Effect of breakfast timing on the cognitive functions of elementary school students

Association between daily breakfast habit during pregnancy and neurodevelopment in 3-year-old offspring: The Japan Environment and Children's Study

The association between daily breakfast habits during pregnancy and offspring neurodevelopment remains unknown. We evaluated the association between breakfast habits during pregnancy and offspring neurodevelopment. Data of 72,260 women with singleton deliveries at and after 37 weeks of gestation enrolled during 2011-2014 in the Japan Environment and Children's Study were analysed. Offspring neurodevelopmental delays at 3 years of age were evaluated using the Ages and Stages Questionnaire, Third Edition (ASQ-3). Participants were stratified by tertiles of maternal daily energy intake (DEI) (Groups 1, 2, and 3:< 1400, 1400-1799, and ≥ 1800 kcal, respectively) during pregnancy and by offspring sex. The adjusted odds ratio (aOR) for abnormality in communication among participants with daily breakfast consumption habit was 0.87 (95% confidence interval, 0.80-0.96). A stratified analysis based on total DEI showed no significant differences in the neurodevelopment of Group 1 offspring. The aOR for abnormality in communication was 0.80 (95% confidence interval, 0.68-0.94) in Group 2. The aOR for abnormality in personal-social characteristics was 0.84 (95% confidence interval, 0.71-0.99) in Group 3. Maternal daily breakfast habits are associated with offspring neurodevelopment at 3 years of age, with the association influenced by maternal DEI and offspring sex.

Association Between Breakfast Consumption and Suicidal Attempts in Adolescents

Purpose

It has been previously reported that skipping breakfast is positively associated with increased depression, anxiety, stress, and psychological distress. This study examined the effects of breakfast consumption on suicide attempts among adolescents.

Patients and Methods

The Korean Youth Risk Behavior Web-based Survey (KYRBWS) is an anonymous self-report survey conducted with middle- and high-school students to understand the health behavior of Korean adolescents. Variables related to suicide risk such as suicide attempts, breakfast frequency, depression, anxiety, and violence were analyzed using multivariate logistic regression analysis. The class selected as the sample class was surveyed for all students and the number of youths selected as the sample in 2020 was 57,925 students from 800 schools (400 middle schools and 400 high schools) in 17 cities and provinces nationwide. Among them, the dataset for this study was 54,948 completed adolescent health behavior surveys.

Results

Adolescents who attempted suicide often skipped breakfast and had high stress levels. In the regression analysis, those who ate breakfast less than once a week had a stronger association with suicide attempts than the group of six or seven times a week (OR = 2.186; 95% CI = 1.873-2.552). In the group of feeling sadness or hopeless for more than two weeks in the past year, those who ate breakfast zero or once a week (OR = 1.269; 95% CI = 1.044-1.542), or two or three times (OR = 1.300; 95% CI = 1.043-1.619), showed a stronger correlation with suicide attempts than the group of six or seven times a week.

Conclusion

Breakfast can affect adolescents' emotions. Helping adolescents regularly eat breakfasts might be a suicide prevention strategy.

Teachers' Perceptions and Attitudes Toward Breakfast in the Classroom: The Importance of Health

BACKGROUND

Teacher resistance is sometimes cited as a barrier to implementing Breakfast in the Classroom (BIC), an approach to school breakfast in which students eat at their desks after the school day has begun. Given their role in serving breakfast with BIC, teacher perceptions may be critical in implementing an effective BIC program.

METHODS

K-5 teachers (N = 249) in an urban, low-income school district completed an online survey that assessed their expectations of BIC (retrospectively), perceptions of its benefits and challenges, and current program satisfaction. Descriptive statistics, Pearson's correlation tests, and multiple regression analyses were performed.

RESULTS

Most teachers (64%) whose students were currently receiving BIC were satisfied with the program overall, and 81% of teachers agreed that (1) BIC should continue and (2) is worth the effort. The most commonly identified problem was lack of breakfast variety and healthfulness. Retrospective positive expectations were positively correlated with current program satisfaction (r = .61, p < .001), although overall post-implementation perceptions are much more positive. Additionally, the perception that BIC improves students' health is related to higher satisfaction with BIC.

CONCLUSIONS

Focusing on the health implications of BIC may be important to implementing new BIC programs.

Use of a social jetlag-mimicking mouse model to determine the effects of a two-day delayed light- and/or feeding-shift on central and peripheral clock rhythms plus cognitive functioning

Social jetlag (SJL) is defined as the discrepancy between social and biological rhythms and calculated by the difference between the midpoint of sleep time on working-days and free-days. Previous human and mouse studies showed SJL is positively related to evening chronotype and significantly related to smoking habit, cardiovascular risk, cognitive ability, and that SJL-mimicking conditions, simulating the real lifestyle situation of SJL in many humans, disrupt the regularity of estrous cycles of female animals. The effects of SJL-mimicking conditions on circadian rhythms and cognitive function and the reasons why the discrepancy between social and biological rhythms is involved in SJL have not yet been investigated. Therefore, in this study, we utilized a mouse model of SJL-mimicking conditions - 6-hour delayed-light/dark (LD) conditions for 2 days and normal-LD conditions for the following 5 days - applied for several weeks during which biological rhythms were monitored. Circadian rhythms of central and peripheral clocks and metabolism of the mice under the SJL-mimicking condition were always delayed for 2-3 hours compared with those under the normal-LD condition. Moreover, SJL-mimicking conditions impaired their cognitive function using a novel object recognition test. Only the delayed timing of either the light phase of the LD or of feeding for 2 days, comparable to the free-days situation of humans, delayed the circadian staging of rhythms the following 5 days. Furthermore, sleep deprivation during the early mornings for 5 days, which is comparable to early rise times experienced by humans on working-days and does affect the staging of circadian rhythms (circadian misalignment schedule), delayed the locomotor activity rhythms the next 2 days, comparable to free-days in humans, which is similar to the lifestyle rhythm of the evening chronotype. Our results demonstrated that the circadian misalignment schedule for 5 days changed the locomotor activity rhythms the following 2 days to the evening chronotype, that light- and/or feeding-shift conditions for 2 days exacerbate SJL, and that SJL-mimicking conditions delay the metabolic rhythm and cause cognitive impairment.

The effects of breakfast on short-term cognitive function among Chinese white-collar workers: protocol for a three-phase crossover study

Background

As the first meal of the day, breakfast plays an important role in supplying energy and nutrients, which are critical to working and learning activities. A three-phase crossover study was designed to investigate the effects of breakfast on cognitive function among Chinese white-collar workers. The planned study protocol is presented.

