***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: It is hypothesized that giving children a daily breakfast at school may improve their scholastic achievement through several mechanisms : increasing the time spent in school , improving certain cognitive functions and attention to tasks , and , perhaps indirectly , improving nutritional status . Two Jamaican studies showed that providing breakfast to students at school improved some cognitive functions , particularly in undernourished children . However , changes in classroom behavior varied depending on the quality of the school . Children in better-organized schools concentrated on tasks for longer periods and made fewer undesirable movements , whereas in poorly organized schools the children 's behavior deteriorated . Studies to date have provided insufficient evidence to determine whether children 's long-term scholastic achievement is improved by eating breakfast daily . Well- design ed , r and omized , controlled , long-term trials are essential for determining public policy on the implementation of school feeding programs School feeding programs exist in many countries , but few have been properly evaluated . In this study , the short-term effects of breakfast on children 's cognitive functions were examined . The subjects were 97 undernourished ( weight-for-age < or = -1 SD of reference ) and 100 adequately nourished ( weight-for-age > -1 SD ) children in four primary schools in rural Jamaica . The children were r and omly assigned to a group provided with breakfast or a group given a quarter of an orange as a placebo , and then given a battery of four cognitive function tests . After a few weeks the treatments were reversed and the tests repeated . Undernourished children 's performance improved significantly on a test of verbal fluency when they received breakfast , whereas that of the adequately nourished children did not change ( breakfast x group interaction , P < 0.05 ) . There were no other effects of breakfast on test scores . The findings extend those of a previous Jamaican study conducted under more controlled conditions , and support the targeting of school meals to undernourished children We examined the effects of omitting breakfast on the cognitive functions of three groups of children : stunted , nonstunted controls , and previously severely malnourished . They were admitted to a metabolic ward twice . After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time . The treatment order was reversed for the other half . When breakfast was omitted , both the stunted and previously malnourished groups responded similarly . The malnourished groups had lower scores in fluency and coding whereas the control group had higher scores in arithmetic . The children were divided into wasted and nonwasted groups . Wasted children were adversely affected in the digit span backwards tests , and wasted members of the malnourished groups were adversely affected in efficiency of problem solving and those in the control group in digit span forwards . These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children Effects of skipping breakfast on speed and accuracy of response in a number of problem solving tasks were assessed in 9- to 11-yr-old , well-nourished children . The conceptual framework for this study was derived from an experimental model of the effects of mild environmental stress , e.g. , noise , on human performance . Plasma glucose , beta-hydroxybutyrate , lactate , and free fatty acids were used as indicators of the induced metabolic stress , and the extent of their association with the behavioral measures was determined . Fasting had an adverse effect on the accuracy of responses in problem solving , but it had a beneficial effect on immediate recall in short-term memory . Both effects are explained by a heightened arousal level associated with the brief experimental fast Twenty-nine schoolchildren were tested throughout the morning on 4 successive days , having a different breakfast each day ( either of the cereals Cheerios or Shreddies , glucose drink or No breakfast ) . A series of computerised tests of attention , working memory and episodic secondary memory was conducted prior to breakfast and again 30 , 90 , 150 and 210 min later . The glucose drink and No breakfast conditions were followed by declines in attention and memory , but the declines were significantly reduced in the two cereal conditions . This study provides objective evidence that a typical breakfast of cereal rich in complex carbohydrates can help maintain mental performance over the morning Serotonergic hypofunction may underlie at least part of the symptoms that are experienced by women with premenstrual complaints , including memory deficits . In the current study we investigated changes in memory functions in the premenstrual phase compared to the early postmenstrual phase in 16 women with premenstrual complaints . In addition , the effect of an acute serotonergic stimulation by administration of an alpha-lactalbumin protein on premenstrual memory performance was assessed using a double-blind placebo-controlled crossover design . It was found that both short-term and long-term memory for words ( 30-word learning task ) and abstract figures ( abstract visual learning task ) were mildly impaired in the premenstrual phase . Administration of alpha-lactalbumin during the premenstrual phase could only partially attenuate the memory performance decrements that are seen in the premenstrual phase . Specifically , alphalactalbumin improved long-term memory for abstract figures , but not for words . There were no effects of menstrual phase or alpha-lactalbumin on planning functions ( computerized Tower of London ) . The data suggest that serotonergic hypofunction may play a role in premenstrual memory decline , but serotonergic mechanisms can not fully account for observed cognitive changes in the premenstrual phase Abstract Rationale : It is known that glucose administration is capable of improving performance on tests of declarative verbal memory and non-mnemonic tasks requiring high ” mental effort ” . At the same time , cognitively dem and ing tasks are associated with elevated heart rate , a response that could feasibly be part of a physiological mechanism serving to increase the delivery of glucose to active brain substrates . Objective : The present placebo-controlled , double-blind , balanced , crossover study examined the interaction between glucose administration , cognitive performance and heart rate during three tasks of differing mental dem and and somatically-matched control tasks . Methods : The effects of a glucose drinkon  participants ’ performance on two  serial subtraction tasks ( Serial Threes and Serial Sevens ) and a Word Retrieval ( Verbal Fluency ) task were assessed . Heart rates were monitored throughout the experiment , and participants rated each task in terms of its perceived mental dem and . Results : Serial Sevens was rated as the most mentally dem and ing task , followed by Word Retrieval , then Serial Threes . Glucose consumption significantly improved performance on Serial Sevens , with a trend for improved performance on Word Retrieval . Both Serial Sevens and Serial Threes were associated with significant heart rate elevation above that seen in somatically matched control tasks ( ruling out the possibility that accelerated heart rate was due to peripheral mechanisms alone ) . Unexpectedly , participants in the glucose condition had higher heart rates during cognitive processing . Additionally , individuals whose baseline heart rates were below the median performed better on Serial Threes and Serial Sevens . Conclusion : We suggest that supplemental glucose preferentially targets tasks with a relatively high cognitive load , which itself ( through unknown mechanisms ) mobilises physiological reserves as part of a natural response to such tasks . Furthermore , baseline heart rate and responses to cognitive dem and and glucose administration may represent important physiological individual differences In 1993 , in Peru , the Institute of Nutritional Research conducted two studies in Huaraz in the And ean region to evaluate the educational and nutritional impact of the government 's School Breakfast Program . The school breakfast included a small cake and a glass of Amilac ( similar in taste and color to milk ) , which provided 30 % of each child 's energy requirements , 60 % of recommended dietary allowances for minerals and vitamins , and 100 % of dietary iron needs . A case control study examined the effects of breakfast on cognition among 54 elementary schoolchildren 9 - 11 years old . It found that the school breakfast did not have a significant effect on the children 's performance in the Number Discrimination , Peabody Picture Vocabulary Test , Raven Progressive Matrices , or Reaction Time tests .  Children nutritionally at risk who received the placebo had significantly slower short-term memory scanning than their counterparts who received the breakfast . The no-risk placebo group exhibited more rapid discrimination between visual stimuli than the no-risk breakfast group . A field evaluation of the program in 10 rural schools , which were r and omly assigned to a treatment or control condition , was conducted . In terms of energy , protein , and iron intake , the children in the case and control conditions were not significantly different . The children tended to be either very stunted or overweight . School attendance increased 0.58 points in the experimental group , while it decreased by 2.92 points in the control group ( p 0.05 ) . When both groups received the breakfast , attendance rates increased significantly in both groups ( p 0.05 ) . Vocabulary was sensitive to the effects of the breakfast . Specifically , the greater the child 's weight , the higher his/her vocabulary test scores ( p 0.05 ) . These findings suggest that the brain is sensitive to decreases in the short-term availability of nutrients , and that an overnight and morning fast produces a physiological state accompanied by changes in brain function , especially working memory , particularly among nutritionally at-risk children Abstract Recent research findings indicate that glucose administration enhances some aspects of cognitive functioning . To date , those studies which have investigated the effects of glucose on memory in human participants have concentrated on its apparent ability to attenuate memory impairment . Relatively little research has been done in humans investigating the effects of glucose on memory performance in young healthy participants in whom no memory deficits exist . Moreover , the work which has been conducted in this population has produced somewhat equivocal findings . In this study , after overnight fasting the influence of a 25 g oral dosage of glucose on a range of measures of memory performance was investigated in healthy young female participants . Two control treatments ( saccharin and water ) were also administered . There was a significant glucose facilitation effect upon performance of long-term verbal free and cued recall tasks which did not