title: Views of parents in four European countries about the effect of food on the mental performance of primary school children.
abstract: OBJECTIVE
  Several factors affect the mental performance of children. The importance that parents attribute to food-related determinants, compared with genetic, socio-economic and school environment, was investigated.
  
  
  METHODS
  Parents of school children (aged 4-11) were recruited through state primary schools in four European countries. Interviews were conducted in which participants were asked to sort 18 cards representing possible determinants of four elements of mental performance (attention, learning, mood and behaviour) according to perceived strength of effect. Determinants were identified from the literature and grouped in six categories: food-related, school environment, physical, social, psychological and biological. Effects were scored: 0=none; 1=moderate; and 2=strong. Views were compared between and within countries.
  
  
  RESULTS
  Two hundred parents took part (England: 53; Germany: 45; Hungary: 52; Spain: 50). Differences existed between countries in the proportions reporting university education and being in employment. Taking all countries together, parents consider the food category (mean 1.33) to have a lower impact on a child's mental performance than physical (activity and sleep, 1.77), psychological (mood and behaviour, 1.69) and school environment (1.57). Social (1.12) and biological (0.91) determinants were ranked lower than food. Of determinants in the food category, parents thought regularity of meals had more influence on mental performance (1.58) than what a child eats now (1.36), food at school (1.35), nutrition as a baby/infant (1.02).
  
  
  CONCLUSIONS
  Scope exists to improve parental awareness of the repercussions of their dietary choices for the mental performance of their children.
authors.affiliation: Department of Economics, University of Surrey, Guildford, UK.
authors.forename: H
authors.initials: H
authors.lastname: Gage
authors.affiliation: Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, UK.
authors.forename: B
authors.initials: B
authors.lastname: Egan
authors.affiliation: Department of Mathematics, University of Surrey, Guildford, UK.
authors.forename: P
authors.initials: P
authors.lastname: Williams
authors.affiliation: Department of Paediatrics, University of Pécs, Pécs, Hungary.
authors.forename: E
authors.initials: E
authors.lastname: Györei
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Brands
authors.affiliation: Department of Paediatrics, University of Granada, Granada, Spain.
authors.forename: J-C
authors.initials: JC
authors.lastname: López-Robles
authors.affiliation: Department of Paediatrics, University of Granada, Granada, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Campoy
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Koletzko
authors.affiliation: Department of Paediatrics, University of Pécs, Pécs, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Decsi
authors.affiliation: Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, UK.
authors.forename: M
authors.identifier: 0000000280572783
authors.initials: M
authors.lastname: Raats
mesh_terms: D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D004032:Diet; D004739:England; D005247:Feeding Behavior; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006814:Hungary; D008297:Male; D009752:Nutritional Status; D010290:Parents / Q000523:psychology*; D012574:Schools; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires