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

Katie Adolphus, Alexa Hoyland, Jenny Walton, Frits Quadt, Clare L Lawton, Louise Dye, Katie Adolphus, Alexa Hoyland, Jenny Walton, Frits Quadt, Clare L Lawton, Louise Dye

Abstract

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

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

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

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

Keywords: Adolescents; Breakfast; Cognition; Cognitive function; Randomised controlled trial.

Conflict of interest statement

This study was conducted as part of a Knowledge Transfer Partnership between the University of Leeds and The Kellogg Company funded by ESRC, BBSRC, TSB and The Kellogg Company. The study was funded by additional funding from The Kellogg Company to supplement the ongoing Knowledge Transfer Partnership. Alexa Hoyland is currently an employee of The Kellogg Company. Katie Adolphus and Jenny Walton were previous employees of The Kellogg Company. At the time that the study was conceptualised, designed, and conducted, Alexa Hoyland was an employee of the University of Leeds and was the Knowledge Transfer Associate on the Knowledge Transfer Partnership between the University of Leeds and The Kellogg Company funded by ESRC, BBSRC, TSB and The Kellogg Company. At the time that the study was conceptualised, designed, and conducted, Katie Adolphus was a PhD student funded by the ESRC and the Schools Partnership Trust Academies.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Participant flow chart. RTEC, ready to eat cereal
Fig. 2
Fig. 2
a Number of levels achieved on the PAL task according to intervention pooled across test sessions one and two. Figure shows percentage of participants reaching each level when baseline performance reached level 2 only. b Scatterplot of baseline performance against post-intervention PAL task total number of errors (adjusted) pooled across test sessions one and two by intervention
Fig. 3
Fig. 3
a Percentage of participants who made fewer, more, or no change in the number of errors of no response on SRT relative to baseline pooled across test sessions one and two. SRT Simple Reaction time. b Least Squares Mean ± SE movement time (ms) for 5-CRT according to intervention and test session. 5-CRT 5 choice reaction time

