Importance of a Healthy Breakfast on a Daily Basis Amanda Badgley Shanwyon Bradley Mary Duncan

1. Importance of a Healthy Breakfast on a Daily Basis Amanda Badgley Shanwyon Bradley Mary Duncan Laura Maclam Kimberly Miller Sara Tonder

2. Introduction • Breakfast is said to be the most important meal of the day. But why does it have this title? • This presentation will explain this by looking at the • School aged children • Relevance of a healthy breakfast • Effects on health • Health effects of skipping breakfast • Social determinants to eating breakfast • Effects on the community • Goals will be established, a plan of action will be made, measured and evaluated

3. Relevance of Healthy Breakfast Providing school-aged children with an appropriate healthy breakfast promotes a healthy lifestyle Eating a healthy breakfast is important for children to have healthier bodies and minds Introducing good eating habits to school-aged children teaches healthy habits (Hoyland, et al, 2009)

4. Health Promotion Model • Self Efficacy • Personal change • Motivation • Action • Cognitive Theory • Social beliefs • Self observation • Self reflection • Human functioning

5. Health effects of skipping breakfast • Children who eat a healthy breakfast are more likely to: • Meet daily nutrient requirements • Concentrate better • Have better problem-solving skills • Have better hand-eye coordination • Be more alert • Be more creative • Miss fewer days of school • Be more physically active • Eat more vitamins and minerals • Reduce the risk of childhood obesity (Hoyland, et al, 2009)

6. