Neuropsychology Clinical Trial
Official title:
The Effects of Breakfast on Neuropsychological Functioning in Children Ages 8-10 From Low to Middle Income Families
This study is designed to examine healthy children who skip breakfast and the effects of
fasting on their neuropsychological functioning and the potential benefits that a Balanced
Breakfast may have on their learning abilities. It is expected that this study will provide
new knowledge on how prolonged periods of 8 or more hours without food affect neurocognitive
processes and thus learning how specific meals following this period of fasting, which most
children experience, change those processes, potentially for the better.
The hypotheses for this study are:
1. Children who consume breakfast will demonstrate significantly higher levels of
attention, greater concentration, and diminished impulsivity compared to children who
do not consume breakfast.
2. Children who consume breakfast will demonstrate a significantly quicker reaction time
and increased accuracy in correctly identifying target stimuli from an array compared
to children who do not consume breakfast.
3. Children who consume breakfast will demonstrate increased freedom from distractibility
and enhanced short-term memory compared to children who do not consume breakfast.
4. Children who consume breakfast will demonstrate increased cognitive processing speed
compared to children who do not consume breakfast.
5. Children who consume breakfast will have improved verbal learning compared to children
who do not consume breakfast.
6. Children who consume breakfast will have improved visual memory compared to children
who do not consume breakfast.
Hunger can be considered a chronic health condition. Among children, the lack of available
food to meet usual physical needs on a regular basis leads to poor cognitive and behavioral
performance and is associated with adverse physical and mental health outcomes. All of these
findings are well documented among poor children living in families with sufficient food and
are exacerbated even more among those in families living under conditions of food
insufficiency. There has been a significant effort over the past 2 decades to document the
effects of mechanisms of how hunger affects learning, cognitive performance, and behavior
and how a meal, such as breakfast can mitigate those effects.
The longest period during a 24-hour day when children go without food is the period from the
beginning of sleep at night to the first meal of the following day. Therefore, the morning
seems an ideal time to examine those biological factors that result from hunger or fasting
and how they affect basic processes that underpin learning and behavior. Underprivileged but
otherwise healthy children seem most affected by hunger. Thus, studies are needed to compare
children from families of different economic income strata to understand better how a
breakfast meal might affect those learning and behavioral processes, and whether the
breakfast meal truly has a positive effect on basic learning and behavior.
The goal of this study is to evaluate the effects on short-term neuropsychological
functioning of: a) consumption of breakfast versus no breakfast (2 different breakfast meals
will be employed); and b) consumption of breakfast by groups of children from low income
families vs children from families with average/middle incomes, who are 8-10 years of age.
The primary outcome will be neuropsychological functioning in specific areas of cognition,
as measured by standardized tests. A secondary outcome will be glucose homeostasis, measured
by blood ketones and blood glucose and insulin.
A total of 154 children will be recruited with an anticipated 20% drop out rate. The final
sample will consist of 64 children in each socioeconomic group (total n=128) who will stay
overnight three separate nights and participate in each breakfast condition. The sample will
consist of low and middle income African- and Hispanic-Americans and Caucasian male and
female children between the ages of 8-10. The sample size will consist of an equal number of
boys and girls and will have an equal representation of children from the socioeconomic
conditions (i.e. low and middle income) and ethnicities (African and Hispanic Americans and
Caucasians) identified.
The design consists of two independent groups based on SES with a crossover,
repeated-measures (within subject and across subject design, under three breakfast
conditions. The outcome measures (dependent variables) will include a battery of
neuropsychological measures. All participating subjects are admitted to the Children's
Nutrition Research Center (CNRC) Metabolic Research unit (MRU) three times for overnight
stays with intervals of at least 2 weeks apart across 3 months.
;
Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Supportive Care
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