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. Design 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. Subjects About 30 students in second through sixth grades were randomly selected from each school (n=4,358). Intervention 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). Main outcome measures Breakfast consumption and food and nutrient intake. Statistical analyses 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.