Effects of a free school breakfast programme on children's attendance, academic achievement and short-term hunger: results from a stepped-wedge, cluster randomised controlled trial

Abstract

BackgroundFree school breakfast programmes (SBPs) exist in a number of high-income countries, but their effects on educational outcomes have rarely been evaluated in randomised controlled trials.MethodsA 1-year stepped-wedge, cluster randomised controlled trial was undertaken in 14 New Zealand schools in low socioeconomic resource areas. Participants were 424 children, mean age 9±2 years, 53% female. The intervention was a free daily SBP. The primary outcome was children's school attendance. Secondary outcomes were academic achievement, self-reported grades, sense of belonging at school, behaviour, short-term hunger, breakfast habits and food security.ResultsThere was no statistically significant effect of the breakfast programme on children's school attendance. The odds of children achieving an attendance rate <95% was 0.76 (95% CI 0.56 to 1.02) during the intervention phase and 0.93 (95% CI 0.67 to 1.31) during the control phase, giving an OR of 0.81 (95% CI 0.59 to 1.11), p=0.19. There was a significant decrease in children's self-reported short-term hunger during the intervention phase compared with the control phase, demonstrated by an increase of 8.6 units on the Freddy satiety scale (95% CI 3.4 to 13.7, p=0.001). There were no effects of the intervention on any other outcome.ConclusionsA free SBP did not have a significant effect on children's school attendance or academic achievement but had significant positive effects on children's short-term satiety ratings. More frequent programme attendance may be required to influence school attendance and academic achievement.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR)—ACTRN12609000854235.

Dietary Intake and Plasma Levels of Choline and Betaine in Children with Autism Spectrum Disorders

“…The deterioration of behavior following breakfast in the less well-equipped schools could reflect greater difficulties in accurately observing whether children are on-task or off-task when they do not have their own desk or are in overcrowded classrooms. In developed high income countries where school infrastructure is more standardized and where classrooms are not overcrowded, this possibly spurious effect is less likely to occur (Murphy et al, 2011;Ni Mhurchu et al, 2013). However, negative effects on behavior have also been reported in UK primary and secondary school children within deprived areas following a SBP (Shemilt et al, 2004).…”

“…Both Ni Mhurchu et al (2013) and Murphy et al (2011) reported no significant effects of a 1 year SBP on hyperactivity, inattention, emotional symptoms, conduct and peer relationship problems, and pro-social behavior in children. However, in both trials, SBP attendance was low and variable, limiting the potential impact on behavior.…”

“…Four of the seven studies demonstrated a benefit of breakfast on arithmetic scores (Powell et al, 1998;Simeon, 1998;Wahlstrom and Begalle, 1999;Cueto and Chinen, 2008). Four of the studies were carried out in samples which included undernourished children Powell et al, 1998;Simeon, 1998;Cueto and Chinen, 2008) and two studies included low SES samples (Meyers et al, 1989;Ni Mhurchu et al, 2013). Effects were demonstrable after an intervention period of at least 1 month and up to 3 years.…”

“…However, both studies were not well-controlled. A recent large RCT in pupils from low SES schools in New Zealand failed to show any benefit of a 1 year SBP on school achievement tests for literacy and numeracy and self-reported reading ability (Ni Mhurchu et al, 2013).…”

Appraisal of Government Feeding Programme on Increased School Enrollment, Attendance, Retention and Completion among Secondary School Students in Maiduguri, Borno State

“…In the United Kingdom, a programme that subsidized milk for school children was initiated in 1934 and milk was provided free afterwards (Baker et al, 1980). In a stepped wedge cluster randomized trial, Mhurchu et al (2010) studied the effects of a free school breakfast programme on achievement, psychosocial function, nutrition and school attendance among primary school children in New Zealand and they reported that school breakfast programmes initiated had beneficial outcomes on students' attendance, psychosocial functioning and school grades of the students. correspondingly, Kristjansson et al (2007) conducted a review on school feeding designed for improving the physical and psychosocial health of disadvantaged students and reported that there were significant weight gains in kilogramme and height gain in centimeter and bone density.…”