School Breakfast Program Participation Research Articles

Associations between a Universal Free Breakfast Policy and School Breakfast Program Participation, School Attendance, and Weight Status: A District-Wide Analysis.

Breakfast consumption among youth is associated with improved diet quality, weight, cognition, and behavior. However, not all youth in the United States consume breakfast. Participation in the School Breakfast Program (SBP) is also low relative to the lunch program. Universal free breakfast (UFB) policies have been implemented to increase breakfast participation by reducing cost and stigma associated with the SBP. This study examined whether a UFB policy implemented in a school district in the Southeast US was associated with changes in breakfast participation, school attendance, and student weight. A longitudinal study of secondary data was conducted, and a mixed modeling approach was used to assess patterns of change in SBP participation. General linear models were used to assess attendance and student weight change. On average, across schools in the district, there was an increase in breakfast participation of 4.1 percentage points following the implementation of the policy. The change in breakfast participation in schools differed by the percent of students in the school who received school meals for free or at a reduced price, the percent of students of color, and the grade level of the school. Increases in SBP participation were not associated with significant changes in attendance or weight. UFB policies may be effective in increasing participation in the SBP.

Associations between a Universal Free Breakfast Policy and School Breakfast Program Participation, School Attendance, and Weight Status: A District-Wide Analysis

Associations between a Universal Free Breakfast Policy and School Breakfast Program Participation, School Attendance, and Weight Status: A District-Wide Analysis

State-wide School Breakfast Promotion Initiatives and Trends in School Breakfast Participation

ABSTRACT A variety of policies and practices have been implemented to increase participation in the National School Breakfast Program (SBP) and the impact of these initiatives on SBP participation is not known. The purpose of this study was to determine whether new SBP policies and practices implemented in North Carolina were associated with an improvement in SBP participation. A mixed modeling approach was used to assess longitudinal patterns of change in district-level and school-level SBP participation rates between 2007 and 2015. Most of the policy initiatives implemented in NC were associated with an increase in participation either at the school or district level.

The Role of District Wellness Policies in Encouraging Student Participation in the School Breakfast Program, United States.

Eating breakfast is associated with better academic performance and nutrition and lower risk of obesity, but skipping breakfast is common among children and adolescents, and participation in the U.S. Department of Agriculture’s School Breakfast Program (SBP) is low. This study assessed the association between school district wellness policy provisions coded as part of the National Wellness Policy Study and student SBP participation and acceptance of the breakfasts provided using cross-sectional survey data from the School Nutrition and Meal Cost Study. Separate survey-adjusted multivariable logistic regressions were computed, linking students eating (N = 1575) and liking (N = 726) the school breakfast to corresponding district policy measures, controlling for school and student characteristics. Strong district policy, as opposed to no policy, was associated with significantly higher odds of students eating the school breakfast (odds ratio (OR): 1.86; 95% CI: 1.09, 3.16; p = 0.022), corresponding to an adjusted prevalence of 28.4% versus 19.2%, and liking the school breakfast (OR: 2.14; 95% CI: 1.26, 3.63; p = 0.005), corresponding to an adjusted prevalence of 69.0% versus 53.9%. District policy has the potential to play an important role in encouraging higher levels of SBP participation.

Do High School Students Participate in Second Chance Breakfast Programs?

Breakfast consumption often decreases as youth get older. The School Breakfast Program (SBP) provides an opportunity to intervene and increase breakfast consumption, especially among high school students. Project breakFAST implemented an expanded breakfast service at 12 high schools. In this longitudinal evaluation, school administrators provided SBP participation and demographic data on all ninth and 10th graders for two full consecutive school years. Students screened for eating breakfast <3 times/week were randomly selected to participate in the cohort study. The cohort completed a survey on perceived barriers, benefits, and breakfast habits. At baseline, all 12 schools had only traditional before school cafeteria SBP service. Mean participation was 16.3% and ranged from 7.9 to 38.1%. After the intervention, there was an increase in participation to 25.7% (p=.004) ranging from 14.1 to 47.5%. There was no change in breakfast participation before school (13.3%, p=.06). Students who traveled to school by car, bike, or walking at baseline were 4.5% less likely to participate in second chance breakfast at follow-up than those who took the bus to school (p=.006). Second chance breakfast is an option for increasing high school breakfast participation, especially for those riding the bus.

