Ready-To-Eat (RTE) cereals, as with Ultra-Processed Foods (UPF), are attractive to many consumers because of their taste, price, availability, shelf life, and ready-to-eat nature (1, 2). Such products are often considered highly appealing, are packaged in large servings, and are promoted through marketing messages that claim or imply that purchasing or consuming the product will confer specific benefits, such as improved health or social status (3). However, various studies that have assessed the impact of RTE cereals on dietary intakes and human health show that despite the supposed health benefits (4–8), the majority of these products are highly processed and high-in some nutrients like (4) sugar, sodium and unhealthy saturated fats (9). Nutrients frequently associated with consumption on increased dietary intake and weight gain (10), which in turn relate to an increased risk of overweight and obesity, abdominal obesity, all-cause mortality, metabolic syndrome, and depression in adults (9, 11).

This is a matter of concern if we consider the UPF has been particularly pronounced in Latin America and the Caribbean (12–14). In Colombia, a recent study found that adolescents and urban residents were the leading consumers of UPF, particularly snacks, processed cereals, dairy drinks and junk food (15). According to Euromonitor, in Colombia alone, the daily calorie intake per capita of RTE cereals has increased by 15.2% from 2009 to 2017 (16).

Marketing strategies may contribute to increased purchase and intake of UPF by creating a “health halo” effect, where consumers view a positive claim about health, nutrition, or nature and attribute that positive attribute to the whole product, perceiving the product to be healthier overall (17). Health claims include the suggestion of health benefits or reduced health risk from consuming the product (e.g., heart-healthy), nutrient-content claims highlight the presence of nutrients associated with positive health outcomes (e.g., high in fiber) (18), and nature claims identify a product or ingredient as natural (e.g., all-natural). Marketing claims related to nature can additionally reflect a valued aspect of one's identity, and so consumers may be predisposed to view foods with these claims as better choices (19, 20). Most consumers make their purchasing decisions in a matter of seconds (21), and marketing claims related to health, nutrients, and nature often influence their purchasing behavior (22, 23). As a result, these types of claims may increase sales of certain types of foods over others within a given category (24, 25).

Research around the world has revealed that health-related claims are widely used with products identified as unhealthy or with a high content of critical nutrients, such as sugar, fat, or sodium, according to the nutritional guidelines of regional or country-specific health organizations (26–28). For example, in Australia, 18.3% of nutrient content claims appeared on products that did not meet nutrient profile scoring criteria (29). Studies in Canada and Costa Rica have found that the proportion of sugar-sweetened milk drinks, breakfast cereals, and beverages with and without added sugar has a higher proportion of nutrition and health claims compared to other food categories (24, 30). In New Zealand, 65% of “less healthy” cereals had nutrition claims and 17% had health claims (31).

Breakfast cereals are among the foods most often marketed to children (32, 33). Products marketed to children, including RTE cereals, have a high number of health-related claims, even though many products with those claims do not meet national dietary guidelines or recommendations (34, 35). Yet, little is known about the types and prevalence of health, nutrient, and nature claims on RTE cereals in Colombia, specifically, or how the presence of these claims varies based on the product's nutritional profile. A better understanding of this issue is needed to inform policy actions aimed at reducing the prevalence of obesity and obesity-related diseases in Colombia through discouraging consumption of ultra-processed cereals (36). Therefore, the objective of this study is to examine the proportion of marketing claims about health, nutrient content, and nature-related found on RTE cereal packages offered at the most important supermarkets in the country as a function of the nutritional quality of the products.

All the analyzed RTE cereal packages (n = 178) were high in at least one of the nutrients considered in the CNPM, for more information on the nutritional quality of the products, see Supplementary Table 1. Additionally, 91% (n = 162) of these products carried a nature, nutrition, or health-related claim. The most common claims on the products were nature-related claims, carried by 66.3% (118) of the sample, including fruit claims (in Spanish: con frutos rojos/with red berries) and claims related to (lack of) processing (in Spanish: con granos de maiz de orígen natural/with natural corn grains). Nutrient-content claims were also common, with 57.3% (102) of products containing claims like “good source of vitamins and minerals” (in Spanish: 8 vitaminas y 2 minerales/8 vitamins and 2 minerals). Health claims were less common but appeared on 15.7% of products and included claims like “feel good about your digestion” (in Spanish: siéntete bien con tu digestión) (see Table 1).

Table 2 shows the number and percentage of products featuring at least one nutrient-content, health, or nature-related claims that were above the CNPM thresholds for saturated fat, sodium, sugars, and energy. Nearly all products with at least one claim were high in energy (98.7%), ranging from 92.9% of products with a health claim to 99.2% of products with a nature-related claim. Similarly, most products with claims were high in sugar (88.8%). While the percentage of products with claims that exceed the saturated fat and sodium thresholds was lower, 29% of products with claims were high in saturated fat and 24.7% were high in sodium. Cramer's V was used to analyze the strength of the relationship between high levels of critical nutrients and products with and without claims; however, although two of the variables (Health claims vs. High-In energy and Any Claim vs. High-in Sodium) obtained a significant p-value, Cramer's V does not reach the expected levels to be considered as even a moderate association. For this reason, it is not considered that there is a relationship between the variables. for more information about the comparison between products with and without claims (see Supplementary Table 2).

