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Eur J Clin Nutr. 2019 Mar;73(3):465-473. doi: 10.1038/s41430-018-0235-6. Epub 2018 Jul 4.

Improving breakfast patterns of portuguese children-an evaluation of ready-to-eat cereals according to the European nutrient profile model.

Author information

1
Department of Food and Nutrition, National Health Institute Dr. Ricardo Jorge (INSA, IP), Av Padre Cruz, 1649-016, Lisboa, Portugal. ana.i.rito@gmail.com.
2
Center for Studies and Research In Social Dynamics and Health (CEIDSS), Fabrica da Pólvora de Barcarena, 2730-036, Oeiras, Portugal. ana.i.rito@gmail.com.
3
Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), Av. Estados Unidos da América, No 77, Piso 8, 1749-096, Lisboa, Portugal.
4
Center for Studies and Research In Social Dynamics and Health (CEIDSS), Fabrica da Pólvora de Barcarena, 2730-036, Oeiras, Portugal.
5
Department of Food and Nutrition, National Health Institute Dr. Ricardo Jorge (INSA, IP), Av Padre Cruz, 1649-016, Lisboa, Portugal.
6
National School of Public Health, Av. Padre Cruz, 1600-560, Lisboa, Portugal.

Abstract

BACKGROUND/OBJECTIVES:

Ready-to-eat cereal (RTEC) breakfasts have been increasing in Portugal, among children. Eat Mediterranean (EM), a Portuguese comprehensive community-based intervention, proposed to improve breakfast patterns of children and adolescents and to evaluate the healthiness of RTEC according to WHO/Europe nutrient profile model (Euro-NP).

SUBJECTS/METHODS:

EM Program was developed during two scholar years (15/16 and 16/17) toward 2333 students (pre to secondary education). Data on breakfast was provided using a family record form. The intervention consisted of 257 educational sessions addressing the principles of Mediterranean Diet, and promoting a "healthy breakfast at home". To check for compliance with Euro-NP, RTEC package food labels' nutritional composition was used.

RESULTS:

After intervention 92.9% of children/adolescents had breakfast daily with no report of breakfast skippers. RTECs were one of the most frequent (66.5%) breakfasts. Statistically significant improvements were showed for: daily qualitative and complete breakfast frequency (5.6%) and fruit (11.2%). Consumption of RTEC decreased 28%. According to Euro-NP, 84.6% of the RTECs were non-compliant, regarding sugar content. Children's RTECs presented 5% more of energy and 26% more sugar than the "non-children's" RTECs.

CONCLUSION:

EM strategy showed to be a successful program to improve patterns and quality of breakfast of the children and adolescents, reinforcing the importance of school-based nutritional programs in changing lifestyles. Nutrient profiling can be a useful tool to provide a selection of foods to be part of a healthy diet and can be used by policy-makers to design policies to identify the foods to which marketing restrictions to children, will apply.

PMID:
29973677
DOI:
10.1038/s41430-018-0235-6

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