acid. The median usual vitamin B12 intake (μg/d) was 5.2 for vitamin B12 supplement nonusers and 21.8 for users. Consumption of RTE and/or supplements with folic acid was associated with higher serum and red blood cell folate concentrations. Vitamin B12 supplement users had significantly higher serum vitamin B12 concentrations. ConclusionsFolic acid fortification plays a critical role in helping United States adults meet the folate EAR. At current fortification levels, United States adults who do not consume supplements do not have the usual folic acid intake exceeding the UL.

An Analysis of Consumer Willingness to Pay for Sorghum-Pigeon Pea Flakes: A Case of Makueni and Busia Counties, Kenya

Purpose: The study seeks to determine the level of awareness and the highest amount consumers were willing to pay by positioning the novel product ready-to eat-cereals for breakfast Sorghum-pigeon pea processed from locally grown crop.&#x0D; Methodology: Contingent Valuation Method (CVM) to assess consumer willingness to pay (WTP) for sorghum-pigeon pea flakes, which are Ready-to-Eat Cereals (RTEC). Three-stage sampling technique was used in selection of the two counties, and from each county three market places was identified. Glen sample size formula was used to obtain the total number of respondents, whereby a well semi-structured dichotomous questionnaire was used on 223 consumers from Makueni and Busia counties in Kenya. Double bounded logit model was employed in determining consumers' willingness to pay (WTP) for SPPF.&#x0D; Findings: Results from the WTP assessment showed that consumers in both counties were willing to pay for the Sorghum-Pigeon Pea Flakes. The average WTP value in Busia and Makueni Counties was 140 and 136 Kenya Shillings, respectively. Further, nearly half of the respondents in both counties were aware of the ready-to-eat breakfast cereal SPPF for nutritional improvement. According to the findings of the double-bounded logit regression, being male, marital status, awareness of SPPF, and living in Busia County all positively influenced WTP for SPP. Having formal employment and household expenditure, on the other hand, had a negative impact on the WTP for SPPF.&#x0D; Recommendations: The study recommends nutritional training to raise awareness of the benefits of consuming SPP. Furthermore, policies should focus on raising awareness of the nutritional benefits of SPPF among families, particularly those in Makueni.

Folate and Vitamin B12 Usual Intake and Biomarker Status in U.S. Adults: National Health and Nutrition Examination Survey (NHANES) 2007–2018

Abstract Objectives There are 3 major folic acid intake sources in the US—enriched cereal grain products (ECGP), ready-to-eat cereals (RTE), and folic acid containing supplements (SUP), generating 4 mutually exclusive consumption groups. This study aims to describe the contribution of these sources to folic acid intakes above the tolerable upper intake level (UL, 1000 mg/d), and their impact on red blood cell (RBC) folate and serum vitamin B12 concentrations. Methods We used data for nonpregnant US adults (≥19 y) from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 (n = 31,128); serum vitamin B12 data were only available for 2011–2014 (n = 9,298). Median usual intake was estimated from two 24-h dietary recalls using the National Cancer Institute (NCI) method. Statistical analyses accounted for complex survey design using appropriate weights. Results The proportions of those who consumed folic acid from ECGP only, ECGP +RTE, ECGP +SUP, and ECGP +RTE +SUP were 50%, 18%, 22%, and 10%, and the median modelled usual folic acid intakes (mg/d) were 126 (interquartile range (IQR): 92,168), 308 (IQR: 267, 360), 490 (IQR: 347, 586), and 687 (IQR: 577, 767), respectively. Overall, 1.97% (95% CI: 1.96%, 1.98%) of adults consumed &amp;gt;UL. Adults who did not consume SUP did not have intakes &amp;gt;UL. The median usual vitamin B12 intake was 6.4 (IQR: 4.1, 11.7) mg/d. Consumption of RTE and/or SUP was associated with higher RBC folate concentrations (nmol/L) (ECGP only: 976 [95% CI: 963, 989], ECGP +RTE: 1130 [95% CI: 1110, 1150], ECGP +SUP: 1307 [95% CI: 1283, 1332], ECGP +RTE +SUP: 1467 [95% CI: 1439, 1495]). Serum vitamin B12 concentrations (pmol/L) were 350 (95% CI: 343, 356; ECGP only), 380 (95% CI: 366, 393; ECGP +RTE), 456 (95% CI: 440, 473; ECGP +SUP), and 485 (95% CI: 462, 509; ECGP +RTE +SUP). RBC folate deficiency (&amp;lt;305 nmol/L) was &amp;lt; 2% and vitamin B12 deficiency (&amp;lt;148 pmol/L) was &amp;lt; 6% across all folic acid consumption groups. Conclusions Folate and vitamin B12 deficiencies are low in the US population. At current fortification levels, US adults who do not consume supplements do not have usual folic acid intake exceeding the UL. Vitamin B12 intake among most US adults meets the recommended daily allowance (2.4 mg/d). Funding Sources This project was conducted with no specific support..

