NEW HAVEN, CONN. — Parents often misinterpret nutrition-related health claims on children’s cereals and additional government regulation of front-of-package labeling is needed to protect consumers, according to a study from the Rudd Center for Food Policy at Yale University in New Haven. The study appeared on-line Aug. 2 in the journal Public Health Nutrition.

Minneapolis-based General Mills, Inc., responded, “We feel this study has little applicability to our products. General Mills has led the way on this issue, and has included specific calorie, sugar and sodium information on the front panel of all of our cereals for many years.”

Grants from the Robert Wood Johnson Foundation and the Rudd Foundation supported the study. The authors had no conflict of interest to report.

The study involved 306 parents with children between the ages of 2 and 11 viewing images of boxes for children’s cereals and taking an on-line survey. The selected cereals ranked in the bottom half of all cereals, according to a nutrient profiling model, due primarily to high levels of sugar. Some also contained high levels of sodium and/or low levels of fiber.

The boxes featured such nutrition-related claims as “supports your child’s immunity,” “whole grain,” “fiber,” “calcium and vitamin D,” and “organic.” The claims were chosen from those that appeared frequently on children’s cereals in 2009. With the exception of the organic claim, about half the parents said the claims would make them more likely to buy the cereals. Thirty per cent said organic cereals are too expensive.

“Promoting specific positive nutrients in products with other, less beneficial, ingredients (e.g, high-sugar cereals) appears to be a highly effective and low-risk marketing strategy for food companies,” said Jennifer Harris, lead author of the study and the Rudd Center’s director of marketing initiatives. “These claims provide an opportunity to enhance product image and increase sales with limited potential for consumer skepticism or other negative reactions.”

The study said if companies profit from this practice, it is unlikely they will discontinue its use in the absence of government intervention. The study said one potential regulatory approach would be to require that any products with nutrition-related claims meet minimum overall nutrition criteria to ensure that claims do not lead consumers to incorrectly infer that products are nutritious. Another option would be to require the Food and Drug Administration to pre-approve all types of claims, not just health claims, before companies are allowed to use them.

The study gave an example of a cereal having a claim “good source of B vitamins” while also containing high levels of nutrients to limit, such as added sugar and sodium, and low levels of other beneficial nutrients, such as protein and fiber.

“Closer scrutiny of the Nutrition Facts Panel is required to obtain this information and accurately assess the overall nutritional quality of the product,” the study said. “As a result, although the claim refers only to the amount of B vitamins contained in the product, consumers might incorrectly infer that the product is nutritious, more nutritious than other similar products, and/or conveys specific health benefits (e.g, boosts energy).”

About one quarter of parents said they believed the whole grain claim on Lucky Charms, a General Mills brand, and the calcium and vitamin D claim on Cinnamon Toast Crunch, another General Mills brand, meant those cereals were healthier than other children’s cereals.

The front of a Lucky Charms box in 2011 had “whole grain guaranteed” on the top as well as per-serving information, although in smaller type, for calories (110), saturated fat (0 grams), sodium (170 mg), sugar (10 grams), calcium (100 mg) and vitamin D (40 international units).

The front of a Cinnamon Toast Crunch box in 2011 also had “whole grain guaranteed” on the top as well as per-serving information, although in smaller type, for calories (120), saturated fat (0.5 grams), sodium (220 mg), sugar (10 grams), calcium (100 mg) and vitamin D (40 international units).

Three quarters of the parents said they believed an immunity claim on Cocoa Krispies, a Kellogg Co. brand, in 2009 meant that eating the cereal would keep their child from getting sick. The front of a Cocoa Krispies cereal box in 2011 had no immunity claim. The front of the box had a good source of vitamin D claim along with per-serving information, although in smaller type, for calories (120), saturated fat (0.5 grams), sodium (130 mg), sugar (12 grams), vitamin C (25% of the Daily Value) and vitamin A (25% of the Daily Value).

The study also found different types of claims confused parents. For example, the nutrient content claim “good source of calcium and vitamin D” was interpreted as a structure/function claim. Also, parents said they believed a structure/function claim about immunity was a health claim.

Among the parents, 30% held a four-year college degree or higher, 48% had completed some college or held a 2-year college degree, and 21% held a high school degree or equivalent. Among the parents, 83% were white.

According to the study, the average children’s cereal consists of 35% added sugar by weight and 553 mg of sodium per 100 grams. Children’s cereals contain 85% more sugar, 60% more sodium and 65% less fiber than cereals marketed to adults.