School Breakfast Program but Not School Lunch Program Participation Is Associated with Lower Body Mass Index

Mathematica Policy Research, Inc, PO Box 2393, Princeton, NJ 08543-2393, USA.
Journal of the American Dietetic Association (Impact Factor: 3.92). 02/2009; 109(2 Suppl):S118-28. DOI: 10.1016/j.jada.2008.10.058
Source: PubMed


Rates of overweight and obesity have increased dramatically during the past 2 decades. Children obtain a large fraction of their food energy while at school.
To estimate the relationship between participation in school meal programs and children's body mass index (BMI) and their likelihood of being overweight or obese, testing the hypothesis that school meal participation influences students' weight status, as measured by their BMI and indicators of overweight and obesity.
A cross-sectional design in which a regression model was used to estimate the association between participation in the School Breakfast Program and National School Lunch Program and children's BMI and risk of overweight or obesity, controlling for a wide range of student and school characteristics.
Participants included a nationally representative sample from the third School Nutrition Dietary Assessment Study of 2,228 students in grades 1 through 12 for whom height and weight measurements were obtained. These students, along with their parents, each completed a survey.
Multivariate regression models were used to examine the relationship between usual school meal participation and BMI and indicators of whether students were overweight or obese. These models controlled for students' demographic and socioeconomic characteristics, levels of physical activity, usual eating habits, screen time, and school characteristics.
No evidence was found of any relationship between usual school lunch participation and any of four different measures of weight status based on students' BMI. School breakfast participation was associated with significantly lower BMI, particularly among non-Hispanic, white students.
There was no evidence that either the school breakfast or lunch program is contributing to rising rates of childhood obesity. In fact, School Breakfast Program participation may be a protective factor, by encouraging students to consume breakfast more regularly.

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    • "However, the evidence regarding the influence of school meals on childhood obesity is mixed. Gleason and Dodd (2009) found the consumption of school breakfast to be associated with lower BMI, while Schanzenbach (2009) reports that consumption of school lunch may in fact increase obesity. "
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    • "These results also differ from studies published in 1998 [10] and 2010 [12] that showed no significant relationship between school-meal participation (based on parental responses and daily administrative records, respectively) and BMI. In addition, these results conflict with a study published in 2009 that showed an inverse relationship between breakfast participation (based on student or parental responses) and BMI among White students [11] and with a study published in 1994 that showed a positive relationship between children who participated in school lunch (based on parental responses) and BMI [9]. These conflicting results emphasize the need to consider the source of information concerning children's school-meal participation when investigating the relationship between school-meal participation and childhood obesity. "
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    • "Being older and/or Jewish was associated with a higher OR for eating a healthy breakfast. A cross-sectional study estimated the association between participation in the School Breakfast Program and National School Lunch Program and children's BMI and risk of overweight or obesity; participants included 2228 students in grades 1 through 12. School breakfast participation, but not school lunch, was associated with significantly lower BMI, particularly among non-Hispanic, white students (Gleason and Dodd, 2009). Our analysis has several shortcomings and limitations: other variables included in the program were not evaluated (such as promoting physical activity and hygiene). "
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