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Khan AS, Frank T, Swart RE. Child-directed marketing on packaged breakfast cereals in South Africa. Public Health Nutr 2023; 26:2139-2148. [PMID: 37539472 PMCID: PMC10564615 DOI: 10.1017/s1368980023001507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE Childhood obesity is on the rise in South Africa (SA), and child-directed marketing (CDM) is one of the contributing factors to children's unhealthy food choices. This study assessed CDM on packaged breakfast cereals available in SA supermarkets and their nutritional quality. DESIGN Photographic images were examined in a descriptive quantitative study. A codebook of definitions of CDM was developed for this purpose. REDCap, an online research database, was used for data capturing, and SPSS was used for data analyses including cross-tabulations and one-way ANOVA. SETTING The current study was set in the Western Cape province of SA. SUBJECTS Photographic images of all packaged breakfast cereals sold in major retailers in the Western Cape province of SA in 2019 were studied. RESULTS CDM strategies were classified as direct (to the child) or indirect (through the parent). A total of 222 breakfast cereals were studied, of which 96·9 % had a nutritional or health claim, 95·0 % had illustrations, 75·2 % had product and consumption appeals, 10·8 % had characters, 10·8 % consisted of different appeals, 8·6 % alluded to fantasy and 7·7 % had role models. In breakfast cereals with direct CDM, the protein and fibre content was significantly lower than in breakfast cereals without direct CDM. This study found a significantly higher total carbohydrate and total sugar content in breakfast cereals with direct CDM than those without direct CDM. CONCLUSION CDM was highly prevalent in breakfast cereals sold in SA. Regulations to curb the marketing of packaged foods high in nutrients of concern is recommended.
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Affiliation(s)
- Alice S Khan
- Department of Dietetics and Nutrition, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
| | - Tamryn Frank
- School of Public Health, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
| | - Rina Elizabeth Swart
- Department of Dietetics and Nutrition, University of the Western Cape, Robert Sobukwe Road, Belville, 7535Cape Town, South Africa
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Ganderats-Fuentes M, Morgan S. Front-of-Package Nutrition Labeling and Its Impact on Food Industry Practices: A Systematic Review of the Evidence. Nutrients 2023; 15:nu15112630. [PMID: 37299593 DOI: 10.3390/nu15112630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
The obesity epidemic has become a major public health concern globally, and the food supply is a significant driver of this trend. Front-of-package (FOP) labels have been implemented in many countries to encourage healthier food choices. This systematic review aimed to examine the effect of FOP label implementation on food manufacturers' practices. A comprehensive search of multiple databases was conducted following PRISMA guidelines, identifying 39 relevant articles from 1990 to 2021. The studies indicated that FOP labels conveying intuitive information influenced product reformulation, whereas those with numerical information without specific guidance had no impact on reducing unhealthy nutrients. The most common outcomes were sodium, sugar, and calorie reduction. Mandatory policies reported higher and more consistent effects on product reformulation compared to voluntary approaches. Voluntary FOP labeling resulted in low uptake and tended to be applied to healthier products. Food manufacturers responded to FOP labeling heterogeneously, depending on the label design and type of enforcement. FOP label implementation can reduce nutrients of concern but food manufacturers behave strategically by labeling healthier choices. This review provides recommendations for maximizing the benefits of using FOP labels to prevent obesity, and findings can inform future public health research and policymaking.
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Affiliation(s)
| | - Sherry Morgan
- Holman Biotech Commons, University of Pennsylvania, Philadelphia, PA 19104, USA
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O’Mahony S, O’Donovan CB, Collins N, Burke K, Doyle G, Gibney ER. Reformulation of Processed Yogurt and Breakfast Cereals over Time: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3322. [PMID: 36834017 PMCID: PMC9964677 DOI: 10.3390/ijerph20043322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Poor diet is responsible for a quarter of European non-communicable disease (NCD)-related deaths. The reformulation of sugar, salt, and saturated fat in processed packaged foods offers an opportunity to reduce consumption of nutrients of concern and also support a reduction in energy intake. To date, there have been no publications measuring progress in food reformulation by compiling published evidence for a food category. The aim of this scoping review was to identify, characterize and summarise the findings of studies analysing the reformulation of processed yogurt and breakfast cereals. The review answered the research question: "What is the impact of food reformulation on the nutrient quality of yogurt and breakfast cereals available in the retail environment?" The research protocol was defined based on PRISMA-ScR guidelines. Five databases were searched in May 2022. Thirteen studies, published between 2010 and 2021 and completed across seven countries were eligible for inclusion. There were sufficient eligible studies to identify trends in sodium, salt, and sugar reduction in breakfast cereals. However, there was minimal or no reduction in energy, which may bring into question the use of food reformulation as part of an overall health strategy for obesity reduction.
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Affiliation(s)
- Sinead O’Mahony
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Clare B. O’Donovan
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Nuala Collins
- Food Safety Authority of Ireland, The Exchange, Georges Dock, D01 P2V6 Dublin, Ireland
| | - Kevin Burke
- Department of Mathematics and Statistics, University of Limerick, V94 T9PX Limerick, Ireland
| | - Gerardine Doyle
- College of Business, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- UCD Geary Institute of Public Policy, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Eileen R. Gibney
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin (UCD), Belfield, D04 V1W8 Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
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Ducksbury C, Stefoska-Needham A. A Cross-Sectional Audit of Sorghum in Selected Cereal Food Products in Australian Supermarkets. Nutrients 2022; 14:nu14091821. [PMID: 35565789 PMCID: PMC9105842 DOI: 10.3390/nu14091821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023] Open
Abstract
Sorghum (Sorghum bicolor (L.) Moench) may play a role in mechanisms that elicit favourable health effects. In Australia, sorghum is successfully grown, but it is not widely consumed, and its presence in common food products is unknown. This study examined the utilisation of sorghum in common food products, specifically breakfast cereals and snack bars, in a cross-sectional study of five supermarkets in New South Wales, over a 7-day period in February 2020. Details relating to ingredients, food format, brand, and product name were recorded. Sorghum was present in 6.1% (23/379) of breakfast cereals in a variety of formats, such as extruded shapes, flour, and puffed grain. In 8.7% of these, sorghum was listed as the first ingredient (greatest contribution by weight). Sorghum was utilised in 2% (6/298) of snack bars mainly as puffed sorghum and was listed in the fourth or subsequent position in the ingredient lists for all. 'Sorghum' did not appear in the name of any products. In conclusion, this baseline study indicates that sorghum is present in a small proportion of breakfast cereals and snack bars, highlighting the opportunity for greater investment in sorghum food innovation and marketing that would encourage consumer recognition and expand the product range.