Serving Breakfast Free to All Students and Type of Breakfast Serving Model Are Associated with Participation in the School Breakfast Program

BackgroundMany students experience challenges participating in the School Breakfast Program (SBP) when breakfast is served before school in the cafeteria. Serving breakfast free to all students or offering innovative breakfast serving models, such as breakfast in the classroom (BIC), grab n’ go, or second chance breakfast, may encourage higher SBP participation rates. ObjectiveTo examine the association between offering breakfast free to all students as well as breakfast serving model with student participation in the SBP in October 2017 among public schools in North Carolina. DesignCross-sectional study using data from the North Carolina Department of Public Instruction. Participants/settingThis study included data from 2,285 North Carolina public schools who served breakfast in October 2017 with 1,445,287 students. Main outcome measuresThe main outcome measures are the odds of a student participating in the SBP among students overall, students eligible for free or reduced-price (FRP) meals, and students not eligible for FRP meals. Statistical analyses performedMultiple logistic regression assessed the association between offering breakfast free to all students and breakfast serving model with the probability of participating in the SBP (number of students participating out of number of students enrolled) for students overall, eligible for FRP meals, and not eligible for FRP meals. Statistical models were stratified by school type (elementary, middle, and high schools). ResultsBreakfast serving models positively associated with SBP participation were BIC and BIC plus grab n’ go for elementary and high school students and grab n’ go and second chance for middle and high school students (P<0.05). Serving breakfast free to all students was positively associated with SBP participation alone and in combination with BIC, second chance, and BIC plus grab n’ go (P<0.05). ConclusionsServing breakfast free to all students and breakfast serving model were associated with SBP participation, and different relationships existed for different school levels.

School Administrators’ Attitudes Toward the School Breakfast Program

ABSTRACTThe School Breakfast Program (SBP) can strengthen household food security, yet participation remains low. Stakeholder perspectives may influence SBP participation; thus, the purpose of this study was to explore school administrators’ perspectives on the SBP. Administrators from (blinded state) were recruited via email and were asked to complete an online survey about the SBP. Results indicated that almost one-third of administrators (n = 56) perceived low statewide participation was due to family-centered values. Administrators reported academic performance (n = 100; 23.8%) and hunger abatement (n = 97; 23.1%) as benefits of the SBP. Administrators indicated they did not feel the need to improve SBP rates and were not favorable to alternative breakfast models (n = 38; 30.6%). While many administrators see benefits to the SBP, many administrators throughout the state of blinded state do not see the need for increased participation or the benefits of alternative models. Continual efforts to improve administrators’ perspectives of SBP and particularly, alternative school breakfast models as a way of decreasing childhood food insecurity are needed.

Effect of a Breakfast in the Classroom Initiative on Obesity in Urban School-aged Children

Serving breakfast in the classroom is promoted to increase participation in the federal School Breakfast Program. However, little is known about the effect of breakfast in the classroom on children's weight status. To evaluate the effect of a breakfast in the classroom initiative, which combined breakfast in the classroom with breakfast-specific nutrition education, on overweight and obesity among urban children in low-income communities. A cluster-randomized clinical trial among 1362 fourth- through sixth-grade students from low-income urban communities across 2.5 years. Sixteen kindergarten through eighth grade Philadelphia public schools with universal breakfast participated. Participants were recruited in September 2013, and the intervention began in January 2014. Data analysis took place from April 1, 2018, to August 30, 2018. Intervention schools received a program that included breakfast in the classroom and breakfast-specific nutrition education. Control schools continued breakfast before school in the cafeteria and standard nutrition education. The primary outcome was the combined incidence of overweight and obesity. Secondary outcomes included the combined prevalence of overweight and obesity, incidence and prevalence of obesity, changes in body mass index (BMI) z score, and School Breakfast Program participation. Among the 1362 students, mean (SD) age was 10.8 (0.96) 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 (β = 0.33; 95% CI, 0.22-0.42). 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%; odds ratio [OR] 1.31; 95% CI, 0.85-2.02; P = .22). However, the incidence (11.6% vs 4.4%; OR, 2.43; 95% CI, 1.47-4.00) and prevalence (28.0% vs 21.2%; OR, 1.46; 95% CI, 1.11-1.92) of obesity were higher in intervention schools than in control schools after 2.5 years. A breakfast in the classroom initiative increased participation in the School Breakfast Program and did not affect the combined incidence of overweight and obesity. However, the initiative had an unintended consequence of increasing incident and prevalent obesity. Further research is needed to identify approaches to increase participation in the School Breakfast Program that do not increase obesity among students. ClinicalTrials.gov identifier: NCT01924130.