Methods

A total of 264 participants aged 25–45 years will be recruited from Shenyang and Chongqing. Self-administered questionnaires will be used to collect information on age, gender, marital status, education level, occupation, smoking habits, drinking habits, and breakfast behaviours. The participants will be randomly assigned to 3 equal-sized groups (Groups A, B, and C) and will be provided with a nutrition-adequate breakfast, a nutrition-inadequate breakfast, or no breakfast, respectively. Each participant will receive the breakfast treatment on the basis of assignment to one of three sequences (ABC/BCA/CAB). Each participant will complete a battery of cognitive tests assessing short-term memory, attention, and working memory 120 minutes after breakfast. Mood will be measured through a self-administered questionnaire assessing the dimensions of positive and negative frames of mind. Additionally, fasting blood glucose and postprandial 2-hour blood glucose levels will be tested with a blood-glucose meter (Roche ACCU-CHEK®-Performa). All the participants will take all the tests in three successive weeks, and the order of presentation will be counter-balanced across groups.

Discussion

The present study will be the first investigation of the effect of breakfast food type and quality on cognitive function amongst white-collar workers in China. We predict that a nutrition-adequate breakfast, compared with a nutrition-inadequate breakfast and no breakfast, will significantly improve short-term cognitive function. The results of this study should provide scientific evidence of the effect of breakfast quality on cognitive function and provide scientific data to inform nutrition education strategies and promote a healthy lifestyle.

Trial registration

Chinese clinical trial registry (Primary registry in the WHO registry network) Registration number: ChiCTR-IPR-15007114. Date of registration: August 25, 2015.

Effect of Sugar versus Mixed Breakfast on Metabolic and Neurofunctional Responses in Healthy Individuals

We investigated the effects of glucose and diverse breakfasts on glucose increment and ghrelin suppression and cognitive processing of sensory information assessed by frontal P300 evoked potentials. In a randomized crossover design, 12 healthy individuals (6M/6F; BMI 22.2 ± 0.4 kg/m²; 27 ± 1.3 years, mean ± SEM) underwent 50 g OGTT (A) and 3 breakfasts (B1: milk and cereals; B2: milk, apple, and chocolate cream-filled sponge cake; B3: milk, apple, bread, and hazelnut chocolate cream) to assess plasma glucose-, insulin-, and ghrelin excursions. An electroencephalography was performed before and 100 min after consumption of each load to measure the latency of frontal P300 evoked potentials as index of cognitive performance. Breakfasts B1 and B2 exhibited significantly lower glycemic and insulinemic responses as compared to A. Breakfast B3 exhibited significantly lower glycemic, but not insulinemic response, as compared to A. Final plasma ghrelin inhibition was more pronounced, albeit not significantly, in all breakfasts with respect to A. P300 latency tended to decrease following each of the three breakfasts, but B3 was the only breakfast capable to elicit a statistically significant reduction in P300 latency with respect to A (p < 0.01), suggesting ameliorated cognitive performance. Such amelioration was correlated with the 2-hour final inhibition of plasma ghrelin concentration (r = 0.61, p = 0.01).

Can the Provision of Breakfast Benefit School Performance?

Studies of an association between school performance (enrollment, attendance, achievement, classroom behavior, and school drop-out) and nutritional status are discussed and the evidence of an effect of school meals evaluated. Many studies have shown associations between hunger, poor dietary intakes, stunting, underweight, and poor school performance after controlling for socioeconomic conditions. However, it remains possible that unmeasured socioeconomic variables could explain the relationship. Rigorous short-term studies of missing breakfast have generally found detrimental effects on children's cognition whereas studies of providing breakfast have shown benefits particularly in malnourished children. Classroom conditions may modify the effects of breakfast on behavior. There are extremely few longer term studies of the effects of giving school meals. Nearly all involved breakfast and very few had randomized controlled designs. Studies comparing participants with non-participants or comparing matched schools have found benefits (but bias due to self-selection) of receiving breakfast; inadequate matching of schools also remains possible. One longer term randomized controlled trial found benefits associated with attendance and arithmetic performance. In conclusion, most studies of giving breakfast have found benefits to school performance but many had serious design problems, were short-term, and were not conducted in the poorest countries. In order to advise policy makers correctly, there is an urgent need to run long-term randomized controlled trials of giving school meals in poor countries and to determine the effects of age and nutrition status of the children, the quality of the school, and the timing of the meal. The special needs of orphans should also be considered.

Breakfast consumption has no effect on neuropsychological functioning in children: a repeated-measures clinical trial

BACKGROUND

Although many studies have investigated the relation between breakfast consumption and various domains of cognitive functioning within children, some of the reported findings are inconsistent.

OBJECTIVE

We sought to determine the short-term effects of a breakfast meal on the neuropsychological functioning of healthy school-aged children after an overnight fast.

DESIGN

The study was conducted in a clinical research center with the use of a counterbalanced repeated-measures design among children who either consumed breakfast or were fasting. The administered neuropsychological tests included measures of attention, impulsivity, short-term memory, cognitive processing speed, and verbal learning. The sample consisted of children aged 8-10 y (n = 128), of whom 52% were female, 38% were African American, 31% were Hispanic, 28% were white, and 3% were of another race/ethnicity.

RESULTS

There were no significant (P ≥ 0.004) differences between breakfast meal consumption and fasting for any of the neuropsychological measures administered.

CONCLUSION

Breakfast consumption had no short-term effect on neuropsychological functioning in healthy school-aged children. This trial was registered at clinicaltrials.gov as NCT01943604.

The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review

Breakfast is thought to be beneficial for cognitive and academic performance in school children. However, breakfast is the most frequently skipped meal, especially among adolescents. The aim of the current article was to systematically review the evidence from intervention studies for the effects of breakfast on cognitive performance in children and adolescents. The effects of breakfast were evaluated by cognitive domain and breakfast manipulation. A total of 45 studies reported in 43 articles were included in the review. Most studies considered the acute effect of a single breakfast (n = 34). The acute studies looked at breakfast compared with no breakfast (n = 24) and/or comparisons of breakfast type (n = 15). The effects of chronic school breakfast program interventions were evaluated in 11 studies. The findings suggest that breakfast consumption relative to fasting has a short-term (same morning) positive domain-specific effect on cognition. Tasks requiring attention, executive function, and memory were facilitated more reliably by breakfast consumption relative to fasting, with effects more apparent in undernourished children. Firm conclusions cannot be made about the acute effects of breakfast composition and the effects of chronic breakfast interventions because there are too few studies and these largely report inconsistent findings. This review also highlights methodologic limitations of the existing research. These include a lack of research on adolescents, few naturalistic breakfast manipulations or testing environments, small samples, and insensitive cognitive tests.

