Health-related on-pack communication and nutritional value of ready-to-eat breakfast cereals evaluated against five nutrient profiling schemes

BACKGROUND There is an ongoing debate regarding health-related on-pack information appearing on products with low nutritional quality. The purpose of the study was to contribute to this discussion by examining the relationship between health-related on-pack information and the overall nutritional value of highly processed ready-to-eat breakfast cereals (RTECs). METHODS Maximum variation sampling was used to select 128 highly processed RTECs in Germany in 2010. In 2012, two additional samples were collected in Norway (n =38) and Germany (n =73) to allow for comparisons of products from countries with different regulations concerning nutrient profiles. All products were evaluated against five nutrient profiling models from government-related agencies. Mann-Whitney U Tests and Chi-square statistics was used to compare the nutrient profiles of different product categories. Logistic regression analysis was conducted to identify on-pack information on German products predicting a satisfactory nutritional profile. RESULTS The majority of RTECs displayed health-related information on the packaging, but only 4-36% of German products met the criteria of the different nutrient profiles. The rate was lower for cereals marketed to children, Norwegian cereals performed better (36-64%). Health-related on-pack information was not consistently related to the nutrient profiles. The following on-pack criteria predicted a satisfactory nutrient profile on RTECs of the German 2010 sample: i) cereals not marketed to children, ii) clean labelling (free-from claims) and possibly organic labelling and whole grain claims. CONCLUSIONS Our results suggest that the implementation of a mandatory nutrient profiling scheme for products with health-related on-pack information could contribute to a consistent relationship between health-related information on RTECs and the overall nutritional value of the product. Improvements should also consider the provision of a simple nutritional labelling scheme on the front of the packaging, standardized serving sizes, accurate product names, and clearly defined whole grain claims.