Eating breakfast enhances the efficiency of neural networks engaged during mental arithmetic in school-aged children

A randomised crossover trial of nitrate and breakfast on prefrontal cognitive and haemodynamic response functions

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

Association Between Eating Habits and Perceived School Performance: A Cross-Sectional Study Among 46,455 Adolescents From 42 Countries

PURPOSE

This study analyzed the association between selected self-reported eating habits and perceived school performance in adolescents by gender.

METHODS

A cross-sectional analysis was conducted with data from a large representative sample of adolescents from 42 different countries. Participants answered questions about their weekly frequency of fruit, vegetable, sweets, and soft drink consumption, as well as the frequency of breakfast consumption and family meals. The adolescents subjectively rated their school performance compared to that of their classmates. Logistic regression models were adjusted for region, age, body mass index (z-score), socioeconomic status, physical activity, recreational screen time, and sleep difficulties.

RESULTS

Among the 46,455 (53.5% female, mean age of 13.7 ± 1.6 years) adolescents studied, 20.6% of males and 25.5% of females reported high perceived school performance. In the results of the fully adjusted analyses, the higher the frequency of all healthy eating habits studied, the higher the perceived school performance in both males and females. Specifically, both males and females reporting a higher frequency of fruit and vegetable consumption, a lower frequency of sweets and soft drink consumption, more frequent breakfast consumption, and more frequent family meals (breakfast and dinner) were more likely to perceive their school performance as higher compared to their classmates. In addition, having breakfast regularly on weekends and the frequency of family dinner were associated with better school performance in both males and females.

CONCLUSIONS

In summary, this study provide cross-sectional evidence on the association between healthy eating habits and perceived school performance. Considering that school performance is an indicator of healthy development in adolescence, our findings reinforce and extend the evidence on the importance of healthy eating at this stage of life.

Ready-to-eat cereal and milk for breakfast compared with no breakfast has a positive acute effect on cognitive function and subjective state in 11-13-year-olds: a school-based, randomised, controlled, parallel groups trial

PURPOSE

We tested the acute effect of breakfast (ready-to-eat-cereal [RTEC] and milk) versus (vs.) no breakfast on cognitive function and subjective state in adolescents.

METHODS

Healthy adolescents (n = 234) aged 11-13 years were recruited to take part in this school-based, acute, randomised, controlled, parallel groups trial with two interventions; Breakfast or No Breakfast. The breakfast intervention consisted of ad libitum intake of RTEC (up to 70 g) with milk (up to 300 ml) administered in a naturalistic school breakfast programme environment. Cognitive function was assessed at baseline and + 70 and + 215 min post-intervention in a group-testing situation, similar to a school classroom context. The CANTAB test battery included: Simple Reaction Time (SRT), 5-Choice Reaction Time (5-CRT), Rapid Visual Information Processing (RVIP), and Paired Associates Learning (PAL; primary outcome). Data collection commenced January 2011 and ended May 2011. This trial was retrospectively registered at www.clinicaltrials.gov as NCT03979027 on 07/06/2019.

RESULTS

A significant effect of the intervention (CMH[1] = 7.29, p < 0.01) was found for the number of levels achieved on the PAL task. A significant difference between interventions was found when baseline performance reached level 2 (JT, z = 2.58, p < 0.01), such that 100% of participants in the breakfast intervention reached the maximum level 4 but only 41.7% of those in the no breakfast intervention reached level 4. A significant baseline*intervention interaction (F[1,202] = 6.95, p < 0.01) was found for total errors made on the PAL task, indicating that participants who made above-average errors at baseline reduced the total number of errors made at subsequent test sessions following breakfast consumption whilst those in the no breakfast intervention did not. There was a positive effect of breakfast on reaction time and visual-sustained attention. The results also demonstrated interactions of intervention with baseline cognitive performance, such that breakfast conferred a greater advantage for performance when baseline performance was poorer.

CONCLUSION

Consuming breakfast has a positive acute effect on cognition in adolescents.

