The effect of breakfast composition and energy contribution on cognitive and academic performance: a systematic review

The effect of meal frequency and glycemic index during the night shift on alertness, hunger and gastrointestinal complaints in female health care workers - a two-armed randomized cross-over trial

BACKGROUND

Nutrition strategies for night shift workers could optimize alertness, and minimize hunger and reduce gastrointestinal complaints, enhancing safety and well-being.

OBJECTIVE

To investigate the effects of 1 or 3 small meals, with either low or high glycemic index (GI), compared to no meal, on alertness, hunger, and gastrointestinal complaints during the night shift.

METHODS

Fifty-one female healthcare workers, aged 18 to 61, participated in a 2-armed randomized cross-over design. In one study arm, participants received one yogurt meal during the night shift, in the other, they received three. Each study-arm involved three intervention periods during night shifts, with participants consuming yoghurt with low GI (1LGI or 3LGI), high GI (1HGI or 3HGI) carbohydrates or no meal (0NGI). Objective alertness was assessed using a validated brief psychomotor vigilance task (PVT-B), subjective alertness with the Samn-Perelli scale, and hunger and gastrointestinal complaints through questionnaires.

RESULTS

Participants in the 1LGI (ß -4.6; 95% CI 0.0, 9.3) and 3LGI (ß -3.4; 95% CI 0.0, 6.8) conditions had fewer lapses during the PVT-B than those in the 3HGI condition. No differences were found between meal conditions for median and reciprocal reaction time or subjective alertness. All four conditions reported less hunger (ß from -0.6 to -1.2) compared to no meal. The 3LGI condition resulted in more rumbling intestines than the 3HGI (ß 1.1; 95% CI 0.4, 1.7) and 0NGI (ß 0.74; 95% CI 0.11, 1.37) conditions.

CONCLUSIONS

Our study suggests that consuming three small low GI meals during the night shift helps maintain alertness, and reduces lapses compared to three high GI meals. It also minimizes hunger but may cause mild gastrointestinal complaints. https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON25574.

Low blood glucose and fatigue accumulation at peak hours of occupational trauma in secondary industry workers

Objectives. The incidence of occupational traumatic injuries caused by human error has been reported to occur at 11:00 and 8-9 h after commencing work. Impaired attention is closely related to the incidence of these accidents. Therefore, this study aimed to clarify the changes in blood glucose, fatigue and stress response hormone levels over time among workers in a secondary industry. Methods. The blood glucose and subjective fatigue levels of 26 male secondary-industry workers were measured on workdays. In addition, the cortisol and dehydroepiandrosterone levels in saliva were measured on one workday and one holiday. Results. Blood glucose levels at 11:00 and 17:30 on the workday were significantly lower than those at 09:30. Moreover, hypoglycemia was observed in some participants. A significant increase in subjective fatigue levels was observed during the workday. However, no significant differences in salivary cortisol levels were observed between the workday and the holiday at any time point. Conclusions. Blood glucose levels decreased and subjective fatigue levels increased at the time points that occupational accidents were reported to occur most frequently during work. These factors may contribute to human errors due to impaired attentional function.

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).

No food for thought-How important is breakfast to the health, educational attainment and wellbeing of school-aged children and young people?

There have been reports from teachers of pupils in the United Kingdom arriving at school hungry. Poor nutritional intake during childhood can increase the risk of developing both short- and long-term health problems. Breakfast consumption has been associated with several outcomes including better diet quality and healthier weight status. Nevertheless, skipping breakfast is a frequent behaviour in young people, particularly adolescents, and those from lower socio-economic groups, who are less likely to meet dietary recommendations and nutritional targets. The aim of this narrative review is to explore the contribution of breakfast consumption at home or at school and the impact of breakfast skipping on nutrient intakes in school-aged children (aged 4-18 years), and their effect on weight and cardiometabolic health. We will also summarise evidence for a link with cognitive function and educational attainment. A broadly positive effect of breakfast intake on diet quality, weight status and school-related outcomes was found in the literature, although inconsistencies in findings and methodological limitations within the evidence base are notable. Further research is warranted to better understand impact of breakfast intake and school breakfast provision on longer-term learning, educational attainment and health outcomes. This also needs to consider the cost benefit, type of breakfast and any unintended consequences such as encouraging multiple breakfasts. Breakfast consumption could improve the nutritional intakes of the most vulnerable young people and may help to address inequalities in educational outcomes at least in the short term.

Food Categories for Breakfast and Mental Health among Children in Japan: Results from the A-CHILD Study

There is limited evidence that what children eat for breakfast contributes to their mental health. This study aimed to examine the associations between food categories for breakfast and mental health among children in Japan. A proportion of participants aged 9-10 years in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in Japan who consumed breakfast daily were included (n = 281). Foods eaten for breakfast were reported by the children each morning for 7 consecutive days, and defined according to the food categories in the Japanese Food Guide Spinning Top. Child mental health was assessed by caregivers using the Strength and Difficulties Questionnaire. The mean intake frequencies per week were six times for grain dishes, two times for milk products, and one time for fruits. Linear regression analysis revealed an inverse association between the frequent intake of grain dishes, whether rice or bread, and problem behaviors after adjustment for potential confounders. However, confectionaries, which mainly consisted of sweet breads or pastries, were not associated with problem behaviors. The intake of non-sweet grain dishes at breakfast may be effective for preventing behavioral problems in children.

Associations between Dietary Intake, Blood Levels of Omega-3 and Omega-6 Fatty Acids and Reading Abilities in Children

Lower levels of omega-3 polyunsaturated fatty acids (PUFAs) have been described in individuals with reading difficulties, but the degree and the nature of such deficiencies as well as the role of nutrition are a matter of debate. The aim of the present study was to investigate the associations between PUFA blood levels, nutritional status, and reading/writing/phonological awareness performances in 42 school-age children with varying levels of reading ability. Significant correlations were found between PUFA levels (specific omega-6/omega-3 ratios), the ratio of omega-6-derived calories to the total amount of calories and reading scores. Mediation analysis showed a mediating effect of fatty acids on the association between reading speed scores and nutritional status. Moderation analysis, moreover, showed that the associations of omega-6/omega-3 ratios in the blood and Kcal omega-6/Kcal total in dietary intake were moderated by reading speed performances. Results of the mediation and moderation models confirm that the associations of dietary intake with PUFA levels in the blood vary depending on learning abilities. Reading skills appear to be sensitive to the effects of a complex set of favorable conditions related to the presence of higher omega-3 blood levels. These conditions may reflect the action of dietary as well as genetic and epigenetic mechanisms.

How people wake up is associated with previous night's sleep together with physical activity and food intake

How people wake up and regain alertness in the hours after sleep is related to how they are sleeping, eating, and exercising. Here, in a prospective longitudinal study of 833 twins and genetically unrelated adults, we demonstrate that how effectively an individual awakens in the hours following sleep is not associated with their genetics, but instead, four independent factors: sleep quantity/quality the night before, physical activity the day prior, a breakfast rich in carbohydrate, and a lower blood glucose response following breakfast. Furthermore, an individual's set-point of daily alertness is related to the quality of their sleep, their positive emotional state, and their age. Together, these findings reveal a set of non-genetic (i.e., not fixed) factors associated with daily alertness that are modifiable.

Nutritional Impact on Metabolic Homeostasis and Brain Health

Aging in modern societies is often associated with various diseases including metabolic and neurodegenerative disorders. In recent years, researchers have shown that both dysfunctions are related to each other. Although the relationship is not fully understood, recent evidence indicate that metabolic control plays a determinant role in neural defects onset. Indeed, energy balance dysregulation affects neuroenergetics by altering energy supply and thus neuronal activity. Consistently, different diets to help control body weight, blood glucose or insulin sensitivity are also effective in improving neurodegenerative disorders, dampening symptoms, or decreasing the risk of disease onset. Moreover, adapted nutritional recommendations improve learning, memory, and mood in healthy subjects as well. Interestingly, adjusted carbohydrate content of meals is the most efficient for both brain function and metabolic regulation improvement. Notably, documented neurological disorders impacted by specific diets suggest that the processes involved are inflammation, mitochondrial function and redox balance as well as ATP production. Interestingly, processes involving inflammation, mitochondrial function and redox balance as well as ATP production are also described in brain regulation of energy homeostasis. Therefore, it is likely that changes in brain function induced by diets can affect brain control of energy homeostasis and other brain functions such as memory, anxiety, social behavior, or motor skills. Moreover, a defect in energy supply could participate to the development of neurodegenerative disorders. Among the possible processes involved, the role of ketone bodies metabolism, neurogenesis and synaptic plasticity, oxidative stress and inflammation or epigenetic regulations as well as gut-brain axis and SCFA have been proposed in the literature. Therefore, the goal of this review is to provide hints about how nutritional studies could help to better understand the tight relationship between metabolic balance, brain activity and aging. Altogether, diets that help maintaining a metabolic balance could be key to both maintain energy homeostasis and prevent neurological disorders, thus contributing to promote healthy aging.

Iron Status, Anemia, and Iron Interventions and Their Associations with Cognitive and Academic Performance in Adolescents: A Systematic Review

In adolescents, iron-deficiency anemia is the leading cause of disability-adjusted life years lost. The World Health Organization recommends delivering iron supplementation through school-based platforms, requiring partnerships with the education sector. This anemia-reduction intervention is valued for the perceived benefits of improved learning and school performance. This article aims to systematically review the available evidence on the relationship between iron status and anemia and impacts of iron interventions on cognitive and academic performance in adolescents. Fifty studies were included: n = 26 cross-sectional and n = 24 iron-containing interventions. Our review suggests that iron status and anemia may be associated with academic performance in some contexts and that iron supplementation during adolescence may improve school performance, attention, and concentration. However, nearly all supplementation trials were judged to have moderate or high risk of bias. We did not find evidence suggesting that iron status and anemia influenced or were associated with attention, intelligence, nor memory in adolescents. Further, iron supplementation did not improve memory and recall or intelligence. Overall, more high-quality research is needed to guide programmers and policy makers to understand the relationships between anemia and educational performance and the potential impacts of iron interventions, which effectively reduce anemia, on adolescents’ learning and school performance.

Breakfast skipping and cognitive and emotional engagement at school: a cross-sectional population-level study

OBJECTIVE

Research on the consequences of breakfast skipping among students tends to focus on academic outcomes, rather than student well-being or engagement at school. This study investigated the association between breakfast skipping and cognitive and emotional aspects of school engagement.

DESIGN

Cross-sectional study using data from a population-level survey of children and adolescents' well-being and engagement at school. Linear regression with adjustment for confounders was used to estimate the effect of breakfast skipping on school engagement.

SETTING

Government schools (i.e. public schools) in South Australia.

PARTICIPANTS

The participants were students, Grades 4-12, who completed the Wellbeing and Engagement Collection in 2019. The analysis sample included 61 825 students.

RESULTS

Approximately 9·6 % of students reported always skipping breakfast, with 35·4 % sometimes skipping and 55·0 % never skipping. In the adjusted linear regression models, children and adolescents who always skipped breakfast reported lower levels of cognitive engagement (β = -0·26 (95 % CI -0·29, -0·25)), engagement with teachers (β = -0·17 (95 % CI -0·18, -0·15)) and school climate (β = -0·17 (95 % CI -0·19, -0·15)) compared with those who never skipped breakfast, after controlling for age, gender, health, sleep, sadness and worries, parental education, socio-economic status and geographical remoteness.

CONCLUSION

Consistent with our hypothesis, skipping breakfast was associated with lower cognitive and emotional engagement, which could be due to mechanisms such as short-term energy supply and long-term health impacts. Therefore, decreasing the prevalence of breakfast skipping could have a positive impact on school engagement.

School-based nutrition education improves breakfast-related personal influences and behavior of Indonesian adolescents: a cluster randomized controlled study

BACKGROUND/OBJECTIVES

Many adolescents in developing countries skip breakfast. Innovative nutrition education (NE) strategies are needed to enhance knowledge and skills related to the breakfasts of adolescents in a low socioeconomic setting. The objective was to evaluate short- and long-term effects of a multi-strategy, school-based NE intervention on adolescents' breakfast-related personal influences and behaviors.

SUBJECTS/METHODS

An intervention study with a cluster randomized controlled trial design was conducted in 4 senior high schools in Makassar, Indonesia. The multi-strategy NE intervention was delivered for 3 months. Data were collected using a self-administered questionnaire and a 3-day breakfast recall (face-to-face interview). Wilcoxon, McNemar, and Mann-Whitney tests were used to determine intra- and intergroup differences.

RESULTS

Unlike knowledge, improvement was observed in attitude and self-efficacy scores in the intervention groups (IGs) (P < 0.01); however, no significant changes were observed in the control group (CG). More students showed improved motivation in the IG than in the CG (P > 0.05). Changes in breakfast frequency and macronutrient intake from breakfast were greater in the IG than in the CG (P < 0.05).

