The relationship of breakfast and snack foods with cognitive and academic performance and physical activity levels of adolescent students

Factors shaping adolescent snack choices in urban Bangladeshi schools: a mixed methods study

Research on adolescents' snack choices in school food environments has predominantly focused on high-income countries, leaving gaps in low- and middle-income contexts. This study addresses these gaps by examining snack choices and their individual, social and environmental influencing factors among adolescents in 20 urban high schools in Bangladesh using a mixed-methods approach guided by a conceptual model informed social cognitive theory (SCT) and an ecological perspective. Quantitative data were collected through surveys with 975 adolescents (ages 11-17), while qualitative data included focus group discussions with 60 adolescents. Adolescents frequently purchased energy-dense, non-nutritious snacks during school breaks, spending 10-20 Bangladeshi Taka (0.1-0.2 USD) daily. Individual factors such as taste were not widely prioritised in the quantitative survey but emerged as a central influence in the qualitative FGDs, often overriding health or hygiene considerations. While health considerations were frequently reported across both data sources, adolescents typically defined healthy food in terms of safety from contamination and chemical adulteration, rather than nutritional content. Many viewed home-cooked meals as compensating for less healthy snacks. Social peer influences were perceived as secondary in the survey data, yet qualitative findings revealed that peers exerted a significant influence through shared routines, group preferences, and subtle conformity. Environmental factors, including cost, availability, and hygiene, were cited less frequently in the survey but featured prominently in the FGDs. Adolescents often selected snacks based on affordability, accessibility, and perceived cleanliness, highlighting the influence of the school food environment on their choices. Interventions should generate demand for nutritious snacks, address food safety concerns, challenge compensatory health beliefs, and consider adolescents' psycho-emotional stressors. Policies must reshape school food environments to ensure safe, affordable, and nutritious snacks.

Predicting and comparing the long-term impact of lifestyle interventions on individuals with eating disorders in active population: a machine learning evaluation

Objective

This study aims to evaluate and predict the long-term effectiveness of five lifestyle interventions for individuals with eating disorders using machine learning techniques.

Methods

This study, conducted at Dr. Irandoust's Health Center at Qazvin from August 2021 to August 2023, aimed to evaluate the effects of five lifestyle interventions on individuals with eating disorders, initially diagnosed using The Eating Disorder Diagnostic Scale (EDDS). The interventions were: (1) Counseling, exercise, and dietary regime, (2) Aerobic exercises with dietary regime, (3) Walking and dietary regime, (4) Exercise with a flexible diet, and (5) Exercises through online programs and applications. Out of 955 enrolled participants, 706 completed the study, which measured Body Fat Percentage (BFP), Waist-Hip Ratio (WHR), Fasting Blood Sugar (FBS), Low-Density Lipoprotein (LDL) Cholesterol, Total Cholesterol (CHO), Weight, and Triglycerides (TG) at baseline, during, and at the end of the intervention. Random Forest and Gradient Boosting Regressors, following feature engineering, were used to analyze the data, focusing on the interventions' long-term effectiveness on health outcomes related to eating disorders.

Results

Feature engineering with Random Forest and Gradient Boosting Regressors, respectively, reached an accuracy of 85 and 89%, then 89 and 90% after dataset balancing. The interventions were ranked based on predicted effectiveness: counseling with exercise and dietary regime, aerobic exercises with dietary regime, walking with dietary regime, exercise with a flexible diet, and exercises through online programs.

Conclusion

The results show that Machine Learning (ML) models effectively predicted the long-term effectiveness of lifestyle interventions. The current study suggests a significant potential for tailored health strategies. This emphasizes the most effective interventions for individuals with eating disorders. According to the results, it can also be suggested to expand demographics and geographic locations of participants, longer study duration, exploring advanced machine learning techniques, and including psychological and social adherence factors. Ultimately, these results can guide healthcare providers and policymakers in creating targeted lifestyle intervention strategies, emphasizing personalized health plans, and leveraging machine learning for predictive healthcare solutions.

Is higher adherence to the mediterranean diet associated with greater academic performance in children and adolescents? A systematic review and meta-analysis

OBJECTIVE

The aim of the present study was to synthesize the available evidence from the relationship between adherence to the Mediterranean diet (MedDiet) and academic performance in children and adolescents.