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Affiliation(s)
- Cecily Ducksbury
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia;
- Correspondence:
| | - Anita Stefoska-Needham
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia;
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
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The Picky Eating Questionnaire and Child-reported Food Preference Questionnaire: Pilot validation in Australian-Indian mothers and children 7-12 years old. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Manohar N, Hayen A, Do L, Scott J, Bhole S, Arora A. Early life and socio-economic determinants of dietary trajectories in infancy and early childhood - results from the HSHK birth cohort study. Nutr J 2021; 20:76. [PMID: 34493286 PMCID: PMC8424821 DOI: 10.1186/s12937-021-00731-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Early childhood is a period when dietary behaviours are established. This study aimed to examine the longitudinal intake of core and discretionary foods and identify early life and socio-economic factors influencing those intakes. METHODS Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids study, an ongoing birth cohort study, were interviewed. The information on 'weekly frequency of core and discretionary foods intake' using a food frequency questionnaire was collected at 4 months, 8 months, 1 year, 2 years and 3 years age points. Group-based trajectory modelling analyses were performed to identify diet trajectories for 'core' and 'discretionary' foods respectively. A multinomial logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. RESULTS The intake of core and discretionary foods each showed distinct quadratic (n = 3) trajectories with age. Overall, core foods intake increased rapidly in the first year of life, followed by a decline after age two, whereas discretionary foods intake increased steadily across the five age points. Multiparity (Relative Risk (RR): 0.46, 95%CI: 0.27-0.77), non-English speaking ethnicity of mother (RR: 0.66, 95%CI: 0.47-0.91) and having a single mother (RR: 0.40, 95%CI: 0.18-0.85) were associated with low trajectories of core foods intake whereas older maternal age (RR: 1.05, 95%CI: 1.01-1.08) and longer breastfeeding duration (RR: 1.02, 95%CI: 1.00-1.03) were associated with higher trajectories of core foods intake. Also, multiparity (RR 2.63, 95%CI: 1.47-4.70), low maternal education (RR 3.01, 95%CI: 1.61-5.65), and socio-economic disadvantage (RR 2.69, 95%CI: 1.31-5.55) were associated with high trajectories of discretionary foods intake. Conversely, longer duration of breastfeeding (RR 0.99, 95%CI: 0.97-0.99), and timely introduction of complementary foods (RR 0.30, 95%CI: 0.15-0.61) had a protective effect against high discretionary foods consumption in infancy and early childhood. CONCLUSION Children's frequency of discretionary foods intake increases markedly as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socio-demographic factors and infant feeding choices. Hence, there is a need for targeted strategies to improve nutrition in early childhood and ultimately prevent the incidence of chronic diseases in children.
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Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia
- Australian College of Physical Education, Sydney Olympic Park, NSW, 2127, Australia
| | - Andrew Hayen
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Loc Do
- Faculty of Health and Behavioural Sciences, School of Dentistry, University of Queensland, Brisbane, QLD, 4072, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Jane Scott
- Discipline of Nutrition and Dietetics, School of Population Health, Curtin University, Perth, WA, 6102, Australia
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia
- Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Surry Hills, NSW, 2010, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia.
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, Westmead, NSW, 2145, Australia.
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Impact of Dietary Trajectories on Obesity and Dental Caries in Preschool Children: Findings from the Healthy Smiles Healthy Kids Study. Nutrients 2021; 13:nu13072240. [PMID: 34209914 PMCID: PMC8308427 DOI: 10.3390/nu13072240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
This study examines the impact of longitudinal dietary trajectories on obesity and early childhood caries (ECC) in preschool children in Australia. Mother–infant dyads from the Healthy Smiles Healthy Kids study were interviewed at 4 and 8 months, and 1, 2, and 3 years of age. Children underwent anthropometric and oral health assessments between 3 and 4 years of age. Multivariable logistic regression and negative binomial regression analysis were performed for the prevalence of overweight and obesity, and the number of tooth surfaces with dental caries, respectively. The intake of core, discretionary, and sugary foods showed distinct quadratic (n = 3) trajectories with age. The prevalence of overweight or obesity was 10% (n = 72) and that of early childhood caries (ECC) was 33% (mean decayed, missing, and filled tooth surfaces (dmfs) score: 1.96). Children with the highest trajectories of discretionary foods intake were more likely to be overweight or obese (adjusted OR: 2.51, 95 %CI: 1.16–5.42). Continued breastfeeding beyond 12 months was associated with higher dmfs scores (adjusted IRR: 2.17, 95 %CI: 1.27–3.73). Highest socioeconomic disadvantage was the most significant determinant for overweight or obesity (adjusted OR: 2.86, 95 %CI: 1.11–7.34) and ECC (adjusted IRR: 2.71, 95 %CI: 1.48–4.97). Targeted health promotion interventions should be designed to prevent the incidence of two highly prevalent conditions in preschool children.
