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Iron intake and iron status of preschool children: associations with breakfast cereals, vitamin C and meat.

OBJECTIVE: To examine associations between breakfast cereal consumption and iron status and identify dietary patterns that might improve iron status in this vulnerable group. DESIGN: Analysis of data from the UK National Diet and Nutrition Survey (NDNS) of children aged 1.5-4.5 years, including dietary intakes calculated from 4-day weighed records. SUBJECTS: Data were used from 904 children with haematological measurements, excluding those taking iron supplements; 20% had low iron stores (ferritin < 10 microgl-1) while 8% were anaemic (Hb < 11 g dl-1). RESULTS: High cereal consumers had significantly higher iron intakes than low cereal consumers (classified by tertiles) but the 10% difference in mean ferritin levels was not significant (P= 0.067). Lower intakes of vitamin C and meat among high consumers of cereal may have diluted the impact of cereal iron on iron status. When children were reclassified according to their intakes of vitamin C and iron from meat and breakfast cereals, the group with high (above median) intakes of two or more factors had a higher mean haemoglobin (Hb) level and a lower prevalence of anaemia compared with the group with low (below median) intakes of all three dietary constituents. CONCLUSIONS: Nutritional advice that aims to improve iron status should emphasize not only rich sources of iron but also factors that may enhance or inhibit absorption. Strategies to optimize iron status in this vulnerable age group include consuming an iron-fortified breakfast cereal, vitamin C-rich fruit or drink at breakfast, and avoiding tea with (or after) meals.

Anemia, Iron-Deficiency↗

[Frequency of intake and energy value of breakfast for students from selected primary schools in Warsaw].

Energy value and frequency breakfast intake in Warsaw primary schools were estimated in a group of 330 children aged 7-15 years. The research was carried out in autumn 1998 year. The nutrition mode was assessed by questionnaire interviews and of 24-hour recall [4] and computer programme "Zywienie". The size of the consumed portion was determined with an album containing colour photographs of products and dishes of different size [14]. Food consumption quality was estimated using test of Bielińska modified by Kulesza et al. [8]. Frequency breakfast intake decreased at older schoolchildren. Breakfast milk and products, vegetables and fruits intake was too low; intake of fat sweets and beverages like "coca-cola" was too high. Breakfast energy value was too low compared with recommended dietary allowances.

Adolescent↗

[Influence of breakfast on cognitive functions of children from an urban area in Valencia, Venezuela].

It's well known that physical growth and intellectual activity is influenced by nutritional status. With the purpose of evaluate the fasting effects on the cognitive functions, anthropometric state and cognitive functions (logic and school work performance), under fasting and post-breakfast condition were assessed in a group of 68 school children age 9 and 10 years, who studied in a private school (1998-1999). Logic reasoning was measured with Raven test and attention, precision, velocity and fatigue with the Lepez test. The main of the children (80%) were well-nourished and 20% had showed overweight. At breakfast condition all subjects were over 50 percentil for Raven test. Consumption of breakfast influence on logic reasoning (p < 0.001) and school work performance (p < 0.01). It is concluded that in these well nourished children, breakfast consumption improved cognitive performance.

Anthropometry↗

[Evaluation of a breakfast as screening test for the detection of gestational diabetes].

A standard breakfast was evaluated as a screening test (BT) for gestational diabetes in a case-control study. The breakfast had a high carbohydrate content and was designed based on women's preferences in a similar sample. Women were selected with a standard 50 g, 1 hour glucose screening test (GT). Fifteen women had a positive GT and 15 had a negative test. A glucose tolerance test (GTT) and a standard breakfast (719 kcal) were performed to all women. Age, weight, height, tricipital and subscapular skinfold thicknesses were obtained by previously standardized personnel and glucose levels were determined by an automatic technique (oxidase glucose). Ten women had gestational diabetes. Sensitivity and specificity were calculated for the GT and several values of the BT, in order to identify the threshold and optimum time. Concordance of both screening tests with GTT was calculated through Kappa test. For the BT, a sensitivity of 0.90 and specificity of 1.00 with a glucose level > or = 140 mg/L (7.2 mmol/L) at 60 and 90 minutes were found. The 60 minutes timing were preferred due to a shorter waiting time to performed the test. Concordance of GTT with GT and BT was 0.53 and 0.92 respectively, both statistically significant. GT had high frequency of false negative values (6/15) that explain the low kappa value. Standard breakfast can be used as an alternative method for assessing carbohydrate tolerance in pregnancy with a better physiological response in these women.

