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The relationship between breakfast, academic performance and vigilance in school aged children
Abstract
This research was designed to investigate the relationship between breakfast habits and academic performance and vigilance in upper primary children. The content of breakfast consumed, the frequency of skipping breakfast, gender differences, social impacts and reasons for skipping breakfast in upper primary school children are also examined. There is little Australian research on children's breakfast habits or its relationship with academic performance and vigilance. Hence there is a need for research on this issue in the Australian context.
The study involved 72 children of 5th, 6th and 7th grades from two schools in Western Australia. Data were obtained in three ways (a) the children completed a questionnaire which explored their breakfast habits, (b) the class teachers recorded the classroom performance/grades based on their classroom evaluations, and behaviour of the children based on the observations, and (c) the children were then given three vigilance tasks approximately one and a half hours into the school day. The children were divided into breakfast and no-breakfast groups based on the self-report of breakfast consumption on that day.
The study found that more than half of the children at least sometimes skip their breakfast, with no differences attributed to gender. A number of children reported eating breakfast on the way to school but the proportion of those having a nutritious breakfast on the way to school was almost negligible. Even those having breakfast regularly (55%) might not be consuming a nutritious breakfast. Children reported feeling sleepy, inactive and forgetful as a consequence of skipping breakfast on the day. Reasons offered for skipping mainly had to do with personal choice and convenience, rather than with dieting and concern about body shape. There was no relationship found between breakfast skipping and academic performance and vigilance. Evidence that breakfast skipping affects concentration span of children was found for year 6 and 7 students in the study.
Potential strategies based on the findings of this study are discussed. Providing a nutritious breakfast for children or supplementing their daily diets with fruit are interventions which have the potential to make a significant impact on children's health and well-being. In order to have a nutritious breakfast, children should be encouraged to have breakfast at home before leaving for school as they usually tend to eat a less nutritious breakfast on the way to school or at school. Organizing a breakfast day at school will also promote the importance of having breakfast. Further emphasis on nutrition and healthy eating in schools could make a difference.
... In addiion to studies completed by medical professionals; studies, both longitudinal and short term, from across various academic disciplines, support the noion that adequate nutriion can assist in children's educaional progress. Khan, 2006, suggested that proteins, fats, carbohydrates and other nutrients, such as iron and calcium are essenial building blocks for cogniive development and processing. In essence, nutriion plays a vital role in cogniion and the learning process by acing on molecular systems or cellular processes that are vital for maintaining cogniive funcion [6]. ...
... Khan, 2006, suggested that proteins, fats, carbohydrates and other nutrients, such as iron and calcium are essenial building blocks for cogniive development and processing. In essence, nutriion plays a vital role in cogniion and the learning process by acing on molecular systems or cellular processes that are vital for maintaining cogniive funcion [6]. As such, in response to the supposiion, educaing children in rural schools: does nutriion really mater -the answer is a resounding yes [7]. ...
... Schoolchildren completed a self-report questionnaire consisting of 11 questions exploring their breakfast consumption habits, including the frequency and the types of items consumed (Khan, 2011). The content validity of this questionnaire has been checked and described in an earlier publication (Al Turki et al., 2018). ...
Breakfast is considered the most important meal of the day, especially for schoolchildren. To address the need for data to develop public health policies and programs for children in Saudi Arabia, we aimed to investigate the association between breakfast consumption habits and cognitive/academic performances among primary schoolchildren in Riyadh. A cross-sectional study was conducted among schoolchildren (aged 6 to 12 years), randomly selected from 8 primary schools. Anthropometric measurements were obtained to determine the body mass index (BMI)-for-age percentile. A self-reported questionnaire was used to collect information on their breakfast consumption habits. Cognitive functioning was assessed using the Raven Progressive Matrices test. The academic performance was determined using their scores in three subjects. Statistical analyses were performed using STATA 15 (Stata Corp., College Station, Texas). A total of 384 students were included in this study. The mean (± SD) age of the subjects was 9.1 ± 1.7 years. Sixty percent of the schoolchildren reported consuming breakfast more than 4 times per week. Breakfast consumption was significantly associated with cognitive test scores. Children who consumed breakfast regularly were found to be twice more likely to achieve higher cognitive scores compared to those who were not regular breakfast consumers. A greater percentage of schoolchildren who consumed breakfast regularly
achieved excellent scores in mathematics (78%), science (87%), and Arabic language (98%). However, the difference in the academic performances of regular breakfast consumers and skippers did not achieve statistical significance. In conclusion, the findings of the present study support the hypothesis that regular consumption of breakfast has a short-term positive impact on the cognitive function and performance among young children. Nevertheless, the long-term beneficial effects of having regular breakfast on the academic performances of schoolchildren were not confirmed. School breakfast programs should, therefore, be developed and implemented to promote healthy eating habits among school-age children.
... Breakfast habit was assessed using a self-reported screening questionnaire of 11 questions on the frequency, reasons and effects of skipping breakfast (Khan, 2011). The content validity of the questionnaire was checked using field experts' panel to assess the relevancy of the questionnaire to the outcomes and check the clarity of questions. ...
Evidence suggests that breakfast consumption can enhance cognitive and psychosocial function, academic performance, and school attendance of schoolchildren. In addition, there is some evidence to suggest that children who frequently skip breakfast have a higher risk of being obese compared to those children that regularly consume breakfast. There is a growing body of literature that recognizes the importance of this meal for school children, however, limited number of researches have explored the breakfast habits among Saudi young school children. We assessed breakfast consumption habits, food preferences and student perspectives concerning breakfast consumption among young Saudi female students living in Riyadh city.
