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

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


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Breakfast / physiology*
  • Child
  • Child, Preschool
  • Diet / methods*
  • Edible Grain / metabolism*
  • Europe
  • Feeding Behavior / physiology*
  • Female
  • Humans
  • Male
  • Nutrients / metabolism*
  • Portugal