Associations between Food Group Intake, Cognition, and Academic Achievement in Elementary Schoolchildren

Academic achievement and healthy lifestyle habits in primary school children: an interventional study

Purposes

First, to examine the relationship between primary school children's academic achievement and healthy lifestyle habits. Second, to evaluate the effectiveness of two different 5-month physical education interventions (traditional physical education vs. coordinative physical education) on children's academic achievement. Third, to examine whether variations of anthropometric variables, fitness level, gross motor coordination, physical activity level, sedentary time, attentional performance, fruit and vegetable consumption, meal frequency and type of physical education intervention could predict children's academic achievement variations.

Methods

Before and after the intervention, Italian language and mathematics skills, anthropometric variables (weight, height, body fat percentage, BMI), physical fitness (aerobic fitness, muscular strength, flexibility), gross motor coordination, attentional performance (processing speed, concentration performance, performance accuracy, attentional and inhibitory control), physical activity level, sedentary time and eating habits (meal frequency, fruit and vegetable consumption) were assessed in 161 Italian primary school children, randomly assigned to a traditional physical education group or to a coordinative physical education group.

Results

Physical activity level, gross motor coordination and aerobic fitness moderately predicted mathematics skill (R2 = 17%). Moreover, physical activity level, aerobic fitness and muscular strength moderately predicted Italian language skill (R2 = 21%). Intervention type differently affected academic achievement. Specifically, Italian language and mathematics skills significantly improved only after traditional intervention. Fruit consumption increase was positively associated with the improvement in academic achievement. Coordinative physical education intervention was associated with a lower probability of improvement in Italian language and mathematical skills.

Conclusion

Motor ability and lifestyle habits may have a positive influence on academic achievement in children. Unexpectedly, traditional physical education intervention resulted to be more effective on both Italian language and mathematical skills.

Modifiable factors influencing attention performance in healthy children: insights from a comprehensive school nutrition study

BACKGROUND

There is inconclusive evidence for the effects of various leisure activities on attention performance in children. The literature reports inconsistent associations between activities such as physical activities or media use. To date, no study has thoroughly examined the various factors influencing attentional performance in a larger cohort of healthy children. This study aims to close this research gap.

METHODS

From 2018 to 2019, the Leipzig School Nutrition Study collected data from 1215 children and their families. The children report their dietary behavior (using CoCu- Questionnaire), especially their participation in school lunch and their breakfast habits, through a paper questionnaire. Furthermore, attention performance was assessed using a validated test (FAIR-2) at school. Data on physical activity, media consumption, family eating habits and socio-economic status (SES) were collected from parents using questionnaires. Associations between attention and influencing factors were estimated using hierarchical linear regression. Analyses were adjusted for age, SES, and school type.

RESULTS

Attending upper secondary schools (ßadj= 23.6, p < 0.001) and having a higher SES (ß= 1.28, p < 0.001) was associated with higher attention performance. Children doing leisure-time sports (ßadj= 4.18, p = 0.046) or reading books for at least one hour/weekday showed better attention performance (ßadj= 3.8, p = 0.040). Attention performance was also better in children having no electronic devices in the bedroom (ßadj= 13.0, p = 0.005) and in children whose parents limited their children's Internet access (ßadj= 5.2, p = 0.012). We did not find any association between nutritional habits and attention performance.

CONCLUSIONS

We found that fostering modifiable habits such as reading and physical activity could enhance attention performance. These findings have substantial implications for the development of prevention and intervention programs that aim to improve attention in schoolchildren. It is important to note, however, that social status as a hardly modifiable factor also impacts attention performance. Therefore, interventions should address personal habits in a systemic approach considering the child's social status.

TRIAL REGISTRATION

The study is retrospectively registered with the German Clinical Trials Register (DRKS00017317, registration: 05-29-2019).