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Prada M, Saraiva M, Viegas C, Cavalheiro BP, Garrido MV. Examining the Relationship between Sugar Content, Packaging Features, and Food Claims of Breakfast Cereals. Nutrients 2021; 13:nu13061841. [PMID: 34071159 PMCID: PMC8229424 DOI: 10.3390/nu13061841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/14/2023] Open
Abstract
Excessive free-sugar intake has become highly prevalent in numerous countries, and Portugal is not the exception. One product category that contributes to the daily intake of free sugars is breakfast cereals. In the current work, we identified 289 exemplars from two major retailers in Portugal and collected information on their nutritional profile (e.g., sugar, salt, fiber per 100 g), price, packaging features, type of food claims present (e.g., statements about the composition, sensory features, the origin of the product), and ingredients list. Overall, the sugar content of breakfast cereals was high (Mean = 19.9 g), and less than 10% of the products complied with the current national guidelines (i.e., 5 g of sugar per 100 g of product). Sugar (or other sugar sources) was listed in the top three ingredients for over 85% of the products. On average, each product included about four claims (Mean = 3.9), and sugar content was lower when the claims were related to the product composition. Critically, the sugar content was particularly high for children-oriented products (Mean = 26.4 g). Correlation analysis showed that breakfast cereals with higher sugar content also were cheaper and had lower quantities of fiber, proteins, and salt. Our findings suggest the need to implement strategies to reduce sugar in this product category (e.g., incentivize manufacturers to reformulate products). Also, our results may inform strategies aimed at promoting consumers' awareness about the sugar content in breakfast cereals and other processed foods, facilitating healthier decision-making.
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Affiliation(s)
- Marília Prada
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
- Correspondence: ; Tel.:+351-217-650-214
| | - Magda Saraiva
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
| | - Claúdia Viegas
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Av. D. João II, Lote 4.69.0.1, Parque das Nações, 1990-096 Lisboa, Portugal;
- Centre for Tourism Research, Development and Innovation-Pòlo do Estoril, Avenida Condes de Barcelona, n.° 808, 2769-510 Estoril, Portugal
| | - Bernardo P. Cavalheiro
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
| | - Margarida Vaz Garrido
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário de Lisboa, CIS_Iscte, Av. das Forças Armadas, Office AA110, 1649-026 Lisboa, Portugal; (M.S.); (B.P.C.); (M.V.G.)
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Assessing nutritional value of ready-to-eat breakfast cereals in the province of Quebec (Canada): a study from the Food Quality Observatory. Public Health Nutr 2021; 24:2397-2404. [PMID: 33843558 DOI: 10.1017/s1368980021001361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The Food Quality Observatory was created in the province of Quebec (Canada) in 2016. In this study, the Observatory aimed to generate a methodology to (1) test the use of sales data combined with nutrient values to characterise the nutritional composition of ready-to-eat (RTE) breakfast cereals offered and purchased in the province of Quebec (Canada) and (2) verify the extent to which a front-of-pack label based on the percentage of daily value (DV) for total sugar, as a strategy to improve the food supply, would be distributed in this food category. DESIGN Nutritional information were obtained by purchasing each RTE breakfast cereal available in the Greater Montreal area. Cereals were then classified according to their processing type. SETTING The nutritional values of 331 RTE breakfast cereals available in Quebec were merged with sales data covering the period between May 2016 and May 2017. A total of 306 products were successfully cross-referenced. RESULTS Granola and sweetened cereals were the most available (36·6 % and 19·6 %, respectively) and purchased (19·8 % and 40·9 % of sales, respectively). When compared with other types of cereals, granola cereals had a higher energy, fat, saturated fat, protein content and a lower Na content. A larger proportion of chocolate (65 %) and sweetened cereals (49 %) were above 15 % of the DV for sugar. CONCLUSIONS This study showed that the methodology developed generates important data to monitor nutritional quality of the food supply and ultimately contribute to improve the nutritional quality of processed foods.
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Croisier E, Hughes J, Duncombe S, Grafenauer S. Back in Time for Breakfast: An Analysis of the Changing Breakfast Cereal Aisle. Nutrients 2021; 13:nu13020489. [PMID: 33540761 PMCID: PMC7912995 DOI: 10.3390/nu13020489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
- Emilie Croisier
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia; (E.C.); (S.D.)
| | - Jaimee Hughes
- Grains & Legumes Nutrition Council, 1 Rivett Road, North Ryde, NSW 2113, Australia;
| | - Stephanie Duncombe
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia; (E.C.); (S.D.)
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Sara Grafenauer
- Grains & Legumes Nutrition Council, 1 Rivett Road, North Ryde, NSW 2113, Australia;
- School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Correspondence: ; Tel.: +61-401-265-142
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Fichera E, von Hinke S. The response to nutritional labels: Evidence from a quasi-experiment. JOURNAL OF HEALTH ECONOMICS 2020; 72:102326. [PMID: 32526549 DOI: 10.1016/j.jhealeco.2020.102326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/29/2020] [Accepted: 04/08/2020] [Indexed: 05/09/2023]
Abstract
This paper evaluates a UK policy that aimed to improve dietary information provision by introducing nutrition labelling on retailers' store-brand products. Exploiting the differential timing of the introduction of Front-of-Pack nutrition labels as a quasi-experiment, our findings suggest that labelling led to a reduction in the quantity purchased of labelled store-brand foods, and an improvement in their nutritional composition. More specifically, we find that households reduced the total monthly calories from labelled store-brand foods by 588 kcal, saturated fats by 14 g, sugars by 7 g, and sodium by 0.8 mg.
