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Classroom Initiative Ups Participation in School Breakfast

TUESDAY, Feb. 26, 2019 -- A breakfast-in-the-classroom initiative increases participation in the federal School Breakfast Program but has an unintended consequence of increasing the incidence and prevalence of obesity, according to a study published online Feb. 25 in JAMA Pediatrics.

Heather M. Polonsky, from Temple University in Philadelphia, and colleagues examined the effect of a breakfast-in-the-classroom initiative, which combines breakfast in the classroom with breakfast-specific nutrition education, in a cluster-randomized clinical trial. Participants included 1,362 fourth- through sixth-grade students from low-income urban communities.

The researchers found that students in intervention schools had participated in the School Breakfast Program 53.8 percent of school days compared with 24.9 percent of school days among students in control schools after 2.5 years (β = 0.33; 95 percent confidence interval, 0.22 to 0.42). After 2.5 years, intervention and control schools did not differ in terms of the combined incidence of overweight and obesity (11.7 versus 9.3 percent; odds ratio, 1.31; 95 percent confidence interval, 0.85 to 2.02; P = 0.22). However, intervention schools had a higher incidence of obesity (11.6 versus 4.4 percent; odds ratio, 2.43; 95 percent confidence interval, 1.47 to 4) and prevalence of obesity (28 versus 21.2 percent; odds ratio, 1.46; 95 percent confidence interval, 1.11 to 1.92) compared with control schools after 2.5 years.

"It is essential to identify alternative implementation approaches that increase School Breakfast Program participation without promoting obesity," the authors write.

One author disclosed financial ties to Nestle. A second author reported being an employee and shareholder of WW, formerly Weight Watchers.

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Posted: February 2019

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