The impact of school breakfast programs on children's nutrition and health: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Yan ^1,2,3 , YANG Chaoqun ^1,2,3 , CHEN Nan ^1,2,3 , GUO Kangle ^1,2,3 , LI Yanfei ^1,2,3 , E Fenfen ^1,2,3 , SHANG Xue ^1,2,3 , CHEN Yani ^1,2,3 ,  YANG Kehu ^1,2,3 , LI Xiuxia ^1,2,3

1. Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
2. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, P. R. China;
3. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding author：

YANG Kehu, Email: lixiuxia@lzu.edu.cn

Keywords：

School breakfast; Children; Nutrition; Health; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.202204135

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Objective To systematically review the impact of school breakfast on children's nutrition and health. Methods The PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the impact of school breakfast on children's nutrition and health from inception to June 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. Results A total of 8 RCT, involving 8 208 children were included. The results of meta-analysis showed that compared with non-school breakfast, the school breakfast could significantly improve the rate of school attendance (RR=1.38, 95%CI 1.26 to 1.51, P<0.000 1). However, there was no statistically significant difference in height, weight, weight-for-age, height for age, energy, protein, iron, or incidence of nutritional disease between the groups. Conclusion The current evidence suggests that school breakfast has no impact on children's nutrition and health. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Citation： WANG Yan, YANG Chaoqun, CHEN Nan, GUO Kangle, LI Yanfei, E Fenfen, SHANG Xue, CHEN Yani, YANG Kehu, LI Xiuxia. The impact of school breakfast programs on children's nutrition and health: a systematic review. Chinese Journal of Evidence-Based Medicine, 2022, 22(10): 1161-1166. doi: 10.7507/1672-2531.202204135 Copy

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6.	Colley P, Myer B, Seabrook J, et al. The impact of canadian school food programs on children's nutrition and health: a systematic review. Can J Diet Pract Res, 2019, 80(2): 79-86.
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11.	党佳佳, 闫晓晋, 马宁, 等. 儿童青少年超重肥胖评价方法及SPSS和SAS实现. 中华预防医学杂志, 2022, 56(1): 75-81.
12.	冯玉荣, 段爱旭, 范利国. 山西省大同市卫生学校学生早餐状况. 中国学校卫生, 2004, 25(2): 181-182.
13.	刘文, 李红霞. 分析营养早餐影响学生体质发育的效果. 中国社区医师, 2020, 36(30): 164-165.
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15.	李菁菁, 戴诗玙, 欧阳英英, 等. 湖北省农村贫困地区中小学生早餐行为现状及影响因素. 西安: 达能营养中心第二十三届学术会议—营养与认知, 2020.
16.	Bhattacharya J, Haider CSJ. Breakfast of champions. The school breakfast program and the nutrition of children and families. J Hum Resour, 2006, 41(3): 445-466.
17.	Adolphus K, Lawton CL, Champ CL, et al. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr, 2016, 7(3): 590S-612S.
18.	Powell CA, Walker SP, Chang SM, et al. Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children. Am J Clin Nutr, 1998, 68(4): 873-879.
19.	Pollitt E, Mathews R. Breakfast and cognition: an integrative summary. Am J Clin Nutr, 1998, 67(4): 804S-813S.
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25.	Yao X, Florez ID, Zhang P, et al. Clinical research methods for treatment, diagnosis, prognosis, etiology, screening, and prevention: a narrative review. J Evid Based Med, 2020, 13(2): 130-136.
26.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
27.	Li J, Mu Z, Xie J, et al. Effectiveness and safety of Chinese herbal medicine Xiaoyao san for the treatment of insomnia: Protocol for a systematic review and meta-analysis. Medicine (Baltimore), 2019, 98(29): e16481.
28.	Pollitt E, Jacoby E, Cueto S. School breakfast and cognition among nutritionally at-risk children in the Peruvian Andes. Nutr Rev, 1996, 54(4 Pt 2): S22-S26.
29.	Jacoby E, Cueto S, Pollitt E. Benefits of a school breakfast programme among Andean children in Huaraz, Peru. Food Nutr Bull, 1996, 17(1): 54-64.
30.	李世敏, 刘冬, 李广京. 营养早餐对学生营养状况的干预作用. 食品科学, 2003, 24(9): 128-130.
31.	Crepinsek MK, Singh A, Bernstein LS, et al. Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project. J Am Diet Assoc, 2006, 106(11): 1796-1803.
32.	Mhurchu CN, Gorton D, Turley M, et al. Effects of a free school breakfast programme on children's attendance, academic achievement and short-term hunger: results from a stepped-wedge, cluster randomised controlled trial. J Epidemiol Community Health, 2013, 67(3): 257-264.
33.	Jenkins KT, Benton D, Tapper K, et al. A cross-sectional observational study of the nutritional intake of UK primary school children from deprived and non-deprived backgrounds: implications for school breakfast schemes. Int J Behav Nutr Phys Act, 2015, 12: 86.
34.	Lohman T, Roche A, Martorell R, et al. Anthropometrical standardization reference manual: Abridged edition, 1988. Available at: https://www.scienceopen.com/document?vid=f0220587-ecf2-4ee0-9fd0-66427f258aa2.