A Group Randomized Intervention Trial Increases Participation in the School Breakfast Program in 16 Rural High Schools in Minnesota

BackgroundBreakfast consumption is associated with better diet quality and healthier weights, yet many adolescents miss breakfast. Nationally, 17.1% of students participate in the School Breakfast Program (SBP). Only 10% of high school students participate. ObjectiveOur aim was to evaluate an environmental intervention to increase SBP participation in high schools. DesignA group randomized trial was carried out from 2012 to 2015. Participants/settingNinth- and 10th-grade students enrolled in 16 rural schools in Minnesota (median 387 students) were randomized to intervention or control condition. InterventionA school-based intervention that included two key components was implemented over a 12-month period. One component focused on increasing SBP participation by increasing student access to school breakfast through changes in school breakfast service practices (eg, serving breakfast from a grab-n-go cart in the atrium; expanding breakfast service times). The other component focused on promoting school breakfast through student-directed marketing campaigns. Main outcome measureChange in school-level participation in the SBP was assessed between baseline (among ninth and tenth graders) and follow-up (among tenth and eleventh graders). School meal and attendance records were used to assess change in school-level participation rates in the SBP. Statistical analysesThe Wilcoxon test was used for analysis of difference in change in mean SBP participation rate by experimental group. ResultsThe median change in SBP participation rate between baseline and follow-up was 3% (interquartile range=13.5%) among the eight schools in the intervention group and 0.5% (interquartile range=0.7%) among the eight schools in the control group. This difference in change between groups was statistically significant (Wilcoxon test, P=0.03). The intervention effect increased throughout the intervention period, with change in mean SBP participation rate by the end of the school year reaching 10.3% (95% CI 3.0 to 17.6). However, among the intervention schools, the change in mean SBP participation rates was highly variable (range=–0.8% to 24.8%). ConclusionsInterventions designed to improve access to the SBP by reducing environmental and social barriers have potential to increase participation among high school students.

Impact of the 2010 US Healthy, Hunger-Free Kids Act on School Breakfast and Lunch Participation Rates Between 2008 and 2015.

To evaluate National School Lunch Program (NSLP) and School Breakfast Program (SBP) participation over a 7-year period before and after the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA), which required healthier school lunch options beginning in school year (SY) 2012-2013 and healthier school breakfast options beginning in SY2013-2014. Data were gathered from low-income, high-minority public schools in 4 New Jersey cities. We conducted longitudinal analyses of annual average daily participation (ADP) in school meals among enrolled students overall and among those eligible for free or reduced-price meals. We used linear mixed models to compare NSLP and SBP participation rates from SY2008-2009 to SY2014-2015. NSLP participation rates among students overall differed little across years (from 70% to 72%). SBP rates among enrolled students were stable from the beginning of the study period to SY2013-2014 and then increased from 52% to 59%. Among students eligible for free or reduced-price meals, the ADP was lowest in SY2012-2013 (when the HHFKA was implemented) before rebounding. The HHFKA did not have a negative impact on school meal participation over time. Public Health Implications. The HHFKA-strengthened nutrition standards have not affected school meal participation rates. With time, students are likely to accept healthier options.

A Low-Cost, Grab-and-Go Breakfast Intervention for Rural High School Students: Changes in School Breakfast Program Participation Among At-Risk Students in Minnesota

ObjectiveEvaluate the impact of a grab-and-go component embedded within a larger intervention designed to promote School Breakfast Program (SBP) participation. DesignSecondary data analysis. SettingRural Minnesota high schools. ParticipantsEight schools were enrolled in the grab-and-go only intervention component. An at-risk sample of students (n = 364) who reported eating breakfast ≤3 d/wk at baseline was enrolled at these schools. InterventionsGrab-and-go style breakfast carts and policies were introduced to allow all students to eat outside the cafeteria. Main Outcome MeasuresAdministrative records were used to determine percent SBP participation (proportion of non-absent days on which fully reimbursable meals were received) for each student and school-level averages. AnalysisLinear mixed models. ResultsSchool-level increases in SBP participation from baseline to the school year of intervention implementation were observed for schools enrolled in the grab-and-go only component (13.0% to 22.6%). Student-level increases in SBP participation were observed among the at-risk sample (7.6% to 21.9%) and among subgroups defined by free- or reduced-price meal eligibility and ethnic or racial background. Participation in SBP increased among students eligible for free or reduced-price meals from 13.9% to 30.7% and among ineligible students from 4.3% to 17.2%. Conclusions and ImplicationsIncreasing access to the SBP and social support for eating breakfast are effective promotion strategies.

