The role of meals for obesity, health and performance

Background for OPUS

Many school children do not eat breakfast everyday: in a survey of grade 6 children (aged 10–11) conducted in the United Kingdom, 5% of children reported having not had anything for breakfast that day, 3% had only consumed a drink and approximately a further 10% reported eating crisps or chocolate for breakfast (Ells et al. 2008).

 

Skipping breakfast has been identified as a risk factor for a wealth of deleterious health outcomes, poorer overall nutritional adequacy, and adverse effects on memory and concentration.

 

There are studies that suggest that obese children skip breakfast on average twice a week, twice as often as normal weight children.

 

Moreover, there is a substantial social gradient in breakfast eating habits, with children from more deprived backgrounds more likely to skip breakfast and to consume breakfasts with poorer nutritional value than their wealthier counterparts.

 

Therefore, promotion of healthy breakfast eating habits may improve population health and academic performance, and reduce health and educational inequalities.

 

Appropriate manipulation of the school environment may offer an efficient and effective long-term means of improving the health of the population (Tucker et al. 2006, Sharma et al. 2006). Furthermore, if such intervention brings about sufficient dietary improvement to impact upon cognitive functioning and behaviour, this may translate into improved school performance and educational achievement.

 

Recognition of these potential benefits has led to a number of government funded school breakfast initiatives since the first one was implemented in deprived areas in North America in 1966. Since then the number of schools participating in such programmes has risen dramatically (Conroy et al. 2007).

 

However, the objectives of these different breakfast systems have varied considerably, with some have focused on the provision of a healthy breakfast, whilst others have placed more emphasis on childcare, education, or informal interaction between children and school staff.

 

This experience has provided evidence to support that school breakfast programmes can help improve nutrition and may also be associated with improvements in attendance, academic performance and behaviour.

 

However, findings have been inconsistent and the research has had limitations, with most of the studies unable to incorporate appropriate control groups, or suffering substantial contamination between trial arms.

 

Thus although there is good reason to believe that breakfast programmes can have a wide range of beneficial outcomes, the impact in a Nordic country like Denmark, which differs substantially from North America in many aspects, remains to be demonstrated.

 

Considerations for a school based dietary intervention study in children

 

(Published on foodoflife.dk)