Agenda

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What is Cereal?

Importance of Breakfast to Overall Health

Nutrient Contributions of a Cereal Breakfast

Perceived Barriers to Consumption of Ready-To-Eat Cereal

How to Incorporate Cereal into the Modern Diet

What is Cereal?

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What is Cereal?

• In the most basic form, cereal is any food derived from a plant in the grass family that yields edible grain or seed

• Barley, corn, oats, rice, rye and wheat are among the most popular grains

• Breakfast cereal categories include ready-to-eat cereal and cooked cereal

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Brief History of Breakfast Cereal

• Typical 19th century breakfasts were heavy on meat, light on grains

• In 1863, Granula was one of the 1st attempts at a healthier breakfast; its bran nuggets had to be soaked overnight, making it rather unpopular

• Creation of flaked cereal in 1894 revolutionized breakfast by offering a more convenient breakfast option that was quick to prepare

• Corn flakes, the first commercially available cereal, was introduced in 1906, bringing a convenient, affordable breakfast option to the table

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Brief History of Breakfast Cereal

• Bran flake cereal introduced in 1915• In early 30s, companies began printing nutrition

messages, recipes and product information on the back and side panels of cereal packages

• First fortified cereal was introduced in 1938• First high-protein cereal was introduced in 1955• Guideline Daily Amounts (GDA), or front-of-pack

labeling, introduced in 2005 to help consumers evaluate a product’s nutrition

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Importance of Breakfast to Overall Health

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Getting a Boost from Breakfast

• After 8-12 hours of fasting, the body and brain need to refuel

• Eating breakfast helps improve mental alertness and physical performance

• Eating breakfast is positively associated with improvements in short-term memory

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Breakfast and Academic Performance

• A review of 22 studies published in the Journal of the American Dietetic Association suggests that eating breakfast may help children do better in school by improving:1

– Memory– Test grades– School attendance– Psycho-social function– Mood

91 Rampersaud et al. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc. 2005;105:743-760.

Breakfast and Cognitive Function/Memory

• A study of 319 adolescents published in the Journal of Adolescent Health suggests:2 – High energy intake from breakfast had a beneficial

effect on immediate recall in short-term memory• A study published in the American Journal of

Clinical Nutrition found eating breakfast had beneficial effects on cognitive function in previously undernourished children3

102 Michaud C et al. Effects of breakfast-size on short-term memory, concentration, mood and blood glucose. J Adolesc Health. 1991;12:53-57.3 Simeon DT et al. Effects of missing breakfast on the cognitive functions of school children of differing nutritional status. Am J Clin Nutr. 1989;49:646-53.

Calories at Breakfast and Performance

• Breakfast should provide approximately 20% of your daily energy intake and nutrient needs– Study of 195 children published in the

International Journal of Food Science showed that when children consumed 20% of daily calories at breakfast their physical endurance and performance on a creativity test were much better than when they consumed less than 10% of their recommended calories at breakfast4

114 Wyon DP et al. An experimental study of the effects of energy intake at breakfast on test performance of 10-year-old children in school. Int J Food Sci Nutr. 1997;48:5-12.

Breakfast Eaters and Nutrient Intake

• A study of 467 U.S. children published in the Journal of the American Dietetic Association found:5

– Those who ate breakfast had higher intakes of vitamins A and E, iron and the B vitamins

– Higher percentage of breakfast skippers (16% of participants) were less likely to achieve even 2/3 of their recommended daily intake for vitamins and minerals

125 Nicklas TA et al. Breakfast consumption affects adequacy of total daily intake in children. J Am Diet Assoc. 1993;93(8):886-891.