Adult↗

Evaluation of a ghetto school breakfast program.

A program was initiated to provide a free breakfast at a ghetto elementary school. Community support was achieved at the expense of randomization of study subjects. While no significantly greater increase in school attendance or performance was detected in comparison with a control school, none of the students was malnourished and diets of students in the control school were as adequate as those in the breakfast school. Thus, it cannot be concluded that school breakfast programs would not benefit malnourished children or teen-agers who most often go without breakfast.

Black People↗

[Effect of energy intake at breakfast on school performance].

In order to examine the effect of energy intake at breakfast on school performance, 151 grade three school children from four classes of two schools were sampled for this study. Children were randomly assigned to breakfast A or B on any given day. They were provided with breakfast with either high or low energy content at school over a period of 5 successive days. The remained foods were collected and weighed. Performance tests including addition, multiplication, number checking, logic, creativity, physical endurance, visual-analogue scales were applied at the third or fourth period of courses in the morning on Tuesday through Friday during the experimental week. The teachers involved in the study were blind to the kind of treatment. No significant effect of energy intake at breakfast on these performance indicators was found in this study.

Child↗

Acute effect of consumption/omission of breakfast on exercise tolerance in adolescents.

The purpose of this study was to determine the acute effects of the consumption or omission of breakfast on exercise tolerance in adolescents. Physically active adolescents (14 males and 21 females) were randomly assigned to receive a breakfast (B) or placebo (P) after an overnight fast. Exercise tolerance tests were done 1.5 hours (test 1) and again 4 hours (test 2) after consuming B or P and consisted of cycling on a stationary bike for 4 minutes at each of four consecutive power settings: 25, 50, 75, and 100 watts. Blood glucose and beta-hydroxybutyrate concentrations were measured before both tests. VO2 and VCO2 were measured during minute 3 of cycling at loads 50 and 75 watts and were used to compute the respiratory exchange ratio (RER). Heart rates (HR) were monitored throughout the test and ratings of perceived exertion (RPE) were made at the end of each 4 min interval. Repeated measures ANOVA revealed that there were no differences in RPE; however, differences for HR and RER did exist. Mean RER values were higher for the males receiving B vs males receiving P during test 1. For females, HR were higher for P compared B, and beta-hydroxybutyrate was significantly elevated for P before test 2. The data suggest that exercise tolerance as indicated by the ratings of perceived exertion are unaffected by prior ingestion of a breakfast but breakfast does affect the physiologic responses to exercise.

Adolescent↗

Digestibility of carbohydrates from rice-, oat- and wheat-based ready-to-eat breakfast cereals in children.

OBJECTIVE: To study the effect of the presence and quality of dietary fibre in ready-to-eat (RTE) breakfast cereals on completeness of carbohydrate digestion in children and on starch susceptibility to alpha-amylase in vitro. DESIGN: A controlled intervention study. SUBJECTS: Eight 3-8-year-old healthy children. INTERVENTIONS: Completeness of digestion was evaluated by assessing the amount of carbohydrates apparently fermented into the colon using the breath-H2 technique after consumption in random order, of five breakfast tests containing boiled rice (either alone or supplemented with 3 g of lactulose) as reference food, or RTE cereals based on rice (low-fibre), wheat (high insoluble fibre) and oats (high-soluble fibre). The potential glycaemic impact of the products was estimated in vitro by assessing starch susceptibility to alpha-amylolysis using an enzymatic-dialysis method. RESULTS: Compared to boiled rice and to rice-based RTE cereal, wheat- and oat-based RTE cereals both significantly (P < 0.05) increased the amount of apparently fermented carbohydrates (+1.1 +/- 1.7% of total breakfast carbohydrate fermented for rice, +5.6 +/- 0.9% for wheat and +9.4 +/- 3.7% for oats; mean +/- SEM), calculated using the excess H2 in breath after lactulose as standard. All products showed similar in vitro digestibility, resulting in estimated glycaemic indexes of 117.5 (24.0) for rice, and 105.7 (14.1) for oats-based, 128.4 (17.6) for wheat-based, and 129.8 (16.6) [mean 95% CI)] for rice-based RTE cereals. CONCLUSIONS: Results suggest that the presence of fibre in RTE breakfast cereals, in particular soluble fibre, increases colonic fermentation in children whereas it seems not to affect glucose availability.