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Affiliation(s)
- Eleonora Fichera
- Department of Economics, University of Bath and Institute for Fiscal Studies, United Kingdom; Institute for Fiscal Studies, United Kingdom.
| | - Stephanie von Hinke
- School of Economics, University of Bristol, United Kingdom; Erasmus School of Economics, Erasmus University Rotterdam, The Netherlands; Institute for Fiscal Studies, United Kingdom.
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The nutritional content of children's breakfast cereals: a cross-sectional analysis of New Zealand, Australia, the UK, Canada and the USA. Public Health Nutr 2019; 23:1589-1598. [PMID: 31847924 DOI: 10.1017/s1368980019003537] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare the Nutrition Information Panel (NIP) content, serving size and package size of children's ready-to-eat breakfast cereals (RTEC) available in five different Western countries. DESIGN NIP label information was collected from RTEC available for purchase in major supermarket chains. Kruskal-Wallis, Mann-Whitney U and χ2 tests were applied to detect differences between countries on manufacturer-declared serving size, total energy (kJ), total protein, fat, saturated fat, carbohydrate, total sugar, Na and fibre content. The Nutrient Profiling Scoring Criterion (NPSC) was used to evaluate the number of products deemed to be 'unhealthy'. SETTING Supermarkets in Australia, Canada, New Zealand, the UK and the USA. PARTICIPANTS Children's breakfast cereals (n 636), including those with and without promotional characters. RESULTS The majority of children's RTEC contained substantial levels of total sugar and differences were apparent between countries. Median sugar content per serving was higher in US cereals than all other countries (10·0 v. 7·7-9·1 g; P < 0·0001). Median fat and saturated fat content were lowest in Australia and New Zealand RTEC, while the Na content of RTEC was 60-120 % higher in the USA and Canada than in Australia and the UK (all P ≤ 0·01). CONCLUSIONS Across all countries, there was a high proportion of RTEC marketed for children that had an unhealthy nutrient profile. Strategies and policies are needed to improve the nutrient value of RTEC for children, so they provide a breakfast food that meets nutrition guidelines.
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Kiewlicz J, Rybicka I. Minerals and their bioavailability in relation to dietary fiber, phytates and tannins from gluten and gluten-free flakes. Food Chem 2019; 305:125452. [PMID: 31514050 DOI: 10.1016/j.foodchem.2019.125452] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/29/2019] [Accepted: 09/01/2019] [Indexed: 01/13/2023]
Abstract
Flakes are an assortment of grain products mainly consumed for breakfast. Most of them are important source of nutrients including minerals. Twenty commercial flakes from different raw materials were included in this study, both gluten (barley, rye, spelt, wheat) and gluten-free (amaranth, buckwheat, corn, quinoa, millet, oat, rice, teff). The content of minerals (Ca, Fe, K, Mg, Mn, Na and Zn), dietary fiber (total, soluble and insoluble), tannins and phytates was determined. Moreover, the phytates:mineral molar ratios and the percentage of the realization of mineral requirements were calculated. For the first time the mineral bioavailability from the gluten and gluten-free flakes was evaluated and compared. It allowed indicating amaranth and teff products as flakes with the highest impact on the realization of daily requirements for minerals, especially for magnesium and iron. This aspect is particularly important for people on a gluten-free diet who often represent mineral deficiencies.
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Affiliation(s)
- Justyna Kiewlicz
- Faculty of Commodity Science, Poznań University of Economics and Business, al. Niepodległości 10, 61-875 Poznań, Poland
| | - Iga Rybicka
- Faculty of Commodity Science, Poznań University of Economics and Business, al. Niepodległości 10, 61-875 Poznań, Poland.
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Sussman RL, McMahon AT, Neale EP. An Audit of the Nutrition and Health Claims on Breakfast Cereals in Supermarkets in the Illawarra Region of Australia. Nutrients 2019; 11:nu11071604. [PMID: 31311152 PMCID: PMC6683094 DOI: 10.3390/nu11071604] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/01/2019] [Accepted: 07/09/2019] [Indexed: 01/09/2023] Open
Abstract
Nutrition and health claims can promote healthier food choices but may lead to consumer confusion if misused. Regular monitoring of claims is therefore required. This study aimed to explore the prevalence of nutrition and health claims carried on breakfast cereals in supermarkets, and to assess claim compliance with regulations. Nutrition and health claims on breakfast cereal products across five supermarkets in the Illawarra region of New South Wales, Australia, were recorded in a cross-sectional audit. Prevalence of claim type and claim compliance was determined. Claims were compared across categories of breakfast cereal. Almost all (95.7%) products audited carried at least one nutrition or health claim; nutrition content (n = 1096) was more prevalent than health claims (n = 213). Most claims (91.6%) were compliant with regulations. Additionally, claim prevalence and type differed according to breakfast cereal category, with the highest proportion of claims appearing on ‘health and wellbeing’ and ‘muesli’ products. There is a high prevalence of nutrition and health claims on breakfast cereals, with most claims compliant with regulations. Research should investigate consumer interpretation of claims and the impact of applying nutrient profiling for all claims to assist consumers to make informed health choices.
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Affiliation(s)
- Romi L Sussman
- School of Medicine, University of Wollongong, Wollongong 2522, New South Wales, Australia
| | - Anne T McMahon
- School of Health and Society, University of Wollongong, Wollongong 2522, New South Wales, Australia
| | - Elizabeth P Neale
- School of Medicine, University of Wollongong, Wollongong 2522, New South Wales, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, New South Wales, Australia.