School Breakfast Program Participation and Rural Adolescents' Purchasing Behaviors in Food Stores and Restaurants.

Little is known about adolescents' food purchasing behaviors in rural areas. This study examined whether purchasing food at stores/restaurants around schools was related to adolescents' participation in school breakfast programs and overall diet in rural Minnesota. Breakfast-skippers enrolled in a group-randomized intervention in 2014 to 2015 (N = 404 from 8 schools) completed 24-hour dietary recalls and pre/post surveys assessing food establishment purchase frequency. Healthy Eating Index Scores (HEI-2010) were calculated for each student. Student-level school breakfast participation (SBP) was obtained from school food service records. Mixed-effects regression models estimated: (1) whether SBP was associated with store/restaurant use at baseline, (2) whether an increase in SBP was associated with a decrease in store/restaurant use, and (3) whether stores/restaurant use was associated with HEI-2010 scores at baseline. Students with increased SBP were more likely to decrease fast-food restaurant purchases on the way home from school (OR 1.017, 95% CI 1.005, 1.029), but were less likely to decrease purchases at food stores for breakfast (OR 0.979, 95% CI 0.959, 0.999). Food establishment use was associated with lower HEI-2010 dairy component scores (p = .017). Increasing participation in school breakfast may result in modest changes in purchases at food establishments.

Understanding Perceptions of School Administrators Related to School Breakfast in a Low School Breakfast Participation State.

The National School Breakfast Program (SBP) is a federally funded program that allows states to offer nutritious breakfast to K-12 students. However, rates of SBP participation are low in some rural states, and the reasons are not well understood. The purpose of the study was to explore administrators' perceptions, attitudes, and beliefs related to the SBP, and factors they identify as barriers or facilitators to increased participation. Data were collected from a cross-sectional, online survey of K-12 school administrators (N = 152) in a rural, midsized Midwestern state fielded over an academic year. Descriptive statistics were calculated and open-ended questions were coded and analyzed for relevant themes. Administrators identified busing schedules, time constraints, and a lack of flexibility within the school schedule to accommodate breakfast as primary structural barriers to SBP participation. Administrators described family-centered norms as reasons for low participation in rural areas. Administrators are at varying stages of readiness to work on improving participation. Low SBP participation can be explained in part by a convergence of factors related to access, community norms, and structural barriers. Results may be used to inform ways in which administrators at the state, district, and school level can work to increase participation.

Nutritional, Economic, and Environmental Costs of Milk Waste in a Classroom School Breakfast Program.

To measure fluid milk waste in a US School Breakfast in the Classroom Program and estimate its nutritional, economic, and environmental effects. Fluid milk waste was directly measured on 60 elementary school classroom days in a medium-sized, urban district. The US Department of Agriculture nutrition database, district cost data, and carbon dioxide equivalent (CO2e) emissions and water footprint estimates for fluid milk were used to calculate the associated nutritional, economic, and environmental costs. Of the total milk offered to School Breakfast Program participants, 45% was wasted. A considerably smaller portion of served milk was wasted (26%). The amount of milk wasted translated into 27% of vitamin D and 41% of calcium required of School Breakfast Program meals. The economic and environmental costs amounted to an estimated $274 782 (16% of the district's total annual School Breakfast Program food expenditures), 644 893 kilograms of CO2e, and 192 260 155 liters of water over the school year in the district. These substantial effects of milk waste undermine the School Breakfast Program's capacity to ensure short- and long-term food security and federal food waste reduction targets. Interventions that reduce waste are urgently needed.