Higher adherence to the Mediterranean Diet is associated with better academic achievement in Spanish university students: A multicenter cross-sectional study

The objective was to assess the association of the overall score and different items of the Mediterranean Diet Adherence Screener (MEDAS) questionnaire with academic achievement in Spanish university students. We hypothesized that university students with greater adherence to the Mediterranean Diet (MedDiet) would have better academic achievement. A cross-sectional study was performed involving 266 first-year students from the University of Castilla-La Mancha, Spain, during the 2017-2018 academic year. Adherence to the Mediterranean diet was evaluated with the 14-item MEDAS questionnaire. As an indicator variable for academic achievement, the average marks of the examinations required for access to Spanish universities were used. A total of 63 participants (23.6%) adhered to MedDiet recommendations. Analysis of covariance models showed that participants with higher adherence to the MedDiet had significantly higher scores on academic achievement than their peers with low adherence (P < .001) after controlling for potential confounders. Additionally, the evaluation of each item of the MEDAS questionnaire showed that a diet rich in olive oil, vegetables, fruits, legumes, fish and shellfish, and a low consumption of sweets and carbonated beverages were positively associated with academic achievement; nevertheless, wine intake was inversely associated. This study showed that Spanish university students had a low prevalence of good adherence to the MedDiet. Additionally, our results suggested that higher adherence to the MedDiet is associated with better academic achievement in Spanish university students. From a public health perspective and because of low adherence, it is important to continue to focus on promoting adherence to the MedDiet as part of a healthy lifestyle pattern to improve the academic performance of young university students.

Adolescents with a Favorable Mediterranean-Style-Based Pattern Show Higher Cognitive and Academic Achievement: A Cluster Analysis-The Cogni-Action Project

A Mediterranean diet (MedDiet) has emerged as a crucial dietary choice, not only in attenuating various adolescents' metabolic health issues but it has also been associated with improved cognitive and academic achievement. However, few studies have established patterns of food consumption linked to both cognitive and academic achievement in adolescents living in a developing country with non-Mediterranean-based food. Methods: This cross-sectional study included 1296 Chilean adolescents (50% girls) aged 10-14 years. The MedDiet Quality Index was used to assess adherence to the MedDiet in children and adolescents. Through cluster analysis, four distinct dietary patterns were identified: Western diet (WD = 4.3%); low fruit and vegetables, high-sugar diet (LFV-HSD = 28.2%); low fruit and vegetables, low-sugar diet (LFV-LSD = 42.2%); and the MedDiet (25.3%). A mixed-model analysis was conducted to compare these clusters and their relationships with cognitive and academic achievements. Principal component analysis was performed to identify four primary cognitive domains: working memory, cognitive flexibility, inhibitory control, and fluid reasoning. Academic achievement was determined with five school subjects (Language, English, Mathematics, Science, and History) and included the Academic-PISA score derived from the mean scores in Language, Mathematics, and Science. Results: A marked difference was observed between the four clusters, which was mainly related to the consumption of sugar, ultra-processed foods, fruits, and vegetables. According to cognitive performance, the MedDiet group showed higher performance across all domains than the LFV-HSD, LFV-LSD, and WD groups. Regarding academic achievement, the WD underperformed in all analyses compared to the other groups, while the MedDiet was the unique profile that achieved a positive difference in all academic subjects compared to the WD and LFV-HSD groups (p < 0.05). Conclusions: These findings suggest that higher adherence to Mediterranean-style-based patterns and better food quality choices are associated with improved cognitive and academic achievements.

Differential longitudinal effects of frequent sweetened food consumption at different exposure ages on child cognitive, language, and motor development

BACKGROUND

Evidence reveals frequent sugar consumption worsens cognition in animal models, and similar effects on child development are probable. We aimed to investigate the influence of sweetened foods (SFs) on child developmental trajectories.

METHODS

The prospective cohort recruited 3-month-old children in Taiwan from 1st April 2016 to 30th June 2017. Developmental inventories including cognitive, language, and motor domains, were measured at the age of 3-,12-, 24-, and 36 months old via in-person interviews. We constructed latent growth models with covariates to estimate the influence of SFs on child development.

