Breakfast is the most important meal of the day.

Transcription

1 PRODUCT UPDATE Cereal Choices to Start the Day Right Kristin Sheridan, RD, LD Breakfast is the most important meal of the day. How often have we heard this and how often have we educated our patients on the importance of breakfast? Ready-to-eat cereals are popular, quick, and easy breakfast foods for patients of all ages. It is our job to help patients choose a cereal that fits well into their renal diet while helping them wade through claims regarding fiber, whole grains, vitamins, and minerals. With respect to cereals geared toward children, there may be concerns that some of them are high sugar containing, presweetened foods. However, other cereals might provide a way to increase the uptake of fiber and vitamins as well as provide increased choices in an already limited diet. Armed with the proper information, we can help patients choose the right cereal. To help the renal dietitian sift through information, a review of several cereal companies websites revealed the following: General Mills Big G cereals contain at least 8 g whole grain per serving. 1 They fortify their entire line of children s cereals with calcium and vitamin D. 1 A nutrition highlights panel is displayed on the front of the Big G cereal boxes to provide information related to calories, sugar, saturated fat, and sodium content, in addition to other nutrients that the company deems to be key. 1 Kellogg s has added fiber to many of their cereals for children. They have also displayed some nutrition information on the front of their boxes as a way to make it easier for consumers to see the information quickly without looking at the nutrition panel. These are referred to by the company as GDAs, Guideline Daily Amounts. (Note that the GDAs are based on % daily values University Hospitals Case Medical Center, Cleveland, Ohio. Address reprints requests to Kristin Sheridan, RD, LD, University Hospitals Medical Center, Euclid Ave, 2100 Lakeside Building, Dialysis Unit, Cleveland, OH Kristin.sheridan@uhhospitals.org Ó 2010 by the National Kidney Foundation, Inc. All rights reserved /$36.00 doi: /j.jrn and are not related to the GDAs of the United Kingdom s governmental standards overseen by their Food and Drink Federation. This was confirmed through a telephonic conversation with a Kellogg s representative.) All cereal boxes display calories, total fat, sodium, and sugar content. They also display information for a maximum of any 2 of the following nutritional factors: calcium, fiber, magnesium, potassium, vitamins A, C, and E. 2 As renal dietitians, we must rise to the additional challenge of assessing appropriate intake of minerals such as potassium, calcium, and phosphorus that are present in foods. This challenge is further complicated for the pediatric renal dietitian who is also involved in helping patients select ageappropriate foods. Table 1 presents the nutrition information for major cereals consumed by the pediatric population, and most likely by many adult patients as well. Such information can be used to determine whether any particular cereals could be safely incorporated into a patient s diet and helps give more choices to our patients. General Mills, Inc, P.O. Box 9452, Minneapolis, MN 55440, Phone: (7:30 AM to 5:30 PM weekdays, CT). Kellogg s Consumer Affair, Kellogg Company, P. O. Box CAMB, Battle Creek, MI 49016, Phone: and Post Foods, LLC, Attn: Consumer Services Post Foods, LLC, 800 Market Street, St. Louis, MO 63101, Phone: POST (9 AM to 5 PM, Monday to Friday, Eastern Time). The Quaker Oats Company, P.O. Box , Chicago, IL , Phone: , Cap n (Phone: ). References 1. Benefits of Cereal. General Mills: Big G Nutrition General Mills. Available at: corporate/health_wellness/pdfs/benefits_of_cereal.pdf. Accessed June 13, Kellogg Cereal GDAs. Kellogg Nutrition Kellogg NA Co. Available at: Accessed June 13, Journal of Renal Nutrition, Vol 20, No 5 (September), 2010: pp e23ee28 e23

2 e24 Table 1. Cereals Nutrition Information Calcium Phosphorus Vitamin A Vitamin D Vitamin C Cereal* Serving Size Kcal PRO Total Fat Saturated Fat Trans Fat Cholesterol CHO Fiber Sugars K1 Na1 % DV % DV Phosphate Additives % DV %DV % DV General Mills Apple Banana Nut Berry Burst d Triple Berry Oat Cluster 3 / 4 cup Trisodium 3 / 4 cup Trisodium 3 / 4 cup Trisodium 3 / 4 cup NA Trisodium 1 cup Tripotassium 3 / 4 cup for Tripotassium children under 4 3 / 4 cup Trisodium 3 / 4 cup Trisodium Fruity 3 / 4 cup Trisodium MultiGrain 1 cup Trisodium Yogurt Burst d Strawberry Honey Nut 3 / 4 cup Trisodium 3 / 4 cup Tripotassium Boo Berry 1 cup Tricalcium & Chex 3 / 4 cup , None listed at Chex 3 / 4 cup , None listed at Chex Corn 1 cup NA None listed at SHERIDAN