Breakfast-Skipping and Selecting Low-Nutritional-Quality Foods for Breakfast Are Common among Low-Income Urban Children, Regardless of Food Security Status

Background: Universal access to the School Breakfast Program (SBP) is intended to help low-income and food-insecure students overcome barriers to eating breakfast. However, SBP participation is often still low despite universal access. Further information is needed with regard to these children’s breakfast behaviors, and in particular breakfast behaviors among youth from food-insecure families, to inform effective breakfast interventions.Objectives: The objective of this study was to examine breakfast behaviors among a large sample of urban students with universal access to the SBP and to identify differences in breakfast behaviors among children from food-secure compared with food-insecure households.Methods: A cross-sectional study of 821 fourth- through sixth-grade students and their parents from 16 schools was conducted. Students reported the foods/drinks selected and location of obtaining food/drink on the morning of data collection, parents reported household food security status using the 6-item Food Security Survey Module, and the school district provided SBP participation data during the fall semester of 2013. Multivariable linear regression models accounting for school-level clustering were used to examine differences in breakfast behaviors across 3 levels of household food security: food secure, low food secure, and very low food secure.Results: Students participated in the SBP 31.2% of possible days, with 13% never participating in the SBP. One-fifth (19.4%) of students purchased something from a corner store for breakfast, and 16.9% skipped breakfast. Forty-six percent of students were food insecure; few differences in breakfast behaviors were observed across levels of food security.Conclusions: Despite universal access to the SBP, participation in the SBP is low. Breakfast skipping and selection of foods of low nutritional quality in the morning are common, regardless of household food security status. Additional novel implementation of the SBP and addressing students’ breakfast preferences may be necessary to further reduce barriers to students obtaining a free, healthful breakfast. This trial was registered at clinicaltrials.gov as NCT01924130.

Project BreakFAST: Rationale, design, and recruitment and enrollment methods of a randomized controlled trial to evaluate an intervention to improve School Breakfast Program participation in rural high schools.

A 20-year trend documents an increase in youth routinely skipping breakfast [1]. Breakfast skipping increases with age from 20% among children age 9–13 to 36% among adolescents age 13–18 [2]. Minority youth are sometimes but not always reported to have higher rates of skipping breakfast compared with their white peers [3], [4], [5] and girls are more likely to skip breakfast than boys, especially to lose weight [3], [6], [7]. Observational studies indicate breakfast eaters have healthier diets [8], [9], make better food choices, and are less likely to eat high fat snacks [10], [11]. Establishing healthy weight promoting behaviors during adolescence, such as eating breakfast is especially important as the average American gains 30 pounds between 18 and 35 years of age [12]. Cross-sectional [13] and observational [14] studies provide evidence of an increase in body mass index (BMI) among breakfast skippers. Eating breakfast and particularly the school provided breakfast is also associated with an improvement in cognition and academic outcomes among adolescents. This benefit may be more realized by undernourished and urban, minority youth, suggesting a promising strategy for closing the achievement gap [15], [16], [17]. Students in rural schools are more likely to attend small schools, live in poverty, be food insecure, be eligible for free or reduced priced school meals, and come to school unprepared to learn compared to students from urban or suburban areas [18]. A 2015 meta-analysis found that rural youth have 26% greater odds of obesity, compared to urban children [19]. Very little research has been done on how to improve the school food environment in small town and rural schools even though these environments are lagging behind urban and suburban schools [20]. The few studies on rural schools have focused on younger students [21], the school lunch program [22], or competitive food options [23]. The purpose of this clinical trial is to evaluate the effectiveness of a school-based intervention designed to increase participation in the National School Breakfast Program (SBP) among rural high school students by improving physical access to the program, changing social norms, and engaging in promotional activities.

A Historical Review of Changes in Nutrition Standards of USDA Child Meal Programs Relative to Research Findings on the Nutritional Adequacy of Program Meals and the Diet and Nutritional Health of Participants: Implications for Future Research and the Summer Food Service Program.

Background: The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. Conclusions: There is critical need for policy change that would enable updates to the SFSP nutrition standards to match those of the NSLP and SBP. In addition, strategies are needed to facilitate development of CMP menus that meet current nutrition standards. Finally, rigorously designed studies are needed to understand the direct impact of CMP participation on child diet and health, particularly the SFSP for which there is limited published data.

Estimating impacts of a breakfast in the classroom program on school outcomes.

