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Breakfast in the Classroom Initiative and Obesity

JAMA Pediatrics; ePub 2019 Feb 25; Polonsky, et al

A breakfast in the classroom initiative increased participation in the School Breakfast Program and did not affect the combined incidence of overweight and obesity, according to a recent study. However, the initiative had an unintended consequence of increasing incident and prevalent obesity. Researchers conducted a cluster-randomized clinical trial among 1,362 4th - through 6th-grade students from low-income urban communities across 2.5 years. 16 kindergarten through 8th grade Philadelphia public schools with universal breakfast participated. They found:

  • Among total students, mean age was 10.8 years and 700 (51.4%) were female; 907 (66.6%) were black, 233 (17.1%) were Hispanic, 100 (7.3%) were white, 83 (6.1%) were Asian, and 39 were of multiple or other race/ethnicity.
  • After 2.5 years, students in intervention schools had participated in the School Breakfast Program 53.8% of days, compared with 24.9% of days among students in control schools.
  • There was no difference between intervention and control schools in the combined incidence of overweight and obesity after 2.5 years (11.7% vs 9.3%).
  • However, the incidence (11.6% vs 4.4%) and prevalence (28.0% vs 21.2%) of obesity were higher in intervention schools than in control schools after 2.5 years.

Polonsky HM, Bauer KW, Fisher JO, et al. Effect of a breakfast in the classroom initiative on obesity in urban school-aged children. A cluster randomized clinical trial. [Published online ahead of print February 25, 2019]. JAMA Pediatrics. doi:10.1001/jamapediatrics.2018.5531.