Breakfast and Energy Drink Consumption in Secondary School Children: Breakfast Omission, in Isolation or in Combination with Frequent Energy Drink Use, is Associated with Stress, Anxiety, and Depression Cross-Sectionally, but not at 6-Month Follow-Up

A considerable amount of research suggests that breakfast omission and the frequent use of caffeinated energy drinks may be associated with undesirable effects, and particularly so in children and adolescents. The current paper presents cross-sectional and longitudinal data from the Cornish Academies Project to investigate the effects of consuming energy drinks and missing breakfast on stress, anxiety, and depression in a cohort of secondary school children from the South West of England. Questionnaires were administered at two time-points (spaced 6 months apart) to collect information relating to diet and lifestyle over the previous 6 months. Demographic and school data were acquired through the School Information Management System, and single-item measures of stress, anxiety, and depression were administered at the second time-point only. Associations between breakfast and energy drink consumption and stress, anxiety, and depression were investigated, and a multivariate approach was taken so that additional variance from diet, demography, and lifestyle could be controlled for statistically. Cross-sectional analyses showed that breakfast omission was consistently associated with negative outcomes, and that this was largely observed for both those who frequently consumed energy drinks and those who did not. However, cross-lag analyses showed that neither breakfast omission or energy drink consumption, alone or in combination, was predictive of stress, anxiety, or depression at 6-month follow-up. This suggests that associations between breakfast and mental health may be bi-directional rather than breakfast being the causal factor.

The Effect of Breakfast in the Classroom on Obesity and Academic Performance: Evidence from New York City

Participation in the federally subsidized school breakfast program often falls well below its lunchtime counterpart. To increase take-up, many districts have implemented Breakfast in the Classroom (BIC), offering breakfast directly to students at the start of the school day. Beyond increasing participation, advocates claim BIC improves academic performance, attendance, and engagement. Others caution BIC has deleterious effects on child weight. We use the implementation of BIC in New York City (NYC) to estimate its impact on meals program participation, body mass index (BMI), achievement, and attendance. While we find large effects on participation, our findings provide no evidence of hoped-for gains in academic performance, or of feared increases in obesity. The policy case for BIC will depend upon reductions in hunger and food insecurity for disadvantaged children, or its longer-term effects.

Association between breakfast consumption and educational outcomes in 9-11-year-old children

Objective

Breakfast consumption has been consistently associated with health outcomes and cognitive functioning in schoolchildren. Evidence of direct links with educational outcomes remains equivocal. We aimed to examine the link between breakfast consumption in 9–11-year-old children and educational outcomes obtained 6–18 months later.

Design

Data on individual-level free school meal entitlement and educational outcomes (Statutory Assessment Tests (SATs) at Key Stage 2) were obtained via the SAIL databank and linked to earlier data collected on breakfast consumption. Multilevel modelling assessed associations between breakfast consumption and SATs.

Setting

Trial of the Primary School Free Breakfast Initiative in Wales.

Subjects

Year 5 and 6 students, n 3093 (baseline) and n 3055 (follow-up).

Results

Significant associations were found between all dietary behaviours and better performance in SATs, adjusted for gender and individual- and school-level free school meal entitlement (OR=1·95; CI 1·58, 2·40 for breakfast, OR=1·08; CI 1·04, 1·13 for healthy breakfast items). No association was observed between number of unhealthy breakfast items consumed and educational performance. Association of breakfast consumption with educational performance was stronger where the measure of breakfast consumption was more proximal to SATs tests (OR=2·02 measured 6 months prior to SATs, OR=1·61 measured 18 months prior).

Conclusions

Significant positive associations between self-reported breakfast consumption and educational outcomes were observed. Future research should aim to explore the mechanisms by which breakfast consumption and educational outcomes are linked, and understand how to promote breakfast consumption among schoolchildren. Communicating findings of educational benefits to schools may help to enhance buy-in to efforts to improve health behaviours of pupils.

Social Cognitive Predictors of Breakfast Consumption in Primary School's Male Students

PURPOSE

This study aimed to test the usefulness of social cognitive theory (SCT) in explaining breakfast consumption in a sample of primary male students.

METHODS

Participants in this cross-sectional study were 358 male students (3rd, 4th and 5th grades) from eight public primary schools of Ilam city. Data were collected by a self-administered questionnaire based on components of SCT. Bivariate correlations and multiple logistic regression analysis using an Enter method were used to identify social cognitive correlates and determinants of breakfast consumption.

RESULTS

A total of 358 participants ranging in age from 8-12 years (M=10.06) were studied. The result of the study showed that the SCT significantly predicted breakfast consumption. SCT variables explained 41.4% of the variance in breakfast consumption behaviors, though, self-regulation was found to be the strongest predictor of breakfast consumption behaviors. There was the strongest correlation between behaviors and self-regulation, (r=0.561; P<0.001).

CONCLUSION

The findings support the usefulness of SCT in explaining breakfast consumption behaviors. These results suggest an essential role for self-regulation, self-efficacy and social support in the breakfast consumption behaviors of primary male students.

The effect of breakfast cereal consumption on adolescents' cognitive performance and mood

The aim of the current study was to investigate the effect of breakfast consumption on cognitive performance and mood in adolescents, and any interaction that breakfast consumption might have with cognitive load. The rationale for this approach was that the beneficial effects of any intervention with regard to cognitive function may be more readily apparent when more demands are placed on the system. Furthermore, as skipping breakfast is particularly prevalent within this age group, thus, we focused on adolescents who habitually skip breakfast. Cognitive load was modulated by varying the level of difficulty of a series of cognitive tasks tapping memory, attention, and executive functions. Mood measured with Bond–Lader scales (1974) as well as measures of thirst, hunger, and satiety were recorded at each test session both at baseline and after the completion of each test battery. Forty adolescents (mean age = 14:2) participated in this within-subjects design study. According to treatment, all participants were tested before and after the intake of a low Glycaemic index breakfast (i.e., a 35 g portion of AllBran and 125 ml semi-skimmed milk) and before and after no breakfast consumption. Assessment time had two levels: 8.00 am (baseline) and 10.45 am. The orders of cognitive load tasks were counterbalanced. Overall it appeared that following breakfast participants felt more alert, satiated, and content. Following breakfast consumption, there was evidence for improved cognitive performance across the school morning compared to breakfast omission in some tasks (e.g., Hard Word Recall, Serial 3's and Serial 7's). However, whilst participants performance on the hard version of each cognitive task was significantly poorer compared to the corresponding easy version, there was limited evidence to support the hypothesis that the effect of breakfast was greater in the more demanding versions of the tasks.