Short-term impacts of breakfast consumption on diet quality and cognitive functioning have been reported, but more evidence is needed to draw causal inferences about long-term impacts of school breakfast on indicators of school engagement and academic achievement. To estimate the impact of a Breakfast in the Classroom (BIC) program on School Breakfast Program participation, school attendance, and academic achievement. This quasi-experimental study included a sample of 446 public elementary schools from a large, urban US school district that served predominantly low-income, racial/ethnic minority students. A total of 257 schools (57.6%) implemented a BIC program during the 2012-2013 academic year, whereas 189 (42.4%) did not. School- and grade-level data from 2012-2013 and grade-level achievement data from the prior year were collected from school district records across the elementary schools. Hypotheses that a BIC program would improve school breakfast participation at the school level, school attendance at the grade level (kindergarten through sixth grade), and academic achievement at the grade level (second through sixth grades) were tested using propensity score weights to adjust for demographic differences between the BIC and non-BIC schools. The BIC program was linked with increased breakfast participation during the academic year (F10,414=136.90, P<.001), with mean participation rates of 73.7% in the BIC group vs 42.9% in the non-BIC group. The BIC program was also linked with greater overall school attendance rates (95.5% vs 95.3% in the non-BIC group; F1,2772=8.40, P = .004). When performing attendance analyses in the subset of grade levels for which achievement data were available, results were mostly consistent, although there was a group × time interaction (F10,1891=1.94, P=.04) such that differences between least squares means in the BIC vs non-BIC groups did not reach statistical significance at every month. There were no group differences in standardized test performance in math (57.9% in the BIC group vs 57.4% in the non-BIC group; F1,1890=0.41, P=.52) or reading (44.9% in the BIC group vs 44.7% in the non-BIC group; F1,1890=0.15, P=.70). Findings add to the evidence that BIC can increase school breakfast participation substantially and suggest that it has the potential to improve overall school attendance rates. Additional research is needed to explore the generalizability of these findings and the potential impacts on achievement for longer periods and on additional outcomes, such as weight status.

Ready‐to‐Eat Cereal Consumption and the School Breakfast Program: Relationship to Nutrient Intake and Weight

Children in the United States exhibit high rates of nutrient inadequacy and overweight/obesity; other international studies report similar associations. The School Breakfast Program (SBP) may help alleviate these conditions for youth in the United States. This research examined the association of ready-to-eat (RTE) breakfast cereal consumption with students' (SBP participants and nonparticipants) dietary nutrient intake and weight status. Data were from the third School Nutrition Dietary Assessment Study (SNDA-III), conducted in 2004-2005. Analyses included all 2298 SNDA-III participants (ages 5-18 years), who completed a dietary recall and whose parents completed an interview. Students were categorized as skipping versus eating breakfast; students eating breakfast were categorized by SBP participation (SBP participant vs nonparticipant) and breakfast type (with vs without RTE cereal). Analyses estimated the association of these categorizations with total daily nutrient intake and weight-related measures, after adjusting for covariates. RTE cereal breakfast consumers (regardless of SBP participation) had greater intake of vitamin A, iron, and whole grain, compared with noncereal breakfast eaters. Breakfast consumers (regardless of SBP participation and type) had greater intake of vitamins A and C, calcium, iron, dietary fiber, and whole grain, relative to breakfast skippers. The SBP increases opportunity for improved nutrient intake and healthier body weight through breakfast consumption, especially whole grain RTE cereals, as recommended by the Dietary Guidelines 2010.

A pilot study to expand the school breakfast program in one middle school

School Breakfast Program (SBP) eaters weigh less and have healthier diets than nonSBP eaters. However, SBP is underused nationally, especially among low income youth. To explore the feasibility of expanding access to the SBP to improve participation among sixth grade students in one middle school in Minneapolis, Minnesota. A grab-n-go SBP menu, hallway delivery service and in-classroom eating strategies were implemented and evaluated with a cohort of sixth grade students (n=239) for 6weeks during spring 2010. Process measures were collected from students and teachers and through direct observations. The school district provided objective SBP participation data at baseline and post intervention. Students were very satisfied with eating in the classrooms (64%). Teachers (n=10) rated eating in the classroom as not messy, not disruptive and student behavior as excellent or good (100%). There was a significant increase in SBP participation from 0.74days per week to 1.21days per week (p<0.0001). Improvements were more pronounced among students eligible for free and reduced priced school meals. A school environment that supports convenient SBP menu and serving and eating locations was feasible and increased SBP participation in this suburban middle school.