The influence of breakfast and a snack on psychological functioning

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.

Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults: a 9-year follow-up cohort study

BACKGROUND

It is unclear whether breakfast consumption and breakfast composition are independently associated with changes in cognition over a long-term period in older adults.

OBJECTIVES

We aimed to examine the associations between energy and macronutrient intakes at breakfast and cognitive declines.

METHODS

We included 2935 participants aged 55-93 y at baseline from the China Health and Nutrition Survey in our analysis. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Dietary intake was assessed using weighing methods in combination with 24-h food records.

RESULTS

Breakfast contributed to 25.9% of total energy intake of the day and percentages of breakfast energy intake from protein, fat, and carbohydrates were 12.8%, 11.5%, and 75.7%, respectively. During a median follow-up of 9 y, the β values for changes in global cognitive z-scores for Quintile 5 of protein and fat intakes at breakfast, with Quintile 1 as the reference, were 0.13 (95% CI: 0.01-0.25) and 0.17 (95% CI: 0.04-0.30), respectively. Substitution of 5% energy from carbohydrates with equivalent energy from protein (β, 0.06; 95% CI: 0.01-0.11) or fat (β, 0.05; 95% CI: 0.02-0.08) at breakfast was positively associated with the change in the global cognitive z-score. Energy intake at breakfast was not significantly associated with the global cognitive z-score. Similar results were found for the verbal memory z-score. The positive association of breakfast fat intake and the inverse association of breakfast carbohydrate intake with cognitive declines were stronger in urban residents.

CONCLUSIONS

Higher intakes of protein and fat and lower intake of carbohydrates at breakfast were associated with a lower rate of cognitive decline in older adults. Substitution of carbohydrates with protein or fat intake at breakfast may help to delay or prevent cognitive declines.

Plasma brain-derived neurotrophic factor and dynamic cerebral autoregulation in acute response to glycemic control following breakfast in young men

We examined the acute impact of both low- and high-glycemic index (GI) breakfasts on plasma brain-derived neurotrophic factor (BDNF) and dynamic cerebral autoregulation (dCA) compared with breakfast omission. Ten healthy men (age 24 ± 1 yr) performed three trials in a randomized crossover order; omission and Low-GI (GI = 40) and High-GI (GI = 71) breakfast conditions. Middle cerebral artery velocity (transcranial Doppler ultrasonography) and arterial pressure (finger photoplethysmography) were continuously measured for 5 min before and 120 min following breakfast consumption to determine dCA using transfer function analysis. After these measurements of dCA, venous blood samples for the assessment of plasma BDNF were obtained. Moreover, blood glucose was measured before breakfast and every 30 min thereafter. The area under the curve of 2 h postprandial blood glucose in the High-GI trial was higher than the Low-GI trial (P < 0.01). The GI of the breakfast did not affect BDNF. In addition, both very-low (VLF) and low-frequency (LF) transfer function phase or gains were not changed during the omission trial. In contrast, LF gain (High-GI P < 0.05) and normalized gain (Low-GI P < 0.05) were decreased by both GI trials, while a decrease in VLF phase was observed in only the High-GI trial (P < 0.05). These findings indicate that breakfast consumption augmented dCA in the LF range but High-GI breakfast attenuated cerebral blood flow regulation against slow change (i.e., the VLF range) in arterial pressure. Thus we propose that breakfast and glycemic control may be an important strategy to optimize cerebrovascular health.

Association between Breakfast Skipping and the Metabolic Syndrome: The Korea National Health and Nutrition Examination Survey, 2017

Background and Objectives: Recently, the prevalence of metabolic syndrome in Korea has increased rapidly. Current knowledge reflects the importance of dietary control in relation to the metabolic syndrome. The objective of this study was to evaluate the influence of skipping breakfast on the metabolic syndrome. Materials and Methods: We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey 2017 for the second year. A total of 3864 adults aged 20 to 64 were included in the study. We stratified the study population into three groups, based on breakfast patterns: the regular group, irregular group, and skipping group. Multiple logistic regression analysis was used to analyze the association between skipping breakfast and the presence of metabolic syndrome. Results: We noted an increase in the proportion of metabolic syndrome cases as follows: skipping group (3.3%), irregular group (5.4%), and regular group (8.5%) (p < 0.001). The multivariate-adjusted odds ratios of metabolic syndrome in the skipping and irregular groups compared with the regular group were 0.68 (95% CI; 0.35 to 1.35) and 0.81 (95% CI; 0.51 to 1.28), respectively. In the 40-65-year-old age group, which had a high prevalence of metabolic syndrome, the multivariate-adjusted odds ratios of metabolic syndrome in the skipping group compared with regular group were 0.78 (95%CI, 0.39 to 1.62). Conclusions: There was no significant correlation between skipping breakfast and risk factors of metabolic syndrome (after adjusting for risk factors), but a tendency of skipping breakfast to lower the risk of metabolic syndrome was observed. A rationale for these results is proposed through the association between skipping breakfast and intermittent fasting.

Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood

The effect of carbohydrate (CHO) consumption on mood is much debated, with researchers reporting both mood improvements and decrements following CHO ingestion. As global consumption of sugar-sweetened products has sharply increased in recent years, examining the validity of claims of an association between CHOs and mood is of high importance. We conducted a systematic review and meta-analysis to evaluate the relationship between acute CHO ingestion and mood. We examined the time-course of CHO-mood interactions and considered the role of moderator variables potentially affecting the CHO-mood relationship. Analysis of 176 effect sizes (31 studies, 1259 participants) revealed no positive effect of CHOs on any aspect of mood at any time-point following their consumption. However, CHO administration was associated with higher levels of fatigue and less alertness compared with placebo within the first hour post-ingestion. These findings challenge the idea that CHOs can improve mood, and might be used to increase the public's awareness that the 'sugar rush' is a myth, inform health policies to decrease sugar consumption, and promote healthier alternatives.

Looking through the Keyhole: Exploring Realities and Possibilities for School Breakfast Programs in Rural Western Australia

Objective: To assess the school breakfast program (SBP) in two schools with high Aboriginal student populations in rural Western Australia, their contribution to holistic support, nutritional health education and possibilities for improvement. Methods: The operations and functioning of one regional and one remote SBP were assessed by stakeholder inquiry related to process and challenges, observations and documentary review. An intervention to increase health education, social interaction and learning about nutrition and food origins implemented in one school was assessed. Results: Strengths, system and structural factors that impeded realisation of optimal outcomes of the SBPs were identified. The SBPs focussed on serving food rather than building nutritional understanding or on social interactions and support. Systems for delivery and management of the programs largely relied on staff with limited time. When offered a more interactive and social environment, children enjoyed learning about food. Conclusions: Opportunities for SBPs to offer holistic support and educational enhancement for disadvantaged children are limited by the realities of pressures on staff to support them and a view constraining their primary role as food delivery. The lack of volunteer support in disadvantaged schools limits the potential benefits of SBPs in providing psychosocial support. Health education resources which exist for use in SBPs are not necessarily used.

Skipping breakfast and 5-year changes in body mass index and waist circumference in Japanese men and women

OBJECTIVE

This study investigated the relationship between frequency of skipping breakfast and annual changes in body mass index (BMI) and waist circumference (WC).

METHODS

The participants were 4,430 factory employees. BMI and WC were measured repeatedly at annual medical examinations over a 5-year period. The association between frequency of skipping breakfast at the baseline examination and annual changes in anthropometric indices was evaluated using the generalized estimating equation method.

RESULTS

The mean (standard deviation) BMI was 23.3 (3.0) kg m^-2 for men and 21.9 (3.6) kg m^-2 for women; and the mean WC was 82.6 (8.7) cm for men and 77.8 (9.8) cm for women. During the follow-up period, mean BMI increased by 0.2 kg m^-2 for men and women, and mean WC increased by 1.1 cm for men and 1.0 cm for women. The annual change in the BMI of men who skipped breakfast four to six times per week was 0.061 kg m^-2 higher, and that of those who skipped breakfast seven times per week was 0.046 kg m^-2 higher, compared with those who did not skip breakfast. Annual changes in the WC of male participants who skipped breakfast seven times per week was 0.248 cm higher than that of those who did not skip breakfast. Skipping breakfast was not associated with changes in BMI or WC in women.

CONCLUSIONS

Skipping breakfast was closely associated with annual changes in BMI and WC among men, and eating breakfast more than four times per week may prevent the excessive body weight gain associated with skipping breakfast.

The Mediating Role of Mental Health in the Relations between Dietary Behaviors and General Health: A Cross-sectional Study

Background:

The aim of this study is to find a pathway to explaining the relations between dietary behaviors with mental health and psychological functioning.

Materials and Methods:

This cross-sectional study contains 4763 participants from the employees of Isfahan University of Medical Sciences. In this study, four questionnaires were administered which were provided as follows: demographic characteristics, 21-item dietary behaviors questionnaire, Hospital Anxiety and Depression Scale questionnaire, and 12-item General Health Questionnaire (GHQ-12). We started the analysis with the structural equation modeling (SEM) model with 4 unobserved latent and 16 observed variables.