METHODS

A systematic review and meta-analysis was conducted, which adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Four electronic databases (PubMed, Scopus, Web of Science, and the Cochrane Library) were examined from inception to April 8th, 2024.

RESULTS

Eighteen studies were included in the current systematic review and sixteen in the meta-analysis. The relationship between adherence to the MedDiet and academic performance among children and adolescents was statistically significant (Pearson's correlation coefficient [r] = 0.17, 95% confidence interval [CI]: 0.14 to 0.21, p < 0.001; inconsistency index [I2] = 56.7%). The influence analysis revealed that removing individual studies one at a time did not result in any changes to the overall results (p < 0.05 in all cases).

CONCLUSIONS

A higher adherence to the MedDiet could play a relevant role in academic performance among children and adolescents.

A healthy breakfast each and every day is important for students' motivation and achievement

Breakfast is often cited as the most important meal of the day and vital for students' academic functioning at school. Although much research has linked students' breakfast consumption to better achievement, there has been debate about why and how breakfast has academic benefits. The present study of 648 Australian high school students investigated (a) the role of breakfast consumption and breakfast quality in students' self-reported motivation and their achievement in a science test, (b) the role of motivation in mediating the link between breakfast consumption and quality and students' achievement, and (c) the extent to which breakfast consumption effects are moderated by the quality of breakfast (e.g., more vegetables, fruit, dairy/protein, wholegrains, cereals, water; less sugary drinks, processed meat, fast take-away, unhealthy snack foods). Findings indicated that beyond the effects of personal, home, and classroom factors, breakfast consumption predicted higher adaptive motivation (p < .05), breakfast quality predicted lower maladaptive motivation (p < .05), and in turn, students' adaptive (positively, p < .01) and maladaptive (negatively, p < .01) motivation predicted their achievement. Moreover, adaptive motivation significantly mediated the relationship between breakfast consumption and achievement (p < .05). The effect of breakfast consumption was moderated by the quality of breakfast such that consuming a high-quality breakfast in the morning was associated with the highest levels of adaptive motivation (p < .01) and achievement (p < .05) later in the day. Findings have implications for educational practice and policy seeking to promote a healthy start to the school day to optimize students' motivation and achievement.

Relationship of Self-Reported Physical Activity with Cognition in Middle- Aged Adults

OBJECTIVE

The increasing prevalence of age-related cognitive decline highlights the importance of physical activity for cognitive health. Regular exercise has been associated with improved mental health and reduced risk of cognitive decline. This study investigated the connection between self-reported physical activity and cognitive function in middle-aged adults.

METHODS

This cross-sectional study included 56 Indian adults aged 30-55, selected based on a health screening questionnaire. Participants reported their physical activity using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), which categorized them into low, moderate, and high activity levels. Cognitive functions, including visual memory, executive function, and attention, were assessed using the Cambridge Neuropsychological Automated Testing Battery (CANTAB). Results were statistically analyzed for relationships between cognitive domains and physical activity parameters using Pearson's correlation and linear regression analysis.

RESULTS

The study showed a significant positive correlation of attention with moderate and vigorous physical activity, while sedentary behavior negatively impacted attention. Linear regression showed that attention is affected by moderate-intensity activity whereas executive function and visual memory are affected by age.

CONCLUSION

This study supports the view that moderate and vigorous intensity activities may positively affect attention in middle-aged adults highlighting the benefits of physical activity.

Effect of habitual breakfast skipping on information processing capacity, cortical response, and cognitive flexibility among medical collegiate - a cross-sectional study

OBJECTIVES

Breakfast replenishes glucose homeostasis and provides other micro-nutrients for the normal functioning of the body after a long night at night. Habitually skipping breakfast leads not only to metabolic disturbances but also to neurocognitive impairment. Hence, the current study was carried out to study the effect of skipping breakfast on neurocognitive functions.

METHODS

A 9-item breakfast questionnaire was distributed online to students for identifying habitual breakfast skippers from non-skippers based on inclusion criteria. Random blood glucose was noted and visual and auditory reaction time, critical flicker fusion frequency, and Stroop test were assessed in both groups to assess cognition.