References

    1. Fulford J, Varley-Campbell JL, Williams CA. The effect of breakfast versus no breakfast on brain activity in adolescents when performing cognitive tasks, as assessed by fMRI. Nutr Neurosci. 2016;19(3):110–115. doi: 10.1179/1476830515y.0000000011.
    1. Iovino I, Stuff J, Liu Y, Brewton C, Dovi A, Kleinman R, Nicklas T. Breakfast consumption has no effect on neuropsychological functioning in children: a repeated-measures clinical trial. Am J Clin Nutr. 2016;104(3):715–721. doi: 10.3945/ajcn.116.132043.
    1. Cooper SB, Bandelow S, Nevill ME. Breakfast consumption and cognitive function in adolescent schoolchildren. Physiol Behav. 2011;103(5):431–439. doi: 10.1016/j.physbeh.2011.03.018.
    1. Defeyter MA, Russo R. The effect of breakfast cereal consumption on adolescents’ cognitive performance and mood. Front Hum Neurosci. 2013;7:789. doi: 10.3389/fnhum.2013.00789.
    1. Pivik RT, Tennal KB, Chapman SD, Gu Y. Eating breakfast enhances the efficiency of neural networks engaged during mental arithmetic in school-aged children. Physiol Behav. 2012;106(4):548–555. doi: 10.1016/j.physbeh.2012.03.034.
    1. Godin KM, Patte KA, Leatherdale ST. Examining predictors of breakfast skipping and breakfast program use among secondary school students in the COMPASS study. J Sch Health. 2018;88(2):150–158. doi: 10.1111/josh.12590.
    1. Gibney MJ, Barr SI, Bellisle F, Drewnowski A, Fagt S, Hopkins S, Livingstone B, Varela-Moreiras G, Moreno L, Smith J, Vieux F, Thielecke F, Masset G. Towards an evidence-based recommendation for a balanced breakfast—a proposal from the international breakfast research initiative. Nutrients. 2018 doi: 10.3390/nu10101540.
    1. Adolphus K, Lawton C, Dye L. Associations between habitual school-day breakfast consumption frequency and academic performance in British adolescents: a cross-sectional study. Front Public Health. 2019 doi: 10.3389/fpubh.2019.00283.
    1. Adolphus K, Lawton CL, Dye L. The effects of breakfast on behaviour and academic performance in children and adolescents. Front Hum Neurosci. 2013 doi: 10.3389/fnhum.2013.00425.
    1. Chugani HT. A critical period of brain development: studies of cerebral glucose utilization with PET. Prev Med. 1998;27(2):184–188. doi: 10.1006/pmed.1998.0274.
    1. Thorleifsdottir B, Björnsson JK, Benediktsdottir B, Gislason T, Kristbjarnarson H. Sleep and sleep habits from childhood to young adulthood over a 10-year period. J Psychosom Res. 2002;53(1):529–537. doi: 10.1016/S0022-3999(02)00444-0.
    1. Hoyland A, Dye L, Lawton CL. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev. 2009;22(02):220–243. doi: 10.1017/S0954422409990175.
    1. Adolphus K, Lawton CL, Champ CL, Dye L. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr. 2016;7(3):590S–612S. doi: 10.3945/an.115.010256.
    1. Edefonti V, Rosato V, Parpinel M, Nebbia G, Fiorica L, Fossali E, Ferraroni M, Decarli A, Agostoni C. The effect of breakfast composition and energy contribution on cognitive and academic performance: a systematic review. Am J Clin Nutr. 2014;100(2):626–656. doi: 10.3945/ajcn.114.083683.
    1. Álvarez-Bueno C, Martínez-Vizcaíno V, López EJ, Visier-Alfonso ME, Redondo-Tébar A, Cavero-Redondo I. Comparative effect of low-glycemic index versus high-glycemic index breakfasts on cognitive function: a systematic review and meta-analysis. Nutrients. 2019;11(8):1706. doi: 10.3390/nu11081706.
    1. Adolphus K, Bellissimo N, Lawton CL, Ford NA, Rains TM, Totosy de Zepetnek J, Dye L. Methodological challenges in studies examining the effects of breakfast on cognitive performance and appetite in children and adolescents. Adv Nutr. 2017;8(1):184S–196S. doi: 10.3945/an.116.012831.
    1. de Jager CA, Dye L, de Bruin EA, Butler L, Fletcher J, Lamport DJ, Latulippe ME, Spencer JPE, Wesnes K. Criteria for validation and selection of cognitive tests for investigating the effects of foods and nutrients. Nutr Rev. 2014;72(3):162–179. doi: 10.1111/nure.12094.
    1. Lloyd HM, Green MW, Rogers PJ. Mood and cognitive performance effects of isocaloric lunches differing in fat and carbohydrate content. Physiol Behav. 1994;56(1):51–57. doi: 10.1016/0031-9384(94)90260-7.
    1. Lloyd HM, Rogers PJ, Hedderley DI, Walker AF. Acute effects on mood and cognitive performance of breakfasts differing in fat and carbohydrate content. Appetite. 1996;27(2):151–164. doi: 10.1006/appe.1996.0042.
    1. Hoyland A, McWilliams KA, Duff RJ, Walton JL. Breakfast consumption in UK schoolchildren and provision of school breakfast clubs. Nutr Bull. 2012;37(3):232–240. doi: 10.1111/j.1467-3010.2012.01973.x.
    1. Ingwersen J, Defeyter MA, Kennedy DO, Wesnes K, Scholey AB. A low glycaemic index breakfast cereal preferentially prevents children's cognitive performance from declining throughout the morning. Appetite. 2007;49(1):240–244. doi: 10.1016/j.appet.2006.06.009.
    1. Attwood AS, Higgs S, Terry P. Differential responsiveness to caffeine and perceived effects of caffeine in moderate and high regular caffeine consumers. Psychopharmacology. 2007;190(4):469–477. doi: 10.1007/s00213-006-0643-5.
    1. Wesnes K, Pincock C, Richardson D, Helm G, Hails S. Breakfast reduces declines in attention and memory over the morning in schoolchildren. Appetite. 2003;41(3):329–331. doi: 10.1016/j.appet.2003.08.009.
    1. Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks. J Psychopharmacol. 2006;20(6):771–781. doi: 10.1177/0269881106061516.
    1. Durlach PJ. The effects of a low dose of caffeine on cognitive performance. Psychopharmacology. 1998;140(1):116–119. doi: 10.1007/s002130050746.