Results:

The results show that the regression coefficient (standard error) of diet behavior on mental health and mental health on GHQ were − 1 (0.37) and 0.02 (0.01) with their P values as 0.007 and 0.01, respectively. For this model, the estimated root mean square error of approximation is 0.062 with 90% confidence interval of (0.060–0.065). In addition, the comparative fit indices (CFIs) were as 0.866 for incremental fit index and 0.866 for CFI. All these indices represent fairly good fit of the model to the data.

Conclusion:

We can conclude that “lower scores on diet behavior – higher scores on mental health problems” and “higher mean scores in depression and/or anxiety – higher scores in GHQ domains.” The SEM results showed that dietary behaviors have significance related to depression and/or anxiety and general health status.

Food Safety and Sustainable Nutrition Workshops: Educational Experiences for Primary School Children in Turin, Italy

European control and prevention policies are focused to guarantee a high level of protection of consumers' health. Food-borne diseases as obesity, diabetes, food allergy, and food-borne outbreaks are increasing. To prevent food-borne diseases, it is fundamental to involve consumers, in particular children, in educational experiences aimed to learn the proper behaviours to be applied. In this context, we designed and performed 5 educational workshops about food safety, hidden allergens in food and nutrition aimed to involve children attending primary and summer school. These experiences let us collect observations about children knowledge and behaviours. From May to October 2015, a total of 1708 children aged 6 to 11 years joined our workshops. Children were involved in listening activities, laboratory experiments, handling games and sensory experiences. All participants were familiar with food allergy and were interested to know how to behave with allergic people. Children showed great curiosity in discovering that many foods normally contain live bacteria. Less than 25% of children reported to skip breakfast, to have it watching TV or to spend few minutes for it. Many of them (>75%) thought that fruits and vegetables are all year-round available and are not related to a specific period. Very few participants (<25%) knew that freezing is the treatment to be applied to make fresh fish safe from parasites. Children involved in food safety and nutrition educational experiences have the opportunity to increase their awareness about the correct behaviours to prevent food-borne diseases and to improve their own critical thinking about food consumption.

The Effects of Breakfast and Breakfast Composition on Cognition in Adults

Extensive literature has addressed the acute cognitive effects of breaking a fast. Recent reviews in this line of work have synthesized available research on the cognitive consequences of fasting compared with nutrient intake and the cognitive effects of macronutrient consumption. These largely have been inconclusive, possibly in part because of selection criteria limiting the scope of studies covered. The purpose of the current review is to integrate the results of the literature examining the cognitive effects of breakfast and breakfast composition in adults with the use of a flexible definition of breakfast, specifically, any caloric intake after a fasting period of ≥8 h. This review includes 38 studies that examine the acute cognitive impact of breakfast and 16 studies that examine the effects of breakfast composition. Results suggest that healthy adults show a small but robust advantage for memory (particularly delayed recall) from consuming breakfast. Largely equivocal results emerge for attention and motor and executive function; there were no effects from breakfast on language. Regarding breakfast composition, a smaller number of studies and widely disparate methodology addressing this question preclude definitive conclusions about the effects of cognition. A subset of this literature examines these questions in the context of glucoregulation; the findings emphasize the importance of considering differences in glucoregulation in research designs, even among healthy cohorts. The limitations of this literature include methodologic differences, such as the use of different tests to measure cognitive constructs, as well as the effects of timing in test administration.

The effect of breakfast versus no breakfast on brain activity in adolescents when performing cognitive tasks, as assessed by fMRI

OBJECTIVES

The study examined the feasibility of utilizing functional magnetic resonance imaging (fMRI) with a group of adolescent boys and girls to assess modifications in cognitive function, dependent upon the nutritional state of the participants.

METHODS

Twenty children aged 12-14 years completed two cognitive trials, in a randomized counterbalanced order, one under fasting condition, one after consuming breakfast, during which continuous fMRI data were acquired.

RESULTS

Although no statistically significant (P > 0.05) improvement in task performance was determined, significantly higher activation was recorded in the frontal, premotor, and primary visual cortex areas in the breakfast trial relative to the fasting condition.

DISCUSSION

Such a finding may have important implications in the examination of the role of diet, and specifically breakfast, in determining children's performance within the school environment.

