HealthDay News — A breakfast-in-the-classroom initiative increases participation in the federal School Breakfast Program but has an unintended consequence of increasing the incidence and prevalence of obesity, according to a study published online Feb. 25 in JAMA Pediatrics.

Heather M. Polonsky, from Temple University in Philadelphia, and colleagues examined the effect of a breakfast-in-the-classroom initiative, which combines breakfast in the classroom with breakfast-specific nutrition education, in a cluster-randomized clinical trial. Participants included 1,362 fourth- through sixth-grade students from low-income urban communities.

The researchers found that students in intervention schools had participated in the School Breakfast Program 53.8% of school days compared with 24.9% of school days among students in control schools after 2.5 years (β = 0.33; 95% confidence interval, 0.22 to 0.42). After 2.5 years, intervention and control schools did not differ in terms of the combined incidence of overweight and obesity (11.7 vs 9.3%; odds ratio, 1.31; 95% confidence interval, 0.85 to 2.02; P = 0.22). However, intervention schools had a higher incidence of obesity (11.6 vs 4.4%; odds ratio, 2.43; 95% confidence interval, 1.47 to 4) and prevalence of obesity (28 vs 21.2%; odds ratio, 1.46; 95% confidence interval, 1.11 to 1.92) compared with control schools after 2.5 years.

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“It is essential to identify alternative implementation approaches that increase School Breakfast Program participation without promoting obesity,” the authors write.

One author disclosed financial ties to Nestle. A second author reported being an employee and shareholder of WW, formerly Weight Watchers.

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