Consumption of Ready-to-Eat Cereal and Its Associations with Daily Nutrient Intake in Children Receiving WIC Benefits, NHANES 2013–2016

ObjectivesThe Special Supplemental Nutrition Program for Women, Infants and Children (WIC program) is a federal program providing nutritious foods to eligible participants in the United States. Ready-to-eat cereal (RTEC) products that meet certain nutrition requirements are included in the WIC package. Consumption of RTEC and its association with nutrient intake in this population, however, has not been examined. This study was conducted to estimate the association between consumption of RTEC and daily nutrient intake in children receiving WIC benefits in the United States.Methods531 children aged 1 to 5 years from the National Health and Nutrition Examination Survey (NHANES) 2013–2016 who were receiving WIC benefits at the time of the NHANES interview were classified as RTEC eaters or non-eaters depending on whether RTEC was reported in their day-1 dietary recall. Nutrient Intake was estimated as total intake from the day-1 dietary recall and was compared by RTEC consumption status using ANOVA for survey data.ResultsForty-five % of WIC children reported RTEC consumption. Those who reported RTEC consumption had significantly higher intake of energy (12%), carbohydrate (19%), dietary fiber (16%), calcium (18%), iron (75%), zinc (47%), vitamin A (36%) thiamin (39%), riboflavin (32%), niacin (41%), vitamin B6 (53%), folate (116%), vitamin B12 (57%), and vitamin D (28%), compared to non-eaters.ConclusionsThe results showed that consumption of RTEC was associated with higher intake of key vitamins and minerals in WIC children.Funding SourcesThe study was supported by Bell Institute of Health and Nutrition, General Mills, Inc.

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.

Abstract P130: Association Between Ready-to-eat Cereal Consumption And Nutrient Intakes Among Children 2 To 18 Years, Stratified By Household Income: Results From The National Health And Nutrition Examination Survey 2015-2018

Ready-to-eat (RTE) cereal has been associated with higher diet quality and dairy intake (it is often consumed with milk) in children and is an affordable source of under-consumed nutrients and whole grains. Because of its affordability and accessibility, the contribution of RTE cereal to nutrient and whole grain intake could potentially differ by household income level. We hypothesized that children living in low income households, which may be more susceptible to poor dietary intakes due to food insecurity, may differentially benefit, in terms of nutrient intake, from RTE cereal consumption compared to children in higher income households. The objective of this study was to quantify the nutrient intakes of U.S. children who reported consuming RTE cereal eater versus those that did not according to household income. We used data from the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey. Children 2 to 18 years (n=5,028) were stratified into six groups according to RTE cereal consumption (cereal eaters vs non-eaters) and poverty-to-income ratio (PIR; low-, mid-, and high-income). We calculated the difference in intakes of 28 nutrients between cereal eaters and non-eaters stratified by PIR. Overall, it appeared that there was a greater difference in intake of nutrients between RTE cereal eaters and non-eaters for the low-income compared to the high-income children. For example, in the low-income group, RTE cereal eaters had 23% higher calcium, 70% higher iron, and 90% higher vitamin D intake compared to non-RTE cereal eaters (p&lt;0.0001 for all). In the high-income group, these differences were attenuated with cereal eaters having 12% higher calcium (p=0.03), 58% higher iron (p&lt;0.0001), and 62% higher vitamin D intake (p&lt;0.0001) compared to non-RTE cereal eaters. These data suggest that although cereal eaters had higher intake of under-consumed nutrients across all incomes, children in the low-income group particularly benefited.

