title: School breakfast and body mass index: a longitudinal observational study of middle school students.
abstract: The objectives are to identify breakfast location patterns (frequency and place of breakfast consumption) and explore the association between breakfast patterns and weight status over time among preadolescents.
  
  
  
  Surveys and physical measurements were completed among students from 12 randomly selected schools in a medium-sized urban school district. All students were followed from fifth (Fall, 2011) to seventh grade (Fall, 2013). Latent transition analysis and longitudinal analyses were used in the study.
  
  
  
  Six distinct breakfast location patterns emerged at baseline (1) frequent skippers; (2) inconsistent school eaters; (3) inconsistent home eaters; (4) regular home eaters; (5) regular school eaters and (6) double breakfast eaters. Results from the longitudinal analyses revealed that there was an increased odds of overweight/obesity among frequent skippers compared with double breakfast eaters after adjusting for school, year and students' race/ethnicity (AOR: 2.66, 95% CI: 1.67, 4.24). Weight changes from year to year were similar between double breakfast eaters and other students.
  
  
  
  Concerns that a second breakfast at school increases risk of excessive weight gain are unsupported. Students who regularly consumed breakfasts at school, including double breakfast eaters, were more likely to exhibit a healthy weight trajectory. Additional research is needed to understand the impact of universal school breakfast on students' overall diets.
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.affiliation: Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Schwartz
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Shebl
authors.affiliation: Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.
authors.forename: M
authors.initials: M
authors.lastname: Read
authors.affiliation: Henderson Consulting, Guilford, CT, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Henderson
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.|Community Alliance for Research and Engagement, Yale School of Public Health, New Haven, CT, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Ickovics
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D062408:Breakfast / Q000502:physiology*; D002648:Child; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D012574:Schools; D013334:Students; D015430:Weight Gain
keywords: Childhood obesity; double breakfast; middle school students; school breakfast