A cross-sectional study of 384 female primary school students was conducted in 2016. Four schools each from government and private sector, located in different zones of Riyadh were randomly selected for the study. Age, anthropometric measurements, health status of the students, and information regarding breakfast habits and preferred food choices were collected. Mean and standard deviation (SD) was used to present continuous data. Categorical data was presented in frequencies and percentages. To compare the difference in means, independent t test was also used. Statistical Package for Social Sciences (SPSS version 22) was used for the analysis of data. A p value of less than 0.05 was considered statistically significant.
Eighty-eight percent of schoolchildren reported that they consume breakfast, with only 2% having a regular breakfast more than 4 days a week. The mean (±SD) age of those who consume breakfast was significantly lower than those who usually skipped breakfast. Milk and dairy products and/or carbohydrates were the preferred breakfast food choice of most schoolchildren.
Although that only 12% of the schoolchildren in the sample reported not to consume breakfast, the majority of the rest of the students reported not be frequent breakfast consumers (<4 time per the whole week). The prevalence of breakfast skipping among primary school students statistically increase with age. School health and nutritional programs are recommended to improve dietary practices and nutritional awareness for schoolchildren.
Keywords: Breakfast Consumption, Breakfast food choices, School, Children, Saudi Arabia
This study was carried out to appraise body's health and wellness parameters on students' academic performance in mathematics and sciences. The research design for this study was a descriptive research of the survey type A multi-stage sampling technique was used to collect information from 1800 school students within 3 states in Southwest, Nigeria.. Two instruments used for data collection were Mathematics Achievement Test (MAT) and Standardized Body Measuring devices (SBMD). The face, content and construct validity of the instruments were ascertained, this yielded inter-rater coefficient of 0.76. The reliability of the instrument was calculated using the test-retest which gives 0.78 reliability coefficient. A multi dimensional general question was raised and a multi dimensional hypothesis was postulated at 0.05 alpha levels. The result of the findings shows that the healthier the child the better the academic performance in mathematics. It also reveals that the healthy environment is a sure way for academic propagation in mathematics and science teaching. In light of these findings and considering their implications recommendations were made.
Football athletes require high-quality physical fitness that affects achievement. Nutritional status was the outcome of dietary intake and can influence physical fitness. Athletes who boarded have an organized eating arrangement, so the dietary intake is more assured. The objective of this study was to analyze the differences of energy, macronutrients intake, nutritional status, and V2 max between boarding and nonboarding football athletes aged 13 - 18 years. A cross-sectional study was done in 32 people who divided into two groups (boarding and non-boarding football athletes).The collected datas included food intake using 6x24 hoursfood recalls, height using microtoise, weight using digital scales, BMI for Age using WHO Anthro Plus, body fat percentage using Bioelectrical Impedance Analysis, VO2 max using Cooper Test 2.4 km. Nutrient values were analyzed using NutriSurvey. Statistical analysis using Independent TTest. There were significant differences between energy and macronutrient intake (p=0.001), body fat percentage (p=0.004), and VO2 max score (p=0.001) of boarding and non-boarding athletes. Energy and macronutrient intake of boarding and non-boarding athletes were still in the deficient category; however, the average nutritional intake of boarding athletes were still higher than non-boarding athletes. Most nutritional status of athletes based on BMI/Age were in normal category (87.5% in boarding athletes and 62.5% in non-boarding athletes). There was no over in non-boarding athlete. However, there were 12.5% of boarding athletes in the over fat category. 25% of non-boarding athletes were in the under fat category, while in boarding athletes, none of athlete in under fat category. 62.5% boarding athletes had VO2 max score at a very good level, while 87.5% of non boarding athletes were in enough category. There were significant differences between energy and macronutrient intake, body fat percentage, and VO2 max score between boarding and non-boarding football athletes.
Purpose
The purpose of this review is to examine the effect of nutrition on mental functions of children and adolescents.
Design/methodology/approach
The approach taken is to evaluate published research on key dietary factors, including recent, rigorously designed supplementation studies.
Findings
The result of this analysis is that nutrition has potent effects on brain function. It is concluded that protein, iron, iodine, and the consumption of breakfast all impact on a child’s learning capability and behaviour. Moreover, recent research has identified additional, potent roles of micronutrients, such as essential fatty acids, minerals, and vitamins, in the prevention of learning and behavioural disorders. Among the latter, this review focuses particularly on attention deficit hyperactivity disorder.
Research limitations/implications
While several controlled supplementation trials with supplementation are now available, the limitation of the present analysis is that more large‐scale trials are needed before final conclusions can be reached.
Practical implications
The practical implication of this review for health‐care providers, nutritionists, teachers, and parents at this time is that enough promising evidence has be accumulated to warrant a recommendation to include adequate levels of minerals, vitamins, essential fatty acids, and other nutrients in children’s diets to improve learning and behaviour.
Originality/value
This review is unique in its comprehensive nature and provides a synopsis of the power of diet in influencing learning and behavior for professionals and parents.
This paper reviews two studies that evaluated the school feeding program in Jamaica. The first examined 115 children aged 12-13 y who were enrolled in three classes in a poor, rural school. One class was served the standard school meal at 0900 whereas the other two classes served as controls. The outcome variables included school achievement, attendance, and weight gain. After one semester, the class receiving the meal showed improved arithmetic scores and school attendance compared with the control classes; however, they showed no weight gain. The academic improvement remained significant after school attendance was controlled for. It was therefore hypothesized that the gains in arithmetic resulted from the alleviation of hunger in the classroom. The other study, conducted in a metabolic ward, examined the effects of missing breakfast on cognitive function in 90 children aged 9-10 y and of differing nutritional status. Using a crossover design, the investigators tested each child on two mornings 1 wk apart, once after serving them breakfast and second without. Breakfast, consisting of the school program meal, was served at 0800. When severely malnourished, stunted, or wasted children received no breakfast, their performance in various cognitive tests deteriorated. These results indicate that alleviation of hunger was one of the mechanisms by which school feeding improved academic achievement in the previous study. Undernourished children are more likely to benefit from school feeding programs than are adequately nourished children.
