Tuesday, July 12, 2011

Wheat, Rice, and Children's Brains

There is another post-worthy probiotics paper on the hopper, but before that I wanted to cover an article called Breakfast Staple Types Affect Brain Gray Matter Volume and Cognitive Function in Healthy Children (freely available on PLoS one).  I like some parts of this paper, though it is observational in nature, so keep that in mind.

As we all know, our big old brains develop not only prenatally, but also throughout childhood and adolescence.  In children, several studies have been done showing nourishing breakfasts help cognitive performance compared to skipping breakfast - especially the "high quality" breakfasts, with one study showing that a breakfast of low glycemic index foods having an immediate positive effect on attention throughout the morning (1).

In other introductory information, many studies in children have been able to correlate the amount of brain gray matter (vs. white matter) and IQ, especially gray matter in the prefrontal and orbitofrontal cortex and the cingulate gyrus.  Therefore, since breakfast types affect cognitive function, and brain structure can correlate with IQ, does breakfast type correlate with brain structure and IQ?  I don't know.  Let's find out.

These Japanese researchers (funded by a national Young Scientists' grant) studied 290 healthy children ages 5-18 years.  In Japan, apparently boiled white rice or white bread make up a typical breakfast.  (I remember eating a lot of this cereal plus sugar in skim milk when I was a kid. Kapow!)  The scientists were able to split the children into groups of habitual rice-eaters, habitual white bread eaters, and those who consumed both regularly.  Then they tested the IQs (using standard measures for kids <16 and a separate standard test for 16 and older), scanned the kids in a MRI, and collected their data.  Questionnaires were filled out by the kids or their parents with respect to morning eating habits, health, wealth, etc.

Using varying statistical techniques and a couple varieties of imaging data collection, the researchers found that the gray matter ratios (gray matter volume divided by intracranial volume) were significantly higher among the rice eaters vs. the white bread eaters, even after adjusting for age, gender, wealth, average weekly frequency of eating breakfast, and number of breakfast side dishes.  The Verbal IQ in the rice group averaged 104.7, in the bread group 100.3.  The Performance IQ was 102.1 in the rice group and 97.9 in the bread group.  This difference was non-significant.

As the kids became older, the differences in gray matter ratio increased between bread and rice groups.  Overall, calories consumed among rice eaters were slightly lower than those who habitually ate bread.

Now the researchers spend a lot of time talking about how all of these findings can be explained by the lower glycemic index of rice compared to white bread.  They feel that low GI foods provide steadier blood glucose levels, and "stable and efficient glucose supply is important for neurons."  It is notable that "cerebral metabolic rates of glucose utilization are approximately two times higher in children compared with adults." (Could be why children seem to have so much more of a natural "sweet tooth" than most adults).  The researchers also felt that since white bread has more fat than white rice, that the increased fat content might be a problem for the brains of white bread eaters (they suggest fat decreases neuronal plasticity).  I rather strongly disagree with them here and will have to pull their supporting paper when I have a minute… right now I have to finish up and dash off to work.

So all told, this study is only an observation, and causal factors cannot be determined with this dataset.  And I think the whole high GI/low GI chase is probably a red herring.  These Japanese kids were all likely relatively low-fat and high carb compared to say, American kids of the same age, and I do tend to think that healthy, low-toxicity carbs and fruit are fine for kids, who are not as likely to have leptin resistance as their adult counterparts.  As for the fat issue - I think a common sense way to think about this issue is to look at neonates.  They are the extreme version of the child, after all, and everyone can agree about the best food for them (human breast milk).  Neonates need a diet high in sugar (though lactose does not contain fructose) and 50% fat with lots of saturated fat.  I don't see how fat can be vital for the baby brain but somehow becomes toxic for the growing child brain.  I wish someone could explain that to me in a way that makes any physiologic sense, because it seems to be taken for truth by so many medical professionals and scientists.   If you can explain exactly when and how fat becomes toxic (somewhere presumably between the ages of 3 and 5, which is when ancestral humans were weaned?) drop me a comment.  "Lipotoxicity" doesn't count without more information as to the specific mechanism - neither do studies poisoning animals and/or humans with large amounts of corn oil or trans fats.

