The effects of breakfast on cognitive and academic performance in children: Findings from two systematic reviews.
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1 The effects of breakfast on cognitive and academic performance in children: Findings from two systematic reviews Dr Katie Adolphus
2 Background: Why bother with breakfast? Modifiable Higher brain glucose metabolism Longer overnight fast Dietary habits
3 Is breakfast the most important meal?
4 Breakfast or no breakfast: What does the evidence show?
5 Systematic reviews of the literature: Overview Breakfast & Cognitive Performance Breakfast & Academic Performance SRR 1: Effects of breakfast consumption vs. omission and breakfast type on cognitive performance in children and adolescents 1. Acute effects of breakfast vs. no breakfast on cognitive performance 2. Acute effects of breakfast composition on cognitive performance 3. Chronic effects of SBPs on cognitive performance SRR 2: Effects of breakfast consumption vs. omission and breakfast type on academic performance in children and adolescents 1. Association between habitual breakfast consumption and academic performance 2. Chronic effects of SBPs on academic performance
6 Results: Acute effects of breakfast vs. no breakfast 24 Studies vs.
7 Results: Acute effects of BF vs. no BF Overall advantage of breakfast vs. no breakfast Transient beneficial effect on cognitive function Post-ingestion effects +10 min to +210 min Range of energy loads (95 Kcal 590 Kcal) and foods Observed effects: enhancement and maintenance of performance Domain specific effects Attention, memory, and executive function Undernourished children Positive effects more apparent in undernourished children
8 Proportion of correct responses Stroop Task Results: Acute effects of BF vs. no BF Examples from the literature Cooper et al. (2011) UK School-based Crossover RCT n= year olds 55% HBC Ad-libitum breakfast: RTEC, bread, yoghurt, fruit, juice Mean intake: 500 kcals, 90g CHO; 11.6g PRO; 9.5g FAT Effect: Maintenance of performance Breakfast (upon arrival at school)
9 Hard word recall % correct Results: Acute effects of BF vs. no BF Examples from the literature Defeyter & Russo (2013) UK School-based Crossover RCT n= year olds Breakfast skippers Fixed RTEC breakfast: All bran and milk 162 kcals, 22.7g CHO; 9.4g PRO; 1.2g FAT Effect: Enhancement of performance Breakfast No breakfast 8:00am Breakfast 8:30am Time 10:45am
10 Results: Acute effects of breakfast composition 15 studies vs. vs.
11 Results: Acute effects of BF type Inconclusive Comparisons: differing GI/GL, energy, high CHO vs. high PRO Few studies and inconsistent findings Possible GI effects? Emerging evidence that low GI/GL is more beneficial Suggests that the post-prandial blood glucose profile may mediate the effects But problematic study designs, few and inconsistent findings
12 Results: Acute effects of BF type Ingwersen et al. (2007) GI comparison, not isocaloric UK School-based Crossover RCT n= year olds Coco-pops (HGI) and milk: 133 kcal, 1.6g PRO, 0.9g fat, 29.8g CHO All bran (LGI) and milk: 98kcal, 4.9g PRO, 1.6g fat, 16.1g CHO Secondary memory factor scores
13 Results: Chronic effects of SBPs 11 studies
14 Results: Chronic effects of SBPs Inconclusive Few studies and inconsistent findings Limited effects on cognitive outcomes Unclear if effects are related to breakfast or the SBP regimen. Not a true test of breakfast per se.?
15 Results: Chronic effects of SBPs Cueto and Chinen (2008) Peru Matched school comparison 20 schools n=590, 12 year olds 70% undernourished Government SBP Fortified milk-like drink and 6 biscuits 600 kcal, 19.5 g PRO, 20 g fat 60%-100% of daily requirement of various micronutrients Picture recognition (immediate recall)
16 Adolphus, K., Lawton, C. L., Champ, C. L., & Dye, L. (2016). The Effects of Breakfast and Breakfast Composition on Cognition in Children and Adolescents: A Systematic Review. Advances in Nutrition, 7(3), 590S-612S. doi: /an
17 Breakfast & Cognitive Performance Breakfast & Academic Performance SRR 1: Effects of breakfast consumption vs. omission and breakfast type on cognitive performance in children and adolescents 1. Acute effects of breakfast vs. no breakfast on cognitive performance 2. Acute effects of breakfast composition on cognitive performance 3. Chronic effects of SBPs on cognitive performance SRR 2: Effects of breakfast consumption vs. omission and breakfast type on academic performance in children and adolescents 1. Association between habitual breakfast consumption and academic performance 2. Chronic effects of SBPs on academic performance
18 Results: Associations between HBC and academic performance 15 studies
19 Results: HBC and academic performance Positive association between HBC and academic performance HBC frequency was positively associated with academic performance Some evidence that HBC composition is related to academic performance Subject specific effects Mathematics grades or test scores Consistent across all socio-demographic groups The effects were not modulated by socio-demographic characteristics
20 Results: HBC and academic performance Lien (2007) Norway Cross-sectional study n=7306, years Questionnaire to assess HBC frequency (days/week) Self report school grades
21 Results: Chronic effects of SBPs 10 studies
22 Results: Chronic effects of SBPs SBPs have a positive effect on children s academic performance SBPs tended to have positive effects on academic performance However, few good quality studies Can not attribute the effects directly to the breakfast meal Advantageous effects were not universal Type of school SBP model
23 Adolphus, K., Lawton, C., & Dye, L. (2013). The effects of breakfast on behaviour and academic performance in children and adolescents. Frontiers in Human Neuroscience, 7(425). doi: /fnhum
24 Take away messages Cognitive performance Breakfast consumption (vs. no breakfast) has a modest shortterm beneficial effect on cognitive function measured within 4 hours post-ingestion. Academic performance Habitual breakfast consumption frequency is positively related to academic performance SBPs are associated with better academic performance. The findings need to be treated with caution until they are supported by further observational studies or well controlled RCTs to verify possible causal relationships
25 Thank you
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