It is hypothesized that giving children a daily breakfast at school may improve their scholastic achievement through several mechanisms: increasing the time spent in school, improving certain cognitive functions and attention to tasks, and, perhaps indirectly, improving nutritional status. Two Jamaican studies showed that providing breakfast to students at school improved some cognitive functions, particularly in undernourished children. However, changes in classroom behavior varied depending on the quality of the school. Children in better-organized schools concentrated on tasks for longer periods and made fewer undesirable movements, whereas in poorly organized schools the children's behavior deteriorated. Studies to date have provided insufficient evidence to determine whether children's long-term scholastic achievement is improved by eating breakfast daily. Well-designed, randomized, controlled, long-term trials are essential for determining public policy on the implementation of school feeding programs.
We examined breakfast consumption patterns and trends between 1965 and 1991 for children (1-10 y old) and adolescents (11-18 y old) in the United States. The analysis was undertaken by pooling nationally representative samples obtained from the Nationwide Food Consumption Surveys of 1965 and 1977-1978 and the 1989-1991 Continuing Survey of Food Intakes by Individuals. Breakfast consumption, defined as the consumption of food, beverage, or both between 0500 and 1000, was the focus of the trends analysis. Descriptive results indicated a decline in breakfast consumption between 1965 and 1991, particularly for older adolescents aged 15-18 y; the rates for boys and girls declined from 89.7% and 84.4%, respectively, in 1965 to 74.9% and 64.7%, respectively, in 1991. Multivariate results indicated that breakfast consumption declined predominantly because of behavioral changes and not the population's changing sociodemographic patterns. The nutritional quality of foods consumed at breakfast has improved since 1965, with significant shifts toward consumption of lower-fat milk and smaller changes in other food groups. The improvement over time in the quality of food consumed at breakfast, however, is offset by the large percentage of persons aged > or = 11 y who do not presently consume breakfast. Given the association of obesity with less frequent breakfast consumption and the rise in obesity among persons of this age group, a renewed emphasis on the importance of breakfast is warranted.
To test the hypothesis that participation in the School Breakfast Program by low-income children is associated with improvements in standardized achievement test scores and in rates of absence and tardiness, children in grades 3 through 6 were studied in the Lawrence, Mass, public schools, where the School Breakfast Program was begun at the start of the second semester 1986-1987 school year. The changes in scores on a standardized achievement test and in rates of absence and tardiness before and after the implementation of the School Breakfast Program for children participating in the program were compared with those of children who also qualified but did not participate. Controlling for other factors, participation in the School Breakfast Program contributed positively to the 1987 Comprehensive Tests of Basic Skills battery total scale score and negatively to 1987 tardiness and absence rates. These findings suggest that participation in the School Breakfast Program is associated with significant improvements in academic functioning among low-income elementary school children.
We examined the effects of omitting breakfast on the cognitive functions of three groups of children: stunted, nonstunted controls, and previously severely malnourished. They were admitted to a metabolic ward twice. After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time. The treatment order was reversed for the other half. When breakfast was omitted, both the stunted and previously malnourished groups responded similarly. The malnourished groups had lower scores in fluency and coding whereas the control group had higher scores in arithmetic. The children were divided into wasted and nonwasted groups. Wasted children were adversely affected in the digit span backwards tests, and wasted members of the malnourished groups were adversely affected in efficiency of problem solving and those in the control group in digit span forwards. These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children.
Neurological patients were presented with a succession of 2-11 stimuli which they were required to count, reporting the number in the series when it finished. The stimuli were binaural clicks, or pulses on the right or on the left index finger. Regardless of stimulus modality or lateralization, patients with lesions involving the right frontal lobe were impaired when the presentation rate was 1/sec. There was no corresponding impairment when the presentation rate was increased to 7/sec. It is argued that at slow rates when the task was monotonous patients with right-frontal lesions were less able than others to sustain attention voluntarily.
School feeding programs exist in many countries, but few have been properly evaluated. In this study, the short-term effects of breakfast on children's cognitive functions were examined. The subjects were 97 undernourished (weight-for-age < or = -1 SD of reference) and 100 adequately nourished (weight-for-age > -1 SD) children in four primary schools in rural Jamaica. The children were randomly assigned to a group provided with breakfast or a group given a quarter of an orange as a placebo, and then given a battery of four cognitive function tests. After a few weeks the treatments were reversed and the tests repeated. Undernourished children's performance improved significantly on a test of verbal fluency when they received breakfast, whereas that of the adequately nourished children did not change (breakfast x group interaction, P < 0.05). There were no other effects of breakfast on test scores. The findings extend those of a previous Jamaican study conducted under more controlled conditions, and support the targeting of school meals to undernourished children.
Two experiments examined the effect of breakfast (1.89 MJ) and caffeine (4 mg/kg) on cognitive performance, mood and cardiovascular functioning. In the first experiment, breakfast had no effect on performance of sustained attention tasks, but it increased pulse rate and influenced mood. The mood effects after breakfast differed between a cooked breakfast and a cereal/toast breakfast. In contrast to the effects of breakfast, this relatively high dose of caffeine improved performance of the sustained attention tasks, increased blood pressure and increased mental alertness. In the second experiment, effects of a breakfast and caffeine on mood and cardiovascular functions confirmed the results of the first study. The breakfast improved performance on free recall and recognition memory tasks, had no effect on a semantic memory task and impaired the accuracy of performing a logical reasoning task. In contrast to this, caffeine improved performance on the semantic memory, logical reasoning, free recall and recognition memory tasks. Overall, these results show that breakfast can improve performance in some but not all cognitive tasks and that these changes are very different from those observed after lunch, and those produced by caffeine.