In addition, more than a third of the products that had any claim contained NCS. Table 3 shows the percentage of products with claims containing NCS. According to Cramer's V the percentage of products with claims was not statistically significantly different from the percentage without claims with respect to the presence of NCS.

This study provides an overview of the nutritional quality of RTE cereals offered in the principal Colombian supermarket chains in 2018, according to the presence or absence of health, nutrient-content, and natural claims. In general, all the analyzed cereals exceeded the regulation thresholds under the CNPM in at least one critical nutrient. This should be a cause for concern since 91% of the products analyzed contained some type of claim and the prevalence of critical nutrients seems to have increased. A previous study in Colombia found that 48.2% of cereal products were considered unhealthy according to international nutritional profile model standards (40).

In this study, the explicit textual claims most frequently displayed were related to alleged natural properties and benefits. In the case of natural claims, the most frequent claim pertained to flavor or fruit content. These results are consistent with previous studies in which flavor claims and nutritional claims are frequently used (49, 54). Similarly, previous studies have pointed to explicit references to flavor, texture, and fun as features that promote brand appeal by emphasizing and reinforcing sweet taste qualities (55). Although less frequent, the presence of claims like “wholesome,” “fresh” or “straight from the farm,” “simple,” “natural” or “unprocessed,” “no artificial flavors or colors” and “with nuts” or “with peanuts” were also common natural claims. Brands may use this marketing strategy to appear healthier or more sustainable (56) and to appeal to consumers who consider themselves “healthy eaters” and/or “environmentalists”(20). The true prevalence of nature-related claims may be underrepresented, as this study focused on textual claims and did not evaluate implicit marketing strategies, such as images of fruit or nature on the cereal bar and breakfast cereal packaging.

On the other hand, in the nutrient-content category, claims regarding vitamins and micronutrients (minerals) were the most frequent. These results are similar to those of previous studies conducted in the United Kingdom and Guatemala, where micronutrient and nutrient/ingredient claims were the most common type of claim on breakfast cereals (57, 58). In many cases, these claims were accompanied by the number of vitamins or minerals in the product, without specifying which vitamin or mineral they referred to. Many of these products are aimed at children and their parents. Parents may be motivated to purchase items for their children that contain “positive” ingredients like vitamins, minerals or fiber, but they may be less likely to look for and avoid products high in critical nutrients (56). In this sense, the presence of nutritional claims as a food marketing strategy (56) becomes a problem because the information with which they could contrast the messages is not clear and they are unable to know how nutritious it is on their own (59).

Similarly, parents tend to discard or overlook ingredients with which they are unfamiliar. Many of them are unaware of the presence of NCS in foods and do not regulate whether their children consume them (48). This is concerning given that the habitual consumption of sweet-tasting increases the intake of sweet foods and beverages, including those containing sugar (47). In the case of RTE cereals, previous studies have found that consumers of RTE cereals have a higher total daily intake of sugars than those who do not have breakfast with RTE cereals (60, 61). This may have important implications for NCS consumption because reformulation with NCS has emerged recently as an industry strategy to avoid “high-in sugar” warning labels. Although the effects of these substances are not yet definitive and more research is needed, it is believed that increased exposure to products with NCS may promote a greater liking for sweet foods, including those containing sugar (48). As mentioned earlier, this is especially important in children because consumption at an early age determines lifelong intake habits (47).

Except for the high-in energy density and presence or absence of health claims, no statistical differences were found between critical nutrients and NCS. This finding can be in part explained by the low reformulation of the food industry, in the period in which the information for this study was collected. For instance, a study that assessed the best-selling brands offered in Colombia between 2016 and 2018 found that only the beverage products reduced added sugar content (39). This could suggest that the industry did not have the incentive to use claims to promote reformulated products.

In comparison to natural and nutrient-content claims, health claims were less frequent. This aligns with findings from previous studies conducted in Mexico, Ecuador, Guatemala, and New Zealand (31, 35, 62). One possible explanation for this finding is that consumer associations may be more likely to sue for misleading or inaccurate health claims (63) however, more research is needed. Unlike nutrient-content and natural claims, health claims assume a supposed causal relationship between the consumption of the product and its effect on health, which is harder for a product manufacturer to demonstrate to a regulatory entity.

The finding that there was no statistically significant difference in the healthfulness of products with claims and without claims (in terms of critical nutrient or NCS content) provides evidence that while marketing claims suggest that products with claims are healthy (implicitly or explicitly), they are actually no healthier than products without claims. Claims are likely to mislead consumers into believing that these products are healthier than those without claims, when in fact they are not and may even be higher in one or more critical nutrients. These findings support the need for government intervention to protect its citizens' right to food and health, by implementing public policies that regulate marketing strategies, especially for products marketed to children, and developing a warning labeling system that can be easily understood by the majority of the population (64, 65).

Given the prevalence of nutrient-content, health and nature-related claims on cereal products high in nutrients of concern, there is a need for the Colombian Congress and Government to implement policies restricting the use of claims on food and beverage products high-in critical nutrients, including clear definitions of the types of claims and considering those that have not been regulated to date.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

LG, MM-P, and MP-M contributed to conception and design of the study. MP-M and LG organized the database. MP-M performed the statistical analysis. MP-M and CL wrote the first draft of the manuscript. LG, LT, FD, and MM-P wrote sections of the manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.

This research was funded by Bloomberg Philanthropies (Subward number # 5103721). The funder had no role in the study design, data collection, analysis or interpretation.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.