RESULTS

Ultimately, 4782 children (50.7% boys) were included in the statistical analysis. In the cognitive domain, consumption at one year of age significantly affected the intercept, but not the linear slope and quadratic term (intercept: estimate = -0.054, p < .001); consumption at two years of age significantly affected the intercept and quadratic term (intercept: estimate = -0.08, p < .001; quadratic term: estimate = -0.093, p = .026), but not the linear slope. In the language domain, only consumption at two years of age significantly affected the intercept (estimate = -0.054, p < .001). In the motor domain, consumption at two years of age significantly affected the linear slope and quadratic term (estimate = 0.080, p = .011 and estimate = -0.082, p = .048, respectively).

CONCLUSION

We found SFs exposure at different times has different negative effects on child development. Early exposure to SFs harmed children's cognitive function. Relatively late exposure to SFs not only deteriorated children's cognitive and language abilities but also decelerated developmental velocity in cognitive and motor domains.

Association of ultraprocessed foods consumption and cognitive function among children aged 4-7 years: a cross-sectional data analysis

Background

Sugar-sweetened beverage (SSB) consumption has shown associations with cognitive function in preschool children, but effects of other ultraprocessed foods consumption are rarely discussed in China. This study aimed to investigate the relationship between ultraprocessed food consumption and cognitive function among preschool children in China.

Methods

A total of 325 children aged 4-7 years were included from Guangxi Zhuang Birth Cohort in Guangxi Zhuang Autonomous Region, China. Face-to-face interviews with parents using the Food Frequency Questionnaire (FFQ) was conducted to investigate the status of seven ultraprocessed foods consumption (i.e., chocolate, biscuits, candy, fast-food, ice cream, SSBs, and sweet bakery products). The mandarin-language version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI, Fourth Edition) was applied to assess the cognitive function of children. Multiple linear and logistic regression models were used to assess the associations between ultraprocessed food consumption and the full-scale intelligence quotient (FSIQ) and different domains and risk of cognitive deficit, respectively.

Results

We found that frequent consumption of candy (β = -3.34, 95% CI: -5.62∼-1.06; p = 0.004) and sweet bakery products (β = -2.77, 95% CI: -5.58∼0.04; p = 0.054) were significant associated with decreased FSIQ scores in the linear regression models. However, only frequent consumption of candy was statistically significantly associated with an increased risk of cognitive deficit (OR = 2.05, 95% CI: 1.11∼3.79; p = 0.023) in the logistic regression models. For the different domains, we found frequent consumption of candy (β = -3.85, 95% CI: -6.28∼-1.43; p = 0.002) and sweet bakery products (β = -3.48, 95% CI: -6.47∼-0.49; p = 0.023) was also significantly associated with lower Verbal Comprehension Index (VCI). When combining the seven ultraprocessed foods, we found children who frequently consumed more than two kinds of ultraprocessed foods had a significant decrease of VCI scores (β = -2.66; 95% CI: -5.12∼-0.19; p = 0.035) too.

Conclusion

Our results suggested that frequent consumption of individual (candy and sweet bakery products) and multiple ultraprocessed foods may decrease VCI scores and thereby impact cognitive function in children aged 4-7 years.

Dietary patterns and cognitive achievement among school children in socio-cultural context, a case of Montevideo, Uruguay

PURPOSE

The benefits of a healthy diet on children´s cognition have been described in several studies. However, many previous studies have analyzed the effect on general cognitive domains (e.g. intelligence), used measures based almost exclusively on local examinations, and rarely consider social context.

OBJECTIVE

The objective of the present study was to examine the relationship between two diet patterns and contextualized cognitive performance measures of children aged 6-8 years from low-average income neighborhoods in Montevideo, Uruguay.

