Research Summary | Published:

The 'cereal' killer on your breakfast table

BDJ volume 225, pages 214215 (10 August 2018) | Download Citation


UK children's breakfast cereals – an oral health perspective

Br Dent J 2018; 225: 164–169;

Whether it's a dancing tiger, a singing bumble bee or a snap, crackle and pop, we are all familiar with the cereals gracing many breakfast tables across the nation daily. It is not surprising that cereals remain the most popular breakfast choice for school-aged children in the UK.

Image: © Composite Kraig Scarbinsky/DigitalVision; daz2d/DigitalVision Vectors/Getty

However, as Public Health England release new figures stating the high levels of sugar intake by children in England is almost double the recommended amount, it is important that we realise the urgent need to combat this problem. This article depicts how breakfast cereals may contribute to not only high sugar intake but overall to oral and general health.

The authors of this paper chose to investigate the oral and general health messages contained on the packages of popular breakfast cereals marketed towards children in the UK. Thirteen cereals were selected and the packaging evaluated – images, nutritional content and health claims were all assessed.

The results of the study showed that the majority of popular breakfast cereals marketed towards children had what was classified as high sugar levels: containing over 22.5 g of sugar per 100 g of cereal.

They reported that nutritional claims such as 'added folic acid', 'high in vitamin D' and 'high in iron' were popularly placed on packaging and when mixed with emotive language like 'yummy', 'delicious' and 'tasty', it is clear why these breakfast cereals remain high on our shopping lists.

An interesting finding from this article was the deceptive nature of the imagery appearing on the packaging. It was found that portion sizes depicted on packaging were almost three times the size of the recommended serving size, leading to consumers serving up much larger portions than necessary and thus increasing their sugar intake even more.

The researchers concluded that the majority of the cereals in the study had a high sugar content despite the 'healthy' claims made on the packaging. They explained that it was paramount that we as health professionals are aware of this and advise patients accordingly. They recommend sign posting patients to 'NHS Choices' and 'Change4Life'. Both of which are also useful for us as professionals!

Finally, the authors cry out to higher powers for intervention, commending the UK Government's Childhood Obesity plan for aiming to reduce sugar levels across a range of foods. It is clear that our patients need to be made aware of the 'cereal killer' lurking on their breakfast tables!

Which bowl is the suggested portion of frosted flakes?

Various portion sizes eaten by BDJ staff members. Find the correct portion size here:

Sugar in breakfast cereals (g/100 g)

Image: © Composite Kilroy79/iStock/Getty Images Plus

By Beth Bradley, Dental Student, University of Leeds

Author Q&A

with Maria Morgan

School of Dentistry, University of Cardiff

Were you surprised by any of the results in this study?

Yes, how small the manufacturer recommended 30 g portion actually was. We (the authors) all agreed that we could easily eat three times that amount in one sitting and that would equate to almost 8 tsps of sugar for chocolate-covered puffed rice. This is over the daily maximum of free sugars advised – in just one meal!

What needs to happen to change the sugary cereal problem?

Various strategic actions need to be taken to help affect change here and I think the British Association for the Study of Community Dentistry (BASCD) Statement on Free Sugars sums it up well (available at

We need to:

  • Work with the industry to reformulate recipes to reduce the amount of free sugars in foods and drinks

  • Restrict the marketing of sugar containing products (especially to vulnerable consumers like children)

  • Reduce the amount of sugar-containing food and drinks sold

  • Advise, educate and help people consume less sugar

  • Reduce the amount of sugar produced.

On a positive note we have seen some small reductions in the percentage sugar of high sugar breakfast cereals in the UK since we wrote this paper but more needs to be done.

What would you advise children eat for breakfast?

A good breakfast is an important part of the day. Change4life has some top tips for breakfast at

Various portion sizes eaten by BDJ staff members. Find the correct portion size here:

Try to choose breakfast cereals with less sugar like porridge, plain shredded whole-wheat and plain whole-wheat biscuit cereals, and add some fresh fruit (bananas or raspberries are good) and serve with semi-skimmed milk or natural yoghurt.

Change4life also has some easy, quick and yummy recipes – the breakfast options include traffic light omelettes and baked tomatoes on toast – see

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