Distraction, not hunger, is associated with lower mood and lower perceived work performance on fast compared to non-fast days during intermittent fasting

Using a repeated measures design, 16 females recorded hunger, distraction, mood and perceived work performance on two consecutive fast days, on two earlier and on two subsequent consecutive non-fast days, during intermittent fasting. Using regression analyses, low positive mood was associated with higher distraction ( β = −0.38, p < 0.01), and lower perceived work performance was associated with higher distraction ( β = −0.50, p < 0.01) and lower positive mood ( β = 0.59, p = 0.01). No associations were found with hunger (largest β = −0.11, p = 0.15). Associations between mood, perceived work performance and distraction but not hunger mirror those found in traditional dieting and suggest no benefit for attention from intermittent fasting-type regimes.

Breakfast glycaemic index and exercise: combined effects on adolescents' cognition

The aim of the present study was to examine the combined effects of breakfast glycaemic index (GI) and a mid-morning bout of exercise on adolescents' cognitive function. Participants were randomly allocated to a high or low GI breakfast group in a mixed research design, where each participant completed two experimental trials (exercise and resting). Forty-two adolescents (12.4±0.5 years old), undertook a bout of exercise (ten repeats of level one of the multi-stage fitness test; exercise trial) or continued to rest (resting trial) following consumption of either a high or low GI breakfast. A battery of cognitive function tests (visual search test, Stroop test and Sternberg paradigm) was completed 30 min before and 45 min following the exercise. Average heart rate during exercise was 170±15 beats·min(-1). On the complex level of the Stroop test, response times improved across the morning following the low GI breakfast on both the exercise and resting trials, though the improvement was greatest on the exercise trial. However, response times only improved on the resting trial following the high GI breakfast (p=0.012). On the 5 letter level of the Sternberg paradigm, response times improved across the morning following the low GI breakfast (regardless of exercise) and only on the exercise trial following the high GI breakfast (p=0.019). The findings of the present study suggest that the combined effects of breakfast GI and exercise in adolescents depend upon the component of cognitive function examined. A low GI breakfast and mid-morning bout of exercise were individually beneficial for response times on the Sternberg paradigm, whereas they conferred additional benefits for response times on the Stroop test.

Implicit associations have a circadian rhythm

The current study shows that people's ability to inhibit implicit associations that run counter to their explicit views varies in a circadian pattern. The presence of this rhythmic variation suggests the involvement of a biological process in regulating automatic associations—specifically, with the current data, associations that form undesirable social biases. In 1998, Greenwald, McGhee, and Schwartz introduced the Implicit Association Test as a means of measuring individual differences in implicit cognition. The IAT is a powerful tool that has become widely used. Perhaps most visibly, studies employing the IAT demonstrate that people generally hold implicit biases against social groups, which often conflict with their explicitly held views. The IAT engages inhibitory processes similar to those inherent in self-control tasks. Because the latter processes are known to be resource-limited, we considered whether IAT scores might likewise be resource dependent. Analyzing IAT performance from over a million participants across all times of day, we found a clear circadian pattern in scores. This finding suggests that the IAT measures not only the strength of implicit associations, but also the effect of variations in the physiological resources available to inhibit their undesirable influences on explicit behavior.

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.

Breakfast consumption and exercise interact to affect cognitive performance and mood later in the day. A randomized controlled trial

The current study assessed the interactive effect of breakfast and exercise on cognition and mood. Twelve active males completed four trials; no breakfast-rest, breakfast-rest, no breakfast-exercise or breakfast-exercise in a randomized, cross-over design. The trials consisted of; breakfast or fast, a 2h rest, exercise (treadmill run) or equivalent rest, a chocolate milk drink, a 90 min rest and an ad libitum lunch. Cognitive performance and mood were recorded frequently throughout each trial. Data was analysed as pre-exercise/rest, during and immediately post exercise/rest and post-drink. No effects were found prior to consumption of the drink. Post-drink, fasting before exercise increased mental fatigue compared to consuming breakfast before exercise and fasting before rest. Tension increased when breakfast was consumed at rest and when exercise was undertaken fasted compared to omitting breakfast before rest. Breakfast before rest decreased rapid visual information processing task speed and impaired Stroop performance. Breakfast omission improved Four Choice Reaction Time performance. To conclude, breakfast before exercise appeared beneficial for post-exercise mood even when a post-exercise snack was consumed. Exercise reversed post-breakfast cognitive impairment in active males.

