Food and Behaviour Research

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Kids WILL Eat Low-Sugar Cereals, and Enjoy Them - A Randomized Controlled Trial

by Nancy Walsh, MedPage Today


In a neatly designed randomised controlled trial, researchers have shown that low-sugar breakfast cereals are in fact perfectly acceptable to children. This evidence stands in stark contrast to the views often put forward by food producers (and sadly many parents too) about what children will and will not eat.

It is very noteworthy that total refined sugar consumption was dramatically reduced in the low-sugar breakfast cereal group.

Despite these children choosing to add more sugar than those given the high-sugar breakfast cereals, they did so only to their own taste, and made healthier choices from the other options available, whch included fruit.

Most tellingly, when offered the high-sugar versions, children ate TWICE as much of the actual cereal (two servings instead of one).

That surely tells us all we need to know about the real reason the manufacturers persist in adding so much sugar to their products.

In any case, this study certainly explodes the myth that they do it because that's what children themselves prefer.

For details of this research. see:

Despite the heavy marketing of sugary breakfast cereals to children, kids seem willing to eat low-sugar cereals -- particularly if they can add fresh fruit or a small amount of table sugar, researchers found.

In a randomized study conducted among more than 90 kids, those children offered low-sugar cereals consumed half the amount of refined sugar at breakfast compared with those who ate high-sugar cereals (12.5 g versus 24.4 g, P<0.001), according to Jennifer L. Harris, PhD, of Yale University, and colleagues.

Furthermore, the children eating low-sugar cereals were more likely to add fresh fruit (54% versus 8%, P<0.001), Harris and co-authors wrote in the January Pediatrics.

It's widely accepted that children benefit from eating breakfast -- for reasons ranging from better overall nutrition to improved academic performance.

However, ready-to-eat breakfast cereals contribute 8% to 9% of added sweeteners in children's diets -- and cereals marketed directly to children contain significantly more added sugar than those promoted for adults, totaling 32% to 43% of cereal content by weight, according to background provided by the authors.

"As a consequence, children may consume considerably more than the recommended 27- to 30-g serving for these cereals," Harris and co-authors wrote.

Some pediatric experts have recommended that parents serve only low-sugar cereals -- while others suggest that "a sugar-sweetened cereal is better than no breakfast at all," according to the researchers.

To explore children's willingness to consume low-sugar cereals, Harris and colleagues enrolled 91 children ages 5 years to 12 years who were attending a summer day camp, assigning them to two groups.

Children in the low-sugar cereal group were offered a choice of Cheerios, Rice Krispies, and Corn Flakes, which contain 1 to 4 grams of sugar in a serving. Kids assigned to the high-sugar cereal group were offered Froot Loops, Cocoa Pebbles, and Frosted Flakes, which contain 11 to 12 g of sugar in each serving.

At each place-setting there was a small cup of orange juice, an 8-oz container of 1% fat milk, and bowls of pre-cut strawberry and banana sections.

In the center of each table there were additional containers of milk and juice, as well as individual sugar packets.

The children were instructed to eat as much as they wanted.

After eating, the children filled out a questionnaire on how much they enjoyed the cereal -- using a smiley-face scale of one (loved it) to five (hated it) -- and whether they typically put sugar on their cereal at home.

The mean rating for the cereals in the low-sugar group was 4.5 and 4.6 in the high-sugar group, with 90% of the children saying they "liked" or "loved" their choice.

The low-sugar group consumed about a single serving of cereal, while those in the high-sugar group consumed twice as much, which was a significant difference (P<0.001).

Children in the low-sugar group added more sugar to their cereal -- but the overall refined sugar consumption was 5.7 teaspoons in the high-sugar group and 0.7 teaspoons in the low-sugar group.

Milk and orange juice consumption did not differ between the two groups.

In the high-sugar group, refined sugar was the source of about 25% of calories consumed, compared with 14% in the low-sugar group (P<0.001).

And in the high-sugar group, fresh fruit was the source of only 12% to 13% of calories, compared with 18% to 20% in the low-sugar group (P=0.03).

The researchers observed that their findings probably underestimated the overall effects of providing children with high-sugar breakfast cereals.

"Children's taste preferences develop over time through continued experiences with different foods," they wrote.

If kids are given highly sweetened cereals regularly, they are likely to learn to prefer sweetened foods in general, the researchers suggested.

Limitations of the study included the fact that sugar consumption was measured only on one day and in one meal, so the results may not be generalizable to longer periods.

In addition, the participants were mostly black and Hispanic children from disadvantaged families, so the results may also not be generalizable to children of different backgrounds and ethnicities.

The authors stated that they have no relevant financial relationships to disclose.