Nutrient Intake of Children Eating School Breakfast

Since co-administration of dosage forms with food can impact drug exposure, food effect studies became an integral part of oral drug product development. Studies are usually performed in healthy adults and the dosage form is co-administered with a high-fat high-calorie standard breakfast meal to mimic worst-case dosing conditions. A corresponding study design for children is lacking but would be essential for a proper risk-assessment in this vulnerable patient group. To protect healthy children from unnecessary in vivo studies, it would be even more desirable to predict food effects based on other than in vivo studies in the target age group. In the present study, typical children's breakfasts in different parts of the world were identified, prepared and physicochemical properties were assessed. Subsequently, Simulated Paediatric Breakfast Media (SPBM) resembling breakfast composition and properties were designed and applied in in vitro dissolution experiments mimicking the initial composition of the postprandial stomach after breakfast ingestion. Study results indicate the impact of different simulated gastric conditions on drug release. SPBM enabled to better estimate the variability of in vivo drug release in fed dosing conditions and their use will aid in better assessing food effects in children in different parts of the world.

In Canada, school meals are regarded as important for social, educational, and nutritional reasons and have been provided for several years because of concerns about the health and welfare of children, especially those from low-income households. They are generally offered as local community organization and individual schools, are not regulated by law, and have no set national nutrition standards. The Canadian scientific literature lacks quantitative information on the nutritional adequacy of school meals. Better and more evaluation of such programs would encourage and guide administrators to assess other local programs in a similar fashion. Here, we describe the dietary assessment process of 1 school meal program in Canada and the nutritional adequacy of the meals. Throughout 10 years (1997-2007), the contents of 159 lunches and 90 breakfasts were collected mainly from elementary schools participating in the Child Hunger and Education Program Good Food, Inc's school nutrition program initiative in Saskatoon, Saskatchewan, Canada. We collected, weighed, and analyzed food samples from meals served to children at participating schools. We then compared their nutrient content against standards based on the Dietary Recommended Intakes for children aged 4 to 8 and 9 to 13 years using one third of the recommendations as the standard for lunches and one fourth for breakfasts. Overall, both meals had a good nutrient profile and met the standards for most analyzed macronutrients and micronutrients throughout the years. Although energy was persistently low, vitamin and mineral contents were often above the standards, reflecting a tendency to offer nutrient-dense foods in lieu of energy-dense foods. The rigorous methodology described in this manuscript can be followed to assess other small local programs. Furthermore, the dietary assessment presented can encourage not only the implementation of school meal programs in other locations but also the assessment of already existing programs—a clear need in the scientific literature.

Le petit déjeuner rompt le jeûne nocturne, c’est sa première fonction physiologique. Il fait partie des recommandations hygiéno-diététiques classiques, mais est-il vraiment utile ? Ce travail fait le point sur les données récentes relatives aux effets de la prise du petit déjeuner sur l’équilibre alimentaire de la journée, sur les prises alimentaires suivantes, sur le poids, ainsi que sur certains paramètres métaboliques. Les bénéfices en sont discutés tant dans leurs mécanismes que leurs déterminants. Les effets relatifs aux performances intellectuelles sont également présentés et discutés. Enfin, le rôle des constituants du petit déjeuner, nutriments et aliments, est analysé. Il est donc justifié de conseiller un petit déjeuner et l’on peut en proposer un contenu : pain et/ou céréales riches en fibres, produit laitier, beurre, fruit, boisson.

The first physiological function of breakfast is to break nocturnal fasting. It is part of classical hygienic and dietary recommendations, but is it really useful? This work gathers recent data about effects of breakfast on dietary balance of the day and on the following meals, on weight, as well as on some metabolic parameters. Benefits of breakfast are discussed in their mechanisms as well as in their determinants. Effects concerning intellectual performance are also presented and discussed. Finally, the role of breakfast constituents, nutrients and foods, is analysed. Therefore, it is justified to recommend a breakfast and the following content can be proposed: bread and/or high-fibre cereals, dairy product, butter, fruit and drink.

For school breakfast each day, many elementary schools offer a choice between a cold option that includes ready-to-eat (RTE) cereal and a hot option that includes a non-RTE-cereal entrée such as waffles. For breakfast reports, intrusions (reports of uneaten items) in correctly reported and misreported breakfast options were examined using data from five dietary-reporting validation studies. In each study, fourth-grade children were observed eating school breakfast and school lunch and then interviewed to obtain a dietary recall. A breakfast option was correctly reported in 240 breakfast reports for 203 intrusions total, and misreported in 97 breakfast reports for 189 intrusions total. Asymmetry was evident in misreported options; specifically, children observed eating a cold option almost never misreported a hot option, but children observed eating a hot option often misreported a cold option. Proportionately more breakfast reports were intrusion-free when a breakfast option was correctly reported than misreported. Linking of intrusions (i.e., multiple intrusions from the same option in a breakfast report) was especially evident with misreported breakfast options. Methodological aspects of dietary recalls such as target period (prior 24 h; previous day), interview time (morning; afternoon; evening), and interview format (meal; open) had implications for intrusions and misreported breakfast options.

Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the association of breakfast consumption with nutritional adequacy (nine studies), body weight (16 studies), and academic performance (22 studies) in children and adolescents. Breakfast skipping is highly prevalent in the United States and Europe (10% to 30%), depending on age group, population, and definition. Although the quality of breakfast was variable within and between studies, children who reported eating breakfast on a consistent basis tended to have superior nutritional profiles than their breakfast-skipping peers. Breakfast eaters generally consumed more daily calories yet were less likely to be overweight, although not all studies associated breakfast skipping with overweight. Evidence suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance. Breakfast as part of a healthful diet and lifestyle can positively impact children’s health and well-being. Parents should be encouraged to provide breakfast for their children or explore the availability of a school breakfast program. We advocate consumption of a healthful breakfast on a daily basis consisting of a variety of foods, especially high-fiber and nutrient-rich whole grains, fruits, and dairy products.

The primary goal was to test the validity of digital photography for measuring food portion sizes compared with weighed foods and with direct visual estimation.

A total of 60 test meals consisting of 10 different portion sizes from six different university cafeteria menus were prepared and weighed.

Food selections and plate waste, as estimated by digital photography and direct visual estimation, were compared with weighed foods. For each method, three observers independently estimated portion sizes of each food. Observers expressed the portion sizes as a percentage of a standard serving. These percentages were multiplied by the weight of the standard portion to yield estimated weights.

To test validity, the estimates of food weights derived from both methods were compared with weighed foods using correlations and were compared with each other using Bland-Altman regression analysis.

For the digital photography and direct visual estimation methods, estimates of the portion sizes for food selections, plate waste, and food intake were highly correlated with weighed foods. Both methods tended to yield small overestimates or underestimates. Bland-Altman regression found the two estimation methods to yield comparable results (bias less than 1.5 g).

These findings support the validity of the digital photography method for measuring portion sizes. Digital photography may be most useful for measuring food intake in settings that allow for the direct observation of food selections and plate waste but require minimum disruption of the eating environment, and allow unhurried estimates of portion sizes.