Short-term effect of macronutrient composition and glycemic index of a yoghurt breakfast on satiety and mood in healthy young men

BACKGROUND

Promoting satiety and repressing appetite is one major goal in the dietetic therapy of obesity. In the past, several studies investigated the effect of different macronutrients, especially protein and carbohydrates, on short- and long-term satiety in humans. This paper aims to directly compare the effect of protein, rolled oats (low glycemic index), sugar or cornflakes (high glycemic index), and walnuts (high amount of omega-3 fatty acids) as ingredients of a yoghurt breakfast on short-term hunger and satiety in one setting. A second objective was to study the effect of these yoghurt breakfasts on mental state.

METHODS

14 healthy male volunteers participated in this randomized, controlled, cross-over design study. After consuming the different test meals, volunteers repeatedly completed 2 questionnaires over a total of 3 h.

RESULTS

The protein meal showed the highest satiety scores and the controls (low-calorie yoghurt) the lowest. The other test meals were not different among each other. Regarding mental state (mood, fatigue, and calmness), no significant difference between the test meals and the low-calorie control was observed.

CONCLUSION

The glycemic index does not seem to modify satiety in this short-term setting. The similar mental state between low- and high-calorie breakfasts deserves further investigations.

Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: a meta-analysis

OBJECTIVE

In Western countries, skipping breakfast is associated with a high prevalence of overweight and obesity. This meta-analysis aimed to determine if the same relationship exists in Asian and Pacific regions.

METHODS

A systematic literature search was performed for observational studies using a cross-sectional design that examined the relationship between frequency of eating breakfast and overweight or obesity. Odds ratios (ORs) for overweight or obesity were pooled with a variance-based method.

RESULTS

Nineteen studies (93,108 total participants and 19,270 overweight or obese cases) were included. The pooled OR [95% confidence intervals (CI)] of overweight or obesity for the lowest vs. highest category of breakfast frequency was 1.75 [1.57 to 1.95] (P<0.001). Between-study heterogeneity in the association's strength was highly significant (I-squared=36.4%, P<0.001), although a positive OR was shown in all but one included study. However, no study characteristics could be identified to explain the heterogeneity.

CONCLUSION

This meta-analysis suggests that a positive association between skipping breakfast and overweight and obesity is globally observed regardless of cultural diversity among countries. Promoting the eating of breakfast in all populations may be beneficial.

Breakfast glycaemic index and cognitive function in adolescent school children

It has been suggested that a low-glycaemic index (GI) breakfast may be beneficial for some elements of cognitive function (e.g. memory and attention), but the effects are not clear, especially in adolescents. Thus, the aim of the present study was to examine the effects of a low-GI breakfast, a high-GI breakfast and breakfast omission on cognitive function in adolescents. A total of fifty-two adolescents aged 12–14 years were recruited to participate in the study. Participants consumed a low-GI breakfast, a high-GI breakfast or omitted breakfast. A battery of cognitive function tests was completed 30 and 120 min following breakfast consumption and capillary blood samples were taken during the 120 min postprandial period. The findings show that there was a greater improvement in response times following a low-GI breakfast, compared with breakfast omission on the Stroop (P = 0·009) and Flanker (P = 0·041) tasks, and compared with a high-GI breakfast on the Sternberg paradigm (P = 0·013). Furthermore, accuracy on all three tests was better maintained on the low-GI trial compared with the high-GI (Stroop:P = 0·039; Sternberg:P = 0·018; Flanker:P = 0·014) and breakfast omission (Stroop:P < 0·001; Sternberg:P = 0·050; Flanker:P = 0·014) trials. Following the low-GI breakfast, participants displayed a lower glycaemic response (P < 0·001) than following the high-GI breakfast, but there was no difference in the insulinaemic response (P = 0·063) between the high- and low-GI breakfasts. Therefore, we conclude that a low-GI breakfast is most beneficial for adolescents' cognitive function, compared with a high-GI breakfast or breakfast omission.

Do specific dietary constituents and supplements affect mental energy? Review of the evidence

The numbers of marketing claims and food, beverage, and drug products claiming to increase mental energy have risen rapidly, thus increasing the need for scientific specificity in marketing and food label claims. Mental energy is a three-dimensional construct consisting of mood (transient feelings about the presence of fatigue or energy), motivation (determination and enthusiasm), and cognition (sustained attention and vigilance). The present review focuses on four dietary constituents/supplements (Ginkgo biloba, ginseng, glucose, and omega-3 polyunsaturated fatty acids) to illustrate the current state of the literature on dietary constituents and mental energy. The strongest evidence suggests effects of Ginkgo biloba on certain aspects of mood and on attention in healthy subjects, as well as associations between omega-3 polyunsaturated fatty acids and reduced risk of age-related cognitive decline. Limitations of the current data and challenges for future research are discussed.