A BLP Demand Model of Product-Level Market Shares with Complementarity

Applied researchers most often estimate the demand for differentiated products assuming that at most one item can be purchased. Yet simultaneous multiple purchases are pervasive. Ignoring the interdependence among multiple purchases can lead to erroneous counterfactuals, in particular, because complementarities are ruled out. I consider the identification and estimation of a random coefficient discrete choice model of bundles, namely sets of products, when only product-level market shares are available. This last feature arises when only aggregate purchases of products, as opposed to individual purchases of bundles, are available, a very common phenomenon in practice. Following the classical approach with aggregate data, I consider a two-step method. First, using a novel inversion result in which demand can exhibit Hicksian complementarity, I recover the mean utilities of products from product-level market shares. Second, to infer the structural parameters from the mean utilities while dealing with price endogeneity, I use instrumental variables. I propose a practically useful GMM estimator whose implementation is straightforward, essentially as a standard BLP estimator. Finally, I estimate the demand for Ready-To-Eat (RTE) cereals and milk in the US. The demand estimates suggest that RTE cereals and milk are overall complementary and the synergy in consumption crucially depends on their characteristics. Ignoring such complementarities results in misleading counterfactuals.

Breakfast Characteristics and Its Association with Daily Micronutrients Intake in Children and Adolescents-A Systematic Review and Meta-Analysis.

Breakfast is an important source of key nutrients in the diet. For this reason, the aim of this review was to investigate the associations between breakfast consumption and daily micronutrients intake in both children and adolescents (aged 2–18 years). A peer-reviewed systematic search was conducted in three datasets (PubMed, Scopus and Cochrane Library) in February 2020 in English and Spanish. Two independent reviewers evaluated 3188 studies considering the AXIS critical appraisal and PRISMA methodologies. Meta-analysis was carried out comparing results according to type of breakfast consumed (Ready to eat cereals (RTEC) breakfast or other types of breakfast) and breakfast skipping. Thirty-three articles were included in the systematic review (SR) and 7 in the meta-analysis. In the SR, we observed that those children and adolescents who usually consume RTEC at breakfast had a higher consumption of B-vitamins than those not consuming RTEC at breakfast. Breakfast consumers had a higher mineral intake (iron, calcium, magnesium, potassium, zinc, and iodine) than breakfast skippers. In the Meta-Analysis, RTEC consumers had significantly higher vitamin C intake than breakfast skippers (Standard Mean Difference (SMD), −4.12; 95% confidence intervals (CI): −5.09, −3.16). Furthermore, those children who usually consume breakfast had significantly higher daily intake of calcium than breakfast skippers (SMD, −7.03; 95%CI: −9.02, −5.04). Our review proposes that breakfast consumption seems to be associated with higher daily micronutrients intake than breakfast skippers.

Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database.

Vitamin D status is relatively poor in the general population, potentially leading to various conditions. The present study evaluates the relationship between vitamin D status and intake in the UK population and the impact of vitamin D fortified ready-to-eat cereals (RTEC) on this status via data from the National Diet and Nutrition Survey (NDNS: 2008–2012). Four cohorts were addressed: ages 4–10 (n = 803), ages 11–18 (n = 884), ages 19–64 (n = 1655) and ages 65 and higher (n = 428). The impact of fortification by 4.2 μg vitamin D per 100 g of RTEC on vitamin D intake and status was mathematically modelled. Average vitamin D daily intake was age-dependent, ranging from ~2.6 (age range 4–18 years) to ~5.0 μg (older than 64 years). Average 25(OH)D concentration ranged from 43 to 51 nmol/L, the highest in children. The relationship between vitamin D intake and status followed an asymptotic curve with a predicted plateau concentration ranging from 52 in children to 83 nmol/L in elderly. The fortification model showed that serum concentrations increased with ~1.0 in children to ~6.5 nmol/L in the elderly. This study revealed that vitamin D intake in the UK population is low with 25(OH)D concentrations being suboptimal for general health. Fortification of breakfast cereals can contribute to improve overall vitamin D status.

Association Between Ready-to-Eat Cereal Consumption and Serum Level of 25-hydroxyvitamin D in US Children and Adults, NHANES 2013–2014