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Shangguan S, Afshin A, Shulkin M, Ma W, Marsden D, Smith J, Saheb-Kashaf M, Shi P, Micha R, Imamura F, Mozaffarian D. A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices. Am J Prev Med 2019; 56:300-314. [PMID: 30573335 PMCID: PMC6340779 DOI: 10.1016/j.amepre.2018.09.024] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 01/03/2023]
Abstract
CONTEXT The influence of food and beverage labeling (food labeling) on consumer behaviors, industry responses, and health outcomes is not well established. EVIDENCE ACQUISITION PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Ten databases were searched in 2014 for studies published after 1990 evaluating food labeling and consumer purchases/orders, intakes, metabolic risk factors, and industry responses. Data extractions were performed independently and in duplicate. Studies were pooled using inverse-variance random effects meta-analysis. Heterogeneity was explored with I2, stratified analyses, and meta-regression; and publication bias was assessed with funnel plots, Begg's tests, and Egger's tests. Analyses were completed in 2017. EVIDENCE SYNTHESIS From 6,232 articles, a total of 60 studies were identified, including 2 million observations across 111 intervention arms in 11 countries. Food labeling decreased consumer intakes of energy by 6.6% (95% CI= -8.8%, -4.4%, n=31), total fat by 10.6% (95% CI= -17.7%, -3.5%, n=13), and other unhealthy dietary options by 13.0% (95% CI= -25.7%, -0.2%, n=16), while increasing vegetable consumption by 13.5% (95% CI=2.4%, 24.6%, n=5). Evaluating industry responses, labeling decreased product contents of sodium by 8.9% (95% CI= -17.3%, -0.6%, n=4) and artificial trans fat by 64.3% (95% CI= -91.1%, -37.5%, n=3). No significant heterogeneity was identified by label placement or type, duration, labeled product, region, population, voluntary or legislative approaches, combined intervention components, study design, or quality. Evidence for publication bias was not identified. CONCLUSIONS From reviewing 60 intervention studies, food labeling reduces consumer dietary intake of selected nutrients and influences industry practices to reduce product contents of sodium and artificial trans fat.
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Affiliation(s)
- Siyi Shangguan
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ashkan Afshin
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington
| | - Masha Shulkin
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; University of Michigan Medical School, Ann Arbor, Michigan
| | - Wenjie Ma
- Clinical and Translational Epidemiology Unit and Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Daniel Marsden
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Jessica Smith
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; Bell Institute of Health and Nutrition, General Mills Inc., Minneapolis, Minnesota
| | - Michael Saheb-Kashaf
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts; School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Peilin Shi
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Renata Micha
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
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Morrison H, Meloncelli N, Pelly FE. Nutritional quality and reformulation of a selection of children's packaged foods available in Australian supermarkets: Has the Health Star Rating had an impact? Nutr Diet 2018; 76:296-304. [PMID: 30426624 DOI: 10.1111/1747-0080.12486] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 08/01/2018] [Accepted: 09/11/2018] [Indexed: 01/29/2023]
Abstract
AIM To examine whether the nutritional quality of children's packaged food products available in Australian supermarkets improved between 2013 and 2016, and whether any change could be detected in product reformulation since the introduction of the Health Star Rating (HSR) labelling scheme. METHODS Packaged food products marketed towards children were purchased from three Australian supermarkets in July 2013 (for a previous study) and July 2016. Nutritional quality was assessed using the Food Standards Australian New Zealand Nutrient Profiling Scoring Criterion. Comparisons were made between the nutrient composition and formulation of products (a) available in 2013 and 2016; and (b) with and without HSR graphics. RESULTS Of the 252 children's packaged products analysed, 53.6% were classified as 'less healthy'. HSR-labelled products had a significantly higher proportion classified as 'healthy' than those without the HSR (χ2 = 26.5; P < 0.0001; 73.8% and 59.0%, respectively). Overall, 28.5% displayed the HSR; the majority (81.5%) having a rating of ≥3.0 stars. Cereal-based products had the greatest uptake of the scheme, with HSR-labelled products having significantly lower mean energy and saturated fat content (P < 0.01) and higher mean protein and fibre content (P < 0.001) than non-HSR products. Reformulation of products that were available in 2013 had occurred in 100% of HSR-labelled products in comparison to 61.3% of non-HSR labelled products. CONCLUSIONS Despite the introduction of the HSR, more than half of children's packaged foods sampled are 'less healthy'. However, early indications suggest that the HSR may stimulate healthier product reformulation.
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Affiliation(s)
- Holly Morrison
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - Nina Meloncelli
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
| | - Fiona E Pelly
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
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17
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Tong T, Rangan A, Gemming L. Evaluating the Nutritional Content of Children's Breakfast Cereals in Australia. CHILDREN-BASEL 2018; 5:children5070084. [PMID: 29933610 PMCID: PMC6068905 DOI: 10.3390/children5070084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 11/16/2022]
Abstract
Breakfast is an important contributor to the daily dietary intake of children. This study investigated the nutritional composition of ready to eat (RTE) children’s breakfast cereals, which display fictional cartoon characters and themes, compared to other cereals available in Australia. Nutrient content claims on packaging were also examined. Data were collected from RTE breakfast cereal packages (N = 347) from four major supermarkets in Sydney. Cereals were classified based on product type and promotional information displayed. Overall, 46% of children’s cereals were classified as “less healthy” as per nutrient profiling score criteria. Children’s cereals had a similar energy and sodium content per 100 g compared to other cereals but contained significantly higher levels of total sugar and lower levels of protein and dietary fibre compared to other varieties. Children’s cereals with nutrient content claims had improved (lower) nutrient profiling scores than those that did not (2 vs. 13, p = 0.021), but total sugar per 100 g was similar: 25 g (interquartile range (IQR) 14 g) vs. 32 g (IQR 19 g). In conclusion, RTE children’s breakfast cereals were found to be less healthy compared to other cereals on the market and the use of nutrient content claims on children’s cereals may mislead consumers regarding their overall nutrient profile.
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Affiliation(s)
- Terence Tong
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney NSW 2006, Australia.
| | - Anna Rangan
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney NSW 2006, Australia.
| | - Luke Gemming
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney NSW 2006, Australia.