METHODS

270 first-grade children with complete data participated in the study. Consumption of foods was determined via two averaged 24-h dietary recalls with the mother. Two dietary patterns were identified via principal component analysis: "processed (high calorie) foods" and "nutrient dense". Children´s cognitive performance, including general cognitive abilities, achievement in mathematics and reading, and discrepancy scores between predicted and actual achievement was assessed with the Woodcock-Muñoz Cognitive and Achievement scales. The association of dietary patterns and cognitive endpoints was analyzed in multilevel models, clustered by children´s school. Sociodemographic and biological variables were used as covariates.

RESULTS

The nutrient dense foods pattern, characterized by higher consumption of dark leafy and red-orange vegetables, eggs, beans & peas, potatoes, was associated with better performance in reading, with beta coefficient 3.28 (95% CI 0.02, 6.54). There was also an association between the nutrient dense foods factor and the Discrepancy in reading, 2.52 (0.17, 4.87). Processed (high calorie) foods pattern, characterized by higher consumption of breads, processed meats, fats and oils, sweetened beverages, and sweetened yogurt/dairy products; reduced intake of milk, pastries and pizza dinners was not associated with cognitive performance.

CONCLUSIONS

Nutrient dense food pattern was positively associated with children's reading achievement. A nutrient-rich diet may benefit written language acquisition at the beginning of schooling.

‘Mens sana in corpore Sano’: Home food consumption implications over child cognitive performance in vulnerable contexts

Diet directly affects children’s physical and mental development. Nonetheless, how food insecurity and household food consumption impact the cognitive performance of children at risk of social exclusion remains poorly understood. In this regard, children in Guatemala face various hazards, mainly related to the socioeconomic difficulties that thousands of families have in the country. The main objective of this study was to analyze the differences in cognitive performance considering food insecurity and household food consumption in a sample of rural and urban Guatemalan children and adolescents at risk of social exclusion. Child cognitive performance was assessed in 134 children and adolescents (age M = 11.37; SD = 3.54) from rural and urban settings. Language, attention, and executive functions were assessed using neuropsychological tasks. Differences in cognitive performance in each level of food insecurity and household diet consumption were compared using the Mann–Whitney U test. A stepwise multivariate regression analysis was conducted to determine which factors may influence cognitive scores. The results showed that rural and urban groups did not differ in terms of food insecurity. However, considering just rural areas, differences were found between groups with food security and insecurity in attention and executive function tasks. Moreover, differences were found in food consumption for certain groups of food (e.g., meat, U = 1,146, p < 0.001, g = 0.72). Regarding regressions, protein food consumption (e.g., meat and fish), which is related to having a more balanced diet, was a relevant factor in executive performance. Contrary to what we expected, performance in attentional tasks was not related to the consumption of any food group. These findings could help politicians and decision-makers to select actions focused on improving diet balance and food security in families at risk of social exclusion. It is necessary to carry out more specific studies on the factors related to diet that affect the cognitive development of minors at risk of social exclusion. In addition, it is necessary to study the implementation of alternative interventions that include low-cost nutrients, thus ensuring that minors have access to a more balanced diet.

Meta-analysis of sugar-sweetened beverage intake and the risk of cognitive disorders

BACKGROUND

Previous epidemiological studies revealed inconsistent associations between sugar-sweetened beverage (SSB) consumption and cognitive disorders, but there have been no meta-analyses of the pooled results. Thus, a meta-analysis was performed to determine the association between SSB consumption and cognitive disorders.

METHODS

A systematic search of the literature prior to May 20, 2022 was performed using the PubMed and Web of Science databases. Random effects models were used to calculate and combine odds ratios (ORs) depending on the degree of heterogeneity.

RESULTS

13 studies met the inclusion criteria. A total of 242,014 participants (2752 in three cross-sectional studies and 239,262 in ten cohort studies) were included. A random effects meta-analysis, according to the comprehensive analysis of SSB consumption, was associated with a greater prevalence of cognitive disorders (OR = 1.17, 95 % CI = 1.05-1.29; I² = 90.1 %). Subgroup analyses of study design, type of SSB, or cognitive disorders outcome was performed. In subgroup analyses, we found that SSB intake was associated with a higher prevalence of cognitive disorders in cohort studies, middle-aged and elderly population, and participants with sugar-sweetened soft drinks. However, no significant association was found in other subgroups.

