***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: Methods : Various developmental problems including attention-deficit/hyperactivity disorder ( ADHD ) have been linked to biological deficiencies in polyunsaturated fatty acids ( PUFAs ) . Additionally , there is evidence that symptoms may be reduced with PUFA supplementation . This study investigated effects of supplementation with PUFAs on symptoms typically associated with ADHD . Because nutrients work synergistically , additional effects of micronutrient supplementation were also investigated . A total of 132 Australian children aged 7 to 12 years with scores ≥2 SD above the population average on the Conners ADHD Index participated in a r and omized , placebo-controlled , double-blind intervention over 15 weeks , taking PUFAs alone , PUFAs + micronutrients , or placebo . Due to unreturned question naires , data were only available for 104 children . Results : Significant medium to strong positive treatment effects were found on parent ratings of core ADHD symptoms , inattention , hyperactivity/impulsivity , on the Conners Parent Rating Scale ( CPRS ) in both PUFA treatment groups compared with the placebo group ; no additional effects were found with the micronutrients . After a one-way crossover to active supplements in all groups for a further 15 weeks , these results were replicated in the placebo group , and the treatment groups continued to show significant improvements on CPRS core symptoms . No significant effects were found on Conners Teacher Rating Scales . Conclusion : These results add to preliminary findings that ADHD-related problems with inattention , hyperactivity , and impulsivity might respond to treatment with PUFAs and that improvements may continue with supplementation extending to 30 weeks This pilot study evaluated the effects of supplementation with PUFA on blood FA composition and behavior in children with Attention-Deficit/Hyperactivity Disorder (AD/HD)-like symptoms also reporting thirst and skin problems . Fifty children were r and omized to treatment groups receiving either a PUFA supplement providing a daily dose of 480 mg DHA , 80 mg EPA , 40 mg arachidonic acid ( AA ) , 96 mg GLA , and 24 mg α-tocopheryl acetate , or an olive oil placebo for 4 mon of doubleblind parallel treatment . Supplementation with the PUFA led to a substantial increase in the proportions of EPA , DHA , and α-tocopherol in the plasma phospholipids and red blood cell ( RBC ) total lipids , but an increase was noted in the plasma phospholipid proportions of 18∶3n-3 with olive oil as well . Significant improvements in multiple but outcomes ( as rated by parents ) were noted in both groups , but a clear benefit from PUFA supplementation for all behaviors characteristic of AD/HD was not observed . For most outcomes , improvement of the PUFA group was consistently nominally better than that of the olive oil group ; but the treatment difference was significantly , by secondary intent-to-treat analysis on only 2 out of 16 outcome measures : conduct problems rated by parents ( −42.7 vs. −9.9 % , n=47 , P=0.05 ) , and attention symptoms rated by teachers ( −14.8 vs. + 3.4 % , n=47 , P=0.03 ) . PUFA supplementation led to a greater number of participants showing improvement in oppositional defiant behavior from a clinical to a non clinical range compared with olive oil supplementation ( 8 out of 12 vs. 3 out of 11 , n=33 , P=0.02 ) . Also , significant correlations were observed when comparing the magnitude of change between increasing proportions of EPA in the RBC and decreasing disruptive behavior as assessed by the Abbreviated Symptom Question naire ( ASQ ) for parents ( r=−0.38 , n=31 , P<0.05 ) , and for EPA and DHA in the RBC and the teachers ' Disruptive Behavior Disorders ( DBD ) Rating Scale for Attention ( r=−0.49 , n=24 , P<0.05 ) . Interestingly , significant correlations were observed between the magnitude of increase in α-tocopherol concentrations in the RBC and a decrease in scores for all four subscales of the teacher 's DBD ( Hyperactivity , r=−0.45 ; Attention , r=−0.60 ; Conduct , r=−0.41 ; Oppositional/Defiant Disorder , r=−0.54 ; n=24 , P<0.05 ) as well as the ASQ for teachers ( r=−0.51 , n=24 , P<0.05 ) . Thus , the results of this pilot study suggest the need for further research with both n−3 FA and vitamin E in children with behavioral disorders 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 Children ( 227 ) , aged 7 - 12 years , weighed and recorded all food and drink consumed for seven consecutive days . Each child completed tests of verbal and non-verbal intelligence , and was then r and omly allocated to one of two groups after matching for age , sex , IQ and height . In a double-blind trial lasting for 28 d , one group received a vitamin-mineral supplement daily and the other group a placebo . On re-testing , there were no significant differences in performance between the two groups . Furthermore , there was no consistent correlations between test scores and micronutrient intakes based on the weighed records . Thus , we found no evidence that learning ability in a cross-section of British schoolchildren was limited by the quality of their diets OBJECTIVES To investigate whether docosahexaenoic acid ( DHA ) supplementation was able to ameliorate attention-deficit/hyperactivity disorder(AD/HD ) symptoms in AD/HD children . DESIGN AND SUBJECTS A placebo-controlled double-blind study with 40 AD/HD ( including eight AD/HD-suspected ) children of 6 - 12 y of age who were mostly without medication . Subjects of a DHA group ( n=20 ) took active foods containing fish oil ( fermented soybean milk , bread rolls and steamed bread ; 3.6 g DHA/week from these foods ) for 2 months , whereas those of a control group ( n=20 ) took indistinguishable control foods without fish oil . The following items were measured at the start and end of the study : ( 1 ) attention deficit , hyperactivity and impulsivity ( AD/HD-related symptoms according to DSM-IV criteria ) ; ( 2 ) aggression assessed by both parents and teachers ; ( 3 ) visual perception ( finding symbols out of a table ) ; ( 4 ) visual and auditory short-term memory ; ( 5 ) development of visual-motor integration ; ( 6 ) continuous performance ; ( 7 ) impatience . RESULTS Changes in tests 1 , 2 , 3 , 5 and 7 over time did not significantly differ between the two groups . However , visual short-term memory and errors of commission ( continuous performance ) significantly improved in the control group compared with the changes over time in the DHA group ( P=0.02 and 0.001 , respectively ) . Recalculation without AD/HD-suspected subjects ( n=4 each group ) showed similar P-values with regard to both measures . CONCLUSION DHA supplementation did not improve AD/HD-related symptoms . Treatment of ADHD with fatty acids deserves further investigation , but careful attention should be paid as to which fatty acid(s ) is used Background . Developmental coordination disorder ( DCD ) affects ∼5 % of school-aged children . In addition to the core deficits in motor function , this condition is associated commonly with difficulties in learning , behavior , and psychosocial adjustment that persist into adulthood . Mounting evidence suggests that a relative lack of certain polyunsaturated fatty acids may contribute to related neurodevelopmental and psychiatric disorders such as dyslexia and attention-deficit/hyperactivity disorder . Given the current lack of effective , evidence -based treatment options for DCD , the use of fatty acid supplements merits investigation . Methods . A r and omized , controlled trial of dietary supplementation with ω-3 and ω-6 fatty acids , compared with placebo , was conducted with 117 children with DCD ( 5–12 years of age ) . Treatment for 3 months in parallel groups was followed by a 1-way crossover from placebo to active treatment for an additional 3 months . Results . No effect of treatment on motor skills was apparent , but significant improvements for active treatment versus placebo were found in reading , spelling , and behavior over 3 months of treatment in parallel groups . After the crossover , similar changes were seen in the placebo-active group , whereas children continuing with active treatment maintained or improved their progress . Conclusions . Fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioral problems among children with DCD . Additional work is needed to investigate whether our inability to detect any improvement in motor skills reflects the measures used and to assess the durability of treatment effects on behavior and academic progress A challenge design was used in two separate studies to investigate the effects of sucrose ingestion on the behavior and learning of hyperactive boys . In both studies , 16 boys were admitted to a clinical research center for 3 successive days , on each of which they were given a  sucrose-free diet .  On day 1 , baseline levels on the learning tasks were established ; on days 2 and 3 a challenge drink of either sucrose 1.75 gm/kg or a placebo ( aspartame in equivalent sweetness ) was presented , in a counterbalanced order . In the first study the challenge drink was administered 1 hour after lunch ; in the second study it was given in the morning after an overnight fast . On days 2 and 3 of both studies , 37 behavioral ( playroom observation and examiner ratings ) and cognitive ( learning and memory tasks ) measures were collected , starting 1/2 hour after ingestion of the drink . The results of both studies revealed no differences between the boys ' performance on the two challenge days . These findings undermine the hypothesis that sucrose plays a major role in accounting for the inappropriate behavior of hyperactive boys 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 A program was initiated to provide a free breakfast at a ghetto elementary school . Community support was achieved at the expense of r and omization of study subjects . While no significantly greater increase in school attendance or performance was detected in comparison with a control school , none of the students was malnourished and diets of students in the control school were as adequate as those in the breakfast school . Thus , it can not be concluded that school breakfast programs would not benefit malnourished children or teen-agers who most often go without breakfast This study focuses on the effects of breakfast omission on cognitive performance . We studied 279 children from low so 
    Output:
    
However , there is emerging evidence for the effects of certain fatty acids which appear to be a function of dose and time .
Whilst the importance of diet in educational attainment remains under investigation , the evidence for promotion of lower-fat , -salt and -sugar diets , high in fruits , vegetables and complex carbohydrates , as well as promotion of physical activity remains unequivocal in terms of health outcomes for all schoolchildren