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18
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Spiteri SA, Olstad DL, Woods JL. Nutritional quality of new food products released into the Australian retail food market in 2015 - is the food industry part of the solution? BMC Public Health 2018; 18:222. [PMID: 29415698 PMCID: PMC5804078 DOI: 10.1186/s12889-018-5127-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 01/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Food manufacturers have made public statements and voluntary commitments, such as the Healthier Australia Commitment (HAC), to improve the nutritional quality of foods. However, limited information about the nutritional quality or healthfulness of new products makes it difficult to determine if manufacturers are doing this. The purpose of this study was to assess the healthfulness of new food products released into the Australian retail market in 2015, and whether those companies who were HAC members released healthier food options compared to non-HAC members. METHODS This cross-sectional study assessed the healthfulness of all new retail food products launched in Australia in 2015 as indexed in Mintel's Global New Products Database. Healthfulness was assessed using three classification schemes: Healthy Choices Framework Victoria, Australian Dietary Guidelines and NOVA Food Classification System. Descriptive statistics and chi-squared tests described and compared the number and proportions of new foods falling within each of the food classification schemes' categories for companies that were and were not HAC members. RESULTS In 2015, 4143 new food products were launched into the Australian market. The majority of new products were classified in each schemes' least healthy category (i.e. red, discretionary and ultra-processed). Fruits and vegetables represented just 3% of new products. HAC members launched a significantly greater proportion of foods classified as red (59% vs 51% for members and non-members, respectively) discretionary (79% vs 61%), and ultra-processed (94% vs 81%), and significantly fewer were classified as green (8% vs 15%), core foods (18% vs 36%) and minimally processed (0% vs 6%) (all p < 0.001). CONCLUSIONS This study found that the majority of new products released into the Australian retail food market in 2015 were classified in each of three schemes' least healthy categories. A greater proportion of new products launched by companies that publicly committed to improve the nutritional quality of their products were unhealthy, and a lower proportion were healthy, compared with new products launched by companies that did not so commit. Greater monitoring of industry progress in improving the healthfulness of the food supply may be warranted, with public accountability if the necessary changes are not seen.
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Affiliation(s)
- Sheree A. Spiteri
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Dana Lee Olstad
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Julie L. Woods
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
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19
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Mineral availability is modified by tannin and phytate content in sorghum flaked breakfast cereals. Food Res Int 2018; 103:509-514. [DOI: 10.1016/j.foodres.2017.09.050] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/13/2017] [Accepted: 09/17/2017] [Indexed: 01/01/2023]
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Abstract
AbstractObjectiveTo compare the nutritional quality of New Zealand breakfast cereals in 2013 and 2017.DesignNutrition Information Panel data were collected from all cereals available from two large supermarket chains in 2017 and compared with earlier published data collected in 2013.SettingUrban New Zealand supermarkets.SubjectsThe nutritional content of breakfast cereals (‘biscuits and bites’, ‘brans’, ‘bubbles, flakes and puffs’, ‘children’s cereals’, ‘muesli’ and ‘oats’) was analysed for total energy, protein, fat (total and saturated), carbohydrate, sugar, fibre and Na. The Nutrient Profile Scoring Criterion (NPSC) for each cereal was calculated to determine the proportion of ‘less healthy’ cereals (NPSC≥4) in each product category.ResultsThe energy and fat content of bubbles, flakes and puffs, muesli and oats were significantly higher in 2017 compared with 2013 (all P≤0·01). However, there was a small reduction in Na overall in 2017 (P<0·05). There was no change between 2013 and 2017 in the proportion of ‘healthy’ or ‘less healthy’ breakfast cereals available.ConclusionsThe nutrient profile of breakfast cereals has not improved since 2013, suggesting that industry self-regulation of the nutritional composition of cereals in New Zealand is not working and needs urgent reconsideration.
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21
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Wiles NL. The nutritional quality of South African ready-to-eat breakfast cereals. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2017. [DOI: 10.1080/16070658.2017.1319124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Nicola Laurelle Wiles
- Dietetics & Human Nutrition, University of KwaZulu-Natal, Pietermaritzburg, South Africa
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23
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Abstract
AbstractPrevious studies in Australian children/adolescents and adults examining added sugar (AS) intake were based on now out-of-date national surveys. We aimed to examine the AS and free sugar (FS) intakes and the main food sources of AS among Australians, using plausible dietary data collected by a multiple-pass, 24-h recall, from the 2011–12 Australian Health Survey respondents (n 8202). AS and FS intakes were estimated using a previously published method, and as defined by the WHO, respectively. Food groups contributing to the AS intake were described and compared by age group and sex by one-way ANOVA. Linear regression was used to test for trends across age groups. Usual intake of FS (as percentage energy (%EFS)) was computed using a published method and compared with the WHO cut-off of <10 %EFS. The mean AS intake of the participants was 60·3 (sd 52·6) g/d. Sugar-sweetened beverages accounted for the greatest proportion of the AS intake of the Australian population (21·4 (sd 30·1) %), followed by sugar and sweet spreads (16·3 (sd 24·5) %) and cakes, biscuits, pastries and batter-based products (15·7 (sd 24·4) %). More than half of the study population exceeded the WHO’s cut-off for FS, especially children and adolescents. Overall, 80–90 % of the daily AS intake came from high-sugar energy-dense and/or nutrient-poor foods. To conclude, the majority of Australian adults and children exceed the WHO recommendation for FS intake. Efforts to reduce AS intake should focus on energy-dense and/or nutrient-poor foods.
