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Disguised protein in lunch after low-protein breakfast conditions food-flavor preferences dependent on recent lack of protein intake.

As in the conditioning of appetite for protein in the rat, human preference for and intake of a food at lunch was increased when the flavor of that food was paired with an adequate supply of protein, following a breakfast lacking in protein. Men and women rated their preferences for two flavors in tasted foods (soup and cornflour dessert) on test days before and after a day when one flavor was eaten in very low protein food and another day with a different flavor eaten in food containing protein, but with minimal sensory differences between these foods. Subjects given a low-protein drink preload preferred the protein-paired flavor, while those receiving a high-protein drink did not. In a second experiment, preferences were measured by intake as well as ratings, and the difference in amount of protein between high- and low-protein lunches was increased. By both measures, relative preference for high-protein-paired dessert flavors increased from before to after pairing. The increase in intake preference ratio for the protein-paired flavor was abolished by a high-protein preload. Thus, people have a learning mechanism whereby a lack in protein intake comes to cue the selection of protein-rich foods that are not known to be such, and/or loading with protein might trigger avoidance specifically of a high-protein diet.

Adolescent↗

The effect of breakfast on social behavior and brain amine metabolism in vervet monkeys.

Two groups of vervet monkeys were fed, on alternate days, either before or after a morning observation period. This enabled us to determine changes in behavior when the animals were fed a nutritionally balanced breakfast of monkey chow. Feeding did not alter the proportion of behaviors that were social or non-social, but had a marked effect on individual behaviors. Feeding increased active behaviors among the adult animals except for the vervets who were lowest in the social hierarchy in each cage. For some of the individual behaviors that were altered by feeding, the changes were most marked early on in the observation period, when the animals were still feeding. Other behavioral changes were seen only later in the observation period, a time course consistent with a food-mediated change in brain biochemistry. A parallel biochemical experiment showed that feeding decreased the levels of tryptophan and 5-hydroxyindoleacetic acid in the CSF. Our data indicate that feeding can influence both brain biochemistry and behavior. The behavioral changes may be influenced by social and psychological factors as well as changes in brain biochemistry.

Aging↗

Breakfast, blood glucose and memory.

The hypothesis that blood glucose levels influence memory was re-examined. The performance on two memory tests was quicker when breakfast had been taken, suggesting that the ability to retrieve memories had been facilitated. Performance on a spatial memory test correlated significantly with blood glucose levels.

Adult↗

Systemic anaphylaxis after ingestion of a psyllium-containing breakfast cereal.

Allergic reactions have been described as an occupational hazard among nurses and pharmaceutical workers who handle psyllium-containing laxatives. This study reports the case of a 38-year-old female nurse who ingested a bowl of psyllium-containing Heartwise Cereal (Kelloggs, Battle Creek, MI) and 25 minutes later developed severe systemic anaphylaxis manifested by hypotension, a feeling of constriction in the throat, hoarseness, dyspnea, wheezing, generalized pruritus, urticaria, and vomiting. She was treated with epinephrine, normal saline, diphenhydramine, and methylprednisolone, and recovered completely. Subsequent IgE immunoblot assay was strongly reactive to psyllium. Ingestion of psyllium-containing breakfast foods by sensitized individuals can be associated with life-threatening systemic anaphylaxis.

Adult↗

Evaluation of insulin sensitivity and glucose effectiveness during a standardized breakfast test: comparison with the minimal model analysis of an intravenous glucose tolerance test.

