B REAKFAST F REQUENCY AND Q UALITY M AY A FFECT A PPETITE AND G LYCEMIA IN A DULTS AND C HILDREN Mark A. Pereira, Elizabeth Erickson, Patricia McKee, Karilyn Srankler, Ssan K. Raatz, Leslie A. Lytle, and Anthony D. Pellgrini By: Eliza Wendel

I NTRODUCTION Does skipping breakfast lead to obesity? No breakfast  upregulation of appetite  potential weight gain and increased risk of diabetes and cardiovascular disease Breakfast = “The first meal of the day, eaten before or at the start of daily activities, within 2 hours of waking, typically no later than 10:00 a.m. and of an energy level between 20 and 35% of total daily energy needs.” OBESITY ? ?

C ONTINUED … Breakfast frequency and quality may impact appetite regulation, quality of diet, and prevention of obesity and chronic disease. Improved blood sugar control Improved satiety

P URPOSE To examine the effects of breakfast frequency and quality on appetite and blood sugar in adults and children. Part 1 of this study investigates the acute effects of breakfast frequency and composition on glycemia and perceived appetite in adults. Part 2 looks into the effects of frequency and composition on perceived appetite, energy levels, and mood in children.

H YPOTHESES Part 1: The hypothesis is that consuming breakfast high in whole foods and low in glycemic index (GI) would have a positive impact on postprandial glucose concentrations and insulin concentrations. Part 2: The hypothesis is that children will be less hungry, have more energy, and be in a better mood when a well balanced, whole grain breakfast was consumed rather than skipped.

M ETHODS Study 1: Subjects: 9 overweight adults aged years old receiving 1 of 5 breakfast types

M ETHODS 1. Composition of meals were tested Appetite: “How hungry do you feel at this moment?” Palatability: “How much did you like that meal?” Mood/Energy: “How energetic do you feel at this moment?” 2. Postprandial glucose and insulin concentrations measured every 30 min for up to 5 hours 3. Insulin concentrations were measured 4. AUC for glucose insulin from 0-2 hours after breakfast were calculated 5. PROC Mixed program used to examine effects of breakfast on 2-h glucose and insulin AUC

M ETHODS Study 2: Subjects: 28 children, 14 boys and 14 girls, ages 9-13 without chronic disease or food allergies Mean BMI of 20.2 kg/m 2 Each would receive 1 of 3 breakfasts, 1 time for each condition, over a span of 2 weeks 1. Given Appetite and Mood Questionnaire and Cognitive Assessments were given 3.5 hours after eating 2. Proc Mixed program used to measure effects of breakfast meal on appetite, perceived energy, and mood ratings

R ESULTS S TUDY 1 Study 1: Mean serum glucose significantly >> after 2 hours in the high GI breakfast vs. low GI No significant difference between AUC insulin between high and low carbohydrate breakfasts with similar GIs

C ONTINUED …

R ESULTS STUDY 2 Study 2: Participants enjoyed both the whole grain and refined foods breakfasts similarly with the same results in satiety as well After 2 hours, very strong difference in hunger level between skipping and eating breakfast without significant difference between the two consuming breakfast There was not a significant difference between those who ate a meal and those who did not regarding feeling more tired and lazy

D ISCUSSION Study 1: Lowering GI  reduced postprandial glucose concentrations High GI breakfast  reactive hypoglycemia 5 hours after a meal, similar to skipping a meal altogether Study 2: No significant differences between refined and whole foods breakfast Significant difference between eating a meal and not eating one at all

C ONTINUED … Breakfast frequency and quality: effect appetite control, blood sugar Consuming a regular breakfast meal rich in fiber and nutrients, whole grains, fruit, and low fat dairy  may reduce the risk of obesity and type 2 diabetes.

S OURCES OF E RROR Pilot Study Small study Children received breakfast only 1 time Midmorning snack given to kids who did not have breakfast might have caused incorrect data

Questions?