NEWS | September 19, 1995

RESEARCHERS FIND BREAKFAST CRITICAL TO PERFORMANCE

(SACRAMENTO)

Research scientists from around the world, led by Ernesto Pollitt, Ph.D., professor, Department of Pediatrics, University of California, Davis, recently announced they have reached a consensus that recognizes the importance of breakfast to learning, memory and physical well-being in both children and adults.

“Our studies to date show that breakfast really does get us off to a better start,” Pollitt said. “The first meal of the day especially helps children in school and allows them to cope with the demands of their school work.”

 The consensus document, based on the researchers’ review of the science, points out that:

•  Skipping breakfast is costly, particularly for children. Children who skip breakfast are not as efficient in the selection of critical information for problem solving as their peers who have had breakfast. The ability to recall and use newly acquired information, verbal fluency and their control of attention are principally affected. Both undernourished and well-nourished children experience these effects.

•  The importance of breakfast for cognitive functions also has been demonstrated in young adults and the elderly. Research unraveling the role of breakfast on mental performance has found that glucose levels are associated with memory function. Brain function is sensitive to variation in the immediate availability of nutrient supply and energy.

•  School breakfast feeding programs are beneficial to nutrient intake, school attendance and academic performance. These programs represent a public health intervention that promotes the well-being of children and improves the efficiency of the educational system in developed and developing countries.

•  The benefits of breakfast and the consequences of missing breakfast need to be recognized. Policies that promote public health and encourage related agricultural programs need to be addressed.

The scientists released the consensus document following a three-day summit in which they reviewed new and important findings on breakfast and performance from studies conducted around the world. The group represented a variety of fields, including nutrition, psychology and the neurosciences. Officials from the World Bank and policy-making organizations in the United States joined the other symposium participants.

TEXT OF THE STATEMENT FOLLOWS BELOW:

CONSENSUS STATEMENT: BREAKFAST AND PERFORMANCE

 Breakfast is commonly the first meal of the day following an overnight fast. "Breaking the fast" has long been promoted as a healthy way to start the day.  The "Breakfast and Performance" symposium explored what is known about the contribution of the first meal of the day to health and performance.
Importance of Breakfast in School-Age Children
 Skipping breakfast is costly for children. In mid- or late morning, children who skip breakfast are not as efficient in the selection of critical information for problem solving as their peers who have had breakfast. The ability to recall and use newly acquired information, verbal fluency and creativity are particularly affected by skipping breakfast. These alterations of cognitive function are part of the moderate metabolic stress that children experience following an overnight and morning fast. These observations are valid for undernourished and well-nourished children.
 While not all results from experiments can be applied to real-life situations, the recognition that skipping breakfast affects both simple and complex cognitive processes is critical for learning in the classroom. In agreement with these observations, evaluations suggest that participation in feeding programs in the United States and in other developed and developing countries is beneficial to school achievement. The benefits are particularly significant among those children with a poor nutritional history. School breakfast feeding programs can make an important contribution to nutrient intake, nutritional status and school performance. These programs also have been shown to improve attendance, a problem of concern in many schools.
 Children are engaged in learning activities that will  impact their adult lives and, thus, the societies in which they live. This is one of the many reasons to eradicate malnutrition which, even in its milder forms, causes delayed cognitive development and increased educational failure. The impact of nutrition on cognitive performance in children is recognized by child-development specialists, educators, nutritionists and dietitians.
Importance of Breakfast to Nutrition and Health
 In developed and developing countries around the world, public health policy is concerned not only with inadequate nutrient intake, but also with a rising incidence of obesity. A breakfast meal, including grain-based foods such as cereal, toast, fruit and milk, contributes to a healthy diet as defined by current dietary guidelines. Eating patterns that foster improved health through ideal body weight, reduced-fat intake and increased vitamins and minerals include a healthy breakfast.
Importance of Breakfast for Children
 In populations where calories and nutrients are scarce, a nutritionally appropriate breakfast, delivered in the school, has been shown to improve daily nutrient intake when managed and sustained over time. Breakfast often plays an important role by providing a mechanism to satisfy the child's caloric and nutrient requirements. If well administered, a breakfast program providing adequate energy, iron, calcium, folate, thiamin and vitamin A is an important investment in human capital, in both developed and developing countries.
 Childhood obesity is an increasing public health concern in many parts of the world. Children who skip breakfast are almost twice as likely as breakfast eaters to be overweight. Breakfast is, thus, a healthy habit with beneficial effects on aspects of both physical health and cognitive performance of children. Consumption of breakfast has been studied in many national nutrition surveys and demonstrates the importance of a morning meal, including ready-to-eat cereals, to the nutritional adequacy of children's diets.
 However, representative U.S. nutrition surveys shows a decline in breakfast consumption among children between 1965 to 1991; this decline was strongest in girls age 15 to 18 (85 percent in 1965 to 65 percent in 1991). This decline also was demonstrated in the study of 10-year-old children in Bogalusa, which began in 1973. In this study, introduction of a school  breakfast feeding program in 1988 stopped this decline and has increased the consumption of breakfast.
Importance of Breakfast for Adults
 The benefits of breakfast on mental performance observed in school children have also been demonstrated in young adults and the elderly. Adults of both working and retirement age are concerned with mental performance. People in the global work force strive to increase their productivity while maintaining physical and mental well-being. The role of a well-balanced diet in preventing chronic disease becomes increasingly apparent over the course of the life span. 
 Experimental evidence suggests that breakfast may have important effects on cognitive performance throughout life. Research unraveling the mechanisms for the effects of breakfast on cognition has observed that in adults from 18 to 80 years of age, a carbohydrate source resulted in improved ability to retell a short story, as well as improvements on other aspects of cognitive function. These studies are suggestive of the importance of  breakfast in contributing to optimized brain function.