Breakfast Frequency and Composition in a Group of Polish Children Aged 7-10 Years

Breakfast is considered one of the crucial elements of a healthy diet. Most studies evaluate breakfast consumption with the risk of obesity and other health effects. Less attention is paid to the evaluation of breakfast composition and patterns. Thus, this study aimed to describe the most frequently observed breakfast patterns and to assess breakfast composition and quality in a group of Polish early school-age children. The cross-sectional survey study was conducted in school years 2017/2018 and 2018/2019. Information regarding breakfast was obtained with the use of an original paper-based weekly observation diary, and breakfast quality was assessed with a special scoring designed to be used together with the diary. In total, 223 schoolchildren of the second and third grades participated in the study, and 200 diaries were analyzed. More than ¾ of the participants consumed breakfast every day. Nearly 68% of meals were classified as well balanced, but only 16.5% of children eat a well-balanced breakfast every day. The number of children who usually (≥5 times per week) eat a sandwich for breakfast was 94 (47%), and that of those who habitually eat cereal and milk or porridge was 29 (14.5%). Only 7% of children consumed fruit or vegetables for breakfast daily, and 26.5% never eat fruit or vegetables for breakfast. Concluding, most children eat breakfast regularly, but the meal composition and quality might be improved.

Breakfast skipping alone and in interaction with inflammatory based quality of diet increases the risk of higher scores of psychological problems profile in a large sample of Iranian adults

The authors investigate the association of breakfast skipping and its interaction with a dietary inflammatory index (DII) with the severity of psychological disorders. A total of 2876 Iranian general adults were enrolled in this cross-sectional study. Psychological problems profile score was calculated using the regression method in the framework of factor analysis based on depression, anxiety and psychological distress. The higher scores indicate more severity of mental problem. The frequency of breakfast eating in a week was assessed. Dietary intakes were assessed using a food-frequency questionnaire and twenty-seven items were included in the calculation of DII. In the crude model, individuals who ate breakfast seldom had the highest odds for having worse psychological problems profile (OR 3⋅59; 95 % CI 2⋅52, 5⋅11). Adjustment for various confounders did not change the associations (OR 3⋅35; 95 % CI 2⋅11, 5⋅32). In the adjusted multinomial logistic regression model, participants with high DII (>median) who skipped breakfast had highest risk of being in the higher tertiles of psychological problems profile compared with those who had low DII (<median) and ate breakfast (OR 6⋅67; 95 % CI 3⋅45, 12⋅90). Similar results were observed in women and men regarding the impact of breakfast skipping alone and interaction with DII on scores of psychological problems profile. Breakfast skipping is associated with higher risk of psychological problems. Similar findings were obtained in the stratified analysis by sex. Our findings confirmed that the DII and breakfast skipping are associated with mental health, interactionally. Further longitudinal studies are needed to confirm the true link between breakfast skipping and psychological problems.

Associations between the Chronotypes and Eating Habits of Hong Kong School-Aged Children

Later chronotypes have been found to be associated with unhealthy diets in adolescents and adults, but no study has been conducted in children. The aim of this study was to investigate the associations between the chronotypes and dietary patterns of school-aged children. Children aged 7–11 and their parents were recruited from five mainstream schools in Hong Kong. The parents were told to complete questionnaires on the children’s circadian preferences, food frequency, and dietary behaviors. All of the questionnaires were distributed and collected by schoolteachers. No gender differences in chronotype were observed (all p > 0.05). The evening-type was associated with significantly greater odds of viewing television (TV) during meals (adjusted odds ratios (OR) = 5.62 in boys and 5.39 in girls). Evening-oriented boys were prone to skipping breakfast (adjusted OR = 14.78), whereas evening-oriented girls were at risk of consuming fast food (adjusted OR = 7.74). There are indications of some gender differences in chronotype-related eating patterns. Sleep duration and screen time significantly mediated the associations between later chronotypes and unhealthy eating habits. Individualized dietary recommendations in accordance with circadian preferences may be effective at promoting healthy and nutritious diets for school-aged children.