In order to examine the effect of energy intake at breakfast on school performance the same morning, the parents of ten parallel school classes of 10-year-old school children at five different schools were persuaded to alter their child's breakfast regimen at home over a period of 4 successive days. A total of 195 families were provided with standard breakfasts with either low or high energy content. Uneaten food was returned and weighed. Individual children were randomly assigned to breakfast alternative on any given day. The teachers who carried out the performance assessments at school were blind to treatment condition. Voluntary physical endurance and the performance of a creativity test were significantly better after a breakfast from which children derived over 20% of their recommended daily energy intake than after a breakfast from which they obtained less than 10% of recommended values. The error rate in an addition task was negatively correlated and the rate of working in a number checking task was positively correlated with individual energy intake from the low-energy breakfast. Significantly fewer children reported feeling bad and self-estimates of hunger sensation were lower during the morning at school after the high energy breakfast. Estimates of energy intake at breakfast based on 24-h dietary recall interviews with the children carried out by telephone at their homes showed good correlation with estimates based on returned food (r = 0.89). Energy intake at breakfast as estimated from returned food had no significant effect on energy intake at school lunch as estimated by dietary recall.
The cognitive and behavioural effects of a school breakfast were explored in a study of 55 children in Grade II and Standard 1 at a farm school outside Johannesburg. A previous study had confirmed widespread undernutrition and micronutrient deficiencies among the children. For comparative purposes, 55 children at an inner-city school, among whom no signs of undernutrition were found, were assessed in the same way. Three different types of measures of attention, distractibility, short-term memory and activity level were used: psychometric testing of the children; teacher ratings of children's classroom behaviour, and coded video-recorded classroom behaviour. A pre- and post-test design was employed to assess the effects of a school breakfast, continually in place in the experimental school for a period of 6 weeks. The results indicated significant change from pre- to post-test assessment among the experimental children in respect of the psychometric measures, teacher-rated hyperactivity and video-recorded classroom behaviour. With regard to the latter measure, the children showed a decline in both the occurrence and duration of off-task and out-of-seat behaviour, and an increase in active participation in class and positive peer interaction. While the children in the comparison group also showed some changes from pre- to post-test, probably attributable to the effects of observation, familiarity with the test materials and developmental change, the changes were not generalised or consistent. The findings support the conclusion that a school breakfast programme had a beneficial effect on the cognitive and behavioural performance of socially disadvantaged, undernourished children in their first 2 years of school.
The relationship between breakfast cereal consumption and intelligence was examined in a sample of 205 adults aged between 60 and 79 years. Those who consumed breakfast cereal every day had a higher mean score (38.4) on the National Adult Reading Test, known to correlate highly with intelligence, than that (M = 34.7) for the irregular breakfast eaters (WAIS predicted IQs for breakfast cereal everyday 118 and for irregular breakfast eaters 115).
Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programs, few programs have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < or = -1 SD of the National Center for Health Statistics references) and the adequately nourished group comprised 407 children matched for school and class (weights-for-age >-1 SD). Both groups were stratified by class and school, then randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for 1 school year. Children in the control group were given one-quarter of an orange and the same amount of attention as children in the breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the schools' registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast group. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children's nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programs including health and educational inputs as well as school meals.
Dramatic changes in lifestyles and the environment have brought about significant alterations in children's eating patterns and food choices. Understanding these changes is pivotal if we are to help today's children establish healthy eating patterns, which contribute to the prevention and delay of chronic disease later in life.
This paper describes the most salient environmental factors affecting children's eating patterns and identifies those that appear most amenable to influence through public policy initiatives. A myriad of sociocultural and demographic factors that characterize the U.S. population today have combined to affect what children eat, where children eat, and with whom they eat. What was once mainly in the purview of family decision making is now increasingly in the realm of caregivers and peers, and many eating encounters occur away from home.
Equally important is the plethora of societal and cultural factors that influence children's food intake in the home, schools, institutions, child care settings, health care programs, and the marketplace. American children are given more and more responsibility for making their own food decisions and are constantly exposed to advertising messages about food. Federally sponsored food assistance programs, such as Food Stamps, Child Nutrition Programs, Head Start, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), make positive contributions to the kinds and amounts of food made available to many children.
This paper makes a number of policy recommendations that have the potential to positively influence children's eating patterns and nutritional status. These include:
1.Provide tools to families so that they can provide healthful food choices and facilitate the teaching of sound eating practices to children, by means of (a) promoting partnerships and coordination among government programs, the private sector, and schools to support the family structure, which is pivotal for teaching decision making and self-management of health and nutrition; (b) developing family-school partnerships for teenagers to combat negative peer influences and help parents and adolescents adopt positive health and eating behaviors; (c) reform the welfare system to reward work, bolster parents' academic and job skills, and ensure a decent standard of living that will enable families to provide adequate food and foster healthful eating patterns.2.Reduce fragmentation and lack of coordination among food assistance, public health, social service, and education programs that serve the same target populations.3.Form partnerships with the media to help children improve their eating habits by promoting food choices consistent with recommendations made in Dietary Guidelines for Americans.
An ample supply of healthful foods must be made available to children from which they can choose, and the information base on which these food choices are made must be relevant and sound. By working together in partnerships between public and private sector enterprises, we can make the eating environment more healthful, thus enabling America's children to enjoy better health and well-being.