vary with test delay . Performance on these free and cued verbal recall measures correlated significantly with blood glucose levels across all participants . No glucose-related facilitation was observed on either a test of short-term verbal memory ( forwards/backwards digit recall ) or a test of long-term non-verbal memory ( complex figure reproduction ) . However , the significant glucose-related effects observed with long-term free and cued recall remained after controlling for participants ’ differential baseline blood glucose levels and individual levels of immediate memory performance . Therefore , memory improvement after glucose ingestion was not merely a consequence of lower baseline blood glucose or lower immediate memory performance in the glucose treatment group . These findings indicate that there may be some fractionation in the memory facilitation effects of glucose : the memory enhancing effect of glucose administration in healthy young adults may be greatest on tests of long-term verbal recall . The results suggest that glucose may enhance retention in and /or retrieval from long-term verbal memory Memory for a list of 20 words can be enhanced by preceding learning by consumption of 25 g of glucose , compared with consumption of an equally sweet aspartame solution ( Psychopharmacology 137 ( 1998 ) 259 ; Psychopharmacology 157 ( 2001 ) 46 ) . However , using this antero grade administration procedure , it is impossible to separate whether glucose affects encoding , consolidation , or retrieval . The present placebo-controlled , double-blind study investigated the effect of antero grade and retro grade administration on memory performance in healthy young participants . In order to evaluate whether post-acquisition administration of glucose can improve memory performance and to compare possible differences in the size of the effect , participants were administered 25 g of glucose immediately before or immediately after presentation of a word list . Moreover , in order to investigate whether the effect of glucose administration on memory performance is time-dependent , a third group received 25 g of glucose 15 min before learning the word list . Word- list recall was tested 30 min and 24 h after word list presentation . Measures of spatial memory performance and working memory were also evaluated . The results of this study showed that both pre- and post-acquisition oral glucose administration ( 25 g ) can improve memory performance . However , as the time interval between antero grade glucose administration and memory encoding increased , the glucose memory facilitation effect decreased . This study provides evidence that  glucose enhances memory performance in healthy young people even when it is given after learning has taken place , and that this effect is observed at least up to 24 h after glucose administration . Moreover , it provides evidence that the effect of  glucose  on memory performance may be time-dependent , as the enhancement of retention was decreased when the administration-learning interval was increased In order to examine the effect of energy intake at breakfast on school performance the same morning , the parents of ten parallel school classes of 10-year-old school children at five different schools were persuaded to alter their child 's breakfast regimen at home over a period of 4 successive days . A total of 195 families were provided with st and ard breakfasts with either low or high energy content . Uneaten food was returned and weighed . Individual children were r and omly assigned to breakfast alternative on any given day . The teachers who carried out the performance assessment s at school were blind to treatment condition . Voluntary physical endurance and the performance of a creativity test were significantly better after a breakfast from which children derived over 20 % of their recommended daily energy intake than after a breakfast from which they obtained less than 10 % of recommended values . The error rate in an addition task was negatively correlated and the rate of working in a number checking task was positively correlated with individual energy intake from the low-energy breakfast . Significantly fewer children reported feeling bad and self-estimates of hunger sensation were lower during the morning at school after the high energy breakfast . Estimates of energy intake at breakfast based on 24-h dietary recall interviews with the children carried out by telephone at their homes showed good correlation with estimates based on returned food ( r = 0.89 ) . Energy intake at breakfast as estimated from returned food had no significant effect on energy intake at school lunch as estimated by dietary recall In order to examine the effect of energy intake at breakfast on school performance , 151 grade three school children from four classes of two schools were sample d for this study . Children were r and omly assigned to breakfast A or B on any given day . They were provided with breakfast with 
    Output:
    
The evidence indicates that breakfast consumption is more beneficial than skipping breakfast , but this effect is more apparent in children whose nutritional status is compromised .
There is a lack of research comparing breakfast type , precluding recommendations for the size and composition of an optimal breakfast for children 's cognitive function .
Studies of school breakfast programmes suggest that such interventions can have positive effects on academic performance , but this may be in part explained by the increased school attendance that programmes encourage .