RESULTS

Forty one habitual breakfast skippers who met the inclusion criteria showed increased visual reaction time, and auditory reaction time indicating cognitive impairment. A significant reduction in the Stroop test was observed among the non-skipper group when compared to the skipper group.

CONCLUSIONS

This study suggests that skipping breakfast diminishes neurocognitive functions like problem-solving, planning, judgment, information retention, and reasoning.

Striking a balance: how long physical activity is ideal for academic success? Based on cognitive and physical fitness mediation analysis

Balancing physical activity and studying is an important issue facing Chinese teenagers. Therefore, numerous studies have found that engaging in physical activity can promote academic performance among students. However, what is the optimal duration of physical activity? This study used data from the China Education Panel Survey, with a sample size of 18,009 valid respondents. General linear regression analysis was conducted using Stata 17 software to evaluate the effects of different durations of physical activity, cognitive ability, and physical Fitness on academic performance among adolescents. Furthermore, the "Bootstrap Mediation" method and the "Maximum Likelihood Estimation" method were used to analyze whether physical health and cognitive ability have significant mediating effects. The present study reveals the following findings: (1) There exists a non-linear relationship between students' academic performance and the duration of physical exercise. The greatest improvement in academic performance is observed when the exercise duration reaches 2 hours. (2) Physical exercise can enhance students' academic performance by promoting physical health and cognitive abilities. (3) Gender heterogeneity is observed, with the optimal exercise duration for male students being 2 hours, while female students exhibit the highest academic performance when exercising for one hour. This study provides theoretical guidance for research on adolescents' participation in physical Activity and improving academic performance, enabling adolescents to engage in physical Activity more scientifically and rationally.

Association between aerobic fitness and attentional functions in Egyptian preadolescent children

Growing evidence indicates that culture and education can influence cognitive constructs. Studies targeting Western and Asian populations have shown a positive relationship between aerobic fitness and cognitive control in children; however, this association has yet to be explored in the Arab world. The current study aimed to investigate the relationship between aerobic fitness and attentional networks in Egyptian preadolescent children. In total, 103 preadolescent children (9.76 ± 0.11) completed an assessment of aerobic fitness using a 6-min running test and a computerized attention network test that allowed for assessing alerting, orienting, and executive networks. The results revealed that higher aerobic fitness was associated with shorter response time and higher response accuracy in a more cognitively demanding task condition (i.e., incongruent trials). Furthermore, higher aerobic fitness was associated with a more efficient executive network. No associations were observed for alerting and orienting networks. These findings corroborate growing evidence indicating the importance of aerobic fitness for cognitive development and extend the literature by suggesting that the positive association between aerobic fitness and cognitive control might be generalized to the Arab population and not significantly change across cultures.

Different Effects of Perceived Social Support on the Relationship between Perceived Stress and Depression among University Students with Borderline Personality Disorder Symptoms: A Multigroup Mediation Analysis

Background: While perceived social support can mediate the relationship between perceived stress and depression, little is known about the differences between individuals with high and low borderline personality disorder symptoms (BPDS). This study aimed to investigate the associations among perceived stress, perceived social support, and depression, and compare low and high levels of BPDS. Methods. This cross-sectional analysis was a secondary analysis of data from the SI-Bord study. University students across Thailand completed a screening instrument for borderline personality disorder, the Perceived Stress Scale (PSS), the Revised Thai Multi-dimensional Scales of Perceived Social Support (MSPSS), and the Patient-Health Questionnaire (PHQ)-9. Mediation analysis using PROCESS was applied to test the direct and indirect effects of perceived stress on depression. Multigroup mediational analysis was adopted to compare low and high levels of BPDS. Results. The mean age of the 330 participants was 20.27 (SD, 1.4) and 80% were female. Significant correlations were observed between the PSS, MSPSS, and PHQ scores, with greater magnitude among the high-level BPDS group (p < 0.001). A significant direct effect on perceived stress and a significant indirect effect on depression through perceived social support were noted. Of all the sources of social support, only the significant others variable significantly differed between the two groups (p < 0.05). Conclusion. Perception of social support had a significant mediating role in perceived stress and depression. The magnitude of associations was remarkably high for individuals with high BPDS compared to those with low BPDS. Unlike those with low BPDS, all sources of social support were significant mediators between the two groups.