3 Chex Honey Nut 3 / 4 cup None listed at Chex Multi 3 / 4 cup None listed at Bran Chex Rice 1 cup NA None listed at Chex Wheat 3 / 4 cup Trisodium 3 / 4 cup Trisodium Toast Cocoa Puffs 3 / 4 cup Tricalcium Cocoa Puffs 3 / 4 cup Tricalcium Combos, & Vanilla Cookie Crisp 3 / 4 cup Tricalcium Sprinkles Cookie Crisp Count Chocula Dora the Explorer Franken Berry 3 / 4 cup Tricalcium & 3 / 4 cup Tricalcium 3 / 4 cup Dicalcium & 1 cup Tricalcium & 3 / 4 cup Trisodium Golden Grahams Kix 1¼ cups NA Trisodium Honey Kix 1¼ cups NA Trisodium Lucky Charms 3 / 4 cup Trisodium Reese s Puffs 3 / 4 cup Tricalcium Trix 1 cup Tricalcium & (Continued) CEREAL CHOICES TO START THE DAY RIGHT e25

4 Table 1. Cereals Nutrition Information (Continued) Cereal* Serving Size Kcal PRO Total Fat Saturated Fat Trans Fat Cholesterol CHO Fiber Sugars K1 Calcium Phosphorus Vitamin A Vitamin D Vitamin C Na1 % DV % DV Kellogg s mg or %DV Apple Jacks 1 cup mg Calcium Cocoa Krispies 3 / 4 cup , mg None listed at Corn Flakes 1 cup mg None listed at Corn Pops 1 cup mg None listed at Crispix 1 cup , mg None listed at Froot Loops 1 cup mg None listed at Flakes 3 / 4 cup mg None listed at Flakes, 1 cup , mg None listed at Reduced Sugar Honey 3 / 4 cup mg None listed at Smacks Keebler Cookie Cereal Mini Wheats, Big Bite Mini Wheat, Bite Size Blueberry Muffin Streusel Little Bites 1 cup NA None listed at 5 biscuits mg None listed at 24 biscuits mg None listed at 24 biscuits mg None listed at 24 biscuits mg None listed at 52 biscuits mg None listed at Phosphate Additives % DV %DV % DV e26 SHERIDAN

5 Little Bites, Honey Nut Mini Wheats, Little Bites, Original Maple & Brown Sugar Strawberry Delight Unfrosted, Bite Size 46 biscuits mg None listed at 51 biscuits % None listed at 24 biscuits mg None listed at 24 biscuits % None listed at 30 biscuits % None listed at Rice Krispies 1¼ cups , mg None listed at 3 / 4 cup mg None listed at Krispies Rice Krispies 3 / 4 cup mg None listed at Treats Cereal Smorz 1 cup , mg Sodium hexameta Post Alpha Bits 1 cup None listed at 3 / 4 cup for None listed at children under 4 Golden Crisp 3 / 4 cup , None listed at Honeycomb 1½ cups None listed at Honeycomb with Flavoring Fruity Pebbles Cocoa Pebbles 3 / 4 cup None listed at 3 / 4 cup None listed at 3 / 4 cup None listed at (Continued) CEREAL CHOICES TO START THE DAY RIGHT e27

6 Table 1. Cereals Nutrition Information (Continued) Cereal* Serving Size Kcal PRO Total Fat Saturated Fat Trans Fat Cholesterol CHO Fiber Sugars K1 Calcium Phosphorus Vitamin A Vitamin D Vitamin C Na1 % DV % DV Cupcake Pebbles 3 / 4 cup NA None listed at Waffle Crisp 1 cup , None listed at Quaker mg for Cap n products Cap n 3 / 4 cup None listed at Berries 3 / 4 cup None listed at Oops! 1 cup None listed at All Berries Cap n 3 / 4 cup None listed at Peanut Butter % DV for cereals below Life 3 / 4 cup Disodium Life Maple and Brown Sugar Life Oh s ½ cup for children under Disodium 3 / 4 cup Disodium 3 / 4 cup Disodium 3 / 4 cup None listed at PRO, protein; CHO, carbohydrate; % DV, percent daily value; NA, not applicable. *Information for cereal only, does not include milk. Phosphate Additives % DV %DV % DV e28 SHERIDAN