Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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

European Journal of Clinical Nutrition volume 65, pages 203–209 (2011)Cite this article

Subjects

Abstract

Background/Objective:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

  • Affenito SG (2007). Breakfast: a missed opportunity. JADA 107, 565–569.

    Article  Google Scholar 

  • Armitage P (1995). Test for linear trends in Proportions and Frequencies. Biometrics 11, 375–386.

    Article  Google Scholar 

  • Bellisle F, Rolland-Cachera MF (2007). Commentary on Bellisle F, Rolland-Cachera, MF and the Kellogg Scientific Advisory Committee ‘Child and Nutrition’ (2000) Three consecutive (1993, 1995, 1997) surveys of food intake, nutritional attitudes and knowledge, and lifestyle in 1000 French children, aged 9–11 years. J Hum Nutr Diet 13, 101–111.

    Article  Google Scholar 

  • Cartwright M, Wardle J, Steggles N, Simon AE, Croker H, Jarvis MJ (2003). Stress and dietary practices in adolescents. Health Psychol 22, 362–369.

    Article  PubMed  Google Scholar 

  • Chen X, Sekine M, Hamanishi S, Wang H, Gaina A, Yamagami T (2005). Lifestyles and health-related quality of life in Japanese school children: a cross-sectional study. Prev Med 40, 668–678.

    Article  PubMed  Google Scholar 

  • Cho S, Dietrich M, Brown CJ, Clark CA, Block G (2003). The effect of breakfast type on total daily energy intake and body mass index: results from the Third National Health and Nutrition Examination Survey (NHANES III). J Am Coll Nutr 22, 296–302.

    Article  PubMed  Google Scholar 

  • Condon EM, Crepinsek MK, Fox MK (2009). School meals: types of foods offered to and consumed by children at lunch and breakfast. J Am Diet Assoc 109 (Suppl 2), S67–S78.

    Article  PubMed  Google Scholar 

  • Eliakim A, Nemet D, Balakirski Y, Epstein Y (2007). The effects of nutritional-physical activity school-based intervention on fatness and fitness in preschool children. J Pediatr Endocrinol Metab 20, 711–718.

    Article  PubMed  Google Scholar 

  • Gleason PM, Dodd AH (2009). School breakfast program but not school lunch program participation is associated with lower body mass index. J Am Diet Assoc 109 (Suppl 2), S118–S128.

    Article  PubMed  Google Scholar 

  • Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V (2009). School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med 37, 418–427.

    Article  PubMed  Google Scholar 

  • Grantham-McGregor S (2005). Can the provision of breakfast benefit school performance? Food Nutr Bull 26, 144S–158S.

    Article  Google Scholar 

  • Hosmer DW, Lemeshow S (2000) In: Chichester, Wiley (ed). Applied Logistic Regression, 2nd ed New York; 2000; ISBN 0-471-35632-8.

  • Huerta M, Gdalevich M, Haviv J, Bibi H, Scharf S (2006). Ten-year trends in obesity among Israeli schoolchildren: 1990–2000. Acta Paediatrica 95, 444–449.

    Article  PubMed  Google Scholar 

  • Kant AK, Andon MB, Angelopoulos TJ, Rippe JM (2008). Association of breakfast energy density with diet quality and body mass index in American adults: National Health and Nutrition Examination Surveys, 1999–2004. Am J Clin Nutr 88, 1396–1404.

    CAS  PubMed  Google Scholar 

  • Keski-Rahkonen A, Kaprio J, Rissanen A, Virkkunen M, Rose RJ (2003). Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr 57, 842–853.

    Article  CAS  PubMed  Google Scholar 

  • Nicklas TA, Myers L, Reger C, Beech B, Berenson GS (1998). Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, Louisiana: ethnic and gender contrasts. J Am Diet Assoc 98, 1432–1438.

    Article  CAS  PubMed  Google Scholar 

  • O’Dea JA, Caputi P (2007). Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents. Health Education Research 16, 521–532.

    Article  Google Scholar 

  • Pearson N, Biddle SJ, Gorely T (2009). Family correlates of breakfast consumption among children and adolescents. A systematic review. Appetite 52, 1–7.

    PubMed  Google Scholar 

  • Pollitt E, Cueto S, Jacoby ER (1998). Fasting and cognition in well- and undernourished schoolchildren: a review of three experimental studies. Am J Clin Nutr. 67, 779S–784S.

    Article  CAS  PubMed  Google Scholar 

  • Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD (2005). Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 105, 743–760.

    Article  PubMed  Google Scholar 

  • Siega-Riz AM, Popkin BM, Carson T (2000). Differences in food patterns at breakfast by sociodemographic characteristics among a nationally representative sample of adults in the United States. Prev Med 30, 415–424.

    Article  CAS  PubMed  Google Scholar 

  • Song WO, Chun OK, Obayashi S, Cho S, Chung CE (2005). Is consumption of breakfast associated with body mass index in US adults? J Am Diet Assoc 105, 1373–1382.

    Article  PubMed  Google Scholar 

  • Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C (1996). Relationship between feeding pattern and body mass index in 220 free-living people in four age groups. Eur J Clin Nutr 50, 513–519.

    CAS  PubMed  Google Scholar 

  • Tapper K, Murphy S, Lynch R, Clark R, Moore GF, Moore L (2008). Development of a scale to measure 9-11-year-olds’ attitudes towards breakfast. Eur J Clin Nutr 62, 511–518.

    Article  CAS  PubMed  Google Scholar 

  • Vereecken C, Dupuy M, Rasmussen M, Kelly C, Nansel TR, Al Sabbah H, et al., HBSC Eating and Dieting Focus Group (2009). Breakfast consumption and its socio-demographic and lifestyle correlates in schoolchildren in 41 countries participating in the HBSC study. Int J Public Health 54 (Suppl 2), S180–S190.

    Article  Google Scholar 

  • Widenhorn-Müller K, Hille K, Klenk J, Weiland U (2008). Influence of having breakfast on cognitive performance and mood in 13- to 20-year-old high school students: results of a crossover trial. Pediatrics 22, 279–284.

    Article  Google Scholar 

  • Williams P (2007). Breakfast and the diets of Australian children and adolescents: an analysis of data from the 1995 National Nutrition Survey. Int J Food Sci 58, 201–216.

    Article  Google Scholar 

Download references

Acknowledgements

‘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.

Author information

Authors and Affiliations

  1. Zinman College for Physical Education & Sports, School of Exercise and Sport Sciences, Wingate Institute, Netanya, Israel

    S Eilat-Adar

  2. Department of Epidemiology and Preventive Medicine, Sackler Medical Faculty, Tel Aviv University, Tel Aviv, Israel

    S Eilat-Adar & N Koren-Morag

  3. Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Israel

    M Siman-Tov

  4. Supervisor for School Health and Health Education, Ministry of Education, Jerusalem, Israel

    I Livne

  5. Department of Nutrition, Ministry of Health, Jerusalem, Israel

    H Altmen

Authors
  1. S Eilat-Adar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N Koren-Morag
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Siman-Tov
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I Livne
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Altmen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Eilat-Adar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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). https://doi.org/10.1038/ejcn.2010.247

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2010.247

Keywords

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

This article is cited by

Search

Advanced search

Quick links