CONCLUSIONS

A multi-strategy NE intervention is effective in producing positive changes in breakfast-related attitude, self-efficacy, and motivation of adolescents from a low-middle socioeconomic setting. The intervention improved breakfast frequency and nutrient intake. This intervention has promise for sustaining the observed changes over the long-term.

Ready-to-eat cereal and milk for breakfast compared with no breakfast has a positive acute effect on cognitive function and subjective state in 11-13-year-olds: a school-based, randomised, controlled, parallel groups trial

PURPOSE

We tested the acute effect of breakfast (ready-to-eat-cereal [RTEC] and milk) versus (vs.) no breakfast on cognitive function and subjective state in adolescents.

METHODS

Healthy adolescents (n = 234) aged 11-13 years were recruited to take part in this school-based, acute, randomised, controlled, parallel groups trial with two interventions; Breakfast or No Breakfast. The breakfast intervention consisted of ad libitum intake of RTEC (up to 70 g) with milk (up to 300 ml) administered in a naturalistic school breakfast programme environment. Cognitive function was assessed at baseline and + 70 and + 215 min post-intervention in a group-testing situation, similar to a school classroom context. The CANTAB test battery included: Simple Reaction Time (SRT), 5-Choice Reaction Time (5-CRT), Rapid Visual Information Processing (RVIP), and Paired Associates Learning (PAL; primary outcome). Data collection commenced January 2011 and ended May 2011. This trial was retrospectively registered at www.clinicaltrials.gov as NCT03979027 on 07/06/2019.

RESULTS

A significant effect of the intervention (CMH[1] = 7.29, p < 0.01) was found for the number of levels achieved on the PAL task. A significant difference between interventions was found when baseline performance reached level 2 (JT, z = 2.58, p < 0.01), such that 100% of participants in the breakfast intervention reached the maximum level 4 but only 41.7% of those in the no breakfast intervention reached level 4. A significant baseline*intervention interaction (F[1,202] = 6.95, p < 0.01) was found for total errors made on the PAL task, indicating that participants who made above-average errors at baseline reduced the total number of errors made at subsequent test sessions following breakfast consumption whilst those in the no breakfast intervention did not. There was a positive effect of breakfast on reaction time and visual-sustained attention. The results also demonstrated interactions of intervention with baseline cognitive performance, such that breakfast conferred a greater advantage for performance when baseline performance was poorer.

CONCLUSION

Consuming breakfast has a positive acute effect on cognition in adolescents.

Breakfast Consumption Habits at Age 6 and Cognitive Ability at Age 12: A Longitudinal Cohort Study

This study aimed to assess the relationship between breakfast composition and long-term regular breakfast consumption and cognitive function. Participants included 835 children from the China Jintan Cohort Study for the cross-sectional study and 511 children for the longitudinal study. Breakfast consumption was assessed at ages 6 and 12 through parental and self-administered questionnaires. Cognitive ability was measured as a composition of IQ at age 6 and 12 and academic achievement at age 12, which were assessed by the Chinese versions of the Wechsler Intelligence Scales and standardized school reports, respectively. Multivariable general linear and mixed models were used to evaluate the relationships between breakfast consumption, breakfast composition and cognitive performance. In the longitudinal analyses, 94.7% of participants consumed breakfast ≥ 4 days per week. Controlling for nine covariates, multivariate mixed models reported that compared to infrequent breakfast consumption, regular breakfast intake was associated with an increase of 5.54 points for verbal and 4.35 points for full IQ scores (p < 0.05). In our cross-sectional analyses at age 12, consuming grain/rice or meat/egg 6-7 days per week was significantly associated with higher verbal, performance, and full-scale IQs, by 3.56, 3.69, and 4.56 points, respectively (p < 0.05), compared with consuming grain/rice 0-2 days per week. Regular meat/egg consumption appeared to facilitate academic achievement (mean difference = 0.232, p = 0.043). No association was found between fruit/vegetable and dairy consumption and cognitive ability. In this 6-year longitudinal study, regular breakfast habits are associated with higher IQ. Frequent grain/rice and meat/egg consumption during breakfast may be linked with improved cognitive function in youth.

Breakfast and Exercise Improve Academic and Cognitive Performance in Adolescents

This study examined the combined effects of breakfast and exercise on short-term academic and cognitive performance in adolescents. Eighty-two adolescents (64 female), aged 14–19 years, were randomized to four groups over a 4-hour morning: (i) a group who fasted and were sedentary (F-S); (ii) a group who ate breakfast but were sedentary (B-S); (iii) a group who fasted but completed a 30-min exercise bout (F-E); and (iv) a group who ate breakfast and completed a 30-min exercise bout (B-E). Individuals completed academic and cognitive tests over the morning. Adolescents in B-E significantly improved their mathematics score (B-E: 15.2% improvement on correct answers, vs. F-S: 6.7% improvement on correct answers; p = 0.014) and computation time for correct answers (B-E: 16.7% improvement, vs. F-S: 7.4% improvement; p = 0.004) over the morning compared with the F-S group. The B-E group had faster reaction times for congruent, incongruent and control trials of the Stroop Color-Word Task compared with F-S mid-morning (all p < 0.05). Morning breakfast and exercise combine to improve short-term mathematical task performance and speed in adolescents.

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.

Mens Sana in Corpore Sano: Does the Glycemic Index Have a Role to Play?

Although diet interventions are mostly related to metabolic disorders, nowadays they are used in a wide variety of pathologies. From diabetes and obesity to cardiovascular diseases, to cancer or neurological disorders and stroke, nutritional recommendations are applied to almost all diseases. Among such disorders, metabolic disturbances and brain function and/or diseases have recently been shown to be linked. Indeed, numerous neurological functions are often associated with perturbations of whole-body energy homeostasis. In this regard, specific diets are used in various neurological conditions, such as epilepsy, stroke, or seizure recovery. In addition, Alzheimer’s disease and Autism Spectrum Disorders are also considered to be putatively improved by diet interventions. Glycemic index diets are a novel developed indicator expected to anticipate the changes in blood glucose induced by specific foods and how they can affect various physiological functions. Several results have provided indications of the efficiency of low-glycemic index diets in weight management and insulin sensitivity, but also cognitive function, epilepsy treatment, stroke, and neurodegenerative diseases. Overall, studies involving the glycemic index can provide new insights into the relationship between energy homeostasis regulation and brain function or related disorders. Therefore, in this review, we will summarize the main evidence on glycemic index involvement in brain mechanisms of energy homeostasis regulation.