There is a need for reliable measurements of insulin sensitivity (SI) simpler than the euglycemic hyperinsulinemic clamp or the intravenous glucose tolerance test (IVGTT), which could be used when the simpler surrogates based on fasting insulin (Ib) and glucose (Gb) lose their validity. Several evaluations of SI derived from oral glucose tolerance test (OGTT) or its physiologic form, the standardized breakfast test (SBT), have been proposed. We aimed at determining which SBT-derived measurements of SI give the best prediction of the values obtained with the minimal model analysis of an IVGTT. Twenty-eight subjects (23 females and 5 males; age, 44.3+/-0.6 years) with a wide range of glucose tolerance randomly underwent a hyperglucidic SBT and an IVGTT with minimal model analysis. Correlations of 35 indices (converted if appropriated into similar units) with IVGTT-derived SI were calculated, and the accuracy of the empiric formulas obtained with the 11 best predictions were evaluated with Bland-Altman plots. Subjects covered all the spectrum of SI between 0.19 and 21.3 min-1/(microU.mL-1)x10(-4). Eight procedures yielded satisfactory predictions of minimal model SI: (1) SI (from Matsuda's composite index)=-1.24+65/(IbGbImGm)-0.5; (2) SI=1.89+2690/(IbGbImGm); (3) SI (from Bennett's index)=-2.93+5.16/(log Ibxlog Gb); (4) SI (from Sluiter's index)=0.2+2400/(IpGp); (5) SI=-8.54+38.4/(Belfiore's ISI index); (6) SI (from Cederholm's formula)=76/(Gm log Im); (7) SI=0.248+0.947/GbIm; (8) SI (from Mari's "oral glucose insulin sensitivity" index)=oral glucose insulin sensitivity/Ip; (9) Caumo's model. Glucose effectiveness Sg can also be accurately predicted by the following formula: Sg=2.921e-0.185(G60- Gb) (Ip=insulin peak; Gp=glucose peak; Ia=insulin area; Ga=glucose area; G60=glycemia at 60 minutes). The hyperglucidic SBT can provide accurate evaluations of SI and Sg, either by elaborated models or by simple empiric formulas.

Adolescent↗

Skipping breakfast: gender effects on resting heart rate measures in preadolescents.

The cardiovascular response in children to morning nutrition has received little attention, and associated gender-related effects are virtually uninvestigated. This study evaluated resting heart-rate (HR) and heart-rate variability (HRV) in preadolescents after overnight fasting and again after eating a standardized breakfast or continuing to fast. HR increased slightly after eating and decreased significantly with continued fasting. These effects were present for both sexes. Relative to children who ate, those who continued fasting showed increases in HRV-particularly for inter-beat-interval and low frequency component (LF: 0.04-0.15 Hz) measures. Analyses revealed significant increases across variability measures for fasting children, but a selective LF decrease in those who were fed-an effect most prominent in females. Otherwise, males and females showed similar treatment-related changes in HRV. While within-gender comparisons showed similar results for HR, i.e., faster HR in fed compared with fasting males and females, respectively, fasting females-but not males-showed significantly greater increases in variability relative to their fed counterparts. Together, these findings suggest that extended overnight fasting initiates an increase in parasympathetic activity that attenuates the expected increase in cardiovascular output following a mid-morning meal. Observed gender differences were related to greater parasympathetic activity in males and to the apparent emphasis on parasympathetic regulation of LF variability. The implications of these findings for health concerns, the nature of responses to physiological and cognitive stressors, and how such differences may influence performance variables-particularly early in development when cardiovascular responses to these stressors may be more sensitive to nutritional factors-are discussed.

Child↗

Reverse versus forward order reporting and the accuracy of fourth-graders' recalls of school breakfast and school lunch.

BACKGROUND: Do children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order? METHODS: One hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day's intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts. RESULTS: Results failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls. CONCLUSIONS: Prompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children's dietary recalls.

Child↗

The effect of walking before and after breakfast on blood glucose levels in patients with type 1 diabetes treated with intensive insulin therapy.

OBJECTIVE: We examined the effect of walking at different timing on carbohydrate metabolism in patients with type 1 diabetes. SUBJECTS AND METHODS: Subjects included six non-obese patients treated with intensive insulin therapy. The blood glucose profile was determined with and without walking for 30 min before (ExBM) or after (ExAM) breakfast. RESULTS: Mean blood glucose values at 07:00 h in the control, ExBM, and ExAM were 9.0, 8.0, 8.8 mM, respectively. Glucose levels gradually increased after meals up to 13.6, 15.0, and 15.3 mM, respectively, at 09:00 h (0.5 h after meals). At 09:30 h, glucose levels significantly fell to 11.0 mM during walking in the ExAM (P=0.039 vs 09:00 h values). The area under blood glucose response curve was significantly lower only in the ExAM when compared with that in the control (P=0.043) (11.8, 17.8. and 3.8 h mM in the control, ExBM and ExAM, respectively). CONCLUSION: These results might suggest that walking after meals improves glycemic control in patients with type 1 diabetes being treated with intensive insulin therapy consisting of the basal-bolus (NPH-human regular) insulin regimen.