Lifestyle Habits Predict Academic Performance in High School Students: The Adolescent Student Academic Performance Longitudinal Study (ASAP)

This study aimed to determine if lifestyle habits could predict changes in cognitive control and academic performance in high school students using a longitudinal approach. One hundred and eighty-seven grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) completed a 3-year prospective study. Lifestyle habits, cognitive control, and academic performance were assessed every year during the 3-year study. Results show that in female students, screen time measures were negatively correlated with academic performance and cognitive control. Furthermore, changes (Δs) in sleeping habits were associated with Δs in academic performance in both genders, whereas Δs in eating habits and in studying time were correlated with Δs in academic performance only in male students. Moreover, in female students, screen time, social media use, and eating habits measures seem to predict the variance in the Δs of cognitive control measures (r² between 8.2% and 21.0%), whereas, in male students, studying time, eating, and sleeping habits appear to explain the variance in the Δs of academic performance measures (r² between 5.9% and 24.8%). In conclusion, results of the present study indicate that lifestyle habits were able to predict Δs in cognitive control and academic performance of high school students during a 3-year period.

Teachers' Experience and Perspectives of Traditional Breakfast and Breakfast in the Classroom

OBJECTIVE

To understand teachers' perceptions about Breakfast in the Classroom and traditional breakfast.

DESIGN

An electronic survey was sent to teachers across the state of Utah. Teachers responded to an open-ended question exploring what they liked and/or disliked about Breakfast in the Classroom and traditional breakfast.

SETTING

Schools across the state of Utah.

PARTICIPANTS

Kindergarten through grade 12 teachers who were members of the Utah Education Association.

PHENOMENON OF INTEREST

Teachers' opinions regarding Breakfast in the Classroom and traditional school breakfast ANALYSIS: Researchers independently coded all responses and then grouped codes into themes. Themes were reviewed recursively over time.

RESULTS

The 3 overarching themes were food and nutrition, administration of school breakfast, and student outcomes. Aspects most commonly disliked were the nutrition or quality of food, the mess created, the time required, coordination and logistical issues, behavioral issues, and waste. Aspects most commonly liked were breakfast being available to all students, students being fed or not hungry, coordination and logistics, and student learning and academics.

CONCLUSIONS AND IMPLICATIONS

Teachers liked and disliked aspects of Breakfast in the Classroom and traditional breakfast. Schools could potentially increase efforts to garner support and feedback from teachers to create buy-in and identify best practices. Future research could focus on identifying the effect that the School Breakfast Program model has on teachers' perceptions as well as confirming results with a larger and more diverse population.

Skipping Breakfast Affects the Early Steps of Cognitive Processing

Abstract. It has been generally accepted that skipping breakfast adversely affects cognition, mainly disturbing the attentional processes. However, the effects of short-term fasting upon brain functioning are still unclear. We aimed to evaluate the effect of skipping breakfast on cognitive processing by studying the electrical brain activity of young healthy individuals while performing several working memory tasks. Accordingly, the behavioral results and event-related brain potentials (ERPs) of 20 healthy university students (10 males) were obtained and compared through analysis of variances (ANOVAs), during the performance of three n-back working memory (WM) tasks in two morning sessions on both normal (after breakfast) and 12-hour fasting conditions. Significantly fewer correct responses were achieved during fasting, mainly affecting the higher WM load task. In addition, there were prolonged reaction times with increased task difficulty, regardless of breakfast intake. ERP showed a significant voltage decrement for N200 and P300 during fasting, while the amplitude of P200 notably increased. The results suggest skipping breakfast disturbs earlier cognitive processing steps, particularly attention allocation, early decoding in working memory, and stimulus evaluation, and this effect increases with task difficulty.