Varying roles of glucoregulatory function measures in postprandial cognition following milk consumption

PURPOSE

Past work suggests milk consumption may facilitate cognition in children and college students with higher fasting glucose compared to other beverages (e.g., fruit juice). However, no studies have evaluated this phenomenon in adults, or considered other measures of glucoregulatory function. This open-label study assessed the role of glucoregulatory function in postprandial cognition after milk intake in adults. We hypothesized participants with lower fasting or post-consumption plasma glucose following a glucose excursion challenge (glucose response) would demonstrate better cognition following beverages of higher (juice) versus lower (milk) or no (water) glycemic content.

METHODS

Forty-four nondiabetic, overnight-fasted adults attended three laboratory visits, ingesting 237 mL of 2% fat milk, apple juice, or water at each visit in a randomized, counterbalanced, crossover design. Participants completed cognitive testing (CNS Vital Signs) at baseline and 30, 90, and 150 min post-ingestion; primary outcomes were CNS Vital Signs composite scores. Fasting and post-consumption plasma glucose levels were assessed, with glucose response indexed as the change in plasma glucose from baseline to 30 min after juice (ΔGlucose).

RESULTS

Mixed modeling revealed participants with higher fasting glucose demonstrated better complex attention after water versus juice at 30 min, but better performance after juice versus water at 150 min (p = 0.02). Participants with a larger ΔGlucose demonstrated better processing speed (p = 0.01) 30 min after milk versus water; this effect also reversed at 150 min.

CONCLUSION

Different methods of measuring glucoregulatory function reveal its differing roles in postprandial cognition. Time since ingestion may also determine which beverages best optimize cognition.

Physical Fitness with Regular Lifestyle Is Positively Related to Academic Performance among Chinese Medical and Dental Students

Objective

The purpose of this study was to examine the relationship between physical fitness, lifestyle, and academic performance of Chinese college students and investigate the differences among medical and dental students on their lifestyle.

Methods

This study was conducted with 316 students enrolled from 2012 to 2014 at Tongji University. Scores from the college physical test were used to represent the students' physical fitness condition. Lifestyle was measured by some variables extracted from the students' behavior data provided by the university's information center. Academic performance was measured by the average score of basic courses and the average score of professional courses. Demographic information, including age, gender, nation, and family background, was also obtained. Separate multiple linear regression analysis was performed for modeling academic performance and physical fitness with a p value threshold of 0.05.

Results

A total of 212 (45.97% females) medical students and 104 (58.65% females) dental students participated in this study. Physical fitness score (medical: r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05. r = 0.34, p value threshold of 0.05.

Conclusion

Physical fitness, library usage, and the regularity of lifestyle are significant contributors to academic performance among Chinese medical and dental students. Moreover, medical students are shown to have less rest time compared to dental students.

The Effect of Eating Habits' Quality on Scholastic Performance in Turkish Adolescents

Evidence associates scholastic performance to quality of eating habits. However, there is limited information on this topic in Turkey, an emerging economy with notable disparities. Our work aimed to evaluate the effect of eating habits quality of high-school students in Turkey, on the Scholastic Aptitude Standardized Examination (TEOG) scores. The study was conducted in 29 different cities in Turkey during the academic year 2016–2017, involving students of ages 14–17 years (up to senior-high school). A dietary habits survey developed and validated for this population was distributed over the internet in February 2017. Apart from students’ TEOG scores, Family Affluence Score (FAS) was used to categorize the students into low, medium, and high financial standing. Eating Habits Score (EHS) was calculated by using a validated scoring system. A working sample of 298 participants was used. Based on our results, we observed that there is a significant positive correlation between EHS, FAS and success rate of students as assessed by TEOG scores. Further research on this subject should be conducted in combination with intervention studies to reveal potential strategies and policies that would enhance positive behavior change as it relates to nutritional habits, aiming at improved scholastic performance and overall health throughout lifespan.

Social-ecological influences on unhealthy dietary behaviours among Moroccan adolescents: a mixed-methods study

OBJECTIVE

To identify the prevalence of unhealthy dietary behaviours and their social-ecological influences in adolescents.

DESIGN

The study used a sequential explanatory mixed-methods design, which begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. Quantitative data were collected via a global school-based student health survey and were analysed using quantitative approaches. Qualitative data were obtained via focus group discussions and were analysed thematically.

SETTING

Middle and high secondary schools in Taza city, Morocco.

PARTICIPANTS

Our quantitative analyses included 764 students (14-19 years). For the qualitative part, seventeen focus group discussions were conducted with 100 participants (fifty-six adolescents, twenty-six parents and eighteen teachers).

RESULTS

Of total student participants, 46·1 % skipped breakfast, 60·6 % had inadequate intake of fruits and vegetables (F&V), 39·4 % consumed soft drinks and 28·0 % consumed fast foods. All of these dietary behaviours could coexist in the same person except for inadequate intake of F&V. Gender, academic performance, age, perceived family income and education level of mother were associated with unhealthy dietary behaviours. Qualitative findings identified seven themes regarding social-ecological influences on adolescents' dietary behaviours: cognitive, affective/biological, lifestyle, outcome expectation, social network, accessibility/availability and macro-level influences.

CONCLUSIONS

The prevalence of unhealthy dietary behaviours in our study group is a concern. Dietary behaviours are the result of inseparable interactions among social-ecological influences. Modifiable factors identified may be useful when designing a future intervention aimed at improving breakfast and F&V consumption and reducing fast/snack-food consumption among adolescents.

Lifestyle Habits Predict Academic Performance in High School Students: The Adolescent Student Academic Performance Longitudinal Study (ASAP)

This study aimed to determine if lifestyle habits could predict changes in cognitive control and academic performance in high school students using a longitudinal approach. One hundred and eighty-seven grade seventh to ninth students (mean age: 13.1 ± 1.0 years old) completed a 3-year prospective study. Lifestyle habits, cognitive control, and academic performance were assessed every year during the 3-year study. Results show that in female students, screen time measures were negatively correlated with academic performance and cognitive control. Furthermore, changes (Δs) in sleeping habits were associated with Δs in academic performance in both genders, whereas Δs in eating habits and in studying time were correlated with Δs in academic performance only in male students. Moreover, in female students, screen time, social media use, and eating habits measures seem to predict the variance in the Δs of cognitive control measures (r² between 8.2% and 21.0%), whereas, in male students, studying time, eating, and sleeping habits appear to explain the variance in the Δs of academic performance measures (r² between 5.9% and 24.8%). In conclusion, results of the present study indicate that lifestyle habits were able to predict Δs in cognitive control and academic performance of high school students during a 3-year period.

Breakfast Nutritional Quality and Cognitive Interference in University Students from Mexico City

Skipping breakfast might have an impact on cognitive functions, such as interference, which is a basic capacity of executive functions that denotes the possibility of controlling an automated response. This study aimed to analyze the association between nutritional quality of breakfast and cognitive interference in a sample of university students. A cross-sectional study was conducted, a total of 422 students between 18 and 25 years participated. Cognitive interference was assessed with the Stroop Test. Breakfast was assessed with a questionnaire assigning a score for each serving of each food group that was consumed. Logistic regression models were performed. The performance in cognitive tasks was slower in those who had a poor breakfast (32.9 ± 6 vs 29.3 ± 6 s, p < 0.050). Poor cognitive interference was greater in students with poor breakfast (53% versus 23%, p = 0.001). A slower word reading was associated with skipping vegetables (OR: 2.78, 95% CI: 0.09-2.13), and cereals (OR: 1.70, 95% CI: 1.03-2.81). Wrong color identification was associated with skipping fruits (OR: 1.55, 95% CI: 1.43-1.99) and animal protein sources (OR: 1.63, 95% CI: 1.07-2.49). Skipping fat-rich cereals was a protector factor (OR: 0.55, 95% CI: 0.36-0.85). Difficulty in the ability to inhibit interference was associated with skipping vegetables (OR: 2.72, 95% CI: 1.25-4.80) and cereals (OR: 2.65, 95% CI: 1.28-4.68). The nutritional quality of breakfast was associated with the time spent answering the Stroop test, but not with cognitive interference.

Comparative Effect of Low-Glycemic Index versus High-Glycemic Index Breakfasts on Cognitive Function: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aims to compare the effect of High-Glycemic Index (GI) versus Low-GI breakfasts on cognitive functions, including memory and attention, of children and adolescents. We systematically searched the MEDLINE (via PubMed), EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science databases, from their inception until June 2019. Articles comparing the effect of Low-GI versus High-GI breakfasts on the cognitive function (i.e., immediate memory, delayed memory, and attention) of children and adolescents were included. The DerSimonian and Laird method was used to compute the pooled effect sizes (ESs) and their respective 95% confidence intervals (CIs). The pooled ESs were 0.13 (95% CI: −0.11, 0.37) for immediate memory and 0.07 (95% CI: −0.15, 0.28) for delayed memory. For attention, the pooled ES was −0.01 (95% CI: −0.27, 0.26). In summary, GI breakfasts do not affect cognitive domains in children and adolescents.

Changing the behaviour of children living in Dutch disadvantaged neighbourhoods to improve breakfast quality: Comparing the efficacy of three school-based strategies

Children's breakfast habits are suboptimal. A novel school-based education programme was developed and tested with the aim of improving children's attitude, knowledge and breakfast quality. A pre- and post-test design was used with four conditions: group-based education, role modelling, tailored feedback with goal setting, and a combination of these three delivery modes. Two hundred eighty children from disadvantaged communities (9.3 ± 0.8 years) participated in three lessons at school over a two-month period. Children's attitude, knowledge and breakfast behaviour were evaluated by a pre- and post-questionnaire completed by the children. A follow-up measure was executed at 24 weeks. The data were analysed by repeated measures ANOVA. At baseline, 90% of the children ate breakfast on the measurement day; 60-76% of the children ate breakfast daily. Between pre- and post-test, a significant time effect was found for children's attitude, self-efficacy, knowledge and behaviour (all p < 0.05). Children in the feedback condition improved most favourably: correct classification of breakfast products increased by 10 products (out of 44) and breakfast quality score improved by 25 points (on a 100-point scale). The feedback condition also resulted in positive changes in the home setting. The follow-up test showed a decline in children's knowledge and their breakfast quality across conditions. To conclude, this study showed that a three-lesson school programme based on individual feedback and goal setting is most effective for changing knowledge on breakfasting and self-reported breakfast quality among children aged 8-10 years living in disadvantaged neighbourhoods. To maintain effectiveness, longer-term programmes embedded in the school curriculum are needed to enhance breakfast quality. Future research should explore the optimal duration and intensity of such programmes and should incorporate the topic of suitable portion sizes.

Reasoning Abilities and Potential Correlates Among Jordanian School Children

Objectives To investigate factors related to reasoning skills in 434 school children aged 5-9 years. Methods The Leiter International Performance Scale-Revised was used to assess reasoning skills. Demographic, work and family income data, information on child's daily behavior and school academic achievement were provided by the participating children's parents. Results Reasoning scores increased by 4.56 points with increasing subject's age, 1.71 points with increasing level of father's occupation, 1.86 points with each increase in the subject's GPA, 1.13 points with consumption of breakfast at home and 1.81 points when child slept more hours. Having a father who smoked and living in a rural area decreased scores in reasoning. Conclusions for Practice Screening of reasoning and associated factors is essential for a comprehensive and accurate understanding of the child's abilities and limitations. Understanding the child's reasoning abilities is critical for establishing intervention goals and planning therapeutic activities.

Neuro-cognitive Ramifications of Fasting and Feeding in Obese and Non-obese Cases

Preliminary studies have claimed that short term fasting would negatively affect school performance and cognition. In contrast some other studies have reported not important decline in cognition and executive function as a result of fasting. Also limited attention was generally devoted to dietetic regimens, nutritional status and body weight. Yet neuroscience and neuro-cognitive aspects of acute hunger on the electroencephalogram and differences between obese and non-obese cases is not well understood. Hence, we decided to design and perform a case study in a more controlled situation similar to reality. Therefore, we performed several examinations including subjective tests (for eating status) and objective tests (cognitive tests such as Stroop effect and Sternberg search and electroencephalogram measures such as steady-state visual evoked potential and auditory steady-state responses) for an obese and a non-obese academic case before and after a simple breakfast. The results showed that the breakfast effects on the neuro-cognitive functions depend on either obesity status, nutritional status of the case or the type of cognitive task (visual or auditory). This paper would open a new insight to answer some important questions about the neuro-cognitive implications of fasting and feeding in obese and non-obese human cases.

Relationship of a Special Acidified Milk Protein Drink with Cognitive Performance: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Young Adults

A previous in vivo study with rats suggested that a special milk protein drink manufactured using an acidification procedure to suppress the aggregation of milk proteins was absorbed quickly after feeding. We performed a randomized, double-blind, placebo-controlled, repeated-measure crossover study to investigate the short-term effects on cognitive performance in 29 healthy young adult men after they consumed this drink in the morning. After an overnight fast, subjects were tested for performance in the Uchida⁻Kraepelin serial arithmetic test and the Stroop test as well as for subjective feeling, body temperature, and heart rate variability before and after consumption of either the acidified milk protein drink or an isoenergetic placebo drink. Subjects showed a significant improvement in performance in the Uchida⁻Kraepelin test, the primary outcome measured, when they consumed the acidified milk protein drink compared with the placebo control condition. In addition, consumption of the acidified milk protein drink, compared with the placebo control, was associated with increases in vagally-mediated heart rate variability indices which, from recent theoretical perspectives, may reflect a higher ability to modulate cognitive and behavioral processes. There was no significant difference in subjective feelings and body temperature between the test drink conditions. These data suggest that consumption of the acidified milk protein drink may improve cognitive performance, with possible involvement of physiological systems that regulate cognition and behavior.

Postprandial effects of breakfast glycaemic index on cognitive performance among young, healthy adults: A crossover clinical trial

Objective: To evaluate the postprandial effects of high and low glycaemic index (GI) breakfasts on cognitive performance in young, healthy adults.Methods: A crossover clinical trial including 40 young, healthy adults (aged 20-40 years, 50% females) recruited from primary healthcare centres in Salamanca, Spain. Verbal memory, phonological fluency, attention, and executive functions were examined 0, 60, and 120 minutes after consuming a low GI (LGI), high GI (HGI), or water breakfast. Every subject tried each breakfast variant, in a randomized order, separated by a washout period of 7 days, for a total of 3 weeks.Results: A significant interaction between the type of breakfast consumed and immediate verbal memory was identified (P<.05). We observed a trend towards better performance in verbal memory (delayed and immediate), attention, and phonological fluency following an LGI breakfast.Discussion: Cognitive performance during the postprandial phase in young, healthy adults was minimally affected by the GI of breakfast. The potential for breakfast's GI modulation to improve short- and long-term cognitive functioning requires further research.

Meal habits and anthropometric indicators in adolescents from public and private schools of the metropolitan region of Rio de Janeiro

ABSTRACT Objective To describe meal consumption habits and assess their associations with anthropometric indicators. Methods A cross-sectional study was performed on 1,749 elementary and high school students from public and private schools in the city of Rio de Janeiro, Brazil (mean age=15.3 years), who were selected for the baseline of the Longitudinal Study for Nutritional Assessment of Adolescents. Meal habits and meals consumed in the company of parents were assessed using a self-administered questionnaire. The consumption of the main meals was categorized as regular (daily) or irregular (≤6 times a week). The meal consumption profile was considered either satisfactory (breakfast, lunch, and dinner consumed on a daily basis) or unsatisfactory. Body Mass Index, waist-to-height ratio, and body fat percentage were calculated. The association between meal consumption habits and anthropometric indicators was estimated using multivariate logistic regression models, adjusted for age and sex and stratified according to the type of school. Results Regular lunch consumption was more frequent among private schools students, who also had higher frequency of eating dinner irregularly. Among students from private schools, the unsatisfactory meal consumption profile and irregular meal habits were associated with being overweight, having a high waist-to-height ratio, and increased body fat percentage. Among students from public schools, it was observed association between being overweight with irregular breakfast habits. Conclusion In adolescents, the association between meal habits and weight status may be modulated by socioeconomic condition.

Breakfast and behavior in morning tasks: Facts or fads?

BACKGROUND

Most of the studies investigating the effects of breakfast on cognitive performance have compared performance in subjects who have or have not consumed this meal. However, characteristics of breakfast itself may influence mental abilities. Moreover, as far as the positive effects of having breakfast is more evident, research may focus on the specific characteristics of an adequate breakfast.

METHODS

To update an existing systematic review, published at the beginning of 2014, on the role of nutrient composition and/or energy intake at breakfast on the accomplishment of school-related tasks and cognition, we carried out a systematic review of the literature through PUBMED database.

RESULTS

From the literature search, we identified 39 papers, of which 2 were eligible according to our inclusion criteria. Both the selected papers concerned randomized crossover studies on the acute effect of breakfast carried out in a school setting in the United Kingdom. Both studies compared 2 iso-energetic breakfasts with a similar macronutrient composition; however, the alternative breakfasts were meant to differ in terms of glycemic index or glycemic load. The effects of breakfast composition were investigated on memory, attention, and information processing in both studies. However, different tests and subdomains were considered.

LIMITATIONS

Studies on these issues are still inconsistent and quantitatively insufficient to draw firm conclusions.

CONCLUSIONS

While the hypothesis of a better mental performance with breakfast>20% daily energy intake still needs confirmation, there does appear to be extra evidence that a lower postprandial glycemic response is beneficial to mental performance.

Skipping breakfast among 8-9 year old children is associated with teacher-reported but not objectively measured academic performance two years later

Background

Skipping breakfast, habitually and when experimentally manipulated, has been linked in the short-term to poorer academic performance in children. Little is known about the longer-term effects. This study examined whether skipping breakfast at aged 8-9 years predicted poorer academic performance and classroom behavior 2 years later.

Methods

The Longitudinal Study of Australian Children (LSAC) collected data during 2008 (aged 8-9 years) and 2010 (aged 10-11 years). Breakfast consumption was reported by a parent/caregiver on three occasions within 4 weeks during 2008: by face-to-face interview and two subsequent questionnaires. Children who skipped breakfast on at least one of the 3 days were classified as breakfast skippers. During 2010, the child’s teacher assessed their academic performance relative to other children in the same grade (below/far below average; average; above/far above average) and classroom behavior. Objective literacy and numeracy outcomes (reading, writing, spelling, grammar and numeracy, score range 0-1000) were obtained via linkage to Australian standardized national assessment program (NAPLAN) data in Year 5 (aged 10-11 years). Ordinal and linear regression were used, adjusted for sex, age and sociodemographic variables.

Results

At baseline, 243 (10.7%) of the 2280 children skipped breakfast on at least 1 day. Two years later, breakfast skippers were more likely to have poorer teacher-reported reading (RR: 1.18; 95% CI: 1.08, 1.29), mathematics (RR: 1.11; 95% CI: 1.02, 1.20) and overall academic achievement (RR: 1.15; 95% CI: 1.05, 1.25) than non-skippers. In contrast, differences in objective NAPLAN scores were small (<3%), and only one of the five scales (numeracy) was significantly lower among skippers (mean difference − 13.0; 95% CI: -25.6, −0.8). Classroom behavior was similar between skippers and non-skippers.

