The following is an extract of paediatric dietitian Nicole Dos Santos' thoughts on the vital role of breakfast in brain growth and development from the January/February 2012 edition of Journal of Family Health Care - to read the article in full,subscribe here
Breakfast is always referred to as the most important meal of the day, particularly for mental health development in the young. But in an era where the emphasis is on evidence based medicine, does science support this notion and, furthermore, is any breakfast better than none?
Are children's breakfast habits a cause for concern?
Although the majority of UK children eat breakfast, the number that miss breakfast is increasing with more than a tenth of 0 to 10 year olds and almost one-fifth (19 per cent) of 11 to 16 year olds regularly missing breakfast. This mirrors global trends with 25 per cent of US children and 10-30 per cent of European children reported to miss breakfast. A 2005 review of US and European studies has reported that up to 42 per cent of children and adolescents don't eat a regular breakfast.
Children's brains are exceptionally active with a metabolic rate twice that of adults. The preferred brain fuel is glucose, which means that during fasting periods when the child is asleep the brain has to rely heavily on glucose stores - muscle glycogen.
Compared to adults, children's muscle mass is significantly smaller and they tend to sleep for longer periods - resulting in glycogen stores being more readily depleted by the morning.
Fuelling the brain for higher IQs?
The evidence to date clearly demonstrates an association between breakfast consumption in children and adolescents with improved cognitive function, school performance and mood.This was confirmed by a review of 45 studies, which concluded that breakfast consumption had an overall positive effect on cognitive function compared to breakfast omission. The improvement in cognitive function was demonstrated in short-term trials and longer-term school breakfast programme (SBP) studies. These findings reflect the conclusion of an earlier review of 47 studies.
School Breakfast Programmes
Thirteen studies investigating the impact of SBP demonstrate provision of breakfast in schools to improve significantly cognitive function, mood, school performance and attendance. It is difficult to come to an overall conclusion from SBP studies as there are several confounding factors; individuals who attend SBPs will have a learnt association between breakfast consumption and learning, have better school attendance and less likely to be late for class, all of which will influence cognition and school performance.
Low versus high GI choices
To date, studies comparing the type of breakfast consumed rather than just consuming vs not consuming breakfast are few. Such studies have mainly compared breakfast of varying glycaemic index (GI) or glycaemic load (GL). GI reflects the rate at which glucose levels rise in the blood stream - low GI breakfasts result in a steady and longer rise in blood sugar whilst high GI breakfasts result in a rapid rise in blood sugar followed quickly by a rapid drop. Theoretically, low GI breakfasts, which provide a steady stream of fuel to the brain, are preferred. GL Index goes one step further and takes into consideration quality of carbohydrate and impact on blood glucose (GI) as well as the quantity (serving size) of carbohydrate consumed at breakfast (the higher the carbohydrate load the bigger the overall glucose rise).
Cognitive function in relation to breakfast
The underlying mechanism for breakfast's impact on cognitive function remains unclear, but providing adequate glucose energy to meet children's high cerebral metabolic rate is important. Other factors resulting from an elevated blood glucose level through the provision of breakfast may also positively influence cognition: acetyl choline, insulin, serotonin, glutamate and cortisol levels which also impact on cognitive function.
Are ready-to-eat breakfast cereals credible brain fuel?
Walking down the local supermarket breakfast cereal aisles, we cannot ignore the huge choice of brightly packaged cereals targeted at the young. And this is reflected in market data, where ready-to-eat (RTE) breakfast cereals are the most popular breakfast food for children, with 95 per cent of UK households spending some £1.8 billion in 200814,15,16. For some time breakfast cereals have gained bad press for their sugar and salt content. However, looking at the evidence and continuing manufacturer product re-formulations, breakfast cereals are proving to be an increasingly credible breakfast option.
Although we are still not certain of the perfect brain breakfast option, the scientific evidence is convincing that providing a solid breakfast is important for fuelling the minds of our nation's future generation. For parents and carers needing practical solutions for providing a well balanced breakfast for their children, whole grain RTE breakfast cereals are a good option, providing credible brain fuel and contributing significantly to the overall nutrition and health status of our young.
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