Abstract Objectives Previous studies have shown that consumption of ready-to-eat (RTE) cereal is associated with higher dietary intake of vitamin D; however, little is known about the association between RTE cereal consumption and vitamin D status measured by the serum biomarker, 25-hydroxyvitamin D. The study was conducted to examine association between consumption of RTE cereal and serum level of 25-hydroxyvitamin D, the clinical biomarker for vitamin D status in children and adults in the United States. Methods Children aged 1–18 years old (N = 2553) and adults aged 19 years or older (N = 4901) from the National Health and Nutrition Examination Survey 2013–2014 were included in the study. Day 1 dietary data were used to classify participants by RTE cereal consumption status. Vitamin D deficiency and inadequacy were assessed by serum levels of 25-hydroxyvitaminD using cut-off values recommended by the National Academy of Medicine. Adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated using survey logistic regression for associations between RTEC consumption and vitamin D status in children and adults. Results Both children and adults who reported RTE cereal consumption had a significantly higher level of serum 25-hydroxyitamin D than children and adults who did not consume RTE cereal (P &amp;lt; 0.05). Adjusting for age, gender, race/ethnicity, family income to poverty ratio, season of data collection, and use of vitamin D containing supplements, children who consumed RTE cereal were less likely to have vitamin D inadequacy than non-eaters (aOR = 0.48, 95% CI = [0.34, 0.68]). In adults, RTEC eaters were less likely to have vitamin D deficiency than non-eaters (aOR = 0.52, 95% CI = [0.28, 0.97]). Conclusions Consumption of RTE cereal is associated with better vitamin D status in both children and adults in the United States. Funding Sources The study was funded by the Bell Institute of Health and Nutrition, General Mills, Inc.

Composition of ready-to-eat-cereals and their eligibility for marketing to children. How much does Cyprus deviate from the WHO Nutrient Profile Model?

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.

Ready-to-eat cereal fortification: a modelling study on the impact of changing ready-to-eat cereal fortification levels on population intake of nutrients.

Ready-to-eat (RTE) cereal is an important source of nutrients in the American diet. Recent regulatory changes to labelling requirements may impact the fortification of RTE cereal. We used an evidence-based approach to optimize the fortification of RTE cereal considering current dietary patterns and nutrition policy. A US modelling study of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. The percentage of the population below the Estimated Average Requirement (EAR) and above the Upper Tolerable Intake Level (UL) was modelled under three scenarios: baseline, zero fortification and optimized fortification. USA. Toddlers aged 1-3 years, n 559; children aged 4-12 years, n 1540; adolescents aged 13-18 years, n 992; and adults aged ≥19 years, n 576. Comparing current with optimized fortification, nutrient/100 g RTE cereal decreased for vitamin A, thiamin, riboflavin, niacin, vitamin B6, folic acid, vitamin B12, Ca and Fe (by 2-82 %). The amount of vitamins C and D increased (by 13 and 50 %, respectively). Among RTE cereal eaters, these changes resulted in modest increases in the percentage of the population aged ≥1 year below the EAR (+0·5 to +11·5 percentage points). Decreases were observed in the percentage of the population above the UL. Fortification of RTE cereal can be optimized to provide key nutrients and minimize the percentage of the population below the EAR and above the UL. Dietary intake modelling is useful to ensure that RTE cereal continues to help the population meet their nutrient needs.

Breakfast characteristics and its association with daily micronutrients intake – A systematic review and meta-analysis

AbstractIntroductionBreakfast (BF) is widely recognized as an important component of a healthy lifestyle and represents an important source of key nutrients in the diet for both adults and children. Furthermore, BF consumption seems to be associated with a better intake of vitamins and minerals in both, children and adolescents.The aim of this study was to investigate the associations between frequency and characteristics of BF consumption and its relation with micronutrients intake.Material and MethodsAn exhaustive search was carried out in three datasets in March 2019. The search strategy used to identify the articles was as follow: breakfast, food beverages appetite regulation, child nutritional physiological phenomena, diet, digestion, eating, feeding behavior, gastrointestinal absorption, hunger, nutritional requirements, nutritional status, nutritive value, breakfast skipping, meal skipping, fasting, food preferences, diet therapy, child, preschool, adolescent, breakfast skipping and meal skipping. Two independent reviewers performed the data extraction and assessed their quality and risk of bias following the PRISMA methodology and using the Cochrane risk of bias tool. Meta-analysis was performed comparing results based on type of BF: skip BF, Ready To Eat Cereal (RTEC) BF and other types of BF. DerSimonian and Laird estimators using random effects models were applied for continuous data. Effect sizes were calculated for each outcome.ResultsOut of 3105 articles, we selected 30 full-text articles for inclusion and 7 were considered for meta-analysis.. Children who usually skip BF had significantly lower daily intake of vitamin A (SMD, -10.407; 95%CI: -14.147, -6.667) and vitamin C (SMD, -4.127; 95%CI: -5.091, -3.162) than BF consumers. The intake of vitamin B1 (SMD, -16.378; 95%CI: -29.110, -3.647) and vitamin B2 [SMD, -14.757; 95%CI: -20.247, -9.268] was lower in skippers than RTEC BF consumers.Regarding to minerals, children who usually consume BF had significantly higher daily consumption of Calcium (SMD, -7.034; 95%CI: -9.029, -5.040), Iron (SMD, -6.552; 95%CI: -9.242, -3.861) and Sodium (SMD, -3.395; 95%CI: -5.554, -1.236) than BF skippers. The intake of Magnesium (SMD, -10.903; 95%CI: -18.078, -3.729) and Potassium (SMD, -6.972; 95%CI: -10.689, -3.254) was higher in RTEC BF consumers than BF skippers.DiscussionEvidence suggested that BF consumption and RTEC breakfast consumption seems to be associated with better micronutrient intake