I'm perfectly willing to accept that the bread, derived from wheat, has toxic factors that cause inflammation or hurts the microbiota or interfere with absorption of minerals or whatever, and theoretically could be a casual factor as part of the differences seen in the children's brains in this paper.  My kids get rice and potatoes and fruit and milk as carb staples, in addition to meat, fish, nuts, and vegetables.  All in all, I believe metabolic flexibility and low-toxicity and premium quality food for premium micronutrients are the most important things for a healthy diet and a healthy brain.

End note - thanks to Jamie for the paper!!!  Also, Blogger comments were acting up for a few days.  If you asked me a question in the last few posts, I've been meaning to chime in when I get a moment.  Don't despair.


  1. Very interesting paper, and good of you not to jump to conclusions although it is probably fair to conclude something.

    Fat content of grains isn't usually very much saturated fat, but polyunsaturated fat. From nutritiondata.com 200 calories of white bread contains 500mg of omega-6, so that sounds a bit more plausible to me. However these are still small amounts of fat and if you ask these authors what they think of olive oil they are of course going to be fans, so fat is probably a distraction from the real issue.

    I also think that comparing the GI is a distraction from a more important issue. Nutrition is poor in both white rice and white bread; this study isn't very compatible with the notion that the difference between whole grains and refined grains is just nutrition and fiber content.

    Looks like your stack of papers to blog on is starting to rival your stack of books to read. Yikes! At least your brain is more or less bread-free.

  2. My kids are hooked on breakfast cereals, and my wife won't let me turn them primal, so my mission has been to find the least offensive breakfast cereal around that the kids find acceptable. A couple of months ago, I've settled on Rice Krispies. I know there's added sugar, but it's not terribly high compared to most big brand breakfast cereals. And I serve it with a whopping dose of raw milk, so they're getting plenty of CLA, fat-soluable vitamins, and probiotics.

  3. I read the paper last night with the intention of blogging on it. It got put in the 'can't be bothered with explaining why I don't think it is the glycaemic index' bin.

    I also struggled with their explanation that it might be the fat content of the bread... that is an easy exit to keep the word count down for these researchers. I pulled the paper they referenced with regard to this...



    Sugar + Lard + Corn Oil. Nuff said.

  4. BTW - this was my breakfast every day for 20+ years growing up...


    Gives me an out in the gray matter dept me thinks.

  5. My n=1 observation: when my small kids sit in front of a dinner plate of non-toxic foods, say white rice with butter, hamburger patty, and salad, they will eat a few bites of protein, maybe twice as many bites of the salad, and a whole lot of rice. Oh, and they really want the rice (or other starch) to have plenty of butter on it.
    Also, I'm in the same situation as Aaron - my wife likes the kids to eat breakfast cereals. I don't like the malt flavoring in Rice Krispies because it contains gluten so my solution has been gluten-free Rice Chex.

  6. I live in Japan and can confirm that Japanese are fairly cleanly split between old-school rice-for-breakfast types and toast-for-breakfast types. My own observations as a high school teacher here would also suggest that the bread-eaters have a much shorter attention-span. I wouldn't be surprised if the wheat had something to do with it, but there are two things I would blame before the wheat. First, the bread-eaters are typically more likely to scoff down a piece of toast before rushing out the door, while the rice-eaters are more likely to sit down with the family to a proper Japanese breakfast complete with miso soup a bit of grilled fish or eggs, some greens, pickles and maybe even some natto. Second, especially in Japan, the bread is very sweet - plenty of added sugar - not to mention that it's usually eaten with jam. Seems a little simplistic to break it down as rice vs wheat.