Conclusion

In this national sample of 8-9 year old Australian children, skipping breakfast occurred at low levels, and showed little association with measured academic performance 2 years later. This contrasted with teacher perceptions of lower academic performance among skippers than non-skippers, most likely reflecting confounding. This underscores the importance of using objective measures of academic performance to avoid inflated effect estimates and, potentially, unnecessary and costly population interventions to increase breakfast consumption.

Electronic supplementary material

The online version of this article (10.1186/s40795-017-0205-8) contains supplementary material, which is available to authorized users.

The effects of breakfast on short-term cognitive function among Chinese white-collar workers: protocol for a three-phase crossover study

Background

As the first meal of the day, breakfast plays an important role in supplying energy and nutrients, which are critical to working and learning activities. A three-phase crossover study was designed to investigate the effects of breakfast on cognitive function among Chinese white-collar workers. The planned study protocol is presented.

Methods

A total of 264 participants aged 25–45 years will be recruited from Shenyang and Chongqing. Self-administered questionnaires will be used to collect information on age, gender, marital status, education level, occupation, smoking habits, drinking habits, and breakfast behaviours. The participants will be randomly assigned to 3 equal-sized groups (Groups A, B, and C) and will be provided with a nutrition-adequate breakfast, a nutrition-inadequate breakfast, or no breakfast, respectively. Each participant will receive the breakfast treatment on the basis of assignment to one of three sequences (ABC/BCA/CAB). Each participant will complete a battery of cognitive tests assessing short-term memory, attention, and working memory 120 minutes after breakfast. Mood will be measured through a self-administered questionnaire assessing the dimensions of positive and negative frames of mind. Additionally, fasting blood glucose and postprandial 2-hour blood glucose levels will be tested with a blood-glucose meter (Roche ACCU-CHEK®-Performa). All the participants will take all the tests in three successive weeks, and the order of presentation will be counter-balanced across groups.

Discussion

The present study will be the first investigation of the effect of breakfast food type and quality on cognitive function amongst white-collar workers in China. We predict that a nutrition-adequate breakfast, compared with a nutrition-inadequate breakfast and no breakfast, will significantly improve short-term cognitive function. The results of this study should provide scientific evidence of the effect of breakfast quality on cognitive function and provide scientific data to inform nutrition education strategies and promote a healthy lifestyle.

Trial registration

Chinese clinical trial registry (Primary registry in the WHO registry network) Registration number: ChiCTR-IPR-15007114. Date of registration: August 25, 2015.

Satiety and memory enhancing effects of a high-protein meal depend on the source of protein

OBJECTIVE

High- protein diets have become increasingly popular with various touted benefits. However, the extent to which protein quantity and source affects cognitive functioning through altering postprandial amino acid profiles has not been investigated. Further, whether all protein sources are similarly anorexigenic is uncertain. The objective of this study was to determine the influence of protein level and source on Barnes maze performance, satiety and plasma amino acid levels in male Sprague-Dawley rats.

METHODS

Rats were entrained to a meal-feeding schedule consisting of a 30 minutes meal, equivalent to 20% of average daily intake, one hour into the dark phase then ad libitum access to food for 5 h. On test days, rats received one of three isocaloric diets as their first meal, hereafter referred to as Egg White (EW), Wheat Gluten (WG), or Basal, and then were measured for cognitive performance, feeding behavior, or plasma amino acid levels via jugular catheter. Percentage energy from protein was 35% for both EW and WG and 20% for Basal with equal amounts provided by EW and WG proteins.

RESULTS

Rats provided EW performed similarly to Basal on the Barnes maze, whereas WG performed worse. EW increased satiety, whereas WG reduced satiety relative to Basal. Both EW and WG increased postprandial concentrations of large neutral and branched chain amino acids relative to Basal, but in EW, concentrations were slower to peak, and peaked to a higher level than WG.

DISCUSSION

Results demonstrate the importance of protein source for cognition and satiety enhancing effects of a high-protein meal.

Postprandial effect of breakfast glycaemic index on vascular function, glycaemic control and cognitive performance (BGI study): study protocol for a randomised crossover trial

Background

Postprandial glycaemic response affects cognitive and vascular function. The acute effect of breakfast glycaemic index on vascular parameters is not sufficiently known. Also, the influence of breakfasts with different glycaemic index on cognitive performance has been mostly studied in children and adolescents with varying results. Therefore, the purpose of this study is to analyse the postprandial effect of high and low glycaemic index breakfasts on vascular function and cognitive performance and their relationship with postprandial glycaemic response in healthy young adults.

Methods/design

This is a crossover clinical trial targeting adults (aged 20–40 years, free from cardiovascular disease) selected by consecutive sampling at urban primary care health clinics in Salamanca (Spain). Each subject will complete three interventions with a washout period of one week: a control condition (consisting of water); a low glycaemic index breakfast (consisting of dark chocolate, walnuts, yogurt and an apple, with an overall glycaemic index of 29.4 and an energy contribution of 1489 kJ); and a high glycaemic index breakfast (consisting of bread, grape juice and strawberry jam, with an overall glycaemic index of 64.0 and an energy contribution of 1318 kJ). The postprandial effect will be assessed at 60 and 120 minutes from each breakfast including blood sampling and cognitive performance evaluations. Measurements of arterial stiffness and central haemodynamic parameters will be taken at –10, 0, 15, 30, 45, 60, 75, 90, 105 and 120 minutes.

Discussion

The differences in postprandial glycaemic response due to breakfast glycaemic index could affect vascular parameters and cognitive performance with important applications and implications for the general population. This could provide necessary information for the establishment of new strategies in terms of nutritional education and work performance improvement.

Trial registration

ClinicalTrials.gov: NCT02616276. Registered on 19 November 2015.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1649-x) contains supplementary material, which is available to authorized users.

Association between Eating Behavior and Academic Performance in University Students

OBJECTIVE

To determine the association between academic performance and eating behavior in university students in Chile.

METHODS

A total of 680 college students, 409 (60%) women and 271 (40%) men, were randomly recruited and the mean age of the entire sample was 26. The Three-Factor Eating Questionnaire (TFEQ), which evaluates 3 dimensions of eating behavior-cognitive restriction (limiting own intake), uncontrolled eating (inclination to eat), and emotional eating (control of food intake in the context of negative emotions)-was used. Academic performance was measured by the grade point average (GPA) and was associated with eating behavior.