Environmental Forces that Shape Early Development: What We Know and Still Need to Know

Understanding health requires more than knowledge of the genome. Environmental factors regulate gene function through epigenetics. Collectively, environmental exposures have been called the "exposome." Caregivers are instrumental in shaping exposures in a child's initial years. Maternal dietary patterns, physical activity, degree of weight gain, and body composition while pregnant will influence not only fetal growth, but also the infant's metabolic response to nutrients and energy. Maternal over- or underweight, excess caloric intake, nutrient imbalances, glucose dysregulation, and presence of chronic inflammatory states have been shown to establish risk for many later chronic diseases. During the period from birth to age 3 y, when the infant's metabolic rate is high and synaptogenesis and myelination of the brain are occurring extremely rapidly, the infant is especially prone to damaging effects from nutrient imbalances. During this period, the infant changes from a purely milk-based diet to one including a wide variety of foods. The process, timing, quality, and ultimate dietary pattern acquired are a direct outcome of the caregiver-infant feeding relationship, with potentially lifelong consequences. More research on how meal time interactions shape food acceptance is needed to avoid eating patterns that augment existing disease risk. Traditional clinical trials in nutrition, meant to isolate single factors for study, are inadequate to study the highly interconnected realm of environment-gene interactions in early life. Novel technologies are being used to gather broad exposure data on disparate populations, employing pioneering statistical approaches and correlations applied specifically to the individual, based on their genetic make-up and unique environmental experiences.

Maternal Sociodemographic Characteristics and Behaviors as Correlates of Preadolescent's Breakfast Habits

PURPOSE

To explore factors affecting skipping breakfast rate, and to identify its perceived reasons among preadolescent students and their mothers in Jordan.

DESIGN AND METHODS

Using cluster stratified sampling, preadolescent (10-11years) students (N=1915) and their mothers (N=1299) from 26 public and private schools completed a self-reported questionnaire. Breakfast skipping and its related habits were described. Children's and mothers' perceptions of regular breakfast eating and sociodemographic factors were analyzed in relation to breakfast skipping in children.

RESULTS

Although the majority of both children and mothers perceived breakfast as very important, 23% of the children and mothers reported skipping breakfast. Male students skipped breakfast more than female students. Students whose mothers had a low level of education and students with a low value of breakfast consumption had a higher likelihood of skipping breakfast. Mothers' high value of breakfast and encouragement of children to eat breakfast were directly related to an increase in children's perceived importance of breakfast consumption. Preadolescents' and mothers' perceptions of the importance of breakfast and mothers' encouragement to eat breakfast were significant predictors of breakfast consumption among students.

CONCLUSION

The high prevalence of breakfast skipping among students, and knowledge about association between mothers' perceived importance of breakfast consumption and encouragement highlighted the pivotal role of mothers in preadolescent's breakfast consumption.

PRACTICAL IMPLICATIONS

The findings suggest that health care providers, including school health practitioners, are recommended to assess children's and mothers' perceived value of breakfast and to include mothers in health promotion interventions on breakfast consumption.

Who Eats School Breakfast? Parent Perceptions of School Breakfast in a State With Very Low Participation

BACKGROUND

Having breakfast is correlated with health and academic benefits; yet, many children do not consume breakfast, and participation in the federal School Breakfast Program remains low. The purpose of this study was to examine parent perceptions of school breakfast and identify relationships between those who consume breakfast at school and those who do not.

METHODS

A random sample of 100 schools, representing 29 school districts, across the state of Utah was selected to participate in the survey. Administrators were asked to distribute an online survey link to the parents of their school. Parents answered questions about their oldest kindergarten through 12th grade child. Qualitative and quantitative analyses were performed.

RESULTS

A total of 488 parents completed the survey. In a multilevel model, child grade level, participation in free and reduced-price lunch, and perceive benefits to school breakfast were significantly related to eating breakfast at school. Some major themes from the qualitative analysis included no need for school breakfast, perception of regional values, and logistical issues.

CONCLUSIONS

Parent perception of school meals is related to participation. This study identifies several areas of perception that could be address through parent education to increase school breakfast participation.

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day.

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.

Effects of blood glucose levels on resting-state EEG and attention in healthy volunteers

PURPOSE

Although glucose is the primary source of energy for the human brain, only a few studies have quantitatively evaluated the effects of glucose supply in healthy fasting subjects. Thus, this study used an EEG power spectral analysis to investigate whether alterations in EEG are associated with changes in blood glucose levels in healthy fasting subjects.

METHODS

This study included 24 healthy volunteers who underwent resting-state EEG and completed two attention examinations following a fasting period of at least 8 hours. The same tests were repeated after the participants ingested a glucose-rich drink.