Breakfast Consumption is Declining

• Today, people in the U.S. are eating breakfast 10% less than before6

• Recent data indicates that U.S. children tend to eat breakfast less often as they get older7

96% of males95% of femalesEat breakfast

87% of males86% of females

Eat breakfast

69% of males70% of femalesEat breakfast

2-5 year olds

6-11 year olds

12-19 year olds

136 International Food Information Council, IFIC Review: Breakfast and Health. 2008;12.7 What We Eat America, NHANES, 2001-2002. Table 5: Percentage of Americans eating breakfast on any given day and location where eaten. US Department of Agriculture, Agricultural Research Service website.

Nutrient Contributions of a Cereal Breakfast

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Cereal is a Great Way to Start the Day

• Cereal is a typically low-fat, nutrient-dense, cholesterol-free food that encourages breakfast consumption– Variety of flavors and textures– Breakfast cereal is convenient

• Research suggests that people who regularly consume ready-to-eat cereal for breakfast have higher nutrient intakes

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Cereal Provides Key Nutrients for Children

168 Centers for Disease Control and Prevention National Center for Health Statistics NHANES 2005-2006.

Cereal as Part of a Balanced Breakfast• Cereal with milk is an excellent

centerpiece for a balanced breakfast– Ready-to-eat cereal and milk is the

leading source of 10 nutrients in children’s diets (vitamins A, B6, B12, riboflavin, niacin, folate, iron, zinc, thiamin and vitamin D)9

– It’s unlikely that any other two foods contribute so much to the diet9

179 NHANES, 2003-2006.

Cereal and Nutrient Intake Worldwide

• If essential nutrients are missed at breakfast, people don’t compensate for the loss at other meals during the day

• A study of French children, adolescents and adults published in the Journal of the American College of Nutrition suggests:10

– Children and adolescents who ate a breakfast of cereal had higher dietary intakes of calcium, phosphorous, iron and vitamins B1 and B2

– Adults who ate cereal had higher intakes of calcium and phosphorous, vitamins B1 and B2, vitamins A and C and folic acid

• Analysis of data from the U.K. shows that children age 4-18 who typically consume 30-40 grams of breakfast cereal daily have:11

– 20-60% higher intake of iron, B vitamins and vitamin D– Better folate, riboflavin and vitamin B12 levels

1810 Preziosi P et al. Breakfast type, daily nutrient intakes and vitamin and mineral status of French children, adolescents and adults. J Am Coll Nutr. 1999;18:171-78.11 Gibson. Public Health Nutr. 2003;6:815-820.

Cereal Helps Meet Specific Nutrition Needs

For Digestive Health

For Weight Management

For Heart Health

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Cereal’s Role in Digestive Health• Consistent, strong evidence supports role of fiber-

containing foods in improving digestive health• Some ready-to-eat cereals are a good (3 grams) or

excellent (5 grams) source of fiber– Bran cereals– Shredded wheat– Wheat flake cereals– Fiber-added cereals

• Fiber is an important nutrient; however 90% of Americans fall short of meeting adequate intakes12

2012 Food and Nutrition Board, Institutes of Medicine of the National Academies. Dietary reference intakes for energy, carbohydrates, fiber, fat, fatty acids, cholesterol, protein and amino acids. Washington, DC: The National Academies Press; 2002.

Digestive Health Benefits of Fiber

• Fiber helps keep food moving through the digestive system and plays a bulking role so undigested food can be more easily eliminated13

– Increasing the intake of fiber (particularly wheat bran) prevents food from lingering in the digestive system (which can cause a bloated, uncomfortable feeling)

– Fibers help to absorb water and create bulk, which speeds up the passage of food through the digestive system, helping prevent constipation

2113 Jefferson A. Diet and Digestive Health Primary Healthcare. 2005;15:27-31.

Cereal’s Role in Weight Management

• Regular cereal eaters, regardless of the type of cereal they eat, tend to have lower body mass indexes and are less likely to be overweight

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Cereal and Healthier Body Weights14

2314 Albertson AM et al. ready-to-eat cereals consumption: its relationship with BMI and nutrient intake of children aged 4 to 12 years. J Am Diet Assoc. 2003;103:1613-1619.

