1. Breakfast patterns among low-income, ethnically diverse elementary school children Hannah G. Lawman, PhD 1, Heather Polonsky, BS 1, Stephanie Vander Veur, MPH 1, Michelle Abel, MSPH 2, Sandy Sherman, EdD 2, Katherine W. Bauer, PhD 1, Tim Sanders, BA 1, Jennifer O. Fisher, PhD 1, Lisa Bailey-Davis, DEd, RD 3, Janet Ng, PhD 1, Gretchen Van Wye 4, PhD, Gary D. Foster, PhD 1 1 Center for Obesity Research and Education, Temple University School of Medicine; 2 The Food Trust; 3 Center for Health Research, Geisinger Health System; 4 New York City Department of Health and Hygiene BMI Percentile Variable % % Mean ± SD Gender Weight Status Age (yrs)10.7 ±1.0 Female52.3 Underweight2.9Weight (kg)44.8 ± 15.1 Male47.7 Healthy Weight56.6Height (cm)146.4 ± 9.2 Race/Ethnicity Overweight15.8BMI (kg/m2)20.5 ± 5.1 Black61.4 Obese15.2BMI z-score0.7 ± 1.2 Hispanic14.4 Severely obese9.5BMI percentile66.6 ± 30.5 Asian13.2Transportation White6.9 Walked66.0 Other4.1 Driven24.9 Ate dinner96.1 Other9.1 Figure 3. Model estimated curvilinear relation between BMI percentile and number of breakfasts consumed Number of Breakfast Locations Table 1. Sample characteristics (n=651) Background_________________________ Many school districts and federal efforts have sought to increase breakfast participation given its documented benefits on children’s concentration, academic performance, and behavior. To encourage more participation in school breakfast, cities have adopted programs that offer breakfast in the classroom. These programs are seen as a way to combat stigma associated with school breakfast participation, address logistical challenges with breakfast served before school, and fight food insecurity. Providing breakfast at school for children who would not otherwise have one is valuable. At the same time, there is a concern that among children who are already consuming one or more breakfasts, school breakfast could unintentionally increase energy intake and undermine obesity prevention efforts. Project Overview_____________________ Purpose of the study is to assess breakfast patterns among 4 th -6 th graders in an urban public school district that implements a Universal Free School Breakfast Program and to assess the relationship between those patterns and measured relative weight. The feasibility pilot study included 4 th -6 th graders from 3 schools and occurred during the 2012-2013 academic year. Methods____________________________ During the pilot study, students were recruited and baseline measures were collected in Fall 2012; approximately 65% of eligible students were enrolled. Measured heights and weights and questionnaires were collected from 651 students. Students reported whether they ate or drank anything (yes/no) from 1 of 4 locations: home, corner store, school cafeteria, or classroom breakfast. Within each location, students bubbled in the items they ate/drank from a list of food and drink categories. The survey also assessed reasons for not eating/drinking, the consumption of dinner the evening before, and students’ method of transportation to school.. Results/Conclusions A large number of youth (37.8%) reported eating multiple breakfasts (25.5% consumed 2, and 12.3% consumed 3 or 4). These findings suggest that eating breakfast at multiple locations may contribute to excess energy intake and that efforts to promote school breakfast consumption may have unintended effects on childhood obesity. Over 75% of youth reported eating breakfast at home and most (58%) also ate at school (23.5%), a corner store (23.5%) or both (11.2%). These similar findings suggest that interventions designed to increase school breakfast participation should consider that the breakfast may be in addition to what was already consumed prior to school at home and corner stores. Of concern, 12.4% of youth reported not eating breakfast despite the universal free breakfast policy. This suggests a small but significant proportion of youth may be experiencing food insecurity, which has previously been associated with skipping breakfast and increased risk of obesity. Number of breakfasts and BMI percentile showed a significant curvilinear relation, with higher mean BMI percentiles observed among children that did not consume any breakfast and who consumed ≥ 3 breakfasts. Research to Practice Strategies Overall, this study supports the need for careful study of breakfast policies, such as breakfast in the classroom, that offer all youth additional opportunities to eat breakfast. Next steps include the main randomized control trial. The main trial will take place in 16 Philadelphia public schools from 2013-2016, and will follow 4 th -6 th graders until they are 6 th -8 th graders. Contact Information Name: Heather Polonsky Organization: CORE – Temple University Phone Number: 215-707-5320 Email Address: heather.polonsky@temple.edu