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24
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Schaefer D, Hooker NH, Stanton JL. Are Front of Pack Claims Indicators of Nutrition Quality? Evidence from 2 Product Categories. J Food Sci 2015; 81:H223-34. [PMID: 26641596 DOI: 10.1111/1750-3841.13150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/14/2015] [Indexed: 11/28/2022]
Abstract
American grocery shoppers face an array of front of pack (FOP) nutrition and health claims when making food selections. Such systems have been categorized as summary or nutrient specific. Either type should help consumers make judgments about the nutrition quality of a product. This research tests if the type or quantity of FOP claims are indeed good indicators of objective nutrition quality. Claim and nutrition information from more than 2200 breakfast cereals and prepared meals launched between 2006 and 2010 were analyzed using binary and multinomial logistic regression models. Results suggest that no type or number of front of pack claims could distinguish "healthy" foods. However, some types and frequencies of FOP claims were significant predictors of higher or lower levels of certain key nutrients. Given the complex and crowded label environment in which these FOP claims reside, one may be concerned that such cues are not closely related to objective measures of nutrition quality.
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Affiliation(s)
| | - Neal H Hooker
- College of Public Affairs, The Ohio State Univ, Columbus, OH, U.S.A
| | - John L Stanton
- Dept. of Food Marketing, Saint Joseph's Univ, Philadelphia, PA, U.S.A
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25
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Meloncelli NJ, Pelly FE, Cooper SL. Nutritional quality of a selection of children's packaged food available in Australia. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nina J.L. Meloncelli
- School of Health and Sport Sciences; University of the Sunshine Coast; Sunshine Coast Queensland Australia
| | - Fiona E. Pelly
- School of Health and Sport Sciences; University of the Sunshine Coast; Sunshine Coast Queensland Australia
| | - Sheri L. Cooper
- School of Health and Sport Sciences; University of the Sunshine Coast; Sunshine Coast Queensland Australia
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26
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Intake of total and added sugars and nutrient dilution in Australian children and adolescents. Br J Nutr 2015; 114:1875-86. [DOI: 10.1017/s0007114515003542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThis analysis aimed to examine the association between intake of sugars (total or added) and nutrient intake with data from a recent Australian national nutrition survey, the 2007 Australian National Children’s Nutrition and Physical Activity Survey (2007ANCNPAS). Data from participants (n 4140; 51 % male) who provided 2×plausible 24-h recalls were included in the analysis. The values on added sugars for foods were estimated using a previously published ten-step systematic methodology. Reported intakes of nutrients and foods defined in the 2007ANCNPAS were analysed by age- and sex-specific quintiles of %energy from added sugars (%EAS) or %energy from total sugars (%ETS) using ANCOVA. Linear trends across the quintiles were examined using multiple linear regression. Logistic regression analysis was used to calculate the OR of not meeting a specified nutrient reference values for Australia and New Zealand per unit in %EAS or %ETS. Analyses were adjusted for age, sex, BMI z-score and total energy intake. Small but significant negative associations were seen between %EAS and the intakes of most nutrient intakes (all P<0·001). For %ETS the associations with nutrient intakes were inconsistent; even then they were smaller than that for %EAS. In general, higher intakes of added sugars were associated with lower intakes of most nutrient-rich, ‘core’ food groups and higher intakes of energy-dense, nutrient-poor ‘extra’ foods. In conclusion, assessing intakes of added sugars may be a better approach for addressing issues of diet quality compared with intakes of total sugars.
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Intake and sources of added sugars among Australian children and adolescents. Eur J Nutr 2015; 55:2347-2355. [PMID: 26377592 DOI: 10.1007/s00394-015-1041-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/10/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE To examine the intake and sources of added sugars (AS) of Australian children and adolescents, and compare their intake of free sugars (FS) to the recommended limit set by the World Health Organization (<10 % energy from FS). METHOD Data of 4140 children and adolescents aged 2-16 years with plausible intakes based on 2 × 24 h recalls from the 2007 Australian National Children Nutrition and Physical Activity Survey were used. AS content of foods was estimated based on a published method. Intakes of AS and FS, as well as food sources of AS, were calculated. One-way ANOVA was used for comparisons between age groups and gender. RESULTS The mean (SD) AS intake was 58.9 (35.1) g/day, representing 11.9 (5.6) % of daily energy intake and 46.9 (17.5) % of daily total sugars intake. More than 80 % of the subjects had % energy from FS > 10 %. Significant increasing trends for AS intake, % energy from AS, % energy from FS across age groups were observed. Sugar-sweetened beverages (19.6 %), cakes, biscuits, pastries and batter-based products (14.3 %), and sugar and sweet spreads (10.5 %) were the top three contributors of AS intake in the whole sample. Higher contribution of AS from sugar-sweetened beverages was observed in adolescents (p trend < 0.001). CONCLUSIONS A large proportion of Australian youths are consuming excessive amounts of energy from AS. Since the main sources of AS were energy-dense, nutrient-poor foods, interventions which target the reduction in these foods would reduce energy and AS intake with minimal impact to core nutrient intake.