Mood and the macro-nutrient composition of breakfast and the mid-day meal

Six hundred and eighty-six individuals were approached at mid-day after they had chosen a meal in a cafeteria. They were asked to rate their mood during the morning and list what they had eaten that morning. Both males and females who had eaten breakfast rather than fasting reported that they had been happier and more relaxed during the morning. The macro-nutrient compositions of breakfast and lunch were calculated and related to mood during the morning. In males, but not females, the consumption of more carbohydrate in the morning was associated with feeling happy rather than sad and relaxed rather than stressed. Further examination demonstrated that in males the amount of fat, protein and total energy consumed was not associated with mood; that is there was a selective relationship between carbohydrate intake and mood. It was not possible to establish whether the nature of breakfast influenced mood or the pre-existing mood influenced the choice of breakfast although both explanations are plausible. In females, however, there was no relationship between carbohydrate intake and mood, possibly a reflection of the smaller amounts consumed. The suggestion that mood during the morning might influence food choice at mid-day was considered but no association was found.

Effects of cereal bars for breakfast and mid-morning snacks on mood and memory

The aim of the present study was to examine the effects of consuming cereal bars, given either for breakfast or a mid-morning snack, on mood and memory. Thirty-two volunteers (16 males, 16 females; mean age, 20 years 9 months) were randomly assigned to one of four groups formed by combining breakfast (cereal bar versus no breakfast) and snack (cereal bar versus no snack) conditions. A baseline session was completed at 08:30 h followed by breakfast at 9:00 h, another test at 10:00 h, followed by a mid-morning snack and then a final test at 12:00 h. In each session, volunteers rated their mood and carried out four memory tasks: free recall; recognition memory; a verbal reasoning task; and a semantic processing task. The results showed that volunteers who consumed a cereal bar for breakfast felt more alert, happy and sociable and less anxious. In addition, they also recalled more words in a free recall task. When the cereal bar was consumed as a mid-morning snack, alertness and hedonic tone increased, especially in the group who received no breakfast. The group who had no breakfast reported reduced anxiety after consumption of the snack. Recall was also improved after the snack. These findings show that consuming cereal bars in the early and mid-morning leads to beneficial behavioural effects. The results confirm earlier research on effects of breakfast and extend our knowledge of effects of snacks. Consumption of cereal bars may have important practical applications especially in situations where preparation of breakfast is difficult.

Skipping breakfast is associated with dysmenorrhea in young women in Japan

To evaluate the effects of breakfast habits on the quality of life in young women in Japan, the relation between breakfast habits and menstrual and intestinal disorders was estimated by responses to a questionnaire. Subjects were recruited from young Japanese female students of Ashiya College ranging in age from 18 to 20 years. Breakfast habits were classified into three groups (group I, having breakfast every morning, n=289; group II, having breakfast one to six times per week, n=106; group III, having breakfast less than once a week, n=44). The intensity of dysmenorrhea was classified into three grades (score 1, free of pain or painful, but without need for analgesic; score 2, painful, requiring analgesic; score 3, painful, not relieved by analgesic). The grades of bowel movement were classified into three groups (score 1, no more than once a week; score 2, two to six times a week; score 3, every day). Group II and group III had significantly higher scores for dysmenorrhea compared with group I. Students in group III showed a tendency toward constipation. Since dysmenorrhea is a risk factor for psychological disorders as well as gynecological diseases, the present study suggests the importance of eating breakfast to the quality of life of young women.

Evaluating the relationship between breakfast pattern and short-term memory in junior high school girls

The aim of this study was to evaluate the relationship between breakfast pattern and short-term memory in guidance-school students. Memory improves for subjects who have eaten breakfast. It appears that breakfast consumption influences cognition via several mechanisms. What children eat for breakfast before going to school is very important. A total of 150 junior high school girls were taken from a subject pool in four schools in Shiraz (capital of the Fars Province in Iran). They filled out the socio-economic questionnaires as well as food frequency questionnaires for breakfast and provided two-three day breakfast records in two different seasons and their short-term memories were evaluated by Weksler test socio-economic conditions and dietary intakes were analyzed. The results of the study showed that there was no correlation between parents job, students mean age and their school grades with their memory scores. Dietary analysis demonstrated a negative correlation between local soup consumption in breakfast and memory scores. Food record analysis showed no correlation between fat, cholesterol, protein, vitamin B6, B12, calorie and iodine intake in breakfast and memory scores, but there was a positive correlation between carbohydrate, iron and vitamin B3 intake in breakfast and memory scores, similarly there was a positive correlation between B12 intake in the breakfast and students' average school grades during the year.