CONCLUSION

Our results indicate that SSB intake is positively associated with the prevalence of cognitive disorders. Therefore, attention should be paid to reducing SSB intake as an early intervention for cognitive disorders.

Association between Sugar-Sweetened Beverage Consumption and Executive Function in Children

The association between sugar-sweetened beverages (SSB) and executive function among children has been less investigated. We aimed to explore this topic. We randomly recruited 6387 children aged 6-12 years from five elementary schools in Guangzhou, China in 2019. Information on frequency and servings of children's SSB consumption was assessed using a questionnaire. Children's executive function was evaluated using parents' ratings of the Behavioral Rating Inventory of Executive Function (BRIEF), which comprises eight subscales-including inhibit, shift, emotional control, initiate, working memory, plan/organize, organization of materials and monitor, as well as three composite indexes including behavioral regulation index (BRI), metacognition index (MI), and global executive index (GEC). SSB consumption was positively associated with all subscales and composite scores of BRIEF as well as higher risks of elevated executive difficulties, indicating poorer executive function. For example, children who drank SSB ≥2 times/week were related to higher scores of GEC (estimates, 95% confidence interval (CI): 2.44, 1.79 to 3.09) compared with those who never drank SSB. The odds ratio of elevated GEC associated with SSB consumption ≥2 times/week was 1.62 (95% CI: 1.34, 1.96) than non-consumers. The results of this study indicated that SSB consumption was associated with poorer executive function in children.

Effect of glucose and sucrose on cognition in healthy humans: a systematic review and meta-analysis of interventional studies

CONTEXT

Evidence suggests that plasma glucose levels may influence cognitive performance, but this has not been systematically reviewed and quantified.

OBJECTIVE

The aim of this review was to investigate the potential effects of glucose and sucrose, compared with placebo, on cognition in healthy humans.

DATA SOURCES

The electronic databases PubMed and Web of Science were searched up to December 2019. Reference lists of selected articles were checked manually.

STUDY SELECTION

Randomized controlled trials or crossover trials that compared glucose or sucrose with placebo for effects on cognition were eligible.

DATA EXTRACTION

Potentially eligible articles were selected independently by 2 authors. Risk of bias was assessed through the Cochrane Collaboration tool. Standardized mean differences (SMDs) were obtained from random-effects meta-analyses for a subsample of studies that reported the same outcomes.

RESULTS

Thirty-seven trials were identified, of which 35 investigated the effect of glucose consumption compared with placebo on cognition. Two studies found no effect of glucose on cognition, while the others found mixed results. Only 3 of the 37 studies investigated the effects of sucrose intake, reporting mixed results. Meta-analyses revealed a significantly positive effect of glucose compared with control, but only when a verbal performance test (immediate word recall) was used in parallel-design studies (SMD = 0.61; 95%CI, 0.20-1.02; I2 = 0%). Twenty-four studies were classified as having high risk of bias for the selection procedure.

CONCLUSIONS

A limited body of evidence shows a beneficial effect of glucose in individuals performing immediate verbal tasks. High-quality trials with standardized cognitive measurements are needed to better establish the effect of glucose or sucrose on cognition.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number CRD42019122939.

