Scientific Affairs Analyst at Nestlé, Jean Kim (PhD)The following research papers have been selected and summarised by our Scientific Affairs Analyst at Nestlé, Jean Kim (PhD). They are designed to provide a topline overview and summary of the relevant research paper – they are not a full scientific review. For further details of the research paper, click through to the abstracts in the links provided.

1. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality

2. Breakfast consumption and weight-loss maintenance

3. The effects of breakfast on cognitive performance in children and adolescents

 

 

1. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality

A systematic review and dose-response meta-analysis of prospective studies.

 

Aune D, Keum NN, Giovannucci E, Fadnes LT, Boffetta P, Greenword DC, Tonstad S, Vatten LJ, Riboli E and Norat T (2016). British Medical Journal, 353, i2716.

www.ncbi.nlm.nih.gov/pubmed/27301975

 

Oat flakes, seeds and branIntroduction

A high intake of whole grains has been associated with a reduced risk of type 2 diabetes (1), coronary heart disease (2), and obesity (2). Despite a growing body of epidemiological evidence for the health benefits of whole grain consumption, globally, dietary recommendations have often been unclear or inconsistent with regard to the amount and types of whole grain foods that should be consumed to reduce chronic disease and risk of mortality. The objective of this review was to provide a comprehensive and detailed assessment of whole grain intake and health outcomes, and to quantify the dose-response relationship.

 

Summary of findings

Forty-five cohort studies (20 from Europe, 16 from the US, and 9 from Asia) were included in the analyses of grain intake and incidence or mortality from various major chronic diseases.

A high intake of whole grains was associated with reduced risk of coronary heart disease (21% reduction), cardiovascular disease overall (16%), total cancer (11%), and all-cause mortality (18%) for the highest versus lowest category of whole grain intake. Reductions in risk were observed up to an intake of 210-225g per day (~7-7.5 servings per day) and for whole grain bread, whole grain breakfast cereals, and added bran, for most of the health outcomes. However, there was little evidence of an association with refined grains, white rice, total rice or total grains.

Limitations

There was a high heterogeneity in the analysis of whole grains and all-cause mortality. Heterogeneity could have been due to the fact that studies could have differed by the types of whole grains consumed, by how accurately studies measured whole grain intake, or by how they defined whole grains. Secondly, the subgroup analyses showed associations among studies that adjusted for smoking, alcohol, physical activity, BMI, and other dietary factors, however confounding by other lifestyle factors such as socioeconomic status could have been a potential source of bias.

Finally, the number of studies that investigated subtypes of whole grains and total or refined grains was limited.

 

The Bottom Line

This systematic review and meta-analysis provides solid evidence that a high intake of whole grains is beneficial for several health outcomes.

“The current findings support dietary recommendations to increase intake of whole grains and as much as possible to choose whole grains rather than refined grains.”

 

References

  1. Aune D et. al. (2013). Whole-grain and refined grain consumption and the risk of type 2 diabetes:a systematic review and dose-response meta-analysis of cohort studies. Eur J Epidemiol, 28, 845-58.
  2. Ye EQ et. al. (2012). Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease and weight gain. J Nutr, 142, 1304-13.

 

2. Breakfast consumption and weight-loss maintenance.

An analysis of the MedWeight study on breakfast consumption and breakfast quality.

 

Brikou D, Zannidi D, Karfopoulou E, Anastasiou CA and Yannakoulia M (2016). Breakfast consumption and weight-loss maintenance: results from the MedWeight study. British Journal of Nutrition 115, 2246-51.

www.ncbi.nlm.nih.gov/pubmed/?term=Brikou+and+breakfast

 

Bowl of oatsIntroduction

Breakfast has been widely advocated as an important part of a healthy diet and as an effective strategy for achieving and maintaining a healthy weight (1,2). However, supporting evidence is quite conflicting. The contradictory results may be explained partly by the variety of breakfast definitions and limited consensus as to what constitutes the term breakfast meal. Is it defined by weekly frequency, time of day, timing in relation to waking and daily activities, types of food and beverages consumed, or is it the amount of energy provided? The purpose of this study was to examine whether breakfast consumption, specifically which type of breakfast, was associated with weight-loss maintenance, and to also explore differences in breakfast quality.

 

Summary of findings

The study consisted of 354 participants (18-65y) from the MedWeight study, a registry of people who had lost ≥10% of their initial body weight and either maintained the loss for ≥1 year (maintainers) or regained the weight loss (regainers). Participants completed online questionnaires and reported their dietary intake through two telephone 24h recalls. Breakfast consumption was evaluated using twelve different definitions of breakfast.