Effects of lunch on children's short-term cognitive functioning: a randomized crossover study

BACKGROUND/OBJECTIVES

Considering the large number of children worldwide attending all-day schools, information on the effects of lunch on short-term cognitive performance is of public health relevance. However, only adult studies investigated this issue yet. Therefore, this study examined the impact of skipping lunch vs having lunch on children's cognitive functioning in the early afternoon.

SUBJECTS/METHODS

Participants in this randomized crossover study with two groups were healthy 6th grade students of an all-day school in Gelsenkirchen, Germany. Group 1 skipped lunch on study day 1 and received an ad libitum lunch 1 week later on study day 2. The order for group 2 was vice versa. In the afternoon tonic alertness, visuospatial memory and selective attention were determined using a computerized test battery of the Vienna Test System. For continuous and discrete interval-scaled variables, treatment effect was estimated using the two sample t-test or the Wilcoxon rank-sum test, for discrete ordinal-scaled variables using generalized linear models.

RESULTS

Data on 105 children (48% male; 12.6 ± 0.6 years) were analyzed. Except for tonic alertness there were no significant differences in cognitive functioning between the skipping lunch day and the having lunch day. The higher number of omission errors on the skipping lunch day lost significance when adjusting for multiple testing.

CONCLUSIONS

In the first study on this topic lunch did not have relevant effects on children's cognitive functioning in the early afternoon. Future research needs to be done to figure out potential methodical and physiological explanations.

A diet based on multiple functional concepts improves cognitive performance in healthy subjects

Background

Disorders such as the metabolic syndrome (MetS), impaired glucose tolerance and diabetes, are associated with increased risk of cognitive decline. Also several of the individual key features that define the MetS, e.g. hypertension, impaired glucose regulation, dyslipidemia, obesity, and inflammation, are related to an increased risk of cognitive decline. Consequently, a diet that prevents metabolic disorders might be expected to prevent cognitive decline. The purpose of the present study was to, in overweight but otherwise healthy subjects, investigate effects on cognitive functions of a dietary regime combining multiple functional concepts potentially beneficial to risk markers associated with MetS. The purpose was in addition to evaluate cognitive performance in relation to results on cardiometabolic risk variables (BMI, blood pressure, glucose, insulin, cholesterol, triglycerides, free fatty acids, lipoprotein A-1 and B, hs-CRP, HbA1c, interleukin-6, TNF-α, and PAI-1).

Methods

Fourty-four healthy women and men (50–73 years, BMI 25–33, fasting glycemia ≤ 6.1 mmol/L) participated in a randomized, controlled crossover intervention, comparing a multifunctional diet (active diet (AD)) including foods with a potential anti-inflammatory action, with a control diet (CD) devoid of the “active” components. Both diets were composed in close agreement with the Nordic dietary recommendations. Each diet was consumed during 4 wk, separated by a 4 wk washout period. Cognitive tests were performed at fasting and in the postprandial period after a standardized breakfast, after each diet period.

Results

In comparison with the CD, the AD improved performance in the Rey Auditory-Verbal Learning test (recognition test, p < 0.05, ANOVA, n = 42) and significantly improved performance in test of selective attention, which also included aspects of working memory (p < 0.05, n = 40). Performance in cognitive tests was inversely associated with plasma concentrations of cardiometabolic risk markers (fasting cholesterol, blood glucose, blood pressure) and cardiovascular risk scores (Framingham and Reynols), and positivly associated with apolipoprotein A1 (p < 0.05).

Conclusions

The results indicate that diet characteristics may modulate cognitive performance. A relationship seems to exist between cardiometabolic risk markers and cognitive performance in apparently healthy subjects. The results provide additional motives for diet based prevention of metabolic disturbances related to the MetS.

Regular breakfast consumption is associated with increased IQ in kindergarten children

BACKGROUND

Studies have documented a positive relationship between regular breakfast consumption and cognitive outcomes in youth. However, most of these studies have emphasized specific measures of cognition rather than cognitive performance as a broad construct (e.g., IQ test scores) and have been limited to Western samples of school-age children and adolescents. This study aims to extend the literature on breakfast consumption and cognition by examining these constructs in a sample of Chinese kindergarten-age children.

METHODS

This cross-sectional study consisted of a sample of 1269 children (697 boys and 572 girls) aged 6 years from the Chinese city of Jintan. Cognition was assessed with the Chinese version of the Wechsler preschool and primary scale of intelligence-revised. Breakfast habits were assessed through parental questionnaire. Analyses of variance and linear regression models were used to analyze the association between breakfast habits and IQ. Socioeconomic and parental psychosocial variables related to intelligence were controlled for.

RESULTS

Findings showed that children who regularly have breakfast on a near-daily basis had significantly higher full scale, verbal, and performance IQ test scores (all p<0.001) compared to children who "sometimes" have breakfast. This relationship persisted for VIQ (verbal IQ) and FIQ (full IQ) even after adjusting for gender, current living location, parental education, parental occupation, and primary child caregiver.

CONCLUSION

Findings may reflect nutritional as well as social benefits of regular breakfast consumption on cognition, and regular breakfast consumption should be encouraged among young children.

Brain development in childhood

Although human brain development continues throughout childhood and adolescence, it is a non-linear process both structurally and functionally. Here we review studies of brain development in healthy children from the viewpoint of structure and the perfusion of gray and white matter. Gray matter volume increases and then decreases with age, with the developmental time of the peak volume differing among brain regions in the first and second decades of life. On the other hand, white matter volume increase is mostly linear during those periods. As regards fractional anisotropy, most regions show an exponential trajectory with aging. In addition, cerebral blood flow and gray matter volume are proportional at similar developmental ages. Moreover, we show that several lifestyle choices, such as sleeping habits and breakfast staple, affect gray matter volume in healthy children. There are a number of uninvestigated important issues that require future study.

What is the cell hydration status of healthy children in the USA? Preliminary data on urine osmolality and water intake

OBJECTIVE

Hyperosmotic stress on cells limits many aspects of cell function, metabolism and health. International data suggest that schoolchildren may be at risk of hyperosmotic stress on cells because of suboptimal water intake. The present study explored the cell hydration status of two samples of children in the USA.

DESIGN

Cross-sectional study describing the urine osmolality (an index of hyperosmotic cell shrinkage) and water intake of convenience samples from Los Angeles (LA) and New York City (NYC).

SETTING

Each participant collected a urine sample at an outpatient clinic on the way to school on a weekday morning in spring 2009. Each was instructed to wake, eat, drink and do as usual before school, and complete a dietary record form describing the type and amounts of all foods and beverages consumed after waking, before giving the sample.