Avena↗

Breakfast omission and cognitive performance of normal, wasted and stunted schoolchildren.

This study focuses on the effects of breakfast omission on cognitive performance. We studied 279 children from low socioeconomic level background ranging in age from 8 years 7 months to 10 years 11 months, categorized nutritionally as: normal, wasted or stunted. Evaluation comprised three cognitive tasks designed to be applied with a microcomputer. Assessment took place in their natural setting, after a mean of 14 h of overnight fasting, some having received a standard breakfast at random while the remaining children continued a fasting situation. We found no consistent association between study condition and performance in short-term visual memory, problem solving and attention tasks in any of the three nutritional groups. Stunted children showed significantly lower scores in the attention test irrespective of having received breakfast or not. These results suggest that given a motivating short-term task and maintaining routine conditions, missing breakfast does not affect the accuracy of the cognitive performance of children. Nutritionally affected children did not show a particular vulnerability to the fasting condition, but did show a specific cognitive deficit.

Attention↗

[Breakfast habits in moderately obese adults and its effect on daily energy and nutrient intake, on alcohol consumption and on various clinical and anthropometric parameters].

It is widely held that obesity may be due to alterations in the total caloric intake, the distribution of nutrient intake and the number of meals; widely spaced out meals of large proportions may be associated with metabolic dysfunctions. An observational study was performed in a random sample (80 males and 183 females) of moderately obese adults (IMC > 30 and < 40) attending the dietary unit of our hospital to evaluate spontaneous breakfast eating habits (understood as caloric contribution > 10% of daily caloric intake) in relation to: working activity, region of origin, possible influence on daily intake of energy and nutrients and on common clinical and anthropometric variables (arterial pressure, glycemia, cholesterolemia, triglyceridemia, IMC, WHR). Following the subdivision of patients into breakfast eaters (SC = 26 males, 52 females) and non-breakfast eaters (NC = 54 males and 131 females), no significant differences emerged between sexes with regard to region of origin, working activity, IMC, WHR, total kcal, distribution of nutrients, glycemia, cholesterolemia, triglyceridemia, arterial pressure. The only significant difference between SC and NC concerns alcohol consumption which was inversely correlated to breakfast eating in both males and females (males: r = -0.225, p < 0.05; females: r = -0.157, p < 0.05). No significant differences appear between wine consumers (SE = 29) and abstemious males (NE = 51), except for daily caloric consumption (kcal/die), triglycerides and arterial pressure, which were higher in SE (p < 0.05, p < 0.01, p < 0.05 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A standardised breakfast tolerance test in pregnancy: comparison with the 75 g oral glucose tolerance test in unselected mothers and in those with impaired glucose tolerance.

There is still disagreement concerning the optimal procedure for the diagnosis of milder degrees of hyperglycaemia in pregnancy. We have compared the results of a 75 g oral glucose tolerance test (OGTT) and a standardised breakfast test performed one week apart in 102 non-diabetic women with a singleton pregnancy. There was poor correlation between the two tests (r = 0.15) at two hours, and neither test was predictive of adverse maternal or fetal outcome. One hundred and four patients with impaired glucose tolerance, diagnosed at 30 weeks' gestation by 75 g OGTT, subsequently had a breakfast and lunch meal profile. There was no significant correlation between the two-hour OGTT value and either the two hour post-breakfast value (r = 0.35) or the maximum profile value (r = 0.33). Using the WHO diagnostic criterion of > 8 mmol/l for the OGTT and a maximum glucose concentration > 6.8 mmol/l for the meal profile, there was no relationship between an abnormal result in either test and pregnancy outcome. In our obstetric environment, the 75 g OGTT, a standardised breakfast test, and a structured meal profile, all failed to provide a useful indication of pregnancy outcome in mothers not already known to have diabetes.