Statistical significance was only shown for breakfast consumption and weight-loss maintenance in men when using either self-reported breakfast consumption or the breakfast definitions of: (1) the first eating occasion episode consumed at home and (2) the first eating episode consumed at home excluding caffeinated drinks. This finding may be due to the fact that breakfast consumption was more common in women, thus perhaps women consumed breakfast independently of their maintenance status.

Limitations

Although the observational nature of the study indicated associations, no causal inferences could be extracted from the findings. All participant characteristics were self-reported, however research indicated high agreement between objective and web-based self-reported measures of height and weight for adults. Furthermore, participants were not equally distributed, with the maintainer group three times bigger compared to the regainer group, which could have impacted the results.

 

The Bottom Line

The present study indicated that when breakfast was consumed at home, it may influence weight-loss maintenance. However, further research is needed to clarify whether this finding only applied to males only, as was indicated by the study results.

“Breakfast, when consumed at home, may be protective against weight regain.”

 

References

  1. Dialektakou KD and Vranas PB (2008) Breakfast skipping and body mass index among adolescents in Greece: whether an association exists depends on how breakfast skipping is defined. J Am Diet Assoc 108: 1517-25.
  2. Timlin MT and Pereira MA (2007) Breakfast frequency and quality in the etiology of adult obesity and chronic diseases. Nutr Rev 65:268-81.

 

3. The effects of breakfast on cognitive performance in children and adolescents.

A systematic literature review of intervention studies on objective cognitive outcome measures.

 

Adolphus K, Lawton CL, Champ CL and Dye Louise (2016). The Effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Advances in Nutrition, 7 (Suppl), 590S-612S.

www.ncbi.nlm.nih.gov/pubmed/27184287

 

Bowl, toast and yoghurtIntroduction

There is evidence that children and adolescents who habitually consume breakfast are more likely to have better micro- and macronutrient intake (1), less likely to be overweight or obese (2,3), and more likely to have higher physical activity levels (4). In 2009, a systematic review showed that breakfast consumption was beneficial for cognitive performance in school children (5). The objective of the current review was to provide an update of the evidence, particularly by highlighting the cognitive domains that are potentially more sensitive to the effects of breakfast consumption.

 

Summary of findings

The review identified a total of 45 studies in 4-18 yo. Most studies considered the acute effect of a single breakfast, which compared breakfast with no breakfast (n=24) and/or made comparisons of breakfast type (n=15). The effects of chronic school breakfast program interventions were also evaluated in 11 studies. Most studies included ready-to-eat cereals or breads in combination with other foods, such as milk, sweet and fat spreads, fruit, fruit juice, yoghurt and cheese. The effects of breakfast were evaluated by cognitive domain and type of breakfast manipulation, with cognitive tasks grouped into categories of memory, attention, executive function, psychomotor function and language.

Although results did not show large breakfast-induced benefits for cognitive performance, data indicated that consuming breakfast had a short-term positive, domain-specific effect on cognitive function measured within 4h post-ingestion in children and adolescents compared to breakfast omission. Tasks requiring attention, executive function, and memory were facilitated more reliably by breakfast consumption relative to fasting, with effects more apparent in undernourished children. There was consistent evidence that breakfast consumption was associated with improved subjective feelings of mood and alertness in school children.

 

Limitations

The effects of breakfast composition and the long-term effects of consuming breakfast were unclear due to insufficient studies in this area, together with problematic experimental designs, including the need for more well-matched study conditions to establish the effect of breakfast composition on cognitive performance. Larger sample sized studies with sufficient power to detect statistically significant effects were also required, along with more samples with adolescents.

 

The Bottom Line

Firm conclusions could not be made about acute effects of breakfast composition and the effects of chronic breakfast interventions due the small number of studies and inconsistent findings. However, the present review indicated that breakfast consumption had a transient beneficial effect on cognitive function measured within 4h of post-ingestion in children and adolescents.

“The effects of breakfast composition on cognitive function and academic performance in children needs further investigation.”

 

References

  1. Deshmukh-Taskar PR et. al. (2010) The relationship of breakfast skipping and type of breakfast consumption with nutrient intake and weight status in children and adolescents: the National Health and Nutrition Examination Survey 1999-2006. J Am Diet Assoc 110:869-78.
  2. de la Hunty A et. al. (2013) Does regular breakfast cereal consumption help children and adolescents stay slimmer? A systematic review and meta-analysis. Obes Facts 6:70-85.
  3. Szajewska H et. al. (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food Sci Nutr 50:113-9.
  4. Sandercock GRH et. al. (2010) Associations between habitual school day breakfast consumption, body mass index, physical activity and cardiorespiratory fitness in English schoolschildren. Eur J Clin Nutri 64:1086-92.
  5. Hoyland A et. al. (2009) A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 22:220-43.