Cereal Consumption and BMI in Adults

• Analysis of data from the National Health and Nutrition Examination Survey, 1999-2000, published in the Journal of the American Dietetic Association, found an inverse relationship between breakfast consumption and BMI in women15

– Relationship between ready-to-eat cereal consumption and BMI in women was especially noted

2415 Song WO, et al. Is consumption of breakfast associated with body mass index in US adults? J Am Diet Assoc. 2005; 105:1373-82.

Cereal Consumption and BMI in Girls

• A study of 2,000 girls over a 10-year period published in the Journal of the American Dietetic Association found that girls who regularly ate cereal had healthier body weights and lower BMI and higher nutrient intakes than those who did not16

– 41% of the cereals consumed by girls in the study were kids’ cereals, yet it was the number of days cereal was eaten that was predictive of lower BMI and higher nutrient intakes

2516 Barton BA, et al. The relationship between breakfast and cereal consumption to nutrient intake and body mass index: The National Heart, Lung, and Blood Institute Growth and Health Study. J Am Diet Assoc. 2005; 105:1383-1389.

Cereal Consumption and Heart Health

• Studies have shown that breakfast skippers have higher blood cholesterol levels than breakfast eaters, especially those who eat breakfast cereal17, 18

• Eating breakfast is associated with heart-protective eating patterns such as lower fat intakes in adults and higher fiber intakes in adults, children and adolescents19

2617 Stanton JL, et al. Serum cholesterol, fat intake, and breakfast consumption in the United States adult population. J Am Coll Nutr. 1989; 8:567-572.18 Resnicow K. The relationship between breakfast habits and plasma cholesterol levels in schoolchildren. J Sch Health. 1991; 61:81-85.19 Ruxton CH, et al. Breakfast: a review of associations with measures of dietary intake, physiology and biochemistry. Br J Nutr. 1997; 78:199-213.

Important Nutrition for Every Life Stage

• Children

• Women of child-bearing age

• Elderly people

Valuable nutrients they might otherwise miss

Necessary iron, calcium, fiber and folic acid

Women of child-bearing age

Children

Elderly people Important nutrients for relatively few calories

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Perceived Barriers to Consumption of Ready-To-Eat Cereal

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Perceived Barriers to Cereal Consumption

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Processed Food

Confusion About Fiber

Sugar Obesity Sodium

“Many of the media reports around breakfast cereals are inaccurate and misleading, only leading to confusion among consumers. Breakfast cereals can provide a healthy start to the day for adults and children alike.”

C.S. Williamson, British Nutrition Foundation Nutrition Bulletin, 2010

Cereal Begins with Simple Grains

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Wheat Berries Rice

Corn Grain-BasedDoughs

Importance of Fiber-Rich Foods

• Fiber is an important nutrient lacking in 90% of American diets

• Fiber helps contribute to overall health– Consistent, strong evidence supports role of fiber-

containing foods to help:20

• Improve digestive health• Lower cholesterol, important in prevention of heart

disease• Protect against chronic disease, such as obesity,

diabetes and certain cancers

3120 International Food Information Council. Fiber Fact Sheet. 2008; see www.IFIC.org.

Confusion About Where to Find Fiber

In a recent study, 75% of U.S. consumers surveyed said they expect products made with whole grain to

also be at least a good source of fiber.21

While whole grain provides micronutrients, not all whole-grain foods are a good source of fiber.

The fiber content of whole-grain foods varies greatly and some whole-grain foods contain very little fiber.22

This confusion about whole grain and fiber may have unintended consequences leading to the

exacerbation of the fiber deficit.22

3221 Kellogg Company’s Whole Grains & Fiber Omnibus Survey. 2009.22 Kellogg Company’s Every Gram Counts: Eating Away at the Fiber Deficit. 2009.