Innate ability, health, motivation, and social capital as predictors of students' cognitive, affective and psychomotor learning outcomes in secondary schools

Background

Previous studies assessing students' learning outcomes and identifying contributing factors have often dwelt on the cognitive domain. Furthermore, school evaluation decisions are often made using scores from cognitive-based tests to rank students. This practice often skews evaluation results, given that education aims to improve the three learning domains. This study addresses this gap by assessing the contributions of four students' input to their cognitive, affective and psychomotor skills (CAPs).

Methods

A cross-section of senior secondary class II students (n = 870), sampled through the multistage procedure, participated in a physical survey. Students' Inputs Questionnaire (STIQ) and Learning Outcomes Questionnaire (LOQ) were used for data collection. Based on data obtained from a pilot sample (n = 412), principal axis factoring (PAF) was performed to assess the internal structure of the instruments following an oblique rotation. The KMO value of sampling adequacy were 0.88 and 0.94, while the Bartlett's test of sphericity were significant χ2(253) = 5,010; p < 0.001 and χ2(105) = 3693.38, p < 0.001 for the STIQ and LOQ, respectively. Confirmatory factor analysis was used to assess the models' acceptability based on the maximum likelihood estimation technique. The main study used hierarchical linear regression for data analysis.

Results

Findings indicated that innate ability, health, motivation and social capital relatively and cumulatively predicted students' overall, cognitive, affective and psychomotor learning outcomes. The proportion of variance explained by the predictors increased at different levels of the models with the addition of new variables. Students' social capital reduced the effect of students' innate ability regardless of their motivation and health status.

Conclusion/implication

This study has provided evidence that the four students' inputs are crucial predictors of their learning outcomes in the three domains. This result is helpful for school management to provide services aimed at improving the school climate for students' motivation and social capital. The result can provide policymakers with a proper understanding of the constituents of learning outcomes and how policies can be aligned to secure quality student inputs for maximum productivity in education.

ICT-Based Individualized Training of Institutionalized Individuals With Dementia. Evaluation of Usability and Trends Toward the Effectiveness of the InCoPE-App

Physical activity interventions can alleviate the course of disease for individuals with dementia (IWD) who have been extraordinarily affected by the COVID-19 pandemic. Information and Communication Technology (ICT) provides new opportunities not only to mitigate negative effects of the pandemic but also to sustainably improve everyday life of IWD in nursing homes. The aim of the present study was to evaluate the ICT-based InCoPE-App, which was used to assess physical and cognitive performance and deliver individualized exercise for IWD, with regard to 1) user experience of nursing assistants, and 2) trends toward the effectiveness of the intervention on physical and cognitive performance of IWD. An 18-week individualized multidomain intervention (2 × 60 min/session) was delivered to an intervention group (IG; n = 10, mean age 88.4 ± 5.6, 70% female) by nursing assistants (n = 10, mean age 56.1 ± 10.4, 90% female) using the InCoPE-App. A control group (CG; n = 3, mean age 87.3 ± 3.5, 100% female) received conventional treatment. User experience was assessed among nursing assistants by different questionnaires, i.e., PSSUQ and ISONORM 9241/110-S for usability, and AttrakDiff2 for pragmatic (PQ), hedonic quality-identity and stimulation (HQI and HQS), and attractiveness (ATT). Trends toward the effectiveness of the intervention were assessed using MMSE (global cognitive function), FICSIT-4 (balance), 6MWT and TUG (mobility), and m30CST (function of lower limbs). Usability of the InCoPE-App was rated as high by nursing assistants (mean ± SD; overall PSSUQ 2.11 ± 0.75; overall ISONORM 9241/110-S 1.90 ± 0.88; ATT 1.86 ± 1.01; PQ 1.79 ± 1.03; HQI 1.8 ± 0.79; and HQS 1.37 ± 0.69). Dropout was high in the total sample (36.7%). Trends toward the effectiveness were observed within IG in nine IWD who showed positive or neutral trends in at least two physical performance outcomes. Seven participants had positive or neutral trends in the FICSIT-4, seven participants in m30CST, and four and seven participants in 6MWT and TUG, respectively. In conclusion, the InCoPE-App has good nursing assistant-rated usability, whereas training effects and intervention adherence were rather low most likely due to COVID-19 restrictions. Single-subject research revealed more positive than negative trends in IG of IWD. Further research is needed to evaluate feasibility, suitability, and effectiveness of the InCoPE-App.