SUBJECTS

The children (9-11 years) in LA (n 337) and NYC (n 211) considered themselves healthy enough to go to school on the day they gave the urine sample.

RESULTS

Elevated urine osmolality (>800 mmol/kg) was observed in 63 % and 66 % of participants in LA and NYC, respectively. In multivariable-adjusted logistic regression models, elevated urine osmolality was associated with not reporting intake of drinking water in the morning (LA: OR = 2·1, 95 % CI 1·2, 3·5; NYC: OR = 1·8, 95 % CI 1·0, 3·5). Although over 90 % of both samples had breakfast before giving the urine sample, 75 % did not drink water.

CONCLUSIONS

Research is warranted to confirm these results and pursue their potential health implications.

Breakfast and the achievement gap among urban minority youth

OBJECTIVES

To outline the prevalence and disparities of breakfast consumption among school-aged urban minority youth, causal pathways through which skipping breakfast adversely affects academic achievement, and proven or promising approaches for schools to increase breakfast consumption.

METHODS

Literature review.

RESULTS

On any given day a substantial proportion of American youth do not eat breakfast. On an average day, less than half (∼46%) of children participating in free or reduced-price lunch also participated in the School Breakfast Program for which they were also eligible. In a large study of 9-year-olds, 77% of White girls and 57% of Black girls consumed breakfast on all 3 days assessed; by age 19, the respective rates were 32% and 22%. Neuroscience research has identified the processes by which dietary behavior influences neuronal activity and synaptic plasticity, both of which influence cognitive functions. Participation in School Breakfast Programs has also been associated with reduced absenteeism. Universal School Breakfast Programs and allowing youth to eat breakfast in the classroom (vs cafeteria) are approaches that have been shown to increase participation.

CONCLUSIONS

Skipping breakfast is highly and disproportionately prevalent among school-aged urban minority youth, has a negative impact on academic achievement by adversely affecting cognition and absenteeism, and effective practices are available for schools to address this problem. Despite wide availability, the majority of American youth do not participate in School Breakfast Programs. High-quality universal breakfast programs that allow students to eat breakfast in the classroom are especially needed for youth who are not likely to get good nutrition the rest of the day.

Glycaemic index and glycaemic load of breakfast predict cognitive function and mood in school children: a randomised controlled trial

The macronutrient composition of a breakfast that could facilitate performance after an overnight fast remains unclear. As glucose is the brain's major energy source, the interest is in investigating meals differing in their blood glucose-raising potential. Findings vary due to unaccounted differences in glucoregulation, arousal and cortisol secretion. We investigated the effects of meals differing in glycaemic index (GI) and glycaemic load (GL) on cognition and mood in school children. A total of seventy-four school children were matched and randomly allocated either to the high-GL or low-GL group. Within each GL group, children received high-GI and low-GI breakfasts. Cognitive function (CF) and mood were measured 95–140 min after breakfast. Blood glucose and salivary cortisol were measured at baseline, before and after the CF tests. Repeated-measures ANOVA was used to identify differences in CF, mood, glucose and cortisol levels between the breakfasts. Low-GI meals predicted feeling more alert and happy, and less nervous and thirsty (P < 0·05 for each); high-GL meals predicted feeling more confident, and less sluggish, hungry and thirsty (P < 0·05 for each). High-GL (P < 0·001) and high-GI (P = 0·05) meals increased glucose levels 90 min after breakfast, and high-GI meals increased cortisol levels (P < 0·01). When baseline mood, glucose and cortisol levels were considered, low-GI meals predicted better declarative-verbal memory (P = 0·03), and high-GI meals better vigilance (P < 0·03); observed GI effects were valid across GL groups. GI effects on cognition appear to be domain specific. On balance, it would appear that the low-GI high-GL breakfast may help to improve learning, and of potential value in informing government education policies relating to dietary recommendations and implementation concerning breakfast.

Breakfast staple types affect brain gray matter volume and cognitive function in healthy children

Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ) in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume) and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent) of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI) of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence.

Breakfast improves cognitive function in cirrhotic patients with cognitive impairment

BACKGROUND

Cognitive disturbances are relatively common in patients with liver disease. High protein load precipitates hepatic encephalopathy in cirrhotic patients. Minimal hepatic encephalopathy (MHE) is a prevalent neurocognitive complication of cirrhosis.

OBJECTIVE

Because the influence of nutritional factors on the progression of cognitive impairment has not been explored in depth, this study aimed to investigate the effect on cognition of acute metabolic changes induced by breakfast consumption.

DESIGN

Twenty-one subjects (10 women) with Child A cirrhosis and 21 age- and sex-matched healthy controls were enrolled. Patients and controls were divided into 2 groups: those receiving a breakfast of 500 kcal and 21 g protein and those receiving no breakfast. Serum ammonia concentrations and cognitive functions were studied (Mindstreams; NeuroTrax, Fresh Meadows, NY) before and 2 h after breakfast. A mixed model was used to analyze the data.

RESULTS

At baseline, cirrhotic patients had significantly lower total scores and significantly lower subscores (P < 0.015 global cognitive score) in 4 of 7 cognitive categories, which is indicative of MHE. Patients with hyperammonemia (>85 mug/dL) scored significantly lower for attention than did patients with normal serum ammonia concentrations (P < 0.003). After 2 h, MHE patients and controls responded differently to breakfast consumption with regard to attention and executive functions (P < 0.003 and P < 0.04, respectively). Although patients' scores improved after breakfast consumption, despite an increase in serum ammonia, healthy controls who continued to fast performed better.

CONCLUSIONS

Chronic hyperammonemia may negatively affect attention. Eating breakfast improves attention and executive functions of patients with MHE. Prolonged periods of starvation may be partly responsible for these changes. This trial was registered at clinicaltrials.gov as NCT01083446.

A systematic review of the effect of breakfast on the cognitive performance of children and adolescents

Breakfast is recommended as part of a healthy diet because it is associated with healthier macro- and micronutrient intakes, BMI and lifestyle. Breakfast is also widely promoted to improve cognitive function and academic performance, leading to the provision of breakfast initiatives by public health bodies. Despite this positive and intuitive perception of cognitive benefits, there has been no systematic review of the evidence. Systematic review methodology was employed to evaluate the effects of breakfast on cognitive performance in well-nourished children and nutritionally at-risk or stunted children. Acute experimental studies, school feeding programmes and studies of habitual breakfast intake are reviewed. Comparisons of breakfast v. no breakfast and breakfasts differing in energy and macronutrient composition are discussed. Included are forty-five studies described in forty-one papers published between 1950 and 2008. The evidence indicates that breakfast consumption is more beneficial than skipping breakfast, but this effect is more apparent in children whose nutritional status is compromised. There is a lack of research comparing breakfast type, precluding recommendations for the size and composition of an optimal breakfast for children's cognitive function. Few studies examined adolescents. Studies of school breakfast programmes suggest that such interventions can have positive effects on academic performance, but this may be in part explained by the increased school attendance that programmes encourage. The present systematic review considers methodological issues in this field and makes recommendations for future research design and policy priorities.