RESULTS

Women had significantly higher scores in the "emotional eating" dimension than men (p = 0.002). The eating behavior analysis showed that female students with higher GPAs (above 5.5) had statistically significantly lower uncontrolled eating scores (p = 0.03) and higher cognitive restriction scores (p = 0.05) than women with lower academic performance (below 5.5). There were no significant associations between eating behavior and academic performance in men.

CONCLUSIONS

A positive association between eating behavior and academic performance was observed in female university students in Chile. Further studies are needed to explore the causes of this association and determine how to improve the nutritional habits of this population.

Breakfast consumption has no effect on neuropsychological functioning in children: a repeated-measures clinical trial

BACKGROUND

Although many studies have investigated the relation between breakfast consumption and various domains of cognitive functioning within children, some of the reported findings are inconsistent.

OBJECTIVE

We sought to determine the short-term effects of a breakfast meal on the neuropsychological functioning of healthy school-aged children after an overnight fast.

DESIGN

The study was conducted in a clinical research center with the use of a counterbalanced repeated-measures design among children who either consumed breakfast or were fasting. The administered neuropsychological tests included measures of attention, impulsivity, short-term memory, cognitive processing speed, and verbal learning. The sample consisted of children aged 8-10 y (n = 128), of whom 52% were female, 38% were African American, 31% were Hispanic, 28% were white, and 3% were of another race/ethnicity.

RESULTS

There were no significant (P ≥ 0.004) differences between breakfast meal consumption and fasting for any of the neuropsychological measures administered.

CONCLUSION

Breakfast consumption had no short-term effect on neuropsychological functioning in healthy school-aged children. This trial was registered at clinicaltrials.gov as NCT01943604.

Normal weight children have higher cognitive performance - Independent of physical activity, sleep, and diet

BACKGROUND/OBJECTIVES

Aside from the health consequences, observational studies indicate that being overweight may also negatively affect cognitive function. However, existing evidence has to a large extent not controlled for the possible confounding effect of having different lifestyles. Therefore, the objective was to examine the independent associations between weight status and lifestyle indicators with cognitive performance in 8-11year old Danish children.

SUBJECTS/METHODS

The analyses included 828 children (measured in 2011-2012) each having one to three measurement occasions separated by approximately 100days. Dietary intake, physical activity, sedentary time, and sleep duration were measured using dietary records and accelerometers. The Children's Sleep Habits Questionnaire was used to access sleep problems and the Andersen test was carried out to estimate cardio-respiratory fitness (CRF). Weight status (underweight, normal weight, and overweight/obese) was defined according to body mass index and cognitive performance was assessed using the d2-test of attention, a reading test, and a math test. A linear mixed model including a number of fixed and random effects was used to test associations between lifestyle indicators as well as BMI category and cognitive performance.

RESULTS

After adjustment for demographics, socioeconomics, and multiple lifestyle indicators, normal weight children had higher cognitive test scores than overweight/obese and underweight children of up to 89% and 48% of expected learning within one school year (P<0.05). Daily breakfast consumption, fewer sleep problems, higher CRF, less total physical activity, more sedentary time, and less light physical activity were associated with higher cognitive performance independently of each other in at least one of the three cognitive tests (P<0.05).

CONCLUSIONS

Normal weight children had higher cognitive performance compared to overweight/obese as well as underweight children, independent of multiple lifestyle indicators.

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.

Breakfast Intake and Composition Is Associated with Superior Academic Achievement in Elementary Schoolchildren

OBJECTIVE

To determine whether breakfast consumption or content affects academic achievement measured by standardized tests.

METHODS

Baseline data were collected in fall of 2011 from 698 students (50.5% female, age = 7.5 ± 0.6 years) living in the state of Kansas. Academic achievement was assessed using 3 components from the Wechsler Individual Achievement Test (WIAT-III). Prior to taking the WIAT-III, participants completed a breakfast recall of all foods and drinks consumed that morning, which was analyzed using Nutrition Data System for Research (NDS-R). WIAT-III scores were compared between breakfast and non-breakfast consumers in a sample (n = 162) matched for age, sex, race, education level of both parents, household income, body mass index (BMI), and cardiovascular fitness, and Pearson correlations were calculated from all breakfast eaters (n = 617) between test performance and components of the breakfast.

RESULTS

When compared to non-breakfast consumers, the breakfast consumers had significantly higher scores in all 3 WIAT-III components (all p < 0.05). In breakfast consumers, servings of fruit juice were negatively correlated with reading comprehension and fluency standard score and mathematics standard score (both p < 0.0001), and greater servings of whole grains were significantly related to higher scores in reading comprehension and fluency and mathematics (both p < 0.05).

CONCLUSION

Both breakfast consumption and the content may be associated with improved standardized test performance in elementary school students.

Association between breakfast consumption and educational outcomes in 9-11-year-old children

Objective

Breakfast consumption has been consistently associated with health outcomes and cognitive functioning in schoolchildren. Evidence of direct links with educational outcomes remains equivocal. We aimed to examine the link between breakfast consumption in 9–11-year-old children and educational outcomes obtained 6–18 months later.

Design

Data on individual-level free school meal entitlement and educational outcomes (Statutory Assessment Tests (SATs) at Key Stage 2) were obtained via the SAIL databank and linked to earlier data collected on breakfast consumption. Multilevel modelling assessed associations between breakfast consumption and SATs.

Setting

Trial of the Primary School Free Breakfast Initiative in Wales.

Subjects

Year 5 and 6 students, n 3093 (baseline) and n 3055 (follow-up).

Results

Significant associations were found between all dietary behaviours and better performance in SATs, adjusted for gender and individual- and school-level free school meal entitlement (OR=1·95; CI 1·58, 2·40 for breakfast, OR=1·08; CI 1·04, 1·13 for healthy breakfast items). No association was observed between number of unhealthy breakfast items consumed and educational performance. Association of breakfast consumption with educational performance was stronger where the measure of breakfast consumption was more proximal to SATs tests (OR=2·02 measured 6 months prior to SATs, OR=1·61 measured 18 months prior).

Conclusions

Significant positive associations between self-reported breakfast consumption and educational outcomes were observed. Future research should aim to explore the mechanisms by which breakfast consumption and educational outcomes are linked, and understand how to promote breakfast consumption among schoolchildren. Communicating findings of educational benefits to schools may help to enhance buy-in to efforts to improve health behaviours of pupils.