Predictors Of Breakfast Consumption Among Iranian Students: Applying Social Cognitive Theory

Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P<0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.

Assessing adolescent diet and physical activity behaviour, knowledge and awareness in low- and middle-income countries: a systematised review of quantitative epidemiological tools

PURPOSE

Quantitative epidemiological tools are routinely used to assess adolescent diet and physical activity (PA) constructs (behaviour, knowledge, and awareness) as risk factors for non-communicable diseases. This study sought to synthesize evidence on the quantitative epidemiological tools that have been used to assess adolescent diet and PA constructs in low to middle-income countries (LMIC).

METHODS

A systematised review was conducted using 3 databases (EbscoHost, Scopus and Web of Science).

RESULTS

We identified 292 LMIC studies assessing adolescent diet and PA. Identified studies predominantly explored behavioural (90%) constructs with a paucity of studies investigating knowledge and awareness. The majority of studies used subjective (94%) and self-administered (78%) tools. Only 39% of LMIC studies used tools validated for their contexts.

CONCLUSIONS

The findings highlight the need for more contextual tools for assessing adolescent diet and PA in LMICs. Diet and PA measurement tools used in future research will need to incorporate measures of knowledge and awareness for a more comprehensive understanding of the epidemiology of diet and PA in adolescents. Furthermore, there is a need for more evidence on the reliability and validity of these tools for use, in both cross sectional and longitudinal studies, in LMIC contexts.

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.

Influence of eating habits and alcohol consumption on the academic performance among a university population in the community of Madrid: A pilot study

OBJECTIVE

To evaluate the association between dietary habits and alcohol consumption on academic performance among university students.

DESIGN

Cross-sectional study.

SETTING

University located in Madrid, Spain.

PARTICIPANTS

56 university students of nursing (45 women and 11 men). The study complies with the Helsinki Declaration and was approved by the University Ethics Committee (36/2018).

MAIN OUTCOME MEASURE

Dietary intake and habits assessed with validated survey, alcohol consumption and academic performance.

ANALYSIS

Chi-square test, Student's t-test, ANOVA analysis, Mann-Whitney test, Kruskal-Wallis analysis and Shapiro-Wilk test.

RESULTS

The average daily energy intake of the students was 1918 ± 725 kcal and, on average, alcohol accounted for 6%. The increased energy contribution from alcohol was negatively correlated with body mass index (BMI). Moreover, an inverse association was also found in alcohol intake according to Body Mass Index (BMI) (p < 0.02). Students with failing grades (53.6%) reported a higher daily alcohol intake than those who passed (42.2 %) (32 g/day versus 24 g/day) (p = 0.043).

CONCLUSIONS

Alcohol consumption is related to both poor academic performance as well as diminished quality of life. Thus, it is of vital importance to undertake awareness campaigns at various levels to dissuade alcohol consumption especially at early ages.

Analysis of Self-Concept in Adolescents before and during COVID-19 Lockdown: Differences by Gender and Sports Activity

An appeal has been issued to the scientific community to investigate physical, mental and emotional states, and pro-social behaviours during the COVID-19 pandemic. Hence, this study aims to investigate adolescents’ self-concept before and during a lockdown period in relation to gender and type/amount of physical activity or sports. The pre-lockdown sample of 366 adolescents were aged 13–17 years (M = 15.51 ± 0.65), of whom 192 (52.5%) were females and 174 (47.5%) were males. During the lockdown, the age range of the sample was 13–17 years (M = 14.57 ± 1.47), of whom 82 (60.3%) were females, and 54 (39.7%) were males. The Form-5 Self-concept Questionnaire (AF-5) was used to measure adolescents’ self-concept. There was a reduction in adolescents’ overall self-concept during the COVID-19 pandemic, which was positively associated with emotional well-being, with family and peers being essential factors in the development of an appropriate self-concept. Furthermore, girls’ self-concept, especially academic self-concept, was higher than that of boys during the lockdown. However, both physical and emotional self-concept were higher for boys than girls before the COVID-19 lockdown, although no differences were found during the lockdown. The findings reveal that physical activity was positively correlated to self-concept before and during the COVID-19 lockdown.