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Effects on Cognitive Performance of Eating Compared With Omitting Breakfast in Elementary Schoolchildren

Kral, Tanja V. E. PhD*; Heo, Moonseong PhD; Whiteford, Linda M. BA; Faith, Myles S. PhD§

Section Editor(s): Ievers-Landis, Carolyn E. PhD; Associate Editor

Journal of Developmental & Behavioral Pediatrics: January 2012 - Volume 33 - Issue 1 - p 9–16
doi: 10.1097/DBP.0b013e31823f2f35
Original Articles

Objective: The objective of this laboratory-based pilot study was to test the effects of consuming, compared with omitting, breakfast across 6 cognitive domains and on levels of perceived energy and well-being. Methods: In a crossover design, 21 boys and girls, 8 to 10 years of age, were assessed once a week for 2 weeks. On each test day, subjects performed a series of 8 computerized cognitive performance tasks using the CogState© software program throughout the morning, but they either consumed or did not consume breakfast. In addition, subjects repeatedly rated their perceived energy level, fatigue, overall well-being, and cheerfulness using a 100-mm Visual Analog Scale. Results: Results showed no significant main effect of breakfast condition (p > .17) or breakfast condition-by-time interaction (p > .09) for any of the cognitive performance tasks. On the day when children consumed breakfast, they felt significantly more cheerful (p = .02) and indicated to have more energy (p = .04) than on the day when they skipped breakfast. Conclusion: Among children who regularly consume breakfast, skipping breakfast once significantly decreased their perceived level of energy and cheerfulness, but it did not affect their cognitive performance throughout the morning. More experimental studies are needed to assess the effects of different types of breakfast on cognitive performance in children over a prolonged period of time while controlling for familial factors that may affect cognitive performance in children.

From the *Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing and Perelman School of Medicine, Philadelphia, PA; †Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; ‡Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA; §Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC.

Editor's Note

Health behaviors of eating and physical activity for children have become even more under the purview of pediatricians and other care providers with the recent escalation of pediatric obesity. The urgent need for sound, empirically grounded recommendations makes the conduct of well-designed experimental studies a priority for the fields of developmental/behavioral pediatrics and psychology. This article by Kral et al exemplifies this type of effort quite well. That eating breakfast is important to children's mental or physical health is oftentimes just assumed. Kral et al, via a relatively small pilot study, experimentally tested whether eating breakfast objectively impacts children's cognitive performance and their mood and energy levels. We invite you to read this article and discover what they found. We hope that you will be inspired to expand this type of inquiry to other health behaviors and important outcomes for children. As professionals, we should achieve a greater understanding of which specific health behaviors to promote to our patients and their families for which ends.

Received August 2011; accepted October 2011.

T.V.E.K. and M.S.F. participated in study design, interpretation of the data, and critical revision of the manuscript; M.H. participated in statistical analysis and critical revision of the manuscript; L.M.W. participated in study conduct and critical revision of the manuscript; and T.V.E.K. participated in writing of the manuscript.

This study was supported by a research grant K01DK078601 from the General Mills Bell Institute of Health and Nutrition, Minneapolis, MN (to M.S.F. and T.V.E.K.). The sponsor also provided all ready-to-eat breakfast cereals as well as $10 gift cards for child participants. The sponsor had input into the study design, but did not participate in the implementation of the study, statistical analyses, or interpretation of the results.

Disclosure: The authors declare no conflict of interest.

Address for reprints: Tanja V.E. Kral, PhD, Department of Biobehavioral Health Sciences, School of Nursing and Perelman School of Medicine, 308 Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104-4217; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.