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Julia C, Kesse-Guyot E, Ducrot P, Péneau S, Touvier M, Méjean C, Hercberg S. Performance of a five category front-of-pack labelling system - the 5-colour nutrition label - to differentiate nutritional quality of breakfast cereals in France. BMC Public Health 2015; 15:179. [PMID: 25885583 PMCID: PMC4349460 DOI: 10.1186/s12889-015-1522-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breakfast cereals exhibit a wide variability in nutritional quality, and differences are not easily grasped by consumers. A simplified nutritional information system might contribute to help consumers make healthier food choices. A five-category colour label based on the Food Standards Agency Nutrient profiling system (FSA score) has been proposed in France to be implemented on the front-of-pack of foods (the five-colour nutrition label - 5-CNL). Objectives were to evaluate the ability of the 5-CNL to discriminate nutritional quality between types of breakfast cereals, within a category and in equivalent products, as well as its ability to change through product reformulation. METHODS Nutritional information was collected through an Internet and supermarket research for N = 433 breakfast cereals (N = 380 complete data included in the analyses). Breakfast cereals were categorized according to common attributes in terms of processing and/or ingredients used. The FSA score and 5-CNL category allocation were computed for each cereal. Nutrient content and FSA score were compared across types of cereals. Distribution within the 5-CNL categories was assessed across types of cereals and for equivalent products. Impact of reformulation (reduction of 5 and 10% in simple sugar, saturated fat and sodium) on the 5-CNL category allocation was compared to original allocation with Bapkhar's tests of homogeneity of marginal distribution. RESULTS Variability in nutritional quality of breakfast cereals was high, as reflected by the FSA score (range -7- 22 for a theoretical range of -15-40) and the 5-CNL (all five categories represented). The 5-CNL allowed for discrimination across types of cereals, within categories of breakfast cereals and for equivalent products (at least 3 categories of the 5-CNL represented). Reformulation scenarios allowed for significant change in 5-CNL allocation: 5% reduction in sugar lead to a modification of the label for 4.21% of products while a reduction of 10% of sugar, saturated fat and sodium lead to a modification of the label for 19.2% of products. CONCLUSION The 5-CNL adequately discriminates between breakfast cereals. It would therefore be an adequate tool for consumer information on nutritional quality of foods in the French context.
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Affiliation(s)
- Chantal Julia
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France. .,Hôpital Avicenne (AP-HP), Département de Santé Publique, 93017, Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
| | - Pauline Ducrot
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
| | - Sandrine Péneau
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
| | - Mathilde Touvier
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
| | - Caroline Méjean
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France.
| | - Serge Hercberg
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra(U1125), Cnam, COMUE Sorbonne Paris Cité, 93017, Bobigny, France. .,Hôpital Avicenne (AP-HP), Département de Santé Publique, 93017, Bobigny, France.
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Mandle J, Tugendhaft A, Michalow J, Hofman K. Nutrition labelling: a review of research on consumer and industry response in the global South. Glob Health Action 2015; 8:25912. [PMID: 25623608 PMCID: PMC4306755 DOI: 10.3402/gha.v8.25912] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/06/2014] [Accepted: 12/07/2014] [Indexed: 11/14/2022] Open
Abstract
Background To identify peer-reviewed research on consumers’ usage and attitudes towards the nutrition label and the food industry's response to labelling regulations outside Europe, North America, and Australia and to determine knowledge gaps for future research. Design Narrative review. Results This review identified nutrition labelling research from 20 countries in Asia, Africa, the Middle East, and Latin America. Consumers prefer that pre-packaged food include nutrition information, although there is a disparity between rates of use and comprehension. Consumer preference is for front-of-pack labelling and for information that shows per serving or portion as a reference unit, and label formats with graphics or symbols. Research on the food and beverage industry's response is more limited but shows that industry plays an active role in influencing legislation and regulation. Conclusions Consumers around the world share preferences with consumers in higher income countries with respect to labelling. However, this may reflect the research study populations, who are often better educated than the general population. Investigation is required into how nutrition labels are received in emerging economies especially among the urban and rural poor, in order to assess the effectiveness of labelling policies. Further research into the outlook of the food and beverage industry, and also on expanded labelling regulations is a priority. Sharing context-specific research regarding labelling between countries in the global South could be mutually beneficial in evaluating obesity prevention policies and strategies.
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Affiliation(s)
- Jessie Mandle
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Aviva Tugendhaft
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Julia Michalow
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Karen Hofman
- PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand, Johannesburg, South Africa;
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Dalton SM, Probst YC, Batterham MJ, Tapsell LC. Compilation of an Australian database of manufactured and packaged food products containing wholegrain ingredients. J Food Compost Anal 2014. [DOI: 10.1016/j.jfca.2014.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nutritional quality, labelling and promotion of breakfast cereals on the New Zealand market. Appetite 2014; 81:253-60. [DOI: 10.1016/j.appet.2014.06.019] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 06/11/2014] [Accepted: 06/14/2014] [Indexed: 11/20/2022]
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Woodbury NJ, George VA. A comparison of the nutritional quality of organic and conventional ready-to-eat breakfast cereals based on NuVal scores. Public Health Nutr 2014; 17:1454-8. [PMID: 23714263 PMCID: PMC10282433 DOI: 10.1017/s1368980013001456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/30/2013] [Accepted: 04/19/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify whether there were differences in nutritional quality between organic and conventional ready-to-eat breakfast cereals of similar types, based on NuVal scores. DESIGN The current descriptive study analysed NuVal scores for 829 ready-to-eat breakfast cereals and eighteen different cereal types. ANOVA was used to compare the mean NuVal scores of 723 conventional cereals with those of 106 organic cereals. SETTING Ready-to-eat breakfast cereals (n 829) with NuVal scores. SUBJECTS Not applicable. RESULTS There was no significant difference in NuVal scores between conventional (mean 28·4 (sd 13·4)) and organic (mean 30·6 (sd 13·2)) cereal types. CONCLUSIONS Consumers who choose the organic version of a ready-to-eat breakfast cereal believing that nutritional quality is superior may not be making a valid assumption. Public health nutrition educators must help consumers understand that organic cereals are not necessarily more nutritious and their consumption could result in excessive intake of undesirable nutrients, such as fat, sugar and sodium.
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Affiliation(s)
- Nancy J Woodbury
- Department of Dietetics and Nutrition, Stempel School of Public Health, Florida International University, University Park HLS I 445, Miami, FL 33199, USA
| | - Valerie A George
- Department of Dietetics and Nutrition, Stempel School of Public Health, Florida International University, University Park HLS I 445, Miami, FL 33199, USA
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