Breakfast and performance

Free School Meal Improves Educational Health and the Learning Environment in a Small Municipality in Norway

It has been suggested that school meals could have an impact on students’ learning environments; however, existing research in this field is scarce and inconclusive. The purpose of this study was to explore teachers’ and school administrators’ experiences with the introduction of a free school meal and whether this influenced the learning environment. The study was conducted in upper primary and lower secondary schools in a small municipality in Norway. In this qualitative study, 17 informants participated in semi-structured in-depth interviews. The interviews were recorded, transcribed, and coded using NVivo. Thematic analysis was conducted using systematic text condensation (STC). The main findings are that in the informants’ experience, a free school meal led to reduced absenteeism during lunchtime and positive social interactions among students, social equalization, and a more peaceful atmosphere during lunchtime. In conclusion, the introduction of a free school meal had a positive impact on the students’ educational health and the learning environment, and contributed to social equalization as all the students shared the same healthy school meal.

Nutrition in the comprehensive approach of Health Promoting Schools: Survey on attitudes, knowledge and experiences in a sample of European teachers

BACKGROUND: A healthy diet is a major factor in childhood for proper mental and physical development, and schools are valuable settings for promoting nutritional health. Teachers have a key role as educators and as a link between children, families, and institutions. OBJECTIVES: The study aims at describing the teachers’ profile and to evaluate the level of adherence of their schools to the recommendations by Health Promoting Schools concerning nutritional issues. METHODS: A cross-sectional study was conducted on a sample of 131 Spanish and Italian teachers from kindergartens and primary schools. RESULTS: The lack of a structured approach to school food emerged, as well as a low quality level of food consumption at school. Among the positive aspects, there is the compliance with the dietary reference values for the intake of nutrients and energy of meals supplied by cafeterias and the collaboration with nutritionists in health services, but other desirable circumstances are neglected (e.g. training courses for staff, the involvement of students, supply of water and vegetables such as healthy drinks and snacks). CONCLUSION: The study confirmed the need to train teachers and to strengthen school action plans, particularly the agenda around the sustainability of the school food and nutrition environment.

Micromotors for Active Delivery of Minerals toward the Treatment of Iron Deficiency Anemia

As the most common nutritional disorder, iron deficiency represents a major public health problem with broad impacts on physical and mental development. However, treatment is often compromised by low iron bioavailability and undesired side effects. Here, we report on the development of active mineral delivery vehicles using Mg-based micromotors, which can autonomously propel in gastrointestinal fluids, aiding in the dynamic delivery of minerals. Iron and selenium are combined as a model mineral payload in the micromotor platform. We demonstrate the ability of our mineral-loaded micromotors to replenish iron and selenium stores in an anemic mouse model after 30 days of treatment, normalizing hematological parameters such as red blood count, hemoglobin, and hematocrit. Additionally, the micromotor platform exhibits no toxicity after the treatment regimen. This proof-of-concept study indicates that micromotor-based active delivery of mineral supplements represents an attractive approach toward alleviating nutritional deficiencies.

Obesity prevention and the Health promoting Schools framework: essential components and barriers to success

Background

Obesity is an important public health issue. Finding ways to increase physical activity and improve nutrition, particularly in children, is a clear priority. Our Cochrane review of the World Health Organization’s Health Promoting Schools (HPS) framework found this approach improved students’ physical activity and fitness, and increased fruit and vegetable intake. However, there was considerable heterogeneity in reported impacts. This paper synthesises process evaluation data from these studies to identify factors that might explain this variability.

Methods

We searched 20 health, education and social-science databases, and trials registries and relevant websites in 2011 and 2013. No language or date restrictions were applied. We included cluster randomised controlled trials. Participants were school students aged 4-18 years. Studies were included if they: took an HPS approach (targeting curriculum, environment and family/community); focused on physical activity and/or nutrition; and presented process evaluation data. A framework approach was used to facilitate thematic analysis and synthesis of process data.

Results

Twenty-six studies met the inclusion criteria. Most were conducted in America or Europe, with children aged 12 years or younger.

