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School-based intervention to promote eating daily and healthy breakfast: A survey and a case–control study



The recent rapid increase in childhood obesity rates suggests that a consideration of the role of the schools in addressing this problem is necessary. ‘Fits me’ program functions to promote eating daily and healthy breakfast among elementary school children.


Separate children groups were sampled each year by clusters from seven regions around Israel. They filled a self-administered questionnaire at the beginning of 2003, before the program started, and in 2003–2005, after the program. A separate sample was collected in 2006 in a case–control structure. The answer to the question: ‘what do you eat for breakfast?’ considered as a healthy breakfast if it included one of the following food items: A sandwich (not including chocolate, jam or butter), cereals, vegetable, fruit, egg and dairy product.


As compared with 2003 before the program, more children reported eating daily breakfast over the years (51–65% before and until 2005, respectively, P for trend<0.01). Odds ratio (OR) and 95% confidence interval (95% CI) for eating a healthy breakfast, in 2006 in the intervention (n=417) vs controls (n=572), adjusted for sex and age were OR=1.53 (95% CI: 1.15–2.04). However, only a third of 75% of the children who ate a healthy breakfast in the intervention group estimated that they were eating a healthy breakfast.


After implementation an educational program to promote daily and healthy breakfast eating, the goal of a healthier breakfast was achieved. However, one should strive to define an exact definition of a healthy breakfast.

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‘Fits me’ (Tafur Alay) is a joint project the Ministry of Health, Israel Association of Family Physicians, Israel Pediatrics Association, Israel Heart Society, Israel Pediatric Dentistry Association, the Association for Advancement of Nursing in Israel's Public Health, Atid – Association for Advancing Nutrition and Diet in Israel, Elective Parents Associations and approved by the Ministry of Education. This study was supported by Unilever Israel – Telma. We thank Prolog Entrepreneurship and Marketing for concept and management. We also thank Orna Levy, chief dietitian, Unilever, Israel for initiating and Israela Herbelin, CEO prolog initiation and marketing CSM for developing and implementing the program.

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Correspondence to S Eilat-Adar.

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Eilat-Adar, S., Koren-Morag, N., Siman-Tov, M. et al. School-based intervention to promote eating daily and healthy breakfast: A survey and a case–control study. Eur J Clin Nutr 65, 203–209 (2011).

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  • case–control
  • healthy breakfast
  • intervention program
  • school
  • survey

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