Adolescent↗

Dietary analysis of meals served in the breakfast and lunch programs of Puerto Rican schools.

BACKGROUND: Nutritional analysis of meals in the Federally-sponsored Breakfast and Lunch Programs in Stateside Schools has recently been completed. However due to ethnic and cultural differences, the findings may not be directly applicable to similar nutrition programs in Puerto Rico. It is our aim to carry out an analysis of meals served in Federal programs in Puerto Rico and to compare results to the stateside study. METHODS: Twenty eight different breakfast meals and 96 different lunch meals being cycled in elementary, middle and secondary schools throughout the entire island of Puerto Rico were analyzed for content using the Minnesota Nutrition Data System 32 and compared with: 1) compliance to meal pattern requirements of federal programs, 2) dietary guidelines for Americans (DG) and 3) recommended dietary allowances (RDA's). RESULTS: Breakfasts and lunches served in Puerto Rican Schools satisfy federal meal pattern requirements however most frequently offered foods different from programs in the mainland, reflecting ethnic and cultural food preferences. In terms of DG's adequate protein was present, cholesterol content was satisfactory but meals had excess percent energy from fat as well as excess energy from saturated fat, high sodium and a lower than recommended level of energy from carbohydrate. In terms of RDA's meals had prescribed levels of vitamin A, vitamin B12, vitamin C, calcium, folacin, magnesium, phosphorus and potassium. Below prescribed levels included vitamin B6, copper, vitamin E, energy, fiber, iron, niacin and zinc. CONCLUSIONS: While differences in food preferences exist between foods available in the Breakfast and Lunch Programs in Puerto Rican and U.S., schools, they have similar strengths and weaknesses when compared to compliance with U.S. Dietary Guidelines and with recommended dietary allowances.

Adolescent↗

Study on fluorescence of Maillard reaction compounds in breakfast cereals.

During the advanced stage of the Maillard reaction (MR) in food processing and cooking, Amadori rearrangement products undergo dehydration and fission and fluorescent substances are formed. Free and total (free + linked to the protein backbone) fluorescence (FIC) due to Maillard compounds in 60 commercial breakfast cereals was evaluated. Pronase was used for efficient release of linked fluorescent Maillard compounds from the protein backbone. Results were correlated with some heat-induced markers of the extent of the MR or sugar caramelisation during cereal processing, such as hydroxymethylfurfural, furfural, glucosilisomaltol and furosine. The effect of sample composition (dietary-fibre added, protein, etc.) on levels of FIC, expressed as fluorescence intensity (FI) per milligram of sample, is discussed. FIC is significantly correlated to the protein content of the sample and fluorescent Maillard compounds are mainly linked to the protein backbone. The ratio of total-FIC to free-FIC was 10.4-fold for corn-based, wheat-based and multicereal-based breakfast cereals but significantly higher in rice-based samples. Addition of dietary fibre or honey increased the FIC values. Data support the usefulness of FIC measurement as an unspecific heat-induced marker in breakfast cereals.

Dietary Fiber↗

Evaluation of a standardized hyperglucidic breakfast test in postprandial reactive hypoglycaemia.

The oral glucose tolerance test is not specific for diagnosing postprandial reactive hypoglycaemia, since it too frequently induces low blood glucose values in subjects who have never complained of symptoms of this. By contrast, the mixed meal tests are deceptive for this purpose because they do not induce hypoglycaemia in subjects who have complained of of hypoglycaemic symptoms. We investigated the frequency of hypoglycaemia after a standardized hyperglucidic breakfast test in three groups of subjects:group A, 43 control subjects; group B, 38 postprandial reactive hypoglycaemic patients; group C, 1193 asymptomatic subjects undergoing assessment of glycoregulation. In the 38 subjects with suspected reactive hypoglycaemia the mean blood glucose nadir was 3.48 +/- 0.08 mmol/l, i.e. lower than in control subjects (4.83 +/- 0.13 p < 0.0001). Blood glucose levels less than 3.3 mmol/l were found in 47.3% of subjects with suspected postprandial reactive hypoglycaemia (group B), i.e more frequently than in control subjects (group A: 2.2% p = 1.6 x 10(-6)) and asymptomatic subjects (group C: 1% p = 8 x 10(-22)). This markedly higher frequency of low blood glucose values in subjects with postprandial symptoms compared with control and asymptomatic subjects suggests that this test detects a tendency to hypoglycaemia after a standardized hyperglucidic breakfast. Since this test mimics average French eating habits, the results suggest that the patients undergo such symptoms in their everyday life, and that the hyperglucidic breakfast test is a simple alternative to ambulatory glucose sampling for diagnosis of postprandial reactive hypoglycaemia.