Breakfast: A Crucial Meal for Adolescents' Cognitive Performance According to Their Nutritional Status. The Cogni-Action Project

This study aimed to determine whether pupils who have breakfast just before a cognitive demand, do not regularly skip breakfast, and consume a high-quality breakfast present higher cognitive performance than those who do not; furthermore, to establish differences according to their nutritional status. In this study, 1181 Chilean adolescents aged 10–14 years participated. A global cognitive score was computed through eight tasks, and the body mass index z-score (BMIz) was calculated using a growth reference for school-aged adolescents. The characteristics of breakfast were self-reported. Analyses of covariance were performed to determine differences in cognitive performance according to BMIz groups adjusted to sex, peak height velocity, physical fitness global score, and their schools. A positive association was found in adolescents’ cognitive performance when they had breakfast just before cognitive tasks, did not regularly skip breakfast, presented at least two breakfast quality components, and included dairy products. No significant differences were found between breakfast components, including cereal/bread and fruits/fruit juice. Finally, pupils who were overweight/obese who declared that they skipped breakfast regularly presented a lower cognitive performance than their normal-BMIz peers. These findings suggest that adolescents who have breakfast just prior to a cognitive demand and regularly have a high quality breakfast have better cognitive performance than those who do not. Educative nutritional strategies should be prioritized, especially in “breakfast skippers” adolescents living with overweight/obesity.

The Consumption of Sweets and Academic Performance among Mongolian Children

The regular consumption of sweets has been shown to have an adverse association with the academic performance of children in developed countries; however, the situation in developing countries is less clear. Therefore, we examined the association between the consumption of sweets and academic performance among Mongolian children via a cross-sectional study employing data from 787 children aged 8–16 from two public schools in Ulaanbaatar, the capital of Mongolia. The frequency of the consumption of sweets by the children was captured using a questionnaire and then linked to their academic scores; the association between the consumption of sweets and scores in mathematics and the Mongolian language was evaluated using multiple linear regression adjusted for other covariates. It was found that out of 787 students, 58.6% ate sweets every day. After adjusting for covariates, no significant association was observed between the consumption of sweets and mathematics scores (coefficient: 0.15; 95% confidence interval (CI): −0.02–0.32), while a higher consumption of sweets was significantly associated with higher scores in the Mongolian language (coefficient: 0.25; 95% CI: 0.09–0.41). The associations established in this study are inconsistent with the reports of other studies.

Dietary Behaviours Among Han, Tujia and Miao Primary School Students: A Cross-Sectional Survey in Chongqing, China

Background and Purpose

Exploring the differences of children's dietary behaviours from different nationalities could provide a reference for targeted nutritional interventions. This study aims to assess the dietary behaviours among Han, Tujia and Miao primary school students and the differences among the ethnic groups.

Materials and Methods

This cross-sectional survey included 556 primary school students (249 Han, 76 Tujia and 231 Miao students) aged 6-13 years from the representative minority areas of Chongqing, China. Data were collected with a self-administered or one-on-one interview-based questionnaire encompassing questions on sociodemographics, eating habits and dietary intake. Eating habits and dietary intake were categorized into health-protective and health-risk dietary behaviours. χ² tests were conducted to examine the differences in eating habits and dietary intake among the three ethnic groups. Forward stepwise logistic regression models were performed to check the factors affecting dietary intake.

Results

Fewer than half of the students had health-protective dietary behaviours in terms of rice, fruit, fish, eggs and milk intake. Compared with Han students, Tujia students were more likely to meet the recommended intake of vegetables (OR = 2.13, 95% CI [1.22-3.69]), less likely to meet the recommended intake of meat (OR = 0.58, 95% CI [0.35-0.94]) and fish (OR = 0.55, 95% CI [0.32-0.94]); Miao students were more likely to meet the recommended intake of vegetables (OR = 1.73, 95% CI [1.20-2.51]), fruits (OR = 1.62, 95% CI [1.16-2.28]) and water (OR = 1.59, 95% CI [1.12-2.26]) than those of Han students.

Conclusion

The low proportion of health-protective dietary behaviours among primary school students from Han, Tujia and Miao ethnicities was found in this study. There were differences in dietary behaviours among the three ethnic groups. This study could provide a reference for implementing national dietary guidelines in consideration of socioeconomic status, ways of preparing and consuming foods, traditional foods and customs of different ethnic groups.