Putting Sugar Into Perspective

3323 NHANES, 2003-2006.

100% Orange Juice

NUTRITION FACTSServing Size 8-ounces__________________________Amount Per ServingCalories 110__________________________Total Fat 0 gSodium 15 mgPotassium 450 mgTotal Carbohydrate 27 g Sugars 24 gProtein 2 g__________________________

Fruit on the Bottom Yogurt

NUTRITION FACTSServing Size 6-ounces__________________________Amount Per ServingCalories 150__________________________Total Fat 15 gSodium 120 mgPotassium 290 mgTotal Carbohydrate 27 g Sugars 27 gProtein 6 g__________________________

Kellogg’s® Frosted Mini-Wheats® Original Bite Size

NUTRITION FACTSServing Size About 24 biscuits (59 g)__________________________Amount Per ServingCalories 200__________________________Total Fat 1 gSodium 5 mgPotassium 200 mgTotal Carbohydrate 48 g Dietary Fiber 6 g Sugars 12 gProtein 6 g__________________________

• Sugar in cereal is less than 5-7% of kids’ daily sugar intake in the U.S.23

• Other popular breakfast items have more sugar than ready-to-eat cereal

Obesity as an Effect of Calorie ImbalanceCALORIES CONSUMED vs. PERCENT OBESE24, 25

2,500

2,000

1,500

1,000

500

01974 1994 2000 2004 2006

Calo

ries

Cons

umed

Perc

ent O

bese

30%

20%

15%

10%

5%

0

25%

Boys Girls Obese

3424 NHANES, 1971-2006; in boys and girls age 6-11 years of age.25 CDC/NCHS, National Health Examination Survey and National Health and Nutrition Examination Survey.

2008

Sodium in Cereal

• Sodium from cereal contributes about 2% of the sodium in the U.S. diet26

• Cereal contains less than half the sodium of many popular breakfast items27

3526 NHANES, 2003-2006.27 US Department of Agriculture, Agricultural Research Service. 2009. USDA Nutrient Database for Standard Reference Release 22. Nutrient Data Laboratory website http://www.usda.gov/nutrient data.

Reducing Sodium in Cereals

• Finding adequate replacements for sodium in cereals while maintaining taste is a challenge

• Consumers often equate reduced sodium with reduced taste

• The industry has been silently lowering sodium content in cereal for more than 10 years. In the U.S.:• Kellogg’s® All-Bran® – 70% reduction• Kellogg’s® Corn Flakes® – 39% reduction• Kellogg’s® Rice Krispies® – 37% reduction• Kellogg’s® Frosted Flakes® – 30% reduction• Kellogg’s® Raisin Bran® – 29% reduction

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How to Incorporate Cereal into the Modern Diet

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How is Cereal Still Relevant Today?

• Cereal is the preferred breakfast in the U.S.

• Cereal is an effective carrier to help meet nutrient shortfalls of important and often lacking vitamins, minerals and nutrients

82% of women 79% of men

Start their day with a cereal breakfast

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Cereal Delivers Nutrition People Need

• Cereal is nutrient-dense, relatively low in calories and cholesterol-free

• People like cereal– When they eat the food they like, they also

get the nutrition they need• Affordable way of providing nutrients

– A serving of cereal with milk in the U.S. costs an average of 50 cents

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Cereal Fits Into Our Busy Lives

• Quick to the table• Almost everyone in the family can

“make” a bowl of cereal and milk• Can be eaten on the go • Makes a tasty snack• Long shelf-life

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What Can I Do?

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Making a Nutritious Breakfast Relevant for Patients/Clients• Educate patients/clients about getting

ample nutrients at breakfast

• Highlight where to look for their individual nutrition needs

• Educate patients/clients about importance of fiber in the diet – Good source = at least 3 grams

– Calories– Vitamins

– Sodium

– Fiber

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Tools for the Professional• American Dietetic Association website

– www.eatright.org• www.KelloggsNutrition.com

– Printable materials and ready-to-use presentations on breakfast, fiber, diabetes and more

– Helpful tools including a Fiber Tracker interactive database

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THANK YOU!

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