1. Guthrie JF, Newman C, Ralston K. USDA national school meal programs: established programs face new challenges. Choices, 2011, 24(3): 36-46.
2. 国务院办公厅. 关于实施农村义务教育学生营养改善计划的意见(国办发〔2011〕54号). Available at: http://www.gd.gov.cn/zwgk/wjk/zcfgk/content/post_2532411.html.
3. 马莉娜. 美国中小学校供餐体系及启示. 世界教育信息, 2014, 27(20): 48-52.
4. 李伟. 为阳光枝餐点赞—农村学生营养改善计划的重要意义. 中国改革, 2017.
5. 廖郁. 城市学校推广营养餐的必要性及措施. 食品安全导刊, 2019, (24): 92.
6. Colley P, Myer B, Seabrook J, et al. The impact of canadian school food programs on children's nutrition and health: a systematic review. Can J Diet Pract Res, 2019, 80(2): 79-86.
7. Amigo H. School feeding programmes in Latin America: An analysis. Arch Latinoam Nutr, 1997, 47(4): 299-304.
8. 德国大力推广早餐计划. 家庭教育(中小学版), 2016, (4): 1.
9. 法国: 政府出资600万支持学校提供免费早餐. 中国食品, 2019.
10. 孙春燕. 济宁市初中生饮食行为, 健康状况及影响因素研究. 济南: 山东大学.
11. 党佳佳, 闫晓晋, 马宁, 等. 儿童青少年超重肥胖评价方法及SPSS和SAS实现. 中华预防医学杂志, 2022, 56(1): 75-81.
12. 冯玉荣, 段爱旭, 范利国. 山西省大同市卫生学校学生早餐状况. 中国学校卫生, 2004, 25(2): 181-182.
13. 刘文, 李红霞. 分析营养早餐影响学生体质发育的效果. 中国社区医师, 2020, 36(30): 164-165.
14. 刘林涛. 延安市某小学学生早餐行为调查分析. 延安大学学报(医学科学版), 2012, 10(1): 60-61.
15. 李菁菁, 戴诗玙, 欧阳英英, 等. 湖北省农村贫困地区中小学生早餐行为现状及影响因素. 西安: 达能营养中心第二十三届学术会议—营养与认知, 2020.
16. Bhattacharya J, Haider CSJ. Breakfast of champions. The school breakfast program and the nutrition of children and families. J Hum Resour, 2006, 41(3): 445-466.
17. Adolphus K, Lawton CL, Champ CL, et al. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr, 2016, 7(3): 590S-612S.
18. Powell CA, Walker SP, Chang SM, et al. Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children. Am J Clin Nutr, 1998, 68(4): 873-879.
19. Pollitt E, Mathews R. Breakfast and cognition: an integrative summary. Am J Clin Nutr, 1998, 67(4): 804S-813S.
20. Taras H. Nutrition and student performance at school. J Sch Health, 2005, 75(6): 199-213.
21. Borghi E, de Onis M, Garza C, et al. Construction of the World Health Organization child growth standards: selection of methods for attained growth curves. Stat Med, 2006, 25(2): 247-265.
22. Collection U. Convention on the rights of the child. Law Policy, 2010, 17(4): 483-502.
23. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions (version 5.1. 0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
24. Tao WW, Jiang H, Tao XM, et al. Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine five-element music therapy on symptom management and quality of life for cancer patients: a meta-analysis. J Pain Symptom Manage, 2016, 51(4): 728-747.
25. Yao X, Florez ID, Zhang P, et al. Clinical research methods for treatment, diagnosis, prognosis, etiology, screening, and prevention: a narrative review. J Evid Based Med, 2020, 13(2): 130-136.
26. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414): 557-560.
27. Li J, Mu Z, Xie J, et al. Effectiveness and safety of Chinese herbal medicine Xiaoyao san for the treatment of insomnia: Protocol for a systematic review and meta-analysis. Medicine (Baltimore), 2019, 98(29): e16481.
28. Pollitt E, Jacoby E, Cueto S. School breakfast and cognition among nutritionally at-risk children in the Peruvian Andes. Nutr Rev, 1996, 54(4 Pt 2): S22-S26.
29. Jacoby E, Cueto S, Pollitt E. Benefits of a school breakfast programme among Andean children in Huaraz, Peru. Food Nutr Bull, 1996, 17(1): 54-64.
30. 李世敏, 刘冬, 李广京. 营养早餐对学生营养状况的干预作用. 食品科学, 2003, 24(9): 128-130.
31. Crepinsek MK, Singh A, Bernstein LS, et al. Dietary effects of universal-free school breakfast: findings from the evaluation of the school breakfast program pilot project. J Am Diet Assoc, 2006, 106(11): 1796-1803.
32. Mhurchu CN, Gorton D, Turley M, et al. Effects of a free school breakfast programme on children's attendance, academic achievement and short-term hunger: results from a stepped-wedge, cluster randomised controlled trial. J Epidemiol Community Health, 2013, 67(3): 257-264.
33. Jenkins KT, Benton D, Tapper K, et al. A cross-sectional observational study of the nutritional intake of UK primary school children from deprived and non-deprived backgrounds: implications for school breakfast schemes. Int J Behav Nutr Phys Act, 2015, 12: 86.
34. Lohman T, Roche A, Martorell R, et al. Anthropometrical standardization reference manual: Abridged edition, 1988. Available at: https://www.scienceopen.com/document?vid=f0220587-ecf2-4ee0-9fd0-66427f258aa2.

Chinese Journal of Evidence-Based Medicine

The impact of school breakfast programs on children's nutrition and health: a systematic review

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