The effects of a confectionery snack on attention in young boys

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.

Dietary Habits Are Associated With School Performance in Adolescents

Several studies suggest that dietary habits are associated with poor academic performance. However, few studies have evaluated these relations after adjusting for numerous confounding factors. This study evaluated the frequency of various diet items (fruit, soft drinks, fast foods, instant noodles, confections, vegetables, and milk) and the regularity of meal times (breakfast, lunch, and dinner) all at once.A total of 359,264 participants aged from 12 to 18 years old were pooled from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) for the 2009 to 2013 period. Dietary habits over the last 7 days were surveyed, including the regularity of consuming breakfast, lunch and dinner and the frequency of eating fruits, soft drinks, fast foods, instant noodles, confections, vegetables, and milk. Physical activity, obesity, region of residence, subjective assessment of health, stress level, economic level, and parental education level were collected from all of the study participants. School performance was classified into 5 levels. The adjusted odds ratios (AORs) of dietary habits for school performance were analyzed using multinomial logistic regression analyses with complex sampling. Structural equation modeling was used to analyze the effects of diet factors on school performance while considering the effects of other variables on both diet factors and school performance.Frequent intakes of breakfast (AOR = 2.34, 95% confidence interval [CI] = 2.20-2.48), fruits (AOR = 1.73, 95% CI = 1.62-1.86), vegetables (AOR = 1.48, 95% CI = 1.37-1.61), and milk (AOR = 1.35, 95% CI = 1.28-1.43) were related to high levels of school performance (each with P < 0.001). In contrast, soft drinks (AOR = 0.42, 95% CI = 0.38-0.46), instant noodles (AOR = 0.62, 95% CI = 0.55-0.70), fast food (AOR = 0.83, 95% CI = 0.72-0.96), and confectionary (AOR = 0.86, 95% CI = 0.80-0.93) were negatively associated with school performance (each with P < 0.001).This study confirms previous studies of school performance and dietary habits that find a positive association with eating breakfast and consuming fruits and milk and a negative relation with soft drinks, instant noodles, fast foods, and confections.

Cognitive effects following acute wild blueberry supplementation in 7- to 10-year-old children

PURPOSE

Previously, anthocyanin-rich blueberry treatments have shown positive effects on cognition in both animals and human adults. However, little research has considered whether these benefits transfer to children. Here we describe an acute time-course and dose-response investigation considering whether these cognitive benefits extend to children.

METHODS

Using a double-blind cross-over design, on three occasions children (n = 21; 7-10 years) consumed placebo (vehicle) or blueberry drinks containing 15 or 30 g freeze-dried wild blueberry (WBB) powder. A cognitive battery including tests of verbal memory, word recognition, response interference, response inhibition and levels of processing was performed at baseline, and 1.15, 3 and 6 h following treatment.

RESULTS

Significant WBB-related improvements included final immediate recall at 1.15 h, delayed word recognition sustained over each period, and accuracy on cognitively demanding incongruent trials in the interference task at 3 h. Importantly, across all measures, cognitive performance improved, consistent with a dose-response model, with the best performance following 30 g WBB and the worst following vehicle.

CONCLUSION

Findings demonstrate WBB-related cognitive improvements in 7- to 10-year-old children. These effects would seem to be particularly sensitive to the cognitive demand of task.

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

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

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

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

Voluntary dehydration and cognitive performance in trained college athletes

Cognitive and mood decrements resulting from mild dehydration and glucose consumption were studied. Men and women (total N = 54; M age = 19.8 yr., SD = 1.2) were recruited from college athletic teams. Euhydration or dehydration was achieved by athletes completing team practices with or without water replacement. Dehydration was associated with higher thirst and negative mood ratings as well as better Digit Span performance. Participants showed better Vigilance Attention with euhydration. Hydration status and athlete's sex interacted with performance on Choice Reaction Time and Vigilance Attention. In a second study, half of the athletes received glucose prior to cognitive testing. Results for negative mood and thirst ratings were similar, but for cognitive performance the results were mixed. Effects of glucose on cognition were independent of dehydration.

Glucoregulatory and order effects on verbal episodic memory in healthy adolescents after oral glucose administration

The ingestion of oral glucose has been observed to facilitate memory performance in both elderly individuals and in young adults. However, fewer studies have investigated the effect of glucose on memory in children or adolescents. In the present study, the ingestion of a glucose laden drink was observed to enhance verbal episodic memory performance in healthy adolescents under conditions of divided attention, relative to a placebo drink. Further analyses found that this glucose memory facilitation effect was observed only in adolescents exhibiting better glucoregulatory efficiency. These findings demonstrate that the glucose memory facilitation effect can be generalised to younger individuals. The importance of controlling for treatment order in within-subjects designs investigating the glucose memory enhancement effect is also discussed.

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.

Effect of breakfast composition on cognitive processes in elementary school children

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

The effects of nicotine and sucrose on spatial memory and attention

Both nicotine and sucrose can enhance performance on cognitive tasks. However, little is known about whether nicotine and sucrose could act jointly to augment mental performance. To investigate if there is an interaction between nicotine and sucrose on cognitive behavior, performance on a continuous performance task (CPT) and a spatial memory task was examined in 14 healthy smokers after they had drunk 8 oz of either a sucrose- or aspartame-containing beverage, and then chewed a piece of gum containing either 2 mg nicotine or no nicotine. To assess changes in mood as a function of nicotine and sucrose intake, the profile of mood states (POMS) test was administered three times during each test session. Participants made significantly more correct responses and significantly fewer incorrect responses on the CPT when they received nicotine than when they received the placebo gum. Closer analysis of the data revealed that there was an interaction between sucrose consumption and nicotine intake. Nicotine increased hits and decreased misses when participants were given the sucrose-containing beverage, but not when they were given the aspartame-containing beverage. Neither nicotine nor sucrose affected spatial memory or mood across experimental sessions. However, when data were analyzed for just the first session, participants who drank the sucrose-containing beverage performed significantly better on the spatial memory task than those who drank the aspartame-containing beverage. No gender differences in the effects of nicotine or sucrose on cognitive performance were detected. The results provide support that both nicotine and sucrose have positive effects on cognitive behavior, and that under some conditions the two variables have additive effects on performance.