The article considers the many contributions of school breakfast programs to children's health and academic achievement and also suggests ways in which greater student and school participation in such programs can be achieved. (CB)
Insufficient attention to tasks can result in slips of action as automatic, unintended action sequences are triggered inappropriately. Such slips arise in part from deficits in sustained attention, which are particularly likely to happen following frontal lobe and white matter damage in traumatic brain injury (TBI). We present a reliable laboratory paradigm that elicits such slips of action and demonstrates high correlations between the severity of brain damage and relative-reported everyday attention failures in a group of 34 TBI patients. We also demonstrate significant correlations between self-and informant-reported everyday attentional failures and performance on this paradigm in a group of 75 normal controls. The paradigm (the Sustained Attention to Response Task—SART) involves the withholding of key presses to rare (one in nine) targets. Performance on the SART correlates significantly with performance on tests of sustained attention, but not other types of attention, supporting the view that this is indeed a measure of sustained attention. We also show that errors (false presses) on the SART can be predicted by a significant shortening of reaction times in the immediately preceding responses, supporting the view that these errors are a result of `drift' of controlled processing into automatic responding consequent on impaired sustained attention to task. We also report a highly significant correlation of −0.58 between SART performance and Glasgow Coma Scale Scores in the TBI group.
This paper presents the results of an experiment with 54 elementary school boys in the highlands of Peru that assessed the main effects of breakfast consumption and nutritional status (either at-risk or not-at-risk) on six tests of cognition. The subjects spent two nights at a research center, one week apart, where they were randomly assigned to either a breakfast or a no-breakfast condition on the first morning and to the opposite treatment the second morning. The same test battery was administered at 11:00 am on both occasions. It consisted of three paper-and-pencil tests (Number Discrimination, Peabody Picture Vocabulary and Raven Progressive Matrices) and three computer tests (Stimulus Discrimination, Reaction Time and Sternberg Memory Search). Whereas fasting apparently had no negative effects on the no-risk group, it delayed stimulus discrimination and memory retrieval time among the nutritionally at-risk children. Glucose levels were not associated with test performance for either group under either treatment condition.
In this supplement, the papers presented at the International Symposium on Breakfast and Performance in Napa, CA in 1995 are summarized and integrated with data published since that time. In particular, the focus is on issues of research design, measurements, mechanisms, potential effect modifiers (eg, age), and relevance for public policy. No definitive conclusions can be drawn from the existing data on either the long- and short-term benefits of breakfast on cognition and school learning or the mechanisms that mediate this relation. The pooled data suggest that omitting breakfast interferes with cognition and learning, an effect that is more pronounced in nutritionally at-risk children than in well-nourished children. At the very least, breakfast consumption improves school attendance and enhances the quality of the students' diets.
In the Child Nutrition Act of 1966 it was stated that educational progress was an objective of the United States School Feeding programs. In spite of this fact no serious attempt has ever been made to evaluate whether this objective has been met; the few evaluations that have been conducted lack scientific rigor. As a whole the studies fail to provide a strong basis from which to make valid inferences regarding the long-term effects of the feeding program on school achievement and adaptation. Studies that have focused on the short-term effects of hunger or morning feeding suggest that the provision of breakfast may both benefit the student emotionally and enhance his capacity to work on school type tasks.
This survey examined the processes by which programs feeding hungry children in Canada are initiated, implemented and sustained. The responses of 32 operators of these programs were obtained by semi-structured telephone interviews and were analysed using qualitative research methods. Concerned citizens within the community and teachers were the major proponents for programs; their primary indicators of need were children's hunger-related behaviours. Programs generally provided the breakfast or lunch meal, were overseen by a board, and were operated by a mix of paid and volunteer staff. A lack of resources, problems with parents and the community, and managerial stresses were the main perceived barriers to program continuance. Programs run by communities generally had more need for resources, expressed lower confidence in their sustainability, and were less likely to cooperate with other groups than school-run programs. While some programs deliberately tried to avoid stigmatization, program operators did hold some prejudicial views about the communities they served and few programs could be considered empowering to users.
Effects of breakfast size on blood glucose, mood, short-term memory and concentration were assessed in 319 adolescents (age 13-20 years) in real-life setting. Mean energy increase of 63% over habitual breakfast had no effect on blood glucose or late morning mood. High energy intake from breakfast had a beneficial effect on immediate recall in short-term memory evaluated on the whole sample. However, concentration appeared to be impaired by a high caloric breakfast. There were no differences in the studied parameters according to energy supplement size. The present results are consistent with suggestions that meal size supplement has an effect on cognitive function.
The relationship between breakfast habits and plasma total cholesterol (TC) levels was examined in a sample of 530 US schoolchildren ages 9-19. Based on response to a 124-item food checklist, subjects' usual breakfast habits were classified into one of six discrete categories: 1) Skipper, 2) Ready-to-Eat (RTE) cereal with Fiber, 3) Traditional Breakfast, 4) Chips or Sweets, 5) Other RTE, or 6) Mixed Breakfasts. Breakfast skippers, controlling for age, gender, and body mass index, had significantly (p less than 0.05) higher TC levels, 172 mg/dl, than breakfast consumers, 160 mg/dl. Among breakfast eaters, the mean TC of the "Fiber RTE" group was significantly lower (p less than 0.01) than all other breakfast consumers. Usual skippers were less likely to believe in the importance and benefits of breakfast as well as the need to eat foods high in fiber. These findings suggest that encouraging chronic breakfast skippers to modify their dietary habits may improve their nutritional status and possibly reduce their risk for future heart disease.
We studied cognitive function and metabolic status in a group of healthy adolescents fed the government supplied breakfast (n = 18) versus a control group (n = 16) fed a very low calorie meal. Serum glucose and beta-hydroxybutyrate levels were repeatedly measured at predetermined intervals throughout the testing period. Acute cognitive and mood effect were evaluated in all subjects on a pre-post basis. No significant group differences emerged on a battery of psychological measures that assessed short-term auditory memory, vigilance, impulsivity, and mood. Neither serum glucose or beta-hydroxybutyrate levels correlated significantly with any behavioral measure. Results are discussed in the context of previous studies of nutrition and cognition.
