Abstract
BackgroundData from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria).MethodsData were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age.ResultsBreakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria.ConclusionsFor fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.
Highlights
Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location
For analysis of BMI, breakfast location was significant (p = 0.012; coefficient for classroom = 0.88); average BMI was larger for children with breakfast in the classroom (21.50) than in the cafeteria (20.54)
Results from the current analyses showed that daily participation in school breakfast, school lunch, and both school meals combined was not significantly associated with BMI or BMI category
Summary
Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria). It is well known that the incidence of obesity has increased dramatically over the last several decades among children in the United States [1,2] and around the world [3] This is of concern because overweight children are at increased risk for morbidity and mortality later in life [4]. The School Breakfast Program (SBP) and the National School Lunch Program (NSLP) are two food assistance programs administered by the United States Department of Agriculture. An Expert Panel was convened in March, 2004, by the United States Department of Agriculture to identify evidence about whether participation in food assistance programs contributes to obesity [9]. The Panel concluded that “the sparse research that has been published provides no consistent evidence of association” between participation in either the SBP or the NSLP and overweight or obesity [9]
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