3-Hydroxybutyric Acid↗

The efficacy of 48-week oral ibandronate treatment in postmenopausal osteoporosis when taken 30 versus 60 minutes before breakfast.

Since effective prevention and treatment of osteoporosis demands a high degree of long-term compliance, optimization of the dosing regimen in terms of efficacy and convenience of drug intake is a critical issue of oral bisphosphonate treatment. The purpose of the present study was to investigate whether the efficacy of the treatment with oral ibandronate, 2.5 mg daily, can be maintained if changing the postdose fast from 60 to 30 min. This was a 48-week, multicenter, open-label, randomized, parallel-group noninferiority study. Subjects were postmenopausal women 55-80 years old with lumbar spine (L1-L4) bone mineral density (BMD) corresponding to a T score < or =2.5. Women were randomly assigned to take 2.5 mg ibandronate exactly 30 or 60 min before breakfast. Lumbar spine and proximal femur (trochanter, femoral neck, total hip) BMD were measured by dual energy X-ray absorptiometry; serum osteocalcin and creatinine-corrected urinary C-telopeptide of type I collagen (u-CTX/Cr) excretion were measured by ELISA. After 48 weeks of treatment, the relative increase in lumbar spine BMD from baseline in the 30-min fast group was lower than that in the 60-min fast group (3.07% versus 4.95%, one-sided 97.5% CI = -2.89%) such that the prespecified noninferiority criteria were not met. The mean relative increases in BMD at the trochanter (3.04% versus 4.36%), femoral neck (1.82% versus 2.19%), and total hip (2.35% versus 3.21%) in the 30-min fast group were also lower than those in the 60-min fast group. Less suppression of the markers of bone turnover (u-CTX/Cr, -48.5% vs -61.8%; serum osteocalcin, -34.8% vs 43.8%) was observed in the 30-min compared with the 60-min group. In conclusion, if reducing the postdose fasting interval, dose-increase compensation would likely to be required to maintain efficacy of oral ibandronate treatment. Another potential solution for improving the convenience with bisphosphonate treatment is expected from weekly or monthly dosing regimens currently under clinical investigations.

Absorptiometry, Photon↗

Iron absorption from a breakfast cereal: effects of EDTA compounds and ascorbic acid.

Sodium iron ethylenediaminetetracetic acid (NaFeEDTA) has been recommended for food fortification programmes to improve iron status but its performance in commercial products has not been evaluated. The effect of EDTA on iron absorption from fortified cornflakes, given as part of a typical Western breakfast, was determined in a double-blind randomised study with 20 non-anaemic female volunteers, using experimentally prepared iron compounds, enriched with 58Fe, and faecal monitoring. Five meals were compared: hydrogen reduced iron, hydrogen reduced iron plus Na2EDTA (molar ratio EDTA:Fe 1:2), hydrogen reduced iron plus NaFe(III)EDTA at two different molar ratios (EDTA:total Fe 1:3 and 1:2), and hydrogen reduced iron plus 15 mg ascorbic acid (ascorbic acid:Fe 1.3:1). The iron and EDTA compounds were accurately weighed into gelatine capsules and taken with unfortified cornflakes, semi-skimmed milk and tea on two consecutive days; the iron dose per meal was 3.75 mg. Iron absorption from all five test meals was measured in each volunteer with a minimum wash-out period of 2 weeks between tests. Geometric mean iron absorption (%) from the 5 tests was 14.1, 17.6, 20.6, 24.4 and 17.5 respectively (equivalent to 0.5-0.9 mg absorbed iron). There was a significantly higher iron absorption from the mixture of reduced iron and NaFe(III)EDTA (EDTA:Fe 1:2) than from reduced iron alone (p = 0.014). It is not known whether the higher absorption was from reduced iron or NaFeEDTA or both. Absorption was not increased significantly with NaFe(III)EDTA (EDTA:Fe 1:3), Na2EDTA (EDTA:Fe 1:2) or ascorbic acid (15 mg).