Considerable evidence documents the aggregation of cardiovascular risk factors in children; yet, very little is known about the covariation of children's health practices. Accordingly, using a multivariate and developmental perspective, the present research examines the interrelationships among multiple health behaviors (i.e., physical activity, eating habits, smoking, alcohol use, and stress-related behaviors) in 1,092 predominantly low-socioeconomic status, rural schoolchildren (ages 11-18, grades 6-12). Our data provide support for a multidimensional view of children's health habits and suggest that patterns of interrelationships may vary at different developmental levels. Implications of these results are discussed and directions for future research are highlighted.
Studies of nutritional effects on behavior of children present many of the same methodological problems as studies of drugs on behavior of children. Dependent measures must be made across several classes of response at different time scales and levels of precision. A schema is presented for an integrated series of nutritional studies. The effects of missing breakfast and of simple sugars are used to illustrate several applications from this schema, including autonomic (evoked cardiac response), central (event-related potentials), and behavioral measures. Each class of measures is found to be sensitive to these nutritional manipulations. Attention and motor behavior appear to be quite sensitive to subtle nutritional effects.
The effects of short-term fasting (skipping breakfast) on the problem-solving performance of 9 to 11 yr old children were studied under the controlled conditions of a metabolic ward. The behavioral test battery included an assessment of IQ, the Matching Familiar Figure Test and Hagen Central Incidental Test. Glucose and insulin levels were measured in blood. All assessments were made under fasting and non-fasting conditions. Skipping breakfast was found to have adverse effects on the children's late morning problem-solving performance. These findings support observations that the timing and nutrient composition of meals have acute and demonstrable effects on behavior.
A 1981 survey of 3,309 students in grades 3–12 enrolled in 135 Louisiana schools was used to determine their meal and snacking patterns. The data were analyzed according to three grade divisions: elementary, 3–6; junior high, 7–8; and senior high, 9–12.
An analysis of variance was computed with grade division as the independent variable. Students' responses to questions concerning the consumption of meals, snacks and vitamin supplements, and tasting new, unfamiliar or disliked food were the dependent variables.
A majority of students consumed three meals daily; however, breakfast was frequently skipped. Breakfast was usually eaten at home; 15% ate the school breakfast. Most students consumed the school lunch; many reported tasting new, unfamiliar or disliked food as part of these meals. Students snacked, most doing so in the afternoon. Students in grades 9–12 consumed significantly more snacks than their counterparts. Many snacks were purchased at school, primarily from a concession stand. Almost 50% took a vitamin supplement.
1. The results from two studies are reported of the effects on mental performance of omitting breakfast. The objective of the first study was to compare the performances of schoolchildren who habitually ate or did not eat breakfast. In the second study the effectsof omitting breakfast by those accustomed to eating the morning meal were investigated.
2. Mental performance was assessed by two short-term memory tests (a simple cancellation test in which paired letters were marked on a page of random letters) and a memory-search test in which tines containing a group of specified fetters were marked, a series of numerical additions, and an attention-demanding test (in which specified statements had to be verified).
3. Neither study revealed differences attributable to the omission or consumption of breakfast.
Effects of skipping breakfast on speed and accuracy of response in a number of problem solving tasks were assessed in 9- to 11-yr-old, well-nourished children. The conceptual framework for this study was derived from an experimental model of the effects of mild environmental stress, e.g., noise, on human performance. Plasma glucose, beta-hydroxybutyrate, lactate, and free fatty acids were used as indicators of the induced metabolic stress, and the extent of their association with the behavioral measures was determined. Fasting had an adverse effect on the accuracy of responses in problem solving, but it had a beneficial effect on immediate recall in short-term memory. Both effects are explained by a heightened arousal level associated with the brief experimental fast.
The effects of early supplementary feeding on cognition are investigated using data collected during two periods in four Guatemalan villages. The first was the Institute of Nutrition of Central America and Panama (INCAP) longitudinal study from 1969 to 1977 and the second was a cross-sectional follow-up of former participants carried out in 1988-1989. The principal objective of these studies was to assess the differential effect of two dietary supplements, Atole containing 163 kcal/682 kJ and 11.5 g protein per cup or 180 mL and Fresco containing 59 kcal/247 kJ and 0 g protein per cup, that were given to mothers, infants and young children. Performance was assessed on a battery of psychoeducational and information processing tests that were administered during adolescence. Consistent differences between groups were observed on psychoeducational tests. Subjects receiving Atole scored significantly higher on tests of knowledge, numeracy, reading and vocabulary than those given Fresco. Atole ingestion also was associated with faster reaction time in information processing tasks. In addition, there were significant interactions between type of dietary supplement and socioeconomic status (SES) of subjects. In Atole villages, there were no differences in performance between subjects in the lowest and highest SES categories. On the other hand, performance in Fresco villages was best in the highest compared with the lowest SES group. After close scrutiny of alternative hypotheses, it is concluded that dietary changes produced by supplementation provide the strongest explanation for the test performance differences observed in the follow-up between subjects exposed to Atole and those exposed to Fresco supplementation.
Most of the correlational and experimental studies that have tested the hypothesis that mild-to-moderate protein-energy malnutrition (PEM) has an adverse effect on cognitive development disregarded the potential confounder effect of micronutrients. This omission may have been a critical flaw in study design because it is now recognized that iron deficiency increases the probability of deviations in the trajectory of children's motor and mental development from a normal developmental path. This paper discusses two frequently cited studies on the effects of PEM on neurointegrative and cognitive development and proposes that neither study can discard the hypothesis that effects attributed to protein and energy deficiency are, instead, determined by iron deficiency.
This article reviews selectively the literature on the effects of breakfast on cognition and school performance. The focus is on studies published in refereed journals after 1978 that tested those effects on well-nourished and nutritionally at-risk children. In at-risk subjects (defined by clinical history and anthropometry), a morning and overnight fast had adverse effects on cognition, particularly the speed of information retrieval in working memory. Contradictions in the data from different studies prevent definitive conclusions on whether well-nourished children experience similar functional deficits. Nonetheless, available information suggests that brain function is sensitive to short-term variations in the availability of nutrient supplies. Moreover, well-conducted evaluations suggest that the availability of feeding programs in public schools throughout the academic year increases the probability that children will eat breakfast and improve their educational status.