Adult↗

Breakfast meal composition influences plasma tryptophan to large neutral amino acid ratios of healthy lean young men.

The effect of a carbohydrate, a 20% protein, or a carbohydrate +0.3% tryptophan TRP breakfast on plasma large neutral amino acid ratios was studied in 6 healthy men. The carbohydrate-rich meal produced shifts in plasma amino acid concentrations such that plasma TRP/LNAA ratios increased from 0.13 to 0.15 (p less than 0.04) and the protein meal decreased the ratio from 0.14 to 0.11 (p less than 0.04) after 1 hour. Addition of 0.3% TRP to the carbohydrate-rich meal increased plasma TRP/LNAA ratios more than 2-fold. The TRP containing meal was thus the only one likely to influence brain 5-HT synthesis, although the difference between the plasma TRP/LNAA ratios after carbohydrate and protein breakfasts suggests that the brain may distinguish, by synthesizing more or less 5-HT, the composition of breakfast meals.

Adult↗

[Nutritional balance of breakfast of children 7 to 11 years of age: comparison between school health education and eating behavior at home].

Following the favourable impact of a health education programme carried out in a school setting concerning "healthy eating at breakfast", the consumption of food at home for all meals, and separately at breakfast time was evaluated by using a "food-frequency" questionnaire. These results were then compared with the results of the school health education programme which focused primarily on breakfasts. The results of the survey, which included 80 children between 7 and 11 years old, show a great stability in the choice of foods, and during the action interesting variations concerning the respective proportions of nutriments according the recommended dietary allowances. We noticed an increase in the consumption of glucides, starch, vegetable proteins, and certain micronutriments. These changes are minor, but they may have a great importance if they spread to the whole nutrition. One can advise to generalise such school health education interventions.

Child↗

Glycaemic responses to commonly ingested breakfasts in children with insulin-dependent diabetes mellitus.

UNLABELLED: The glycaemic response to commonly ingested breakfast with different glycaemic index (cornflakes, white bread, dark rye bread and muesli) was investigated in 14 children with insulin-dependent diabetes mellitus. The blood glucose response after cornflakes was significantly higher than after the other breakfasts, whereas the areas under the blood glucose curve were not statistically different. We observed no difference in blood glucose rise between the other breakfast types. CONCLUSION: Postprandial blood glucose measurements after meals with high glycaemic index may be useful in order to minimize the postprandial rise in blood glucose.

Adolescent↗

The effect of muesli or cornflakes at breakfast on carbohydrate metabolism in type 2 diabetic patients.

Fourteen overweight insulin-treated type 2 diabetic patients ate a breakfast, consisting of either muesli (slow release starch: SRS) or cornflakes (fast release starch: FRS), in either case with milk (46 g carbohydrate), during two consecutive randomized crossover periods of two weeks. The rest of the diet remained unchanged. At the end of each period the patients underwent a glucose tolerance test after an overnight fast without their usual evening insulin injection. Both mean plasma glucose responses curves were identical after the two dietary periods, but plasma insulin was significantly lower at zero (-17%, P less than 0.05) and 2 h (-21%, P less than 0.05) at the end of the muesli (SRS) period as compared to the cornflakes (FRS) period. The mean day-long plasma glucose level (four measurements) at the end of the muesli period was 21% (P = 0.023) lower than after the cornflakes period. These results show that switching, at breakfast only, from standard cereals to slow release starch cereals improves the carbohydrate metabolism of diabetic patients. In addition, the fact that diabetic patients could reduce their insulin requirement (P less than 0.05) with concomitant reduction of their daily blood glucose level implies that sensitivity to insulin was improved by slow release starct foods consumed at breakfast.

Analysis of Variance↗