Adult↗

Serum leptin is associated with the perception of palatability during a standardized high-carbohydrate breakfast test.

Leptin is an adipocyte-derived signalling molecule which plays a key role in the regulation of body weight and energy expenditure. Since its involvement in human eating behaviour is still poorly understood, we investigated whether the perception of palatability of food was related to fasting serum leptin levels. Twenty-six non-diabetic subjects, six men and twenty women of widely ranging age and body mass index, performed a standardized high-carbohydrate breakfast test. Palatability was evaluated with a visual analogue scale, body composition by bioelectrical impedance, serum leptin and plasma insulin by radioimmunoassay. Palatability was correlated to fasting serum leptin levels independently of body mass index, body fat mass and percentage of body fat (P<0.01). No significant relation was observed with peaks of insulinaemia, integrated concentrations of insulin or insulin resistance indices. A stepwise regression analysis indicated that serum leptin gave the strongest predictive association with palatability. These results suggest that the leptin system may be involved in the regulation of human eating behaviour in relation to the perception of palatability of food.

Adult↗

Impact of ready-to-eat breakfast cereal (RTEBC) consumption on adequacy of micronutrient intakes and compliance with dietary recommendations in Irish adults.

OBJECTIVE: To describe the consumption of ready-to-eat-breakfast cereals (RTEBCs) in Irish adults and its impact on adequacy and safety of micronutrient intakes and compliance with dietary recommendations. DESIGN: Analysis for this paper used data from the North/South Ireland Food Consumption Survey that estimated habitual food intake using a 7-day food diary in a representative sample of adults aged 18-64 years ( 662 men, 717 women). RESULTS: Despite the small quantity consumed (mean 28.6 g day-1 or 4.7% of total energy intake), RTEBCs made an important contribution to the mean daily intake of carbohydrate (8.1%), starch (10.8%), dietary fibre (9.8%) and non-starch polysaccharides (NSP) (10.8%) in consumers. Increased consumption was associated with a more fibre-dense diet and with greater compliance with dietary recommendations for fat, carbohydrate and NSP. Fortified RTEBCs contributed significantly to mean daily intakes of iron (18%), thiamin (14%), riboflavin (17%), niacin (15%), vitamin B6 (13%), total folate (18%) and vitamin D (10%) and most of the contribution was from micronutrients added to RTEBCs. Increased consumption of fortified RTEBCs was associated with an increased nutrient density for a number of micronutrients and with a lower prevalence of dietary inadequacy of calcium, iron, riboflavin and folate, particularly in women. However, it was not associated with intakes in excess of the Tolerable Upper Intake Level for any micronutrient. CONCLUSIONS: The consumption of RTEBCs is associated with improved compliance with dietary recommendations for fat, carbohydrate and fibre, with a more micronutrient-dense diet and a reduced risk of dietary inadequacy for calcium, iron, riboflavin and folate, without increasing the risk of excessive intakes of micronutrients.

Adolescent↗

The Breakfast Club: case study of a teaching-autopsy curriculum.

A decision prohibiting student access to coronial autopsies in Auckland, New Zealand, was recently discussed in the British Medical Journal (O'Grady, ). Clinical and ethical implications aside, the prohibition brought an end to the Breakfast Club, a remarkable community of post-mortem learning. Over 20 years of voluntary attendance at autopsy, this group of students established a self-directed curriculum based around daily encounters at the post-mortem table. The success of the group testifies to the ongoing value of the autopsy as a medical teaching medium in the current era.

Autopsy↗

Growth, hemoglobin, cholesterol, and blood pressure observed in rats fed common breakfast cereals.

Most of the common breakfast cereals tested were unable to support growth or promote health in young rats that consumed these products as their only food. An anemia, accompanied by fatty liver and large concentrations of iron stored in the liver, was observed with cereals having the lowest protein content. Some cereals produced a marked elevation of systolic blood pressure at certain times. Low cholesterol levels were invariably associated with fatty livers, whereas high cholesterol levels seemed to be associated with hypertension at the 45-day period. When only the ready-to-eat cereals were considered, there was a positive correlation between the dietary zinc/copper ratio and the plasma cholesterol concentration.