This paper uses student-level data from the School Nutrition Dietary Assessment Study to examine participation in the National School Lunch Program (NSLP) and the School Breakfast Program (SBP). Among students attending schools offering the relevant program, the NSLP participation rate is 56% and the SBP participation rate is 19%. Students who are certified for free or reduced-price meals are more likely than noncertified students to participate in either program. Among noncertified students, participation is negatively related to meal price. NSLP participation is less likely when the lunch offered contains < 32% of food energy from fat, suggesting that policies designed to drastically reduce the fat in NSLP lunches would also reduce participation. However, the fat content could be reduced somewhat below its current mean amount of 38% of food energy without affecting participation. Finally, the availability of the SBP does not appear to influence the likelihood of students eating breakfast.
The prevalence of breakfast-skipping and inadequate breakfast-eating among schoolchildren in Nova Scotia was determined by surveying 2,500 children in Grades 1 to 3 in 25 randomly selected schools. Breakfast-skipping was measured on two occasions using a validated survey instrument administered by videotaped child entertainers. 4.8% of children came to school without eating or drinking anything on the morning of testing. Breakfast omission was significantly related to grade with 6.1% of Grade 1 children skipping breakfast compared with 3.2% in Grade 3. Boys were significantly more likely to skip breakfast than girls but the absolute differences were small. 86% of children consumed a breakfast including two food groups; 56% three food groups. Adequacy of consumption was poorer in lower grades but did not vary by other sociodemographic variables. Breakfast omission in Nova Scotia children attending Grades 1, 2 or 3 does not warrant a provincial public health response.
Breakfast consumption patterns were assessed for 467 10-year-old children (59% white, 50% girls), who were interviewed in 1984-1985 or in 1987-1988. Consumption patterns were then related to mean daily nutrient intake patterns. More whites (56%) and more girls (46%) ate breakfast at home, whereas more blacks (58%) and more boys (49%) ate breakfast at school. Results indicated that 16% of all children skipped breakfast; the highest percentage was in black girls (24%). Breakfast consumption made a significant contribution to the child's mean daily nutrient intake. The average total energy intake was significantly lower for children who did not consume breakfast (mean = 1,821 kcal) and for children who consumed breakfast at home (mean = 2,098 kcal) compared with children who consumed breakfast at school (mean = 2,326 kcal). A similar pattern was noted for macronutrient contribution. Percentage of total energy from fat was lower in children who did not eat breakfast (34%) compared with those who did (37% to 39%), yet percentage of energy from carbohydrate was higher (53%) in children who did not eat breakfast. Children who skipped breakfast did not make up the differences in dietary intakes at other meals. A higher percentage of children who did not consume breakfast compared with those who ate breakfast did not meet two thirds of the Recommended Dietary Allowance for vitamins and minerals. These data confirm the importance of breakfast to overall dietary quality and adequacy in school-age children.
This study focuses on the effects of breakfast omission on cognitive performance. We studied 279 children from low socioeconomic level background ranging in age from 8 years 7 months to 10 years 11 months, categorized nutritionally as: normal, wasted or stunted. Evaluation comprised three cognitive tasks designed to be applied with a microcomputer. Assessment took place in their natural setting, after a mean of 14 h of overnight fasting, some having received a standard breakfast at random while the remaining children continued a fasting situation. We found no consistent association between study condition and performance in short-term visual memory, problem solving and attention tasks in any of the three nutritional groups. Stunted children showed significantly lower scores in the attention test irrespective of having received breakfast or not. These results suggest that given a motivating short-term task and maintaining routine conditions, missing breakfast does not affect the accuracy of the cognitive performance of children. Nutritionally affected children did not show a particular vulnerability to the fasting condition, but did show a specific cognitive deficit.
Breakfast behaviours of young schoolchildren in the Porcupine Health Unit, Northeastern Ontario were assessed by application of the Halifax Breakfast Survey videotape administered in French or in English to 4,079 children in Grades 1 to 3 in 50 public and separate schools. Six percent of children had come to school without eating or drinking anything on the morning of testing. Breakfast omission was significantly related to grade with 7.5% of Grade 1 children skipping breakfast compared with 5.1 and 5.2% in Grades 2 and 3, respectively. Anglophone schoolchildren were also significantly more likely to skip breakfast than children attending francophone schools. No other sociodemographic predictors of breakfast omission were identified. Eighty-four percent of children consumed a breakfast including at least two food groups, one of which contained protein, while 55% reported the consumption of three food groups. These results are similar to those found in Nova Scotia study conducted in 1992 and raise questions about the need for breakfast programs designed to reduce hunger in the classroom.
Patients with frontal lobe lesions were compared to controls matched for age and education on several tests of sustained attention. One was a simple reaction time task requiring subjects to respond whenever they saw an "X', one was a Continuous Performance Test that required subjects to respond to an "X' but refrain from responding to other letters, and one involved reading a story and responding to a specified target. Patients with right frontal lesions showed longer RTs and missed more targets than control subjects for all three tests. In addition, right frontal patients got worse with time on the CPT. These results suggest a special role for the right frontal lobe in sustaining attention over time.
To study the effect of breakfast timing on selected cognitive functions of elementary school students.
A 2-week randomized control intervention trial.
Five elementary schools.
The subjects comprised 569 children, 51% of them boys, aged 11 to 13 years; the children were in grades 5 through 6 (17 classes). The subjects lived in different areas and had different socioeconomic backgrounds.
