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Dietary Effects of Universal-Free School Breakfast: Findings from the Evaluation of the School Breakfast Program Pilot Project

https://doi.org/10.1016/j.jada.2006.08.013Get rights and content

Abstract

Objective

To determine the effects of offering universal-free school breakfast in elementary schools on students’ dietary outcomes.

Design

Experimental study with random assignment of 153 matched elementary schools in six school districts. Treatment schools offered universal-free school breakfast, and control schools continued to operate the traditional means-tested School Breakfast Program. Twenty-four–hour dietary recalls were collected from sample students near the end of the first year.

Subjects

About 30 students in second through sixth grades were randomly selected from each school (n=4,358).

Intervention

Free school breakfasts were made available to all students in treatment schools, regardless of family income, for three consecutive school years (2000-2001 to 2002-2003).

Main outcome measures

Breakfast consumption and food and nutrient intake.

Statistical analyses

Hierarchical mixed-models and logistic regression, adjusting for age, sex, minority status, and income eligibility for the regular school meal programs, were used to estimate effects.

Results

Despite a significant increase in school breakfast participation among sample students in treatment schools (from 16% to 40%, P<0.01), the rate of breakfast skipping did not differ between groups (4% overall). Treatment school students were more likely to consume a nutritionally substantive breakfast (P<0.01), but dietary intakes over 24 hours were essentially the same.

Conclusions

Making universal-free school breakfast available in elementary schools did not change students’ dietary outcomes after nearly 1 year. To improve children’s diets overall, efforts should focus on ensuring all students have access to a healthful breakfast, at home or at school.

Section snippets

Study Design and Sample

The School Breakfast Program Pilot Project was implemented in elementary schools in six school districts, from school year 2000-2001 to school year 2002-2003. The districts were selected to broadly represent the universe of all districts participating in the SBP (13). The experimental design employed treated schools as the experimental unit and nested students within schools. Participating schools were first paired (within district) on the basis of demographic variables, including average

Breakfast Consumption

Breakfast consisted of all food and beverages reported consumed between 5:00 am and 45 minutes after the start of school, and any items consumed before 10:30 am that the student reported as being part of breakfast. (Some schools served school breakfast mid-morning.) Breakfast consumption was defined, as it has been previously (17), in two ways: 1) any breakfast—consumption of any food or beverage (other than plain water) or 2) a nutritionally substantive breakfast—consumption of food from at

Results

A total of 4,278 students provided data on breakfast consumption, whereas 3,347 students provided data for the full day. Response rates were 98% and 77%, respectively. A second recall was completed by 12% of the full-day sample for a response rate of 90% (403 of 448 randomly selected students).

There were no statistically significant differences in demographic or household characteristics between the treatment and control students at baseline (P>0.05). The mean age of students in the treatment

Discussion

The School Breakfast Program Pilot Project evaluation showed that the availability of universal-free breakfast in elementary schools significantly increased school breakfast participation, similar to state- and school district-led initiatives (10, 11). This study, the first to examine dietary outcomes, found no effect from the availability of universal-free school breakfast on the likelihood of students skipping breakfast altogether. Control school students were more likely to eat breakfast at

Conclusions

The approach of offering free school breakfast to students from households of all incomes did not reduce breakfast skipping, nor did it change the overall quality of children’s diets after nearly 1 year of the intervention. Nonetheless, the positive nutritional and cognitive benefits of eating breakfast are well documented in the literature. Students who cannot eat breakfast at home should have the opportunity to eat it at school.

This study and others have shown that improvements in children’s

M. K. Crepinsek is a senior researcher, Mathematica Policy Research, Inc, Cambridge, MA; at the time of the study, she was an associate, Abt Associates Inc, Cambridge, MA.

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    M. K. Crepinsek is a senior researcher, Mathematica Policy Research, Inc, Cambridge, MA; at the time of the study, she was an associate, Abt Associates Inc, Cambridge, MA.

    A. Singh is a branch chief, Office of Analysis, Nutrition, and Evaluation, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA.

    L. S. Bernstein is senior associates, Abt Associates Inc, Cambridge, MA

    J. E. McLaughlin is senior associates, Abt Associates Inc, Bethesda, MD

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