Effects of Different Breakfast Cereals on Alertness and Wellbeing

Rationale: Previous studies have shown that there are established methodologies that can demonstrate differences between having no breakfast and consuming ready-to-eat cereals (RTEC). Much of this research has used high carbohydrate cereals (e.g. cornflakes) or high fibre cereals (e.g. wheat bran) and the present study extended this research by comparing cereals with different nutrients with a no breakfast condition. &#x0D; &#x0D; Objectives: The main objective of the study was to compare breakfast cereal conditions differing in type of grain and the presence of 2g inulin, over a 14 day period.&#x0D; &#x0D; Methods: The study involved a 14 day intervention where the participants (adults and primary school children) were assigned to either a no breakfast condition, a Rice Krispie breakfast condition or a Multi-grain condition with 2g of inulin. Questionnaires measuring aspects of wellbeing and ratings of alertness were completed at baseline and days 7 and 14.&#x0D; &#x0D; Results: Participants in the breakfast conditions reported lower scores than the no breakfast group for depression, anxiety, emotional distress, fatigue, cognitive difficulties, somatic symptoms, and digestive symptoms. These effects were observed across different cereals, in both children and adults, and were significant in both weeks. Differences between the cereal conditions were not observed in the wellbeing outcomes but the cereal with inulin was associated with increased alertness at day 14. &#x0D; &#x0D; Conclusions: Consumption of RTEC is associated with better wellbeing. These effects appear to be consistent across different products, age groups and over time. In contrast, a Multi-grain cereal with added inulin was, compared to Rice Krispies, associated with greater alertness at the end of the study which could plausibly be due to changes in gut bacteria.

Within-subject Comparison of Dietary Intake and Diet Quality on Days with and Without Ready to Eat Cereal Consumption (P18-053-19)

ObjectivesStudies have shown ready to eat cereal (RTEC) eaters had better dietary intake than non-eaters, however, little is known about within-subject differences by RTEC consumption. The study was conducted to compare differences in dietary intake and diet quality between the day with and without RTEC consumption in adults from the United States. MethodsData from the National Health and Nutrition Examination Survey 2013–2014 and 2015–2016 were used in the study. The sample comprised of 1818 adults aged 18 years or older who reported consumption of RTEC in one day but not the other day based on two 24-hour dietary recalls. Energy and nutrient intake were obtained from the dietary data, whereas intake of whole grains and added sugar were estimated using Food Patterns Equivalent Database. Diet quality was measured by Healthy Eating Index 2015 (HEI-2015). Multiple linear regression analyses for surveys were conducted to estimate within-subject differences in each outcome by RTEC consumption while adjusting for recall day, recall method, as well as a separate fixed effect of each person to control for demographic characteristics. ResultsSubjects had significantly higher intake of vitamin A, vitamin D, vitamin B12, vitamin B6, thiamin, riboflavin, niacin, folate, calcium, magnesium, iron, zinc, potassium, phosphorus, carbohydrate, as well as dietary fiber and whole grains, together with significantly lower intake of total fat and sodium, on the day when they consumed RTEC than the day when RTEC was not consumed (P < 0.05 for all). Total energy intake, intake of protein and total sugar as well as added sugar did not differ significantly between the day with and without RTEC consumption. On days when RTEC was consumed, HEI-2015 total score, as well as sub scores for adequacy components including whole fruits, whole grains, dairy, and moderation components including saturated fat, added sugar, and sodium, were significantly higher (P < 0.05 for all). ConclusionsWhen adults consumed RTEC on a given day, they had a healthier diet with higher daily intake of dietary fiber, whole grains, as well as many key vitamins and minerals than the day when they did not consume RTEC. RTEC consumption is not associated with total energy intake and intake of total sugar or added sugar. Funding SourcesThe study was funded by General Mills, Inc.