Influences of lifestyle and general practice (GP) care on the symptom profile of people with panic disorder

Current treatment guidelines for anxiety disorders, including panic disorder (PD), recommend either medication or cognitive behavioural therapy (CBT). There is currently a call through the Layard Report for significant investment to increase the availability of CBT resources. However, there are reported limitations to both medication and CBT in the treatment of anxiety, and it appears prudent to consider additional methods of treatment that may offer effective interventions. One such intervention is based around the evidence of altered sensitivity within a number of physiological body systems in anxiety patients (particularly those with PD), all of which are influenced in their function by habitual lifestyle behaviours. A randomised controlled trial compared a 16‐week occupational therapy‐led lifestyle intervention and routine general practice (GP) care for PD. At 20 weeks, 14 symptoms with ‘moderate’ to ‘very severe’ ratings were assessed in 36 GP and 31 lifestyle‐intervention patients. Composite symptom profiles, similar at baseline, were produced. The GP intervention produced modest improvements in most symptoms. The lifestyle intervention overall produced greater symptomatic relief (Wilcoxon signed ranks test, P= 0.008). The physiological and cognitive symptom profile also changed more with lifestyle intervention. Occupational therapists have developed their interventions based on their understanding of everyday occupation. Habitual lifestyle behaviours are characterised as being recurrent elements of everyday occupation and are, therefore, legitimate targets for occupational therapy interventions. They provide a vehicle through which to encourage patients to regain understanding and control of their own anxiety symptoms.

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.

Acute effects of macronutrient manipulations on cognitive test performance in healthy young adults: A systematic research review

The potential for foods to exert effects on behaviour is increasingly recognised. Previous studies have incorporated both well-known and lesser-known cognitive tests in the evaluation of relationships between macronutrient interventions and mental performance. Systematic review methodology was used to identify studies of macronutrient effects on cognition, limited to acute effects in young, fasted, healthy adults. Thirty-one studies met the inclusion criteria, yielding a total of 134 outcome measures. The studies reviewed displayed a predominance of soluble glucose manipulations, and a paucity of complex carbohydrate, protein or fat manipulations. Memory performance was most commonly measured, but verbal fluency, attention, reaction time, psychomotor skill and problem solving were also assessed. Significant differences in performance tended to occur under circumstances of more intense cognitive demand and after delays. Memory emerged as the most sensitive cognitive modality to macronutrient manipulations. Tasks identified as sensitive included Serial Sevens, Free Word Recall and Cued Word Recall, with tentative support for the Word Recognition Task. Findings also suggested that visuo-spatial memory may be influenced by macronutrient manipulations.

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 effect of the interaction between glucose tolerance and breakfasts varying in carbohydrate and fibre on mood and cognition

As a glucose containing drink has been reported to improve memory, and missing breakfast has been reported to adversely influence memory late in the morning, meals designed to differ in their ability to release glucose into the blood stream were contrasted. Using a factorial design, breakfasts containing 15, 30 or 50 g of carbohydrate and 1.5, 6 or 13 g of fibre were compared. The glucose tolerance of participants proved to be an important factor. Those with better tolerance reported better mood. Those eating breakfasts containing greater amounts of carbohydrate reported feeling tired rather than energetic. The amount of carbohydrate did not negatively affect memory in those with better glucose tolerance, however, the consumption of more carbohydrate resulted in more forgetting in those with poorer glucose tolerance. The effect with reactions times differed from memory in that a greater intake of carbohydrate resulted in faster responses later in the morning.

Effect of an afternoon confectionery snack on cognitive processes critical to learning

Two experiments examined how an afternoon confectionery snack affects a variety of cognitive processes critical to learning. For Experiment 1, thirty-eight male undergraduates completed a dual learning task where the primary task involved learning either a map or stories and the secondary task required monitoring a radio broadcast for a specific word category. Results showed that for map learning, participants who consumed the confectionery snack performed better on the primary task. They correctly placed more country names and left fewer blanks on a map during long-term recall. However, on the secondary attention task, participants who consumed the confectionery snack had a lower hit rate. The confectionary snack did not affect story memory performance. In Experiment 2, 38 boys, aged 9-11 years, participated in a similar, age appropriate task. Results showed that boys who had consumed the confectionery snack correctly placed more names and left fewer blanks on a map in both short-term and long-term recall. In contrast with Experiment 1, performance on the secondary task was better after confectionary consumption. However, when tested on a separate vigilance attention task, children who consumed the placebo performed better. Overall results indicate that a confectionery snack, ingested in the afternoon, generally improves spatial memory, but has a mixed effect on attention performance.