Benefits of Breakfast for Children and Adolescents: Update and Recommendations for Practitioners

A number of studies report health benefits for children and adolescents who consume breakfast. Breakfast skipping is fairly common in children and adolescents and increases as children age. Breakfast can enhance children's diets by positively contributing to daily nutrient intake, augmenting intake of key nutrients such as fiber and calcium, and provides an opportunity to help meet the recommendations of the Dietary Guidelines for Americans. Breakfast also is associated with more healthful food choices. Cross-sectional studies support that eating breakfast more often may help children and adolescents maintain a healthful weight. However, the results from longitudinal studies are inconclusive and suggest that more research is needed to clarify this relationship, including understanding the mediating effects of initial weight status, dieting behavior, and physical activity levels. Breakfast consumption may provide some benefit toward cognitive function and academic achievement, but more research is needed. Breakfast is one facet of a healthy lifestyle that may help contribute to the short- and long-term health and well-being of children and adolescents. Health practitioners can promote healthy breakfast consumption in children and adolescents by addressing barriers to eating breakfast and focusing on individuals who may be more likely to skip breakfast on a regular basis.

Breakfast: a good habit, not a repetitive custom

In developed countries, obesity is the most frequent nutritional disorder, and overweight and obesity prevalences have increased whilst physical activity and breakfast consumption have declined. There is growing scientific interest in the possible role of breakfast in weight control and in factors such as appetite control, dietary quality and reduced risk for chronic diseases. The current article reviews the literature and discusses how the breakfast 'environment' and the composition of breakfast meals might be improved, particularly in children, so as to maintain the breakfast eating habit throughout life. Recommendations are proposed to encourage children to keep eating breakfast and the nutritional composition of the 'American breakfast' and two types of Mediterranean 'cereal breakfasts' are compared. We also propose a new breakfast type for children and adolescents that is based on chocolate hazelnut spread within a mixed breakfast type in order to reinforce positive experiences.

Influence of having breakfast on cognitive performance and mood in 13- to 20-year-old high school students: results of a crossover trial

OBJECTIVE

The goal was to determine whether breakfast had effects on the cognitive performance and mood of high school students.

METHODS

A crossover trial was performed in boarding schools, involving 104 students between 13 and 20 years of age. The participants were randomly assigned to 2 equal-size groups on the morning of the first testing day. One half of the total sample received a standardized breakfast, whereas the other half received no breakfast. Seven days later, the treatment order was reversed. Measurements of cognitive function included standardized tests of attention and concentration, as well as tests of verbal and spatial memory. In addition, mood was rated with a self-administered questionnaire covering the dimensions of positive and negative affect, information uptake, arousal, and alertness. Statistical analysis consisted of repeated-measures analysis of variance.

RESULTS

Breakfast had no effect on sustained attention among high school students. Visuospatial memory was improved in male students. Self-reported alertness improved significantly in the entire study population. Male students reported feeling more positive after consuming breakfast, compared with the fasting condition.

CONCLUSIONS

This crossover trial demonstrated positive short-term effects of breakfast on cognitive functioning and self-reported alertness in high school students.

A systematic review of the effect of dietary exposure that could be achieved through normal dietary intake on learning and performance of school-aged children of relevance to UK schools

The aim of the present review was to perform a systematic in-depth review of the best evidence from controlled trial studies that have investigated the effects of nutrition, diet and dietary change on learning, education and performance in school-aged children (4-18 years) from the UK and other developed countries. The twenty-nine studies identified for the review examined the effects of breakfast consumption, sugar intake, fish oil and vitamin supplementation and 'good diets'. In summary, the studies included in the present review suggest there is insufficient evidence to identify any effect of nutrition, diet and dietary change on learning, education or performance of school-aged children from the developed world. However, there is emerging evidence for the effects of certain fatty acids which appear to be a function of dose and time. Further research is required in settings of relevance to the UK and must be of high quality, representative of all populations, undertaken for longer durations and use universal validated measures of educational attainment. However, challenges in terms of interpreting the results of such studies within the context of factors such as family and community context, poverty, disease and the rate of individual maturation and neurodevelopment will remain. Whilst the importance of diet in educational attainment remains under investigation, the evidence for promotion of lower-fat, -salt and -sugar diets, high in fruits, vegetables and complex carbohydrates, as well as promotion of physical activity remains unequivocal in terms of health outcomes for all schoolchildren.

Children's perceptions of parental attitude affecting breakfast skipping in primary sixth-grade students

BACKGROUND

Breakfast skipping is an international public health concern. This study investigated the prevalence of breakfast skipping among primary sixth-grade students in Hong Kong and the impact of students' perceptions of parental attitudes on breakfast skipping.

METHODS

A total of 426 students aged 10-14 years in 4 local schools participated in this cross-sectional study and completed a questionnaire adapted from an earlier study in Queensland. Breakfast skipping was defined as having missed any food or beverage (except water) between waking and the commencement of morning school classes at least 1 school day during the past week. Multiple logistic regression analyses were performed to explore the potential risk factors of breakfast skipping.

RESULTS

Of the 426 students, 130 (30.5%, 95% confidence interval [CI]: 26.1-34.9) reported skipping breakfast for at least 1 day in a school week. Multiple logistic regression analyses showed that breakfast skipping was associated with lack of perceived parental emphasis on breakfast (odds ratio [OR] = 3.67, 95% CI: 1.75-7.68) and not believing that breakfast consumption could help concentration in class (OR = 3.82, 95% CI: 1.86-7.87).

CONCLUSIONS

This study suggested that breakfast consumption habits could stem from the students' beliefs and perceptions. Thus, working with students, parents, and schools to build up positive knowledge and beliefs about breakfast consumption might be useful.

