High-Protein and High-Dietary Fiber Breakfasts Result in Equal Feelings of Fullness and Better Diet Quality in Low-Income Preschoolers Compared with Their Usual Breakfast

Effect of Customized Nutritious Breakfast and Nutrition Education on Nutritional Status of Preschool Children in Economically Underdeveloped Multi-Ethnic Areas: A Cluster Randomized Clinical Trial in Linxia, China

The nutritional status of preschool children in economically underdeveloped multi-ethnic areas is a global concern. This study aimed to examine the effect of a 2.2-year cluster randomized clinical trial that provided customized nutritious breakfast and nutrition education to preschool children in Linxia County, China. A total of 578 children aged 3 to 6 years were enrolled. After the intervention, the incidence of undernourishment was significantly lower in the intervention group compared to the control group (8.73% vs. 9.92%, OR = 0.01 [95%CI 0.00, 0.39], p = 0.014). Additionally, children with non-Muslim dietary habits had a lower incidence of undernourishment compared to those with Muslim dietary habits (OR = 0.05 [95%CI 0.00, 0.88]; p = 0.010). The intervention group also had a lower prevalence rate of wasting (OR = 0.02 [95%CI 0.00, 0.40]; p = 0.011) and a higher mean BMI-for-age Z-score (β = 1.05 [95%CI 0.32, 1.77]; p = 0.005) compared to the control group. These findings suggest that providing nutritious breakfast and nutrition education is an effective strategy to improve the nutrition and health of preschool children, particularly in economically disadvantaged regions and among children with Muslim dietary habits.

Changes in Learning Outcomes after Dietary Intervention in Preschoolers: A Pilot Study

The executive functioning skill set, which includes working memory, cognitive flexibility, and inhibitory control, begins developing in early life and continues into adulthood. Preschoolers' abilities to perform those skills may be influenced by diet. The purpose of this study was to explore the acute effects of consuming a low-GI diet compared to the usual childcare diet on preschoolers' self-reported feelings of hunger and fullness and their performance on learning-associated tasks. This study was a prospective feeding trial in n = 20 children 3-4 years of age, completed in a laboratory setting where children attended "day camps" and consumed two days of usual diet (CON) and two days of low-GI (INT) diet. Learning outcomes were evaluated using select learning assessments including the Kansas Reflection-Impulsivity Scale for Preschoolers (KRISP), Track-it, Peg Tapping, and Happy/Sad. Repeated measures, full-factorial analysis of covariance revealed that diet was significantly related to impulsivity (p > 0.05), and univariate analysis of variance indicated that feelings of hunger and fullness differentially affected cognitive constructs in that feeling full improved impulsivity and attention, while feeling hungry improved inhibitory control. These findings highlight that the connection between diet and learning-related skills of children are independently mediated by both diet composition and feelings of hunger and fullness.

How Lifestyle Factors Affect Cognitive and Executive Function and the Ability to Learn in Children

In today's research environment, children's diet, physical activity, and other lifestyle factors are commonly studied in the context of health, independent of their effect on cognition and learning. Moreover, there is little overlap between the two literatures, although it is reasonable to expect that the lifestyle factors explored in the health-focused research are intertwined with cognition and learning processes. This thematic review provides an overview of knowledge connecting the selected lifestyle factors of diet, physical activity, and sleep hygiene to children's cognition and learning. Research from studies of diet and nutrition, physical activity and fitness, sleep, and broader influences of cultural and socioeconomic factors related to health and learning, were summarized to offer examples of research that integrate lifestyle factors and cognition with learning. The literature review demonstrates that the associations and causal relationships between these factors are vastly understudied. As a result, current knowledge on predictors of optimal cognition and learning is incomplete, and likely lacks understanding of many critical facts and relationships, their interactions, and the nature of their relationships, such as there being mediating or confounding factors that could provide important knowledge to increase the efficacy of learning-focused interventions. This review provides information focused on studies in children. Although basic research in cells or animal studies are available and indicate a number of possible physiological pathways, inclusion of those data would distract from the fact that there is a significant gap in knowledge on lifestyle factors and optimal learning in children. In a climate where childcare and school feeding policies are continuously discussed, this thematic review aims to provide an impulse for discussion and a call for more holistic approaches to support child development.

Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES analysis

OBJECTIVE

To investigate protein intakes across demographic characteristics in relation to dietary patterns and functional outcomes in older adults.

DESIGN

Observational and cross-sectional study.

SETTING

Non-institutionalized participants from the 2005-2014 National Health and Nutrition Examination Survey.

PARTICIPANTS

Data from 11,680 adults were categorized into 51-60 years (n= 4,016), 61-70 years (n=3,854), and 71 years and older (n=3,810) for analysis.

MEASUREMENTS

Adults were stratified by meeting or not meeting the protein recommendation (0.8 g/kg/d) to compare demographics, diet quality with Healthy Eating Index-2015, functional limitations, and other dietary intakes. Dietary recalls were collected using the multiple pass method. Data analyses were weighted to create a nationally-representative sample.

RESULTS

Dietary protein intakes were significantly lower in older age groups, with up to 46% of the oldest adults not meeting the protein intake recommendation. Participants consuming protein below the recommended intake level had significantly poorer diet quality across all age groups (P<0.01), however, overall diet quality was better in older adults. Those not meeting the protein recommendation were more likely to have intakes of other nutrients below recommended levels. Those below the protein recommendation had significantly more functional limitations across all age groups, while grip strength was significantly lower in those over 70 years old.

CONCLUSION

Lower protein intakes, and lower diet quality and physical functioning are related in an aging population. Meeting the protein recommendation was linked to better overall diet quality and may be protective of lean mass; therefore, evaluation of individual characteristics which may affect protein intakes is crucial in supporting older adults to meet their protein needs.

Implementing a Health and Wellbeing Programme for Children in Early Childhood: A Preliminary Study

In New Zealand, there is a high prevalence of childhood poverty and food insecurity, which can impact a family’s ability to provide high quality, nutrient dense foods for their children. In an attempt to increase the quality of the food consumed by children attending a decile two (low socio-economic) kindergarten and to address food insecurity issues, an educational health and wellness initiative, in conjunction with a free lunch programme, was introduced. The impact of the lunches and the effectiveness of the programme were evaluated. Baseline and end-intervention 24-h modified dietary recall questionnaire data and a vegetable- and fruit-specific food frequency questionnaire (FFQ) were collected. A follow-up FFQ was administered six months after the end of the intervention. The nutrient composition of the foods recorded in the 24-h recall questionnaires were analysed using FoodWorks8™. Whilst no significant differences were observed with the intakes of individual nutrients, there was a significant decrease in the consumption of ultra-processed snack foods (p = 0.015). The results of the follow-up FFQ, including the comments collected from the parents, suggested that the intervention had a longer-term positive impact on not only the children involved in the study but also on their whānau (wider family members)

Inulin-type fructans and whey protein both modulate appetite but only fructans alter gut microbiota in adults with overweight/obesity: A randomized controlled trial

SCOPE

Independently, prebiotics and dietary protein have been shown to improve weight loss and/or alter appetite. Our objective was to determine the effect of combined prebiotic and whey protein on appetite, body composition and gut microbiota in adults with overweight/obesity.

METHODS AND RESULTS

In a 12 week, placebo-controlled, double-blind study, 125 adults with overweight/obesity were randomly assigned to receive isocaloric snack bars of: (1) Control; (2) Inulin-type fructans (ITF); (3) Whey protein; (4) ITF + Whey protein. Appetite, body composition and gut microbiota composition/genetic potential were assessed. Compared to Control, body fat was significantly reduced in the Whey protein group at 12 wks. Hunger, desire to eat and prospective food consumption were all lower with ITF, Whey protein and ITF + Whey protein compared to Control at 12 wks. Microbial community structure differed from 0 to 12 wks in the ITF and ITF +Whey Protein groups (i.e. increased Bifidobacterium) but not Whey Protein or Control. Changes in microbial genetic potential were seen between Control and ITF-containing treatments.

CONCLUSION

Adding ITF, whey protein or both to snack bars improved several aspects of appetite control. Changes in gut microbiota may explain in part the effects of ITF but likely not whey protein.