Associations Between Consumption of Ready to Eat Cereal and Dietary Intake and Diet Quality in Hispanics (P18-052-19)

ObjectivesTo understand consumption pattern of ready to eat cereal (RTEC) in the Hispanic population in the United States and investigate associations between RTEC consumption and dietary intake as well as diet quality in this population. MethodsChildren aged between 2–17 years old (N = 899) and adults aged 18 years or older (N = 1593) who were Mexican American or other Hispanics from the National Health and Nutrition Examination Survey 2015–2016 were included in the study. Day 1 dietary data were used to determine RTEC consumption status, energy intake, nutrient and food group intake. Diet quality was measured as the Healthy Eating Index 2015 (HEI-2015). Multiple linear regression analyses for surveys were conducted to estimate covariates-adjusted associations between RTEC consumption and dietary intake, as well as diet quality. ResultsAbout 40% of Hispanic children reported RTEC consumption whereas only 14% of Hispanic adults were RTEC eaters. RTEC eaters were more likely from lower income families. Compared to non-eaters, both children and adults who reported RTEC consumption had significantly higher intake of whole grains, dairy products, and vitamins and minerals such as calcium, iron, zinc, folate, thiamin, riboflavin, niacin, vitamin B12, vitamin B6, vitamin A, vitamin D; as well as significantly lower intake of sodium and dietary cholesterol (P < 0.05 for all). Total energy intake and added sugar intake did not differ by RTEC consumption status in both age groups. HEI-2015 total score was significantly higher in RTEC eaters than non-eaters in both Hispanic children and adults (P < 0.05 for both). ConclusionsConsumption of RTEC is associated with improved diet quality including higher intake of whole grain and dairy products, as well as several vitamins and minerals in both Hispanic children and adults. Consumption of RTEC is not associated with total energy intake or added sugar in the Hispanic population. Funding SourcesThe study was funded by General Mills, Inc.

Gluten Content of Brand Name Food Products in a Food and Nutrient Database That Includes Leading U.S. Food Brands (FS10-02-19)

ObjectivesDescribe the gluten content of leading U.S. brands of cookies, crackers, hot cereals, ready-to-eat (RTE) cereals, specially formulated bars (e.g., Clif, Luna bars), granola bars, savory snacks, and candies. MethodsTo address the needs of researcherers examining the role of gluten in gastrointestinal health, gluten was added to a U.S. food and nutrient database. Few foods have been chemically analyzed for their gluten content. Thus, gluten values were assigned to foods based on the assumptions that: 1) foods that do not include any gluten containing grains or their derivatives- wheat, rye or barley may be presumed to contain 0 grams of gluten; and 2) a specified fraction of vegetable protein found in wheat, rye, barley and their derivatives (0.75) may be presumed to be gluten (factor selected based on studies in which gluten content of some gluten containing grains were determined by chemical analysis). Gluten values were assigned to brand name products in the database, thus presenting a unique opportunity to describe the gluten content of brand name products in the U.S. marketplace. For each food category the % of products containing gluten was calculated, and the mean and range in gluten content among gluten containing products were determined. ResultsFood categories with the highest proportion of products containing gluten were cookies (97.1%), crackers (82.7%), hot cereals (66.0%), and RTE cereals (64.8%). Categories with the lowest proportions were candies (15.7%) and savory snacks (25.0%). The mean gluten content among gluten containing products was highest for hot cereals (2.62 grams/serving), crackers (1.82 grams/serving), RTE cereals (1.76 grams/serving), and savory snacks (1.51 grams/serving). Granola bars and specially formulated bars had the lowest content (0.27 and 0.31 grams/serving respectively). The range in gluten content per serving for gluten containing products was lowest for granola bars (0.002–1.11 grams/serving) and highest for RTE cereals (0.001–7.03 grams/serving). ConclusionsThere is considerable variation in the gluten content of brand name products in the categories examined in this study. Studies quantifying dietary gluten intake may need to consider using a dietary assessment method that captures product brand. Funding SourcesAmerican Gastroenterological Association. Supporting Tables, Images and/or Graphs▪