Animals↗

Zinc nutritional status of young middle-income children and effects of consuming zinc-fortified breakfast cereals.

The effects of consuming zinc-fortified ready-to-eat breakfast cereals were determined in a double-blind controlled study. The 96 healthy young children who participated (mean age 58 months) consumed either zinc-fortified cereal, providing 25% United States Recommended Dietary Allowance per 1 ounce serving (test children) or nonzinc-fortified cereals (controls) for a 9-month period. The test children were calculated on average to receive an additional 2.57 mg of zinc per day from this fortification program. This increment increased their mean daily zinc intake to a level that approached the Recommended Dietary Allowance (10 mg) of the National Academy of Sciences for children less than 10 years of age. By the end of the period, the test children (combined sexes) had a mean increment of plasma zinc that was 6.5 micrograms/dl greater than that of the control children (P less than 0.02). The test girls had a greater increment (28.5 micrograms/g) in hair zinc content than controls girls (P less than 0.05). There were no significant differences in other biochemical parameters including plasma copper and serum cholesterol. No significant differences in food intake or growth velocity were associated with the consumption of the zinc-fortified cereal. Multiple sex and time related differences occurred in plasma, hair, urine, and parotid saliva zinc concentrations that were unrelated to the type of cereal consumed.

Child↗

Effects of high fiber breakfasts on glucose metabolism in noninsulin-dependent diabetics.

This study investigated dietary fiber in noninsulin-dependent diabetics, the major North American diabetic population, using modest fiber increases as a strategy to promote dietary adherence. Once weekly over a 3-wk period, five lean, diet-controlled noninsulin-dependent diabetics ingested one of three isocaloric, isocarbohydrate breakfasts (337 kcal, 49 g carbohydrate), differing primarily in dietary fiber: 3 g bran (control), 17 g bran (B), or 18 g bran and fruit (BF). B and BF were higher in protein than control; BF contained more sugar than B and control. Compared to control, B reduced (p less than 0.05) plasma glucose over 180 min; BF did not. The peak blood glucose rise after BF was lower than control (p less than 0.01) whereas no effect was seen with B. B reduced xylose absorption (p less than 0.025) suggesting a reduced rate of glucose absorption; BF did not. Insulin, growth hormone, and glucagon values did not differ. This study suggests significant plasma glucose reductions with bran or bran and whole apple; other nutrient differences (higher protein in fiber meals, higher sugar with whole apple meal) might also be related. Further research is indicated to clarify these responses and extend the data to obese noninsulin-dependent diabetics.

Absorption↗

Glycemic response in children with insulin-dependent diabetes mellitus after high- or low-glycemic-index breakfast.

To examine the effects of various carbohydrate foods on postprandial glycemia in diabetic children, we fed a mixed, isocaloric diet containing either high- or low-glycemic-index (GI) breakfast foods to 22 children with poorly controlled insulin-dependent diabetes mellitus (IDDM) and measured blood sugar response with and without adjustment of insulin doses. We found that IDDM children fed a high-GI meal showed a significantly higher serum glucose level than those fed a low-GI meal. However, such differences were not seen when the preprandial dose of regular insulin was adjusted to the amount of carbohydrate in feedings. Thus, as long as proper adjustment of insulin is made, the type of carbohydrate in a single mixed meal does not appear to have a significant effect on the postprandial glycemic response in children with long-standing poorly controlled IDDM.

Adolescent↗

High-fiber foods at breakfast: influence on plasma glucose and insulin responses to lunch.

This study evaluates acute effects of red kidney bean consumption on postprandial glucose and insulin responses in six healthy young men. Comparisons were made among three mixed-food breakfast meals comprised predominantly of either red kidney beans, bran cereal, or white bread. These meals provided equivalent levels of digestible carbohydrate, protein, and fat. The bean and bran meals contained equivalent levels of fiber while the white-bread meal contained a lower level. The postprandial glucose and insulin responses to the three meals were similar and responses also were similar after a standard whole-wheat-bread meal 4 h later. There appeared to be a reciprocal relationship between glucose and insulin responses after the lunch meal. This would influence interpretation of data regarding second-meal response.

Adult↗