Measuring the healthiness of child-targeted cereals: a study of the FoodSwitch platform in Sweden (Preprint)
BACKGROUND Childhood obesity is a major public health issue. The increase in consumption of foods with poor nutritional value, such as processed foods, contributes to this. Breakfast cereals are often advertised to be a healthy way to start the day, but the healthiness of these products varies greatly. OBJECTIVE Our main objective was to gather information about the nutritional characteristics of breakfast cereals in Sweden and to investigate the healthiness of products targeted at children compared to other cereals. A secondary objective was to evaluate the alignment between the Keyhole symbol and the Health Star Rating. METHODS Ready-to-eat breakfast cereals from the largest Swedish grocery retailers were collected using the FoodSwitch platform. Products were defined as targeting children if they presented features addressed to children on the package. RESULTS In all, information on 261 ready-to-eat cereals were examined. Child-targeted cereals (8%) were higher in sugar (22.3g/100g vs 12.8g/100g, P < .001) and lower in fiber (6.2g/100g vs 9.8g/100g, P < .001) and protein (8.1g/100g vs 10.5g/100g, P < .001). Total fat (3g/100g vs 10.5g/100g, P < .001) and saturated fat (0.8g/100g vs 2.6g /100g, P < .001) were also lower and no difference was found in salt content (P = .61). Fewer child-targeted breakfast cereals displayed an on-pack Keyhole label (5% vs 22%; P = .06) and the mean Health Star Rating values were 3.5 vs 3.8 (P = .07) for child-targeted cereals compared to others. A correlation was found between the Keyhole symbol and the Health Star Rating. CONCLUSIONS Ready-to-eat breakfast cereals targeted at children were less healthy overall compared to products not targeted at children. There is a clear need to improve the nutritional quality of child-targeted cereals.