Although interventions were acceptable to students and teachers, fidelity varied considerably across trials. Involving families, while an intrinsic element of the HPS approach, was viewed as highly challenging. Several themes emerged regarding which elements of interventions were critical for success: tailoring programmes to individual schools’ needs; aligning interventions with schools’ core aims; working with teachers to develop programmes; and providing on-going training and support. An emphasis on academic subjects and lack of institutional support were barriers to implementation.

Conclusions

Stronger alliances between health and education appear essential to intervention success. Researchers must work with schools to develop and implement interventions, and to evaluate their impact on both health and educational outcomes as this may be a key determinant of scalability. If family engagement is attempted, better ways to achieve this must be developed and evaluated. Further evaluations of interventions to promote physical activity and nutrition during adolescence are needed. Finally, process evaluations must move beyond simple measures of acceptability/fidelity to include detailed contextual information to illuminate exactly what works, for whom, in what contexts and why.

Fast-food consumption and educational test scores in the USA

BACKGROUND

  Children in the USA are experiencing obesity and overweight at epidemic rates. Schools have started to make policy decisions based on a popularly presumed connection between nutrition and academic achievement. This study aimed to determine whether such a relationship exists, and if so, its nature.

METHODS

  Data from the Food Consumption Questionnaire administered to approximately 12 000 fifth graders as part of the nationally representative Early Childhood Longitudinal Study-Kindergarten Cohort was analysed using regression analysis. The analysis used propensity score matching to examine the relationship between students' reported fast-food consumption and their test scores in reading and mathematics. Propensity score matching attempts to control for a host of background characteristics that might be correlated with both fast-food consumption and test scores.

RESULTS

  Standard ordinary least squares regression showed that test scores decreased as reported fast-food consumption increased. In the propensity-score-matched analysis, which controlled for 25 student background characteristics, higher-than-average fast-food consumption ('four to six times in the last 7 days' or more) was associated with significantly lower test scores in both reading (-11.15 points or 0.48 SD) and math (-11.13 points or 0.52 SD), even when teacher experience, school poverty level and school urbanicity were also included in the model.

CONCLUSIONS

  Although this study is preliminary, its results indicate that the relationship between poor nutrition and test scores may in fact be quite negative, strengthening the impetus for schools to consider policies that support students' healthy eating. In order to strengthen these findings and investigate possible mechanisms through which poor nutrition might affect test scores, there is a need for further research.

Ready-to-Eat Cereal Breakfasts Are Associated with Improved Nutrient Intake and Dietary Adequacy but Not Body Mass Index in Black Adolescents

The goal of this study was to determine whether nutrient intake, dietary adequacy, and weight status were associated with type of breakfast consumption: skipping breakfast, consuming ready-to-eat cereal (RTEC) at breakfast, or consuming other types of foods at breakfast. Data from black adolescents 13 to 18 years of age (n = 988) participating in the 1999-2002 National Health and Nutrition Examination Survey were used in a secondary data analysis. Thirty-seven percent of black adolescents skipped breakfast, 19% consumed RTEC at breakfast, and 44% consumed other breakfasts. RTEC breakfast and other breakfast consumers had higher mean energy intakes than breakfast skippers (P ≤ .05). After adjusting for gender and energy intake, RTEC breakfast consumers had higher intakes of thiamin, riboflavin, niacin, folate, calcium, phosphorus, magnesium, iron, zinc, potassium, and vitamins A, B6, and B12 than breakfast skippers and other breakfast consumers (P ≤ .05). RTEC breakfast consumers had the highest mean adequacy ratio, followed by other breakfast consumers, then breakfast skippers (P ≤ .05). Those consuming RTEC at breakfast had lower mean body mass index (P ≤ .05) and waist circumference (P ≤ .05) than breakfast skippers; however, there was no difference between those consuming RTEC and other breakfasts. If confirmed in prospective studies, consuming a breakfast meal with RTEC may be a useful strategy to encourage in black adolescents as a way to improve nutrient intake and dietary adequacy without increasing weight.

Are breakfast consumption patterns associated with weight status and nutrient adequacy in African-American children?

OBJECTIVE

The objective of the present study was to assess whether weight status, nutrient intake and dietary adequacy were associated with breakfast consumption patterns.

