Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day

Associations Between Habitual School-Day Breakfast Consumption Frequency and Academic Performance in British Adolescents

Studies indicate that breakfast positively affects learning in children. The present study aimed to examine associations between habitual school-day breakfast consumption frequency and academic performance, as measured by the General Certificate of Secondary Education (GCSE). The GCSE is a national academic qualification obtained by most British children during secondary education. Adolescents aged 16–18 years (n = 294; females: 77.2%) completed a retrospective 7-day food diary to report breakfast intake and a questionnaire to report GCSE grades. Breakfast was defined as any food or drink containing ≥5% of total energy expenditure (TEE) consumed up to 10:00 a.m. on school days. Habitual weekly school-day breakfast consumption frequency was categorized as rare (0–1 school days), occasional (2–3 school days), or frequent (4–5 school days). GCSE grades were aggregated into point scores and linear regression models were applied. Participants' GCSE grades in Mathematics and English were analyzed using ordinal logistic regression. Adolescents who rarely consumed breakfast on school days had a significantly lower capped point score (β = −0.13, p < 0.05) and mean point score (β = −0.14, p < 0.05) compared with frequent consumers. Low/middle socio-economic status (SES) adolescents who rarely consumed breakfast were significantly less likely to achieve higher Mathematics grades compared to low/middle SES adolescents who frequently consumed breakfast [adjusted cumulative odds ratio (OR): 0.35 95% confidence interval (CI): 0.17–0.72]. This cross-sectional study demonstrates that habitual school-day breakfast consumption amongst adolescents is a significant correlate of GCSE attainment. The results offer promising associative evidence which warrants further exploration in well controlled studies

The effects of breakfast on behaviour and academic performance in children and adolescents

Breakfast consumption is associated with positive outcomes for diet quality, micronutrient intake, weight status and lifestyle factors. Breakfast has been suggested to positively affect learning in children in terms of behaviour, cognitive and school performance. However, these assertions are largely based on evidence which demonstrates acute effects of breakfast on cognitive performance. Less research which examines the effects of breakfast on the ecologically valid outcomes of academic performance or in-class behaviour is available. The literature was searched for articles published between 1950-2013 indexed in Ovid MEDLINE, Pubmed, Web of Science, the Cochrane Library, EMBASE databases and PsychINFO. Thirty-six articles examining the effects of breakfast on in-class behaviour and academic performance in children and adolescents were included. The effects of breakfast in different populations were considered, including undernourished or well-nourished children and adolescents from differing socio36 economic status (SES) backgrounds. The habitual and acute effects of breakfast and the effects of school breakfast programs (SBPs) were considered. The evidence indicated a mainly positive effect of breakfast on on-task behaviour in the classroom. There was suggestive evidence that habitual breakfast (frequency and quality) and SBPs have a positive effect on children's academic performance with clearest effects on mathematic and arithmetic grades in undernourished children. Increased frequency of habitual breakfast was consistently positively associated with academic performance. Some evidence suggested that quality of habitual breakfast, in terms of providing a greater variety of food groups and adequate energy, was positively related to school performance. However, these associations can be attributed, in part, to confounders such as SES and to methodological weaknesses such as the subjective nature of the observations of behaviour in class

How can we encourage primary school children to choose and consume high-fibre breakfast products?

Background and Objectives: Increasing fibre consumption is a goal of UK public health nutrition, especially in low socio-economic status (&lsquo;SES&rsquo;) groups, who consume the least fibre [...

Increasing fibre intake in the UK: Lessons from the Danish Whole Grain Partnership

Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public-private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project, and food industry representatives (Food and Drink Federation), this paper examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK’s political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups - which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key ‘success factors’ present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public-private partnerships supported to increase the availability and acceptability of fibre-rich foods

Oily fish consumption in young adults: current intakes, knowledge, barriers and motivations