RESULTS

After consumption of the glucose-rich drink, significant increases in low alpha (8-10 Hz) and theta (4-8 Hz) power were observed in the whole brain and were especially prominent in the frontal and parieto-occipital regions. The participants performed better on the attention tests after than before the intake of glucose, but regional EEG changes were not correlated with this attentional enhancement.

CONCLUSIONS

The present study demonstrated that recovery from low levels of blood glucose following a prolonged fasting period was associated with increased power in the theta and low alpha bands on a resting-state EEG and that this recovery was accompanied by improved attentional performance.

Exercise, nutrition and the brain

Accumulating evidence suggests that diet and lifestyle can play an important role in delaying the onset or halting the progression of age-related health disorders and can improve cognitive function. Exercise has been promoted as a possible prevention for neurodegenerative diseases. Exercise will have a positive influence on cognition and it increases the brain-derived neurotrophic factor, an essential neurotrophin. Several dietary components have been identified as having effects on cognitive abilities. In particular, polyphenols have been reported to exert their neuroprotective actions through the potential to protect neurons against injury induced by neurotoxins, an ability to suppress neuroinflammation, and the potential to promote memory, learning, and cognitive function. Dietary factors can affect multiple brain processes by regulating neurotransmitter pathways, synaptic transmission, membrane fluidity, and signal-transduction pathways. Flavonols are part of the flavonoid family that is found in various fruits, cocoa, wine, tea and beans. Although the antioxidant effects of flavonols are well established in vitro, there is general agreement that flavonols have more complex actions in vivo. Several cross-sectional and longitudinal studies have shown that a higher intake of flavonoids from food may be associated with a better cognitive evolution. Whether this reflects a causal association remains to be elucidated. Several studies have tried to 'manipulate' the brain in order to postpone central fatigue. Most studies have clearly shown that in normal environmental circumstances these interventions are not easy to perform. There is accumulating evidence that rinsing the mouth with a carbohydrate solution will improve endurance performance. There is a need for additional well controlled studies to explore the possible impact of diet and nutrition on brain functioning.

Effectiveness of a school-based nutrition and food safety education program among primary and junior high school students in Chongqing, China

BACKGROUND

Health behavioral patterns, especially eating patterns, established in childhood often carry over into adulthood, and some of the unhealthy ones are later associated with adult morbidity and mortality. Recently, a few nutrition and food safety education programs have been implemented in primary and junior high schools in China.

PURPOSE

This study aims to examine the effectiveness of a school-based nutrition and food safety education program among primary and junior high school students in China.

METHODS

A mixed study design incorporating an intervention study and a quantitative survey was conducted for this research. With stratified cluster sampling, students from the 5(th) and 6(th) grade in one primary school and the 7(th) and 8(th) grade in one junior high school in Chongqing, China, were all selected and separated randomly into an intervention group (n = 501) and a control group (n = 522). Effectiveness evaluation investigations were performed at the initial time and nine-month follow-up (n = 472), respectively. Effectiveness of pre-/post-intervention and nine-month follow-up changes in scores of nutrition knowledge and food safety was assessed using a two-tailed t-test and analysis of variance.

RESULTS

Nutrition knowledge scores for the intervention group were mean 9.03, SD±2.75 at the baseline, and 14.70±3.28 after intervention. There was a significant improvement (t = 29.78, p < 0.01). The nine-month follow-up knowledge scores of the intervention group were 12.35±2.89, which were lower than the immediately after the intervention group (t = 12.40, p<0.01), but higher than those of the baseline level (t = 18.04, p < 0.01). Food safety scores of the post-intervention were higher (p < 0.01) than that of the control group in both pre-intervention and nine-month follow-up. The control group had no significant change in the pre-post intervention.

CONCLUSIONS

It is feasible and effective to improve nutrition and food safety knowledge among primary and junior high school students through school-based nutrition and food safety education programs.