The influence of the glycaemic load of breakfast on the behaviour of children in school

The impact of breakfasts of different glycaemic loads on the performance of nineteen children, aged six to seven years, was explored. Over a four week period, children attended a school breakfast club each day and ate one of three meals. Each meal offered a similar amount of energy but differed in their glycaemic load. When working individually, the behaviour of a child was rated in the classroom every ten seconds for 30 min to produce a measure of time spent on task. Memory was assessed by asking for the recall of a series of objects. The ability to sustain attention was measured by asking for a response after various delays. The incidence of negative behaviour was recorded when playing a video game that was too difficult to allow success. Two to three hours after a low glycaemic load breakfast had been consumed, performance on the tests of memory and the ability to sustain attention were better, fewer signs of frustration were displayed and initially more time was spent on task when working individually in class. The importance of the results was discussed in the context of the wide range of factors that influence behaviour in school.

Development of a scale to measure 9–11-year-olds' attitudes towards breakfast

OBJECTIVE

Development and validation of a questionnaire to measure children's attitudes towards breakfast.

DESIGN

A pilot study was used to select questionnaire items and assess test-retest reliability. The questionnaire was then administered to a larger sample of children together with a dietary recall questionnaire. Randomly selected subsets of these children also completed a dietary recall interview or their parents were asked to complete a questionnaire relating to their child's breakfast eating habits.

SETTING

Primary schools in south, west and north Wales, UK.

SUBJECTS

A total of 2495 children (199 in pilot testing, 2382 in the main study) in years 5 and 6 (aged 9-11 years).

RESULTS

The 13-item scale showed good construct validity, high internal reliability and acceptable test-retest reliability. Boys displayed more positive attitudes towards breakfast than girls but differences between the two age groups did not reach statistical significance. Children who did not skip breakfast displayed more positive attitudes than children who skipped breakfast. In addition, more positive attitudes towards breakfast were significantly correlated with consumption of a greater number of 'healthy' foods for breakfast (i.e., fruit, bread, cereal, milk products), consumption of fewer 'unhealthy' foods for breakfast (i.e., sweet items, crisps) and parental perceptions that their child usually ate a healthy breakfast.

CONCLUSIONS

The breakfast attitudes questionnaire is a robust measure that is relatively quick to administer and simple to score. These qualities make it ideal for use where validity at the individual level is important or where more time-consuming dietary measures are not feasible.

The role of breakfast and a mid-morning snack on the ability of children to concentrate at school

The effect on the ability of children to attend to their school work, of the size of breakfast and whether a mid-morning snack had been consumed, was considered. Nine year old children were studied for four days. They reported what they had eaten for breakfast and days when they either had or had not eaten a mid-morning snack were contrasted. For an hour in the late morning, while performing individual work, activity sampling was used to establish the time spent on task. Those who had eaten a small breakfast, on average 61 kcal, spent significantly less time attending to their work than those who had eaten larger meals. The adverse effect of a small breakfast was reversed by the consumption of a mid-morning snack.

School feeding for improving the physical and psychosocial health of disadvantaged elementary school children

BACKGROUND

Early malnutrition and/or micronutrient deficiencies can adversely affect physical, mental, and social aspects of child health. School feeding programs are designed to improve attendance, achievement, growth, and other health outcomes.

OBJECTIVES

The main objective was to determine the effectiveness of school feeding programs in improving physical and psychosocial health for disadvantaged school children.

SEARCH STRATEGY

We searched a number of databases including CENTRAL (2006 Issue 2), MEDLINE (1966 to May 2006), EMBASE (1980 to May 2006), PsycINFO (1980 to May 2006) and CINAHL (1982 to May 2006). Grey literature sources were also searched. Reference lists of included studies and key journals were handsearched and we also contacted selected experts in the field.

SELECTION CRITERIA

Data from randomized controlled trials (RCTs), non-randomised controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series studies (ITSs) were included. Feeding had to be done in school; the majority of participants had to be socio-economically disadvantaged.

DATA COLLECTION AND ANALYSIS

Two reviewers assessed all searches and retrieved studies. Data extraction was done by one of four reviewers and reviewed by a second. Two reviewers independently rated quality. If sufficient data were available, they were synthesized using random effects meta-analysis, adjusting for clustering if needed. Analyses were performed separately for RCTs and CBAs and for higher and lower income countries.

MAIN RESULTS

We included 18 studies. For weight, in the RCTs and CBAs from Lower Income Countries, experimental group children gained an average of 0.39 kg (95% C.I: 0.11 to 0.67) over an average of 19 months and 0.71 kg (95% C.I.: 0.48 to 0.95) over 11.3 months respectively. Results for weight were mixed in higher income countries. For height, results were mixed; height gain was greater for younger children. Attendance in lower income countries was higher in experimental groups than in controls; our results show an average increase of 4 to 6 days a year. Math gains were consistently higher for experimental groups in lower income countries; in CBAs, the Standardized Mean Difference was 0.66 (95% C.I. = 0.13 to 1.18). In short-term studies, small improvements in some cognitive tasks were found.

AUTHORS' CONCLUSIONS

School meals may have some small benefits for disadvantaged children. We recommend further well-designed studies on the effectiveness of school meals be undertaken, that results should be reported according to socio-economic status, and that researchers gather robust data on both processes and carefully chosen outcomes.

Consumption of a mid-morning snack improves memory but not attention in school children

Muthayya, S., T. Thomas, K. Srinivasan, K. Rao, A. V. Kurpad, J.-W. Van Klinken, G. Owen and E.A. de Bruin: Consumption of a mid-morning snack improves memory but not attention in school children. Physiol Behav 00(0) 000-000, 2006.--This study aimed to determine whether consumption of a mid-morning snack with appropriate energy compensation through a smaller breakfast or lunch, resulted in improved cognitive performance of 7-9 year old children with a low and high socioeconomic status (LSES and HSES, n=35 and 34 respectively). The children were each randomly assigned to three iso-caloric dietary interventions: control (standard breakfast, no snack and standard lunch), intervention A (small breakfast, snack, and standard lunch) and intervention B (standard breakfast, snack, and small lunch), using a cross-over design. The children were tested on three different days, each one week apart. Computerised tests of cognitive performance, consisting of memory, sustained attention and psychomotor speed, were performed during four sessions, i.e., prior to breakfast, after breakfast, after a mid-morning snack and after lunch. Having a mid-morning snack resulted in a smaller decline in immediate and delayed memory in LSES but not in HSES children. Having a snack did not influence sustained attention and psychomotor speed in either LSES or HSES children. This study shows that a more evenly distributed energy intake throughout the morning by consuming a mid-morning snack improves memory performance in school-age LSES children even when the total amount of energy consumed during the morning is not altered.

