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  • Original Article
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Epidemiology

Breakfast skipping in prepubertal obese children: hormonal, metabolic and cognitive consequences

Abstract

Background and Aims:

Skipping breakfast influences cognitive performance. The aim of our study was to investigate the relationship between the variation of hormonal and metabolic postprandial parameters induced by breakfast consumption or fasting and cognitive performance in obese children.

Methods:

Cross-sectional study for repeated measures. Memory and attention assessment tests, hormones and nutrient oxidation were measured before and after consuming breakfast vs fasting in 10 prepubertal obese children.

Results:

Fasting induced a significant (P<0.05) increase of the Overall Index of the Continuous Performance Test II (a global index of inattention) and the Test of Memory and Learning Word Selective Reminding (a test of verbal memory), whereas no changes were found after breakfast. Fasting was associated with a reduction of insulin and an increase in glucagon, with no changes in glucose. The increase in inattention was associated with a reduction of carbohydrate oxidation (ρ=−0.66, P<0.05). We found no difference in the area under the curve of peptide YY and glucagon-like peptide-1 after breakfast or fasting, whereas Ghrelin was significantly lower. No association between postprandial hormone variation and cognitive performance was found.

Conclusions:

Attention and visual memory performance in the morning were reduced when the children skipped breakfast. No association was found with hormones or metabolic changes, but we did find an association with a reduction of carbohydrate oxidation. Nevertheless, these preliminary findings need confirmation in larger sample size.

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References

  • Acheson KJ, Schutz Y, Bessard T, Flatt JP, Jéquier E (1987). Carbohydrate metabolism and de novo lipogenesis in human obesity. Am J Clin Nutr 45, 78–85.

    Article  CAS  PubMed  Google Scholar 

  • Anthony K, Reed LJ, Dunn JT, Bingham E, Hopkins D, Marsden PK et al. (2006). Attenuation of insulin-evoked responses in brain networks controlling appetite and reward in insulin resistance: the cerebral basis for impaired control of food intake in metabolic syndrome? Diabetes 55, 2986–2992.

    Article  CAS  PubMed  Google Scholar 

  • Bandini LG, Schoeller DA, Dietz WH (1990). Energy expenditure in obese and nonobese adolescents. Pediatr Res 27, 198–203.

    Article  CAS  PubMed  Google Scholar 

  • Castañeda TR, Tong J, Datta R, Culler M, Tschöp MH (2010). Ghrelin in the regulation of body weight and metabolism. Front Neuroendocrinol 31, 44–60.

    Article  PubMed  Google Scholar 

  • Chugani HT (1998). A critical period of brain development: studies of cerebral glucose utilization with PET. Prev Med 27, 184–188.

    Article  CAS  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Diez WH (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Conners CK (2002). Conners' Continuous Performance Test. Multi-Health System: Toronto, Canada.

    Google Scholar 

  • Delzenne N, Blundell J, Brouns F, Cunningham K, De Graaf K, Erkner A et al. (2010). Gastrointestinal targets of appetite regulation in humans. Obes Rev 11, 234–250.

    Article  CAS  PubMed  Google Scholar 

  • Flanagan DE, Evans ML, Monsod TP, Rife F, Heptulla RA, Tamborlane WV et al. (2003). The influence of insulin on circulating ghrelin. Am J Physiol Endocrinol Metab 284, E313–E316.

    Article  CAS  PubMed  Google Scholar 

  • Hallschmid M, Schultes B (2009). Central nervous insulin resistance: a promising target in the treatment of metabolic and cognitive disorders? Diabetologia 52, 2264–2269.

    Article  CAS  PubMed  Google Scholar 

  • Hoyland A, Dye L, Lawton CL (2009). A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 22, 220–243.

    Article  PubMed  Google Scholar 

  • Koutkia P, Schurgin S, Berry J, Breu J, Lee BS, Klibanski A et al. (2005). Reciprocal changes in endogenous ghrelin and growth hormone during fasting in healthy women. Am J Physiol Endocrinol Metab 289, E814–E822.

    Article  CAS  PubMed  Google Scholar 

  • Irwin N, Gault V, Flatt PR (2010). Therapeutic potential of the original incretin hormone glucose-dependent insulinotropic polypeptide: diabetes, obesity, osteoporosis and Alzheimer's disease? Expert Opin Invest Drugs 19, 1039–1048.

    Article  CAS  Google Scholar 

  • Istituto Nazionale della Nutrizione. (1977). Tabelle di Composizione Degli Alimenti. A cura di Carnovale E, Marletta L. Occhipinti Sisar & Gioja Press: Milan.

  • Lamport DJ, Hoyle E, Lawton CL, Mansfield MW, Dye L (2011). Evidence for a second meal cognitive effect: glycaemic responses to high and low glycaemic index evening meals are associated with cognition the following morning. Nutr Neurosci 14, 66–71.

    Article  CAS  PubMed  Google Scholar 

  • Li Y, Dai Q, Jackson JC, Zhang J (2008). Overweight is associated with decreased cognitive functioning among school-age children and adolescents. Obesity (Silver Spring, MD) 16, 1809–1815.

    Article  Google Scholar 

  • Lusk G (1928). The Elements of the Science of Nutrition, 4th edn. WV Saunders Co: Philadelphia.