Background:  Long chain omega-3 polyunsaturated fatty acids (n-3 PUFA) play an important role in the prevention of many health problems, including cardiovascular disease, mental health issues such as depression and neurological malformations during foetal growth. The Scientific Advisory Committee on Nutrition recommends that adults should consume at least two portions of fish per week, one of which (approximately 140 g) should be oily, although there be safe upper levels for intake (SACN, 2004). Despite dietary recommendations, recent surveys suggest only one in four adults eat oily fish regularly and that the average intake in consumers is only 45g week-1, approximately one-third of a portion (Bates et al., 2010). This study aimed to improve understanding of the knowledge, motivations, barriers and information access regarding oily fish in young adults in whom dietary habits may still be developing to inform methods for increasing consumption. Methods:  A self-administered cross-sectional survey was used to collect data from students at the University of Bristol [n = 112, mean (SD) age 20.9 (2.6) years, 75% female]. The survey was developed from two previously validated questionnaires to assess current fish intake, knowledge, motivations, barriers and information access in relation to oily fish consumption . The survey was delivered via the University of Bristol Online Survey system. A chi-squared test was used to test for differences between groups and Spearman's rank correlation coefficient was used to identify associations. Alpha was set at <0.05. Results:  Only 36.6% of participants met the dietary recommendation of eating ≥1 portion of oily fish per week. Where oily fish was eaten, the average portion size was below recommended levels at 106 g. A large proportion of participants lacked specific awareness of the intake recommendations (48.8%) and safe upper levels for women (68.8%) and men (70.5%). Neither the frequency of consumption of oily fish, nor the meeting the dietary recommendation significantly differed by overall knowledge level (χ2 = 18.166, d.f. = 15, P = 0.254; χ2 = 1.913, d.f. = 3, P = 0.591, respectively). The main motivational drivers for fish consumption were liking the taste (77.3%) and knowing the associated health benefits (69.1%). The perceived high price (36.8%), unpleasant smell (38.9%) and dislike of taste (30.5%) were the main reported barriers to consuming oily fish. Other key barriers included a dislike of bones (21.5%) and difficulty with preparation and cooking (19.6%). A dislike of the taste was strongly negatively associated with consumption behaviour (r = -0.372, P = 0.004). Wholly or partially following a vegetarian diet was negatively associated with fish consumption and in turn n-3 PUFA intake (r = -0.286, P = 0.31). The types of information participants said they would most like to receive on fish were recipes (38.4%), details of health benefits (30.4%) and tips on cooking and preparation methods (29.5%). Online routes such as e-mail prompts were the preferred channel of communication for this information. Discussion:  Lack of awareness of the dietary recommendations and health benefits of fish has also been noted in previous studies (Burger, 2008). Previous studies have also reported similar barriers to oily fish consumption (Jones & Cornu, 1994). Together, these findings indicate a need to increase understanding of specific key issues around oily fish intake in young people. They suggest a value of health promotion strategies including electronic routes, that address cost, taste, smell, convenience and preparation and cooking issues including recipes and vegetarian sources of n-3 PUFA alternatives. Conclusions:  Oily fish consumption in young people may be facilitated by using electronic methods to target barriers to consumption, gaps in knowledge and awareness around fish consumption

Singular Spectrum Analysis: An Application to Kenya’s Industrial Inputs Price Index

Time series modeling and forecasting techniques serve as gauging tools to understand the time-related properties of a given time series and its future course. Most financial and economic time series data do not meet the restrictive assumptions of normality, linearity, and stationarity of the observed data, limiting the application of classical models without data transformation. As non-parametric methods, Singular Spectrum Analysis (SSA) is data-adaptive; hence do not necessarily consider these restrictive assumptions as in classical methods. The current study employed a longitudinal research design to evaluate how SSA fist Kenya’s monthly industrial inputs price index from January 1992 to April 2022. Since 2018, reducing the costs of industrial inputs has been one of Kenya’s manufacturing agendas to level the playing field and foster Kenya’s manufacturing sector. It was expected that Kenya’s Manufacturing Value Added hit a tune of 22% by 2022. The study results showed that the SSA (L = 12, r =7) (MAPE = 0.707%) provides more reliable forecasts. The 24-period forecasts showed that the industrial inputs price index remains high above the index in 2017 before the post-industrial agenda targeting a reduction in the cost of industrial inputs. Thus, the industrial input prices should be reduced to a sustainable level.</jats:p