  7. Andrew - in the paper they had some detailed info about typical breakfast sides and *claim* to have accounted for it statistically - but you are right - confounders in studies like these are overwhelming. Interesting to know that about sweet bread in Japan too.

    Jamie, thanks for pulling that paper! Sugar with an extra helping of O6 as usual. As we all suspected, I'm sure...

    Peter - my oldest likes rice, the youngest would love to eat meat, fruit, and olives exclusively... Oh, and yogurt.

  8. Aaron:
    Do what I did: Find candy bars with superior nutritional quality to the cereal and serve those instead. Suddenly the wife sees a different point of view.

    In my case it was snickers versus pop-tarts. Turns out the snickers were slightly lower in carbs, lower in total calories, higher in protein and had no hydrogenated oil!

    Watching my kids sitting at the table for breakfast wolfing down a snickers bar and knowing that was actually superior to a pop-tart made me laugh. And it finally convinced my wife to toss the pop-tarts and we started cooking eggs in the morning. :)

  9. @Peter, thanks for the tip to try Rice Chex. I'll look into it and see if the kiddies approve. My kids also love to eat a lot of rice or mashed potatoes with a little bit of protein/fat on the side.

  10. > Wheat, Rice, and Children's Brains

    One of these things is far more nutritious than the others...

  11. My kids eat eggs and bacon......and if they dont like they get eggs and sausage. Cereal went long ago. my kids have been this way going on three yrs. Wife is on board 18 months. Dr. K.

  12. FWIW, Kelloggs just came out with a gluten free version of Rice Krispies. For some odd reason, they made it a separate product instead of just removing the malt like General Mills did with Chex.

  13. Hi Emily!

    Love your blog, this is my first time commenting; sorry for coming this late to an old post.

    Andrew's already said what I wanted to say but I really wanted to highlight the point. The traditional Japanese breakfast consists of:

    white rice
    miso soup
    fresh vegetables
    pickled vegetables
    some protein, typically fish and/or egg

    In a hotel or restaurant it's a pretty substantial meal. At home it's often fresh rice plus leftovers from dinner the night before.

    In natto-eating regions of Japan, natto too is a breakfast food, typically eaten with rice and a quail's egg.

    Put a bunch a typical Japanese traditional breakfast foods into nutrtiondata and you've got some pretty nutrient-dense stuff there.

    As someone who's lived all over East Asia, I've had to smile, when reading the paper, at the typical habit of referring to rice and bread as if they were the only important thing at the meal and referring to everything else as side dishes. But it's literally true: in a traditional Japanese meal you have a bowl of rice in front of you and everything else is indeed on the side.

    Andrew could have gone even further about the 'bread' in Japan and other East Asian countries: the line between 'bread' and pastry is even blurrier than it is in the West, and the bread sold in typical stores is frankly sweet, made with lots of oil and sugar and often topped or stuffed with something sweet and yes, eaten with jam. 'Bread' is short-hand for anything from a croissant (In Nara I once saw hundreds of people lined up outside a croissant bakery early in the morning) to a donut to toast with jam. But whatever it is, it is not typically eaten with vegetables and fish unless I'm greatly mistaken.

    So a few points: people in Japan who eat rice for breakfast are the more traditional type. They're highly unlikely to be eating just rice, whatever the side dishes are. People eating bread, on the other hand, are more likely to be the 'sweets and caffeine' for breakfast types.

    What the paper says (three times) is that they accounted for the 'number' of 'side dishes' eaten. I don't think the important thing is the number but the quality. I find it hilarious that they should concentrate so exclusively on the white carbs, treat everything else as a distraction, and then speculate that the advantage of rice is that bread has more fat. (which it does: probably soy oil....)

    Finally, I have to point out that as in America, a family that sits down to a cooked traditional breakfast probably has other advantages over people who eat a pastry for breakfast: probably parents with more time or who care more, a more traditional eating pattern over all.

    Christopher Tricarick


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