Implications for Public Health Policy
  Concerns about cognitive function are a growing part of public health policy. Policy-makers are charged with establishing programs that enhance the quality of life for populations around the world. Concerns about rising health care costs, the unfulfilled development of human resources and the need for economic stability foster the development of policies and programs that promote public health and encourage related agricultural policies. In that context, the importance of  breakfast and the consequences of missing breakfast need to be recognized and acted upon. Initiatives such as public dietary guidelines and school nutrition programs should include information about  breakfast in an effort to improve the quality of life for world populations.
 The value of school breakfast feeding programs in a number of developing countries is often limited due to a variety of implementation problems. These problems may be anticipated based on past experience and should be taken into consideration in the planning and budgeting of such programs.
Future Research Agenda
 Further research is needed on both the short- and long-term effects of breakfast. A better understanding for the cognitive effects observed within several hours to several days is needed concerning the optimal composition and timing of breakfast. Experiments should be conducted to identify the effects of gender, race and age using tasks and settings that reflect the needs of school, work and society. This research should include factors such as biochemical markers and nutritional status that may mediate the effects. Intervention studies on the importance of breakfast to the health and success of adult populations are lacking.
 Longitudinal studies are needed to investigate the effects of breakfast on school performance and nutritional status in both developed and developing countries. This research should include evaluations of how school  feeding works under well-controlled conditions as well as under the operational constraints of large-scale government programs. In an effort to address these research needs, the U.S. Department of Agriculture recently announced that, as part of its collaboration with the U.S. Department of Education in establishing a collaborative nine-year study, it will evaluate the long-term effects of school breakfast participation on academic performance. Evaluations of smaller programs are being conducted in both Peru and Jamaica. In particular, the intent is to determine the extent to which age and nutritional  status modify the effect of an overnight fast on cognition.

Conclusion
 Eating breakfast is a simple means of improving health and nutritional status, particularly among children, and should be included in public health policies. In that context, school feeding represents a public health intervention toward the well-being of children and improving the efficiency of the educational system in developed and developing countries.