Polonsky HM, et al. - In this 2.5-year cluster randomized clinical trial that was conducted at 16 Philadelphian public schools and included 1,362 fourth through sixth-grade students, researchers assessed the impact of a breakfast-in-the-classroom initiative on the weight status of urban students in low-income communities. The initiative combined breakfast in the classroom with breakfast-specific nutrition education. According to findings, a breakfast in the classroom initiative did not impact the combined incidence of overweight and obesity status vs offering students breakfast before school in the cafeteria. The initiative, however, had an unintended result of an increased incidence and prevalence of obesity after 2.5 years.

Methods

• In September 2013, participants were recruited; the intervention started in January 2014.
• Investigators analyzed data from April 1, 2018, through August 30, 2018.
• Intervention schools received a program that included breakfast in the classroom and nutrition education for breakfast, while control schools continued to have breakfast in the cafeteria and standard nutrition education before school.
• The combined incidence of overweight and obesity was the primary outcome.
• The combined prevalence of overweight and obesity, incidence and prevalence of obesity, changes in body mass index z score, and School Breakfast Program participation comprised secondary outcomes.

Results

• Mean age of study participants was 10.8 years; 700 were female, 907 were black, 233 were Hispanic, 100 were white, 83 were Asian, and 39 were of multiple or other race/ethnicity.
• Students in intervention schools partook in the School Breakfast Program 53.8% of days after 2.5 years vs 24.9% of days among control schools students.
• No difference was evident between intervention and control schools in the combined incidence of overweight and obesity after 2.5 years.
• However, the incidence and prevalence of obesity were higher in intervention vs control schools after 2.5 years.