Each subject was tested twice, by 2 versions of the Rey Auditory-Verbal Learning Test, 2 alternative forms of the logical memory subtest of the revised Wechsler Memory Scale, and 2 versions of the Benton Visual Retention Test. On the first test, before any nutritional intervention, the subjects were asked to complete a questionnaire about their food intake on the day of testing. Two thirds of the subjects received 200 ml of 3%-fat milk and 30 g of sugared cornflakes for the next 14 days, and all the subjects were reexamined on the 15th day.
Scoring on the different tests was compared with baseline scores.
After 15 days, children who ate breakfast at school scored notably higher on most of the test modules than did children who ate breakfast at home and children who did not at breakfast.
Our results indicate that routinely eating breakfast 2 hours prior to being tested does not improve cognitive functions in 11- to 13-year-old elementary school students, but food supplementation 30 minutes prior to taking a test notably improves scoring. We suggest further studies on the relationship between meal content, feeding time, and scholastic performance.
Sixteen subjects consumed low-fat/high-carbohydrate (LFHC), medium-fat/ medium-carbohydrate (MFMC), high-fat/low-carbohydrate (HFLC) iso-energetic breakfasts and no breakfast in a counterbalanced order on four separate days. The LFHC breakfast was similar in macronutrient composition, though not in meal size (more kcal) and types of foods offered, to the habitual breakfast of the subjects. A battery of cognitive performance tasks together with mood and appetite ratings were completed before and during the 3 h following breakfast. Results showed no clear differences in performance between the four dietary conditions, but significant effects on mood were observed. Mood improved (a decline in fatigue/dysphoria) following the LFHC breakfast compared to the other meals. The findings show that the macronutrient content of breakfast, independent of energy value and oro-sensory qualities, can exert small but reliable effects on subsequent mood, and suggest that deviation from habitual meal composition can produce a relative decline in mood state. These conclusions are supported by results from a previous study of the effects of lunch which found very similar relationships between meal composition, habitual choices and postprandial mood changes.
To determine if a relationship exists between participation in a school breakfast program and measures of psychosocial and academic functioning in school-aged children.
Information on participation in a school breakfast program, school record data, and in-depth interviews with parents and children were collected in 1 public school in Philadelphia, Pa, and 2 public schools in Baltimore, Md, prior to the implementation of a universally free (UF) breakfast program and again after the program had been in place for 4 months. One hundred thirty-three low-income students had complete data before and after the UF breakfast program on school breakfast participation and school-recorded measures, and 85 of these students had complete psychosocial interview data before and after the UF breakfast program. Teacher ratings of behavior before and after the UF breakfast program were available for 76 of these students.
Schoolwide data showed that prior to the UF breakfast program, 240 (15%) of the 1627 students in the 3 schools were eating a school-supplied breakfast each day. Of the 133 students in the interview sample, 24 (18%) of the students ate a school-supplied breakfast often, 26 (20%) ate a school-supplied breakfast sometimes, and 83 (62%) ate a school-supplied breakfast rarely or never. Prior to the UF breakfast program, students who ate a school-supplied breakfast often or sometimes had significantly higher math scores and significantly lower scores on child-, parent-, and teacher-reported symptom questionnaires than children who ate a school-supplied breakfast rarely or never. At the end of the school term 4 months after the implementation of the UF breakfast program, school-supplied breakfast participation had nearly doubled and 429 (27%) of the 1612 children in the 3 schools were participating in the school breakfast program each day. In the interview sample, almost half of the children had increased their participation. Students who increased their participation in the school breakfast program had significantly greater increases in their math grades and significantly greater decreases in the rates of school absence and tardiness than children whose participation remained the same or decreased. Child and teacher ratings of psychosocial problems also decreased to a significantly greater degree for children with increased participation in the school breakfast program.
Both cross-sectional and longitudinal data from this study provide strong evidence that higher rates of participation in school breakfast programs are associated in the short-term with improved student functioning on a broad range of psychosocial and academic measures.
Eating breakfast is important for the health and development of children and adolescents. This paper reports on the findings of an Australian survey of 699 thirteen-year-olds concerning the extent of skipping breakfast. Results indicated that approximately 12% of the sample skipped breakfast. Gender was the only statistically significant sociodemographic variable, with females skipping at over three times the rate of males. Skippers were more likely to be dissatisfied with their body shape and to have been on a diet to lose weight than were those who ate breakfast. However, in a follow-up telephone survey, the reasons given for skipping breakfast were almost exclusively lack of time and not being hungry in the morning. While North American school nutrition programs have considered poverty to be a key issue in breakfast skipping, these findings suggest that, for Australian adolescents, skipping breakfast is a matter of individual choice.
This study analyzed, through case studies of day-to-day observations and interviews with recipients and operators, the operations of nine children's feeding programs in Nova Scotia, New Brunswick, and Newfoundland. We found that children's feeding programs result in the stigmatization of participants and families, despite an ideology of equality. Most programs adopt a family substitution role in the lives of children they serve and function in a way that excludes parental participation. Programs also transmit a hidden curriculum to children that teaches them how to behave and how a 'proper' family functions. We found that the professionalization of food and nutrition, a desire for an expanded client base, and dependency creation through the provision of other material goods, permit programs to exert increasing institutional control over recipients, a process we, following Illich, call the dragnet. While these programs may be meeting some nutritional needs in a few poverty-stricken children, they ultimately reproduce, rather than reduce, inequities.
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CCSD (1999). Child Poverty, Canada and the Provinces [Online]. Canadian Centre for Social
Development. Available: http://www.ccsd.ca/fs_cp95.htm
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Food for Thought, Community Partners Program. Survey results from local school nutrition programs in Halton
HSPCVC (1999). Food for Thought, Community Partners Program. Survey results from local school
nutrition programs in Halton. Halton Social Planning Council & Volunteer Centre. Burlington,
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Nutritional issues for low-income children. Better beginnings, better futures
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