Breakfast patterns among low-income, ethnically-diverse 4th-6th grade children in an urban area

Abstract

Background: Increasing school breakfast participation has been advocated as a method to prevent childhood obesity. However, little is known about children's breakfast patterns outside of school (e.g., home, corner store). Policies that increase school breakfast participation without an understanding of children's breakfast habits outside of school may result in children consuming multiple breakfasts and may undermine efforts to prevent obesity. The aim of the current study was to describe morning food and drink consumption patterns among low-income, urban children and their associations with relative weight.

Methods: A cross-sectional analysis was conducted of data obtained from 651 4th-6th graders (51.7% female, 61.2% African American, 10.7 years) in 2012. Students completed surveys at school that included all foods eaten and their locations that morning. Height and weight were measured by trained research staff.

Results: On the day surveyed, 12.4% of youth reported not eating breakfast, 49.8% reported eating one breakfast, 25.5% reported eating two breakfasts, and 12.3% reported eating three or more breakfasts. The number of breakfasts consumed and BMI percentile showed a significant curvilinear relationship, with higher mean BMI percentiles observed among children who did not consume any breakfast and those who consumed ≥ 3 breakfasts. Sixth graders were significantly less likely to have consumed breakfast compared to younger children. A greater proportion of obese youth had no breakfast (18.0%) compared to healthy weight (10.1%) and overweight youth (10.7%, p = .01).

Conclusions: When promoting school breakfast, policies will need to be mindful of both over- and under-consumption to effectively address childhood obesity and food insecurity.

Clinical trial registration: NCT01924130 from http://clinicaltrials.gov/.

Figure 1

Proportion of Students Reporting Eating Breakfast (N = 651). Note: Breakfast was defined as having consumed any caloric food or beverage at any of four specified locations: home, corner store, school cafeteria, and school classroom. All three schools provided all students with access to free breakfast before school hours.

Figure 2

Breakfast frequency by weight status category.

Figure 3

Model estimated curvilinear relation between BMI percentile and number of breakfasts consumed. Note: Breakfast was defined as having consumed any caloric food or beverage at any of four specified locations: home, corner store, school cafeteria, and school classroom. Number of breakfasts refers to the number of locations students reported eating breakfast at. All three schools provided all students with access to free breakfast before school hours.

Figure 4

Model estimated curvilinear relation between BMI z-score and number of breakfasts consumed. Note: Breakfast was defined as having consumed any caloric food or beverage at any of four specified locations: home, corner store, school cafeteria, and school classroom. Number of breakfasts refers to the number of locations students reported eating breakfast at. All three schools provided all students with access to free breakfast before school hours.