The nutritional content of children's breakfast cereals: a cross-sectional analysis of New Zealand, Australia, the UK, Canada and the USA.

Objective: To compare the Nutrition Information Panel (NIP) content, serving size and package size of children's ready-to-eat breakfast cereals (RTEC) available in five different Western countries. Design: NIP label information was collected from RTEC available for purchase in major supermarket chains. Kruskal-Wallis, Mann-Whitney U and chi(2) tests were applied to detect differences between countries on manufacturer-declared serving size, total energy (kJ), total protein, fat, saturated fat, carbohydrate, total sugar, Na and fibre content. The Nutrient Profiling Scoring Criterion (NPSC) was used to evaluate the number of products deemed to be 'unhealthy'. Setting: Supermarkets in Australia, Canada, New Zealand, the UK and the USA. Participants: Children's breakfast cereals (n 636), including those with and without promotional characters. Results: The majority of children's RTEC contained substantial levels of total sugar and differences were apparent between countries. Median sugar content per serving was higher in US cereals than all other countries (10 center dot 0 v. 7 center dot 7-9 center dot 1 g; P < 0 center dot 0001). Median fat and saturated fat content were lowest in Australia and New Zealand RTEC, while the Na content of RTEC was 60-120 % higher in the USA and Canada than in Australia and the UK (all P <= 0 center dot 01). Conclusions: Across all countries, there was a high proportion of RTEC marketed for children that had an unhealthy nutrient profile. Strategies and policies are needed to improve the nutrient value of RTEC for children, so they provide a breakfast food that meets nutrition guidelines.