Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project.
OBJECTIVE
To determine the effects of offering universal-free school breakfast in elementary schools on students' dietary outcomes.


METHODS
Experimental study with random assignment of 153 matched elementary schools in six school districts. Treatment schools offered universal-free school breakfast, and control schools continued to operate the traditional means-tested School Breakfast Program. Twenty-four-hour dietary recalls were collected from sample students near the end of the first year.


METHODS
About 30 students in second through sixth grades were randomly selected from each school (n=4,358).


METHODS
Free school breakfasts were made available to all students in treatment schools, regardless of family income, for three consecutive school years (2000-2001 to 2002-2003).


METHODS
Breakfast consumption and food and nutrient intake.


METHODS
Hierarchical mixed-models and logistic regression, adjusting for age, sex, minority status, and income eligibility for the regular school meal programs, were used to estimate effects.


RESULTS
Despite a significant increase in school breakfast participation among sample students in treatment schools (from 16% to 40%, P<0.01), the rate of breakfast skipping did not differ between groups (4% overall). Treatment school students were more likely to consume a nutritionally substantive breakfast (P<0.01), but dietary intakes over 24 hours were essentially the same.


CONCLUSIONS
Making universal-free school breakfast available in elementary schools did not change students' dietary outcomes after nearly 1 year. To improve children's diets overall, efforts should focus on ensuring all students have access to a healthful breakfast, at home or at school.
Crepinsek
Mary Kay
MK
Mathematica Policy Research, Inc, Cambridge, MA 02139, USA. mcrepinsek@mathematica-mpr.com
Singh
Anita
A
Bernstein
Lawrence S
LS
McLaughlin
Joan E
JE
D001835:Body Weight / Q000502:physiology; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D004032:Diet / Q000592:standards*; D004435:Eating / Q000502:physiology / Q000523:psychology; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005522:Food Services; D006801:Humans; D016015:Logistic Models; D008297:Male; D011939:Mental Recall; D018673:Nutrition Policy; D010865:Pilot Projects; D015397:Program Evaluation; D012574:Schools