The effects of breakfast on behavior and academic performance in children and adolescents

Breakfast consumption is associated with positive outcomes for diet quality, micronutrient intake, weight status and lifestyle factors. Breakfast has been suggested to positively affect learning in children in terms of behavior, cognitive, and school performance. However, these assertions are largely based on evidence which demonstrates acute effects of breakfast on cognitive performance. Less research which examines the effects of breakfast on the ecologically valid outcomes of academic performance or in-class behavior is available. The literature was searched for articles published between 1950–2013 indexed in Ovid MEDLINE, Pubmed, Web of Science, the Cochrane Library, EMBASE databases, and PsychINFO. Thirty-six articles examining the effects of breakfast on in-class behavior and academic performance in children and adolescents were included. The effects of breakfast in different populations were considered, including undernourished or well-nourished children and adolescents from differing socio-economic status (SES) backgrounds. The habitual and acute effects of breakfast and the effects of school breakfast programs (SBPs) were considered. The evidence indicated a mainly positive effect of breakfast on on-task behavior in the classroom. There was suggestive evidence that habitual breakfast (frequency and quality) and SBPs have a positive effect on children's academic performance with clearest effects on mathematic and arithmetic grades in undernourished children. Increased frequency of habitual breakfast was consistently positively associated with academic performance. Some evidence suggested that quality of habitual breakfast, in terms of providing a greater variety of food groups and adequate energy, was positively related to school performance. However, these associations can be attributed, in part, to confounders such as SES and to methodological weaknesses such as the subjective nature of the observations of behavior in class.

Neuroimaging, a new tool for investigating the effects of early diet on cognitive and brain development

Nutrition is crucial to the initial development of the central nervous system (CNS), and then to its maintenance, because both depend on dietary intake to supply the elements required to develop and fuel the system. Diet in early life is often seen in the context of "programming" where a stimulus occurring during a vulnerable period can have long-lasting or even lifetime effects on some aspect of the organism's structure or function. Nutrition was first shown to be a programming stimulus for growth, and then for cognitive behavior, in animal studies that were able to employ methods that allowed the demonstration of neural effects of early nutrition. Such research raised the question of whether nutrition could also programme cognition/brain structure in humans. Initial studies of cognitive effects were observational, usually conducted in developing countries where the presence of confounding factors made it difficult to interpret the role of nutrition in the cognitive deficits that were seen. Attributing causality to nutrition required randomized controlled trials (RCTs) and these, often in developed countries, started to appear around 30 years ago. Most demonstrated convincingly that early nutrition could affect subsequent cognition. Until the advent of neuroimaging techniques that allowed in vivo examination of the brain, however, we could determine very little about the neural effects of early diet in humans. The combination of well-designed trials with neuroimaging tools means that we are now able to pose and answer questions that would have seemed impossible only recently. This review discusses various neuroimaging methods that are suitable for use in nutrition studies, while pointing out some of the limitations that they may have. The existing literature is small, but examples of studies that have used these methods are presented. Finally, some considerations that have arisen from previous studies, as well as suggestions for future research, are discussed.

Breakfast: a multidisciplinary approach

Background

The role of breakfast as an essential part of an healthy diet has been only recently promoted even if breakfast practices were known since the Middle Age. The growing scientific evidences on this topic are extremely sector-based nevertheless breakfast could be regarded from different point of views and from different expertises. This approach, that take into account history, sociology, anthropology, medicine, psychology and pedagogy, is useful to better understand the value of this meal in our culture. The aim of this paper was to analyse breakfast-related issues based on a multidisciplinary approach with input by specialists from different fields of learning.

Discussion

Breakfast is now recommended as part of a diet because it is associated with healthier macro- and micronutrient intakes, body mass index and lifestyle. Moreover recent studies showed that breakfast improves cognitive function, intuitive perception and academic performance. Research demonstrates the importance of providing breakfast not only to children but in adults and elderly too. Although the important role breakfast plays in maintaining the health, epidemiological data from industrialised countries reveal that many individuals either eat a nutritionally unhealthy breakfast or skip it completely.

Summary

The historical, bio-psychological and educational value of breakfast in our culture is extremely important and should be recognized and stressed by the scientific community. Efforts should be done to promote this practice for the individual health and well-being.