Effect of breakfast composition on cognitive processes in elementary school children

The relationship between breakfast composition and cognitive performance was examined in elementary school children. Two experiments compared the effects of two common U.S. breakfast foods and no breakfast on children's cognition. Using a within-participant design, once a week for 3 weeks, children consumed one of two breakfasts or no breakfast and then completed a battery of cognitive tests. The two breakfasts were instant oatmeal and ready-to-eat cereal, which were similar in energy, but differed in macronutrient composition, processing characteristics, effects on digestion and metabolism, and glycemic score. Results with 9 to 11 year-olds replicated previous findings showing that breakfast intake enhances cognitive performance, particularly on tasks requiring processing of a complex visual display. The results extend previous findings by showing differential effects of breakfast type. Boys and girls showed enhanced spatial memory and girls showed improved short-term memory after consuming oatmeal. Results with 6 to 8 year-olds also showed effects of breakfast type. Younger children had better spatial memory and better auditory attention and girls exhibited better short-term memory after consuming oatmeal. Due to compositional differences in protein and fiber content, glycemic scores, and rate of digestion, oatmeal may provide a slower and more sustained energy source and consequently result in cognitive enhancement compared to low-fiber high glycemic ready-to-eat cereal. These results have important practical implications, suggesting the importance of what children consume for breakfast before school.

Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents

Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the association of breakfast consumption with nutritional adequacy (nine studies), body weight (16 studies), and academic performance (22 studies) in children and adolescents. Breakfast skipping is highly prevalent in the United States and Europe (10% to 30%), depending on age group, population, and definition. Although the quality of breakfast was variable within and between studies, children who reported eating breakfast on a consistent basis tended to have superior nutritional profiles than their breakfast-skipping peers. Breakfast eaters generally consumed more daily calories yet were less likely to be overweight, although not all studies associated breakfast skipping with overweight. Evidence suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance. Breakfast as part of a healthful diet and lifestyle can positively impact children's health and well-being. Parents should be encouraged to provide breakfast for their children or explore the availability of a school breakfast program. We advocate consumption of a healthful breakfast on a daily basis consisting of a variety of foods, especially high-fiber and nutrient-rich whole grains, fruits, and dairy products.

Relationship between habitual breakfast and intellectual performance (logical reasoning) in well-nourished schoolchildren of Madrid (Spain)

OBJECTIVE

To determine the relationships between habitual breakfast habits and performance in verbal aptitude, logical reasoning and mathematical tests in a group of well-nourished scholars from Madrid.

DESIGN

The study subjects were 180 children between 9 and 13 y of age. A dietetic study was undertaken using a 7-day food record. Scholastic aptitude was examined using the scholastic aptitude test (SAT-1) test.

RESULTS

Breakfast made up 19.1% of total daily intake. No differences were found between subjects in terms of personal data or total diet with respect to whether they habitually took adequate breakfasts (AB) (ie, more than 20% of daily energy being provided by this meal) or inadequate breakfasts (IB) (less than 20%). However, AB subjects achieved better reasoning scores in the SAT-1 test.

CONCLUSIONS

The normal breakfast habits of schoolchildren should be taken into account when studying diet-mental function relationships, even when studying well-nourished populations.

Family resemblance in breakfast energy intake: the Stanislas Family Study

BACKGROUND

There seems to be a consensus that family influences on dietary habits are important. However, no data relative to breakfast have been published yet.

OBJECTIVE

To investigate whether and how breakfast energy intake aggregates within French families.

DESIGN

A total of 398 families of the Stanislas Family Study who filled in a 3 day food consumption diary were selected. Absolute and relative breakfast energy intakes (BEI in kcal/day and RBEI in percentage of daily intake, respectively) were both studied.

RESULTS

By using a variance component analysis, no genetic influence was shown in family aggregation of both BEI and RBEI. Intra-generation common environmental contribution to total phenotypic variance of BEI and RBEI was higher than inter-generation; both were increased with frequency of sharing breakfast. Furthermore frequency of sharing breakfast contributed to increase family resemblance in breakfast energy intake, particularly in offspring for BEI and RBEI, and in spouses for RBEI. Smoking habits, alcohol consumption, BMI or physical activity were related to family resemblance, but after adjustment on each factor degrees of resemblance were almost unchanged.

CONCLUSION

General findings of this study were that family aggregation in breakfast absolute and relative energy intakes was significant within Stanislas families. Family resemblance depended on inter- and intra-generation components and was modified by the number of shared breakfasts. Our study confirmed that familial habits act on family resemblance in both absolute and relative breakfast energy intakes, so that family should be a favorite unit for health and diet promotion programs.

SPONSORSHIP

Kellogg's PA, France.

The influence of breakfast and a snack on psychological functioning

Although there are reports that breakfast influences both mood and memory, there has been no attempt to consider whether a subsequent snack is beneficial. One hundred and fifty young female adults either fasted or consumed breakfasts of either 10 or 50 g of carbohydrate (corn flakes). Half received a further 25 g of carbohydrate in the form of corn flakes after 1 1/2 h (snack). Predictably, those who ate breakfast, and/or a snack, reported feeling less hungry. The larger the caloric intake, the less subjects reported hunger. Those who consumed a snack reported a better mood. Eating a larger breakfast was associated with poorer mood later in the morning, an effect reversed by eating a snack. Memory for the word lists was not influenced by eating breakfast, however, 20 but not 60 min after a midmorning snack, more words were recalled. Those who had eaten breakfast, as opposed to fasting, did, however, spend longer trying to recall the words. This finding was interpreted as evidence that eating breakfast was associated with better motivation. On a number of occasions, better memory was associated with lower blood glucose levels. These findings support previous observations that better glucose tolerance was associated with better memory.

Functional food science and behaviour and psychological functions

The impact of ingesting various foods on psychological and behavioural functions is a topic of both interest and concern to the general public. In this article, the scientific literature concerning demonstrated cause-and-effect relationships is reviewed, beginning with methodological considerations specific to the quantification of particular behaviours and psychological events. The essential function of food is to satisfy hunger and the need for essential nutrients. The contributions of macronutrients to appetite and satiety are described, as well as their impact on metabolism and energy balance. Functional properties of macronutrient substitutes (high-intensity sweeteners, fat replacers) and flavour enhancers are examined in relation to their contribution to hunger, satiety, and energy balance. The effects of foods and individual nutrients on the performance of diverse psychomotor tasks are studied with consideration given to the various validated quantitative tools used to assess behaviour. The effects of food components on activation, sedation, and affective states such as dysphoria are also reviewed, with special attention given to brain function and neuroactive substances such as serotonin and the endorphins. The case of hyperactivity in children is given special emphasis with reference to the potential influence of sugar and food additives. Safety issues related to food constituents and additives are discussed. Finally, a set of criteria is proposed for the evaluation and elaboration of studies in the behavioural and psychological fields, along with suggestions for future research.