    1. Pham AV, Hasson RM. Verbal and visuospatial working memory as predictors of children's reading ability. Arch Clin Neuropsychol. 2014;29(5):467–477. doi: 10.1093/arclin/acu024.
    1. Fanari R, Meloni C, Massidda D. Visual and spatial working memory abilities predict early math skills: a longitudinal study. Front Psychol. 2019;10:246. doi: 10.3389/fpsyg.2019.02460.
    1. Allen K, Higgins S, Adams J. The relationship between visuospatial working memory and mathematical performance in school-aged children: a systematic review. Educ Psychol Rev. 2019;31(3):509–531. doi: 10.1007/s10648-019-09470-8.
    1. Stanislaw H, Todorov N. Calculation of signal detection theory measures. Behav Res Methods Instrum Comput. 1999;31(1):137–149. doi: 10.3758/BF03207704.
    1. Cole TJ, Freeman JV, Preece MA. Body mass index reference curves for the UK, 1990. Arch Dis Child. 1995;73(1):25–29. doi: 10.1136/adc.73.1.25.
    1. Lohman DF, Thorndike RL, Hagen E, Smith P, Fernandes C, Strand S. Cognitive abilities test. 3. London: GL Assessment; 2001.
    1. Hurvich C, Tsai M, Tsai C-L. Regression and time series model selection in small samples. Biometrika. 1989;76(2):297–307. doi: 10.1093/biomet/76.2.297.
    1. Jonckheere AR. A distribution-free k-sample test against ordered alternatives. Biometrika. 1954;41(1/2):133–145. doi: 10.2307/2333011.
    1. Terpstra TJ. The asymptotic normality and consistency of kendall's test against trend, when ties are present in one ranking. Indagationes Mathematicae. 1952;14(3):327–333. doi: 10.1016/S1385-7258(52)50043-X.
    1. Schmitt JA. Nutrition and cognition: meeting the challenge to obtain credible and evidence-based facts. Nutr Rev. 2010;68(suppl_1):S2–S5. doi: 10.1111/j.1753-4887.2010.00329.x.
    1. Wesnes KA. Evaluation of techniques to identify beneficial effects of nutrition and natural products on cognitive function. Nutr Rev. 2010;68(suppl_1):S22–S28. doi: 10.1111/j.1753-4887.2010.00328.x.
    1. Widenhorn-Müller K, Hille K, Klenk J, Weiland U. Influence of having breakfast on cognitive performance and mood in 13- to 20-year-old high school students: results of a crossover trial. Pediatrics. 2008;122(2):279–284. doi: 10.1542/peds.2007-0944.
    1. Pollitt E, Cueto S, Jacoby E. Fasting and cognition in well- and undernourished schoolchildren: a review of three experimental studies. Am J Clin Nutr. 1998;67(4):779S–784. doi: 10.1093/ajcn/67.4.779S.
    1. Pollitt E, Leibel R, Greenfield D. Brief fasting, stress, and cognition in children. Am J Clin Nutr. 1981;34(8):1526–1533. doi: 10.1093/ajcn/34.8.1526.
    1. Ghazi HF, Isa ZM, Aljunid S, Tamil AM, Abdalqader MA. Nutritional status, nutritional habit and breakfast intake in relation to IQ among primary school children in Baghdad city, Iraq, Pakistan. J Nutr. 2012;11(4):379–382.
    1. Lopez-Sobaler AM, Ortega RM, Quintas ME, Navia B, Requejo AM. Relationship between habitual breakfast and intellectual performance (logical reasoning) in well-nourished schoolchildren of Madrid (Spain) Eur J Clin Nutr. 2003;57:S49–S53. doi: 10.1038/sj.ejcn.1601815.
    1. Nasir MTM, Norimah AK, Hazizi AS, Nurliyana AR, Loh SH, Suraya I. Child feeding practices, food habits, anthropometric indicators and cognitive performance among preschoolers in Peninsular Malaysia. Appetite. 2012;58(2):525–530. doi: 10.1016/j.appet.2012.01.007.
    1. Dye L, Blundell J. Functional foods: psychological and behavioural functions. Br J Nutr. 2002;88(2):S187–211. doi: 10.1079/BJN2002684.
    1. Hetherington MM, Cunningham K, Dye L, Gibson EL, Gregersen NT, Halford JC, Lawton CL, Lluch A, Mela DJ, Van Trijp HC. Potential benefits of satiety to the consumer: scientific considerations. Nutr Res Rev. 2013;26(1):22–38. doi: 10.1017/S0954422413000012.
    1. Schmitt JA, Benton D, Kallus KW. General methodological considerations for the assessment of nutritional influences on human cognitive functions. Eur J Nutr. 2005;44(8):459–464. doi: 10.1007/s00394-005-0585-4.
    1. Micha R. The glycaemic potency of breakfast and cognitive function in adolescent school children. London: King's College London; 2008.
    1. Micha R, Rogers PJ, Nelson M. The glycaemic potency of breakfast and cognitive function in school children. Eur J Clin Nutr. 2010;64(9):948–957. doi: 10.1038/ejcn.2010.96.
    1. Kral TV, Heo M, Whiteford LM, Faith MS. Effects on cognitive performance of eating compared with omitting breakfast in elementary schoolchildren. J Dev Behav Pediatr. 2012;33(1):9–16. doi: 10.1097/DBP.0b013e31823f2f35.
    1. Brindal E, Baird D, Danthiir V, Wilson C, Bowen J, Slater A, Noakes M. Ingesting breakfast meals of different glycaemic load does not alter cognition and satiety in children. Eur J Clin Nutr. 2012;66(10):1166–1171. doi: 10.1038/ejcn.2012.99.
    1. Benton D, Maconie A, Williams C. The influence of the glycaemic load of breakfast on the behaviour of children in school. Physiol Behav. 2007;92(4):717–724. doi: 10.1016/j.physbeh.2007.05.065.
    1. Hallström L, Vereecken C, Labayen I, Ruiz JR, Le Donne C, Garcia MC, Gilbert CC, Martinez SG, Grammatikaki E, Huybrechts I, Kafatos A, Kersting M, Manios Y, Molnar D, Patterson E, Widhalm K, De Vriendt T, Moreno LA, Sjostrom M. Breakfast habits among European adolescents and their association with sociodemographic factors: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutr. 2012;15(10):1879–1889. doi: 10.1017/S1368980012000341.
    1. Defeyter MA, Graham PL, Walton J, Apicella T. NEWS AND VIEWS: Breakfast clubs: availability for British schoolchildren and the nutritional, social and academic benefits. Nutr Bull. 2010;35(3):245–253. doi: 10.1111/j.1467-3010.2010.01843.x.

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