    Google Scholar 

  • Maffeis C, Pinelli L, Schutz Y (1995). Increased fat oxidation in prepubertal obese children: a metabolic defense against further weight gain? J Pediatr 126, 15–20.

    Article  CAS  PubMed  Google Scholar 

  • Maffeis C, Schutz Y, Schena F, Zaffanello M, Pinelli L (1993). Energy expenditure during walking and running in obese and nonobese prepubertal children. J Pediatr 123, 193–199.

    Article  CAS  PubMed  Google Scholar 

  • Maffeis C, Schutz Y, Grezzani A, Provera S, Piacentini G, Tatò L (2001). Meal-induced thermogenesis and obesity: is a fat meal a risk factor for fat gain in children? J Clin Endocrinol Metab 86, 214–219.

    CAS  PubMed  Google Scholar 

  • McNay EC, Ong CT, McCrimmon RJ, Cresswell J, Bogan JS, Sherwin RS (2010). Hippocampal memory processes are modulated by insulin and high-fat-induced insulin resistance. Neurobiol Learn Mem 93, 546–553.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Micha R, Rogers PJ, Nelson M (2010). The glycaemic potency of breakfast and cognitive function in school children. Eur J Clin Nutr 64, 948–957.

    Article  CAS  PubMed  Google Scholar 

  • Nash DT, Fillit H (2006). Cardiovascular diseases risk factors and cognitive impairment. Am J Cardiol 97, 1262–1265.

    Article  PubMed  Google Scholar 

  • Nilsson A, Radeborg K, Björck I (2009). Effects of differences in postprandial glycaemia on cognitive functions in healthy middle-aged subjects. Eur J Clin Nutr 63, 113–120.

    Article  CAS  PubMed  Google Scholar 

  • Porte Jr D, Woods SC (1981). Regulation of food intake and body weight in insulin. Diabetologia 20 (Suppl), 274–280.

    Article  CAS  PubMed  Google Scholar 

  • Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD (2005). Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 105, 743–760; quiz 761–762.

    Article  PubMed  Google Scholar 

  • Reynolds CR (1994). Bigler Test TEMA—Memoria e apprendimento. Ed Erickson: Trento.

    Google Scholar 

  • Reynolds CR, Bigler ED (1994). Test of Memory and Learning (TOMAL). Pro-Ed: Austin, TX.

    Google Scholar 

  • Scholey AB, Sünram-Lea SI, Greer J, Elliott J, Kennedy DO (2009). Glucose administration prior to a divided attention task improves tracking performance but not word recognition: evidence against differential memory enhancement? Psychopharmacology (Berl) 202, 549–558.

    Article  CAS  Google Scholar 

  • Suzuki K, Simpson KA, Minnion JS, Shillito JC, Bloom SR (2010). The role of gut hormones and the hypothalamus in appetite regulation. Endocr J 57, 359–372.

    Article  CAS  PubMed  Google Scholar 

  • Tanner JM, Whitehouse RH (1976). Clinical longitudinal standards from birth to maturity for height, weight, velocity and stages of puberty. Arch Dis Child 51, 170–179.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wesnes KA, Pincock C, Richardson D, Helm G, Hails S (2003). Breakfast reduces declines in attention and memory over the morning in schoolchildren. Appetite 41, 329–331.

    Article  PubMed  Google Scholar 

  • Widenhorn-Müller K, Hille K, Klenk J, Weiland U (2008). Influence of having breakfast on cognitive performance and mood in 13- to 20-year-old high school students: results of a crossover trial. Pediatrics 122, 279–284.

    Article  PubMed  Google Scholar 

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Acknowledgements

The study was sponsored by the Ministry of Health, Research Project of National Interest (PRIN) No. 2008CJ7CTW and supported by funds from the University of Verona and Galbusera Spa (I).

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Correspondence to C Maffeis.

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Competing interests

Dr Cortese has received financial support to attend medical meetings from Eli Lilly and Company (2007–9) and Shire Pharmaceuticals (2009–10), and has been a co-investigator in studies sponsored by GlaxoSmithKline (2006), Eli Lilly and Company (2007–8) and Genopharm (2008). He has served as a consultant for Shire Pharmaceuticals (2009–10). Dr Cortese is currently supported by a grant from the European Commission (‘Marie Curie’ grant for Career Development, Outgoing International Fellowship, POIF-253103). The other co-authors declare no conflict of interest.

Additional information

Contributors: CM designed and coordinated the study, submitted the study to the Ethical Committee, collected the data, performed the statistical analysis and wrote the manuscript. EF collected the data, provided data input, collaborated on the statistical analysis and the writing of the manuscript. MGS recruited the children, collected the data, provided data input and collaborated on the statistical analysis. EC participated in the design of the study, collected the data and provided data input. MC participated in the design of the study, carried out sample analysis and provided data input. MT participated in the design of the study and collected the data. IF participated in the design of the study and collected the data. SC designed the study, performed the statistical analysis and wrote the manuscript.

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Maffeis, C., Fornari, E., Surano, M. et al. Breakfast skipping in prepubertal obese children: hormonal, metabolic and cognitive consequences. Eur J Clin Nutr 66, 314–321 (2012). https://doi.org/10.1038/ejcn.2011.206

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