DESIGN

A representative sample of the US population was used in a secondary analysis of nutrient intake/diet quality and weight status by breakfast consumption patterns.

SETTING

The 1999-2002 National Health and Nutrition Examination Survey (NHANES).

SUBJECTS

The study sample included African-American (AA) children aged 1-12 years (n 1389).

RESULTS

Forty-five per cent of children aged 1-5 years and 38 % of those aged 6-12 years consumed ready-to-eat cereal (RTEC) at breakfast; while 7.4 % and 16.9 % in those age groups skipped breakfast, respectively. The lowest mean BMI (P <or= 0.05) and mean waist circumference (P <or= 0.05) was found in children 1-12 years of age who consumed RTEC at breakfast compared with other consumption groups. RTEC breakfast consumers had the highest mean intakes of vitamins A, B6 and B12, thiamine, riboflavin, niacin, folate, Ca, Fe and Zn (P <or= 0.05) and the highest Mean Adequacy Ratio (P <or= 0.05). RTEC breakfast consumers also had the highest intake of carbohydrates and total sugars, and the lowest intakes of total fat (P <or= 0.05).

CONCLUSIONS

Consuming RTEC at breakfast was associated with improved weight and nutrient adequacy in AA children. AA children in all breakfast categories still had mean intakes of most nutrients below recommended levels. The implications are that consuming a breakfast meal should be encouraged in these children, and that RTEC at breakfast provides important nutrients and may help promote a healthy weight.

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

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

Nutrition and performance in children

PURPOSE OF REVIEW

Malnutrition in late infancy and childhood remains a significant public health issue in developing nations as well as for those in transition to an industrialized economy. In addition, in these settings and particularly in developed nations, overweight is becoming a very serious threat to both the immediate and the long-term health of children. In this review, we present recent studies that have examined relationships between childhood undernutrition and three general areas of performance: physical activity, cognition and behavior.

RECENT FINDINGS

Malnourished children have been shown to have decreased physical activity and endurance, and poorer cognitive function and school performance. Multiple single micronutrient deficiencies, including vitamin B12, thiamin, niacin, zinc and iron, have been associated with poorer cognitive performance. Behavioral problems, including attention deficits, have also been associated with food insufficiency and malnutrition.

SUMMARY

The effects of impaired nutritional status during childhood may have long-standing consequences for the health and performance of children during their adult years.

School region socio-economic status and geographic locale is associated with food behaviour of Ontario and Alberta adolescents

BACKGROUND

In an attempt to elucidate broader determinants of adolescent dietary intake and habits, food intakes and selected food behaviours of grades 9 and 10 students from Ontario and Alberta were examined according to school region socio-economic status and urban/rural locale.

METHODS

Using a stratified random sample framework, 53 high schools from 28 school boards were recruited (45 public and 8 private; 33 urban and 20 rural). Median family income for Canada Post's forward sortation area of the school was used to define school region SES. Public and private schools were compared as a proxy measure of SES. A web-based survey of food intake and behaviours, including a 24-hour diet recall and food frequency questionnaire, was completed by 2,621 students in grades 9 and 10. Comparison of intakes and behaviours by school designation as urban/rural, public/private or regional SES (generalized linear model procedure) controlled for student gender and grade distribution and number of participants within schools.

RESULTS

School region SES ranged from dollars 40,959 to dollars 85,922/year. Vegetable and fruit consumption (p < 0.001), fibre intake (p < 0.001) and frequency of breakfast consumption (p < 0.01) increased with increasing income, while added sugar intake decreased (p < 0.01). Private versus public school students had lower intakes of sweetened drinks (p < 0.01) and higher intakes of fibre (p=0.02). Rural students reported higher mean intakes of calcium (1106 vs. 995 mg/day, respectively, p = 0.03) and milk products (2.7 vs. 2.3 servings/day, p < 0.01) than urban students.

CONCLUSION

Selected food behaviours of youth from Ontario and Alberta improve with increasing school SES and vary with rural/urban school locale. Identifying regional demographics may be useful in tailoring healthy eating programs to the specific school.

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.

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.