Tempest over Tempest in a Cereal Bowl

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ACSH president Dr. Elizabeth Whelan wrote an article for TechCentralStation.com criticizing attacks on breakfast cereal. That in turn inspired comments from two dentists, below (and remember you can easily add your own comments, to this or any other Fears item, by signing in at the right margin):

Dr. Whelan,

The problem with presweetened breakfast cereals is not the lack of nutritional value, as you correctly pointed out, but the amount of simple sugars they contain and their effect on dental decay. Most presweetened cereals contain far more simple sugars than a child would put on the bowl of cereal if left to their own choice. Unsweetened corn flakes with free access to the sugar bowl would probably result in less than half the simple sugar content for most children. The major nutritional value would remain the same, but sugar exposure would be some what reduced. Add to this the problem of snacking on presweetened cereals and you increase further the cariogenic [Editor's note: that is, caries-causing -- not cancer-causing] potential. Most children will not snack on unsweetened cereal, which with the retentive starches also increases caries risk.

I agree with most of the comments you make on issues, but I think you soft-peddled this one a little too much.


Michael J. Gleason, PhD, DDS
University of Detroit Mercy School of Dentistry

ACSH Advisor Dr. Marvin Schissel, also a dentist, weighed in:

All through my dental career, from dental school and from meetings and continuing education courses, I have been bombarded with tales of the evils of sugar, especially in conjunction with other high-carbohydrate foods. Not only sugar-laced cold cereals, but also candies, soft drinks, and jelly sandwiches came in for condemnation for their caries-generating menace. Of course there is little doubt that these foods, especially when combined with ineffective oral hygiene and non-fluoridated community water, contribute heavily to dental disease. And three spoonfuls of sugar is more cariogenic than one spoonful. But, as is always the case, moderation is the wise answer.

A question: does three spoonfuls of sugar in a serving of cereal constitute excess? It might depend on the rest of the diet. No doubt stemming from my prejudice as a dentist, I tried to get my own kids to stay away from sugar cereals. I failed, but they haven't come to any dental harm (I know they are not a statistically significant sample!). Dr. Gleason's point, that children might over-snack during the day on these cereals, is well taken. And so is Beth's point, that the nutritional value of these enriched cereals makes it worthwhile to make them more attractive to children, especially since so many kids have poor diets overall.

I think a sensible answer would be moderation, parental attention to diet, and, especially, careful oral hygiene. From the standpoint of caries, what people eat is less important than what remains around the teeth after eating, and how long it remains. The parents themselves should brush their children's teeth until the kids are old enough to do a capable job. And the teeth should be brushed after breakfast and before bedtime. And if a community is not fluoridated, fluoride supplements should be given to the kids, and the parents should lobby to have their communities fluoridated.

Marvin Schissel, DDS