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.

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.

Green tea consumption in everyday life and mental health

OBJECTIVE

Green tea has been widely acknowledged in Japan to induce a pleasurable mental feeling. Recent laboratory studies have suggested positive psychological effects as a result of consuming green tea. The present study examined whether green tea consumption in everyday life in Japan is associated with positive mental health.

DESIGN

A cross-sectional study was performed in February-March 2002.

SETTING AND SUBJECTS

The subjects of the study consisted of a general population of 600 Japanese aged 20-69 years. Responses of 380 subjects, obtained by home-visit interview, were analysed. The questionnaire inquired about consumption of brewed green tea and other beverages, perceived mental health status, lifestyle and others. The 12-item General Health Questionnaire (GHQ 12) was used for the assessment of mental ill-health (GHQ score >or=4).

RESULTS

After adjustments for age, area, perceived mental stress, lifestyle and daily caffeine intake, the consumption of brewed green tea was not statistically associated with any decrease in risk of mental ill-health among either males or females (odds ratio (OR)=0.78, 95% confidence interval (CI)=0.47-1.29 for males; OR=0.77, 95% CI=0.51-1.14 for females). Daily caffeine intake (100 mg) inclusive of green tea, black tea, coffee and other caffeine-containing beverages was associated with a higher risk of mental ill-health among females (OR=1.26, 95% CI=1.01-1.56).

CONCLUSIONS

The results provide population-based evidence on the consumption of brewed green tea in everyday life and mental health, together with information on consumption patterns of various beverages and lifestyles.

Breakfasts that release glucose at different speeds interact with previous alcohol intake to influence cognition and mood before and after lunch

Alcohol consumption and the glycemic load (GL) of a meal interact to influence both mood and memory. The authors compared the effects of eating a high GL lunch on mood and memory after consumption of a breakfast high in either rapidly (RAG) or slowly (SAG) available glucose. When less than 4.5 g of alcohol had been drunk the previous evening, the eating of a high RAG meal was associated with better memory later in the morning. In contrast, after more than 4.5 g of alcohol had been drunk the previous evening, the SAG meal resulted in better memory. After lunch, if more than 4.5 g alcohol had been drunk the previous evening, the RAG breakfast, but neither the SAG meal nor fasting, resulted in a more confused feeling.

Breakfast food patterns among urban and rural Croatian schoolchildren

The aim of this study was to report breakfast food patterns among the rural and urban Croatian schoolchildren in the post-war socioeconomic changes. A quantitative Food Frequency Questionnaire was used. Subjects were 7-18 year old schoolchildren (815 from urban and 375 from rural areas). The average energy intake was 27.5 and 23.0% of the Recommended Dietary Allowance (RDA) in the urban and rural area respectively. Urban subjects tend to choose healthier options when older, while the rural subjects displayed the opposite (significantly correlated age with energy intake (% RDA) and dietary fibre intake (% of 'age + 5' rule). The same applied to age versus iron intake (urban positive, rural negative correlation). Breakfasts providing 20-30% RDA for energy and more than 300 mg of calcium were consumed by 20.7 and 32.4% of the urban and rural subjects respectively. Cereal products and milk and dairy products were the major breakfast constituents everywhere. Meat and its products, and eggs seem to be uncommon breakfast foods. The urban subjects had a more adequate energy intake at breakfast, but better food choices were observed among rural subjects.

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.

Carbohydrate ingestion, blood glucose and mood

A series of studies have reported that a high carbohydrate meal, or diets high in carbohydrate, were associated with feeling less energetic. However, after a drink containing pure sugar most studies report no effect. Meals almost exclusively carbohydrate increase the availability of tryptophan and hence serotonin synthesis in the brain, however, a small amount of protein blocks this mechanism making it an uncommon response. In many individuals, poor mood stimulates the eating of palatable high carbohydrate/high fat foods that stimulate the release of endorphins. There is a tendency for those with lower blood glucose, when performing cognitively demanding tasks, to report poorer mood. In a range of situations an association between a tendency for blood glucose levels to fall rapidly, and irritability, has been found. Differences in the ability to control blood glucose levels influence the association between carbohydrate intake and mood. There is a need in future research to contrast the impact of carbohydrate on mood in those distinguished because of their pre-existing psychological and physiological functioning.