Effects of Ready-to-Eat-Cereals on Key Nutritional and Health Outcomes: A Systematic Review

Abstract

BackgroundIn many countries breakfast cereals are an important component of breakfast. This systematic review assesses the contribution of consumption of ready-to eat cereal (RTEC) to the recommended nutrient intake. Furthermore, the effects of RTEC consumption on key health parameters are investigated as well as health promoting properties of RTEC.MethodThe Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL have been searched up till 16th of June 2015. Randomized controlled trials were excluded if RTEC were used during hypocaloric diets, if RTEC were eaten at other times than breakfast and if breakfasts included other products than RTEC, milk and fruit. Observational studies were excluded when “breakfast cereals” were not defined or their definition included cooked cereals. From cross-sectional studies only data concerning energy and nutrient intake as well as micronutrient status were used.ResultsFrom 4727 identified citations 64 publications met the inclusion criteria of which 32 were cross-sectional studies, eight prospective studies and 24 randomized controlled trials. Consumption of RTEC is associated with a healthier dietary pattern, concerning intake of carbohydrates, dietary fiber, fat and micronutrients, however total sugar intake is higher. Persons consuming RTEC frequently (≥ 5 times/week) have a lower risk of inadequate micronutrient intake especially for vitamin A, calcium, folate, vitamin B 6, magnesium and zinc. Evidence from prospective studies suggests that whole grain RTEC may have beneficial effects on hypertension and type 2 diabetes. Consumption of RTEC with soluble fiber helps to reduce LDL cholesterol in hypercholesterolemic men and RTEC fortified with folate can reduce plasma homocysteine.DiscussionOne of the review’s strengths is its thorough ex/inclusion of studies. Limitations are that results of observational studies were based on self-reported data and that many studies were funded by food-industry.ConclusionConsumption of RTEC, especially of fiber-rich or whole grain RTEC, is implicated with several beneficial nutritional and health outcomes. The effect on body weight, intestinal health and cognitive function needs further evaluation. Of concern is the higher total sugar intake associated with frequent RTEC consumption.

Breakfast Consumption versus Breakfast Skipping: The Effect on Nutrient Intake, Weight, and Cognition

“…Cho et al [13] , using data from NHANES III (the third National Health and Nutrition Examination Survey), suggested that different types of breakfast were associated with different health parameters, for example, weight. Those findings led to the examination of "types of breakfast" with different parameters, including nutrient intake [12,14] . Using more recent data from NHANES, the mean adequacy ratio of 5 shortfall nutrients (i.e., vitamin E, calcium, magnesium, potassium, and fiber) and 13 micronutrients was lowest in breakfast skippers, followed by "other breakfast" consumers, and highest in ready-to-eat cereal (RTEC) consumers [12] .…”

Sugar Content and Nutritional Quality of Child Orientated Ready to Eat Cereals and Yoghurts in the UK and Latin America; Does Food Policy Matter?

“…In the UK, REBCs and yoghurts contribute to 15% and 16% of free sugar intake in children aged 1.5-10 years, respectively [11]. A systematic review of observational studies found that frequent consumption (>5 servings/week) of REBCs in children was associated with higher total sugar consumption [28]. It has also been a matter of controversy that these products rely heavily on marketing strategies that contradict WHO guidance.…”

Importance of Health Claims in the Adoption of New Breakfast Cereal Products in the UK

“…Breakfast cereals such as porridge and muesli are also reported to contribute to more than 50% of the breakfast energy intake for the UK population [9][10][11][12]. When consumed regularly, breakfast cereals have been linked to an increase in the nutritional profile of diets, only with the exception of a high level of simple sugars associated with those ranges with a high added sugars content [13,14]. Furthermore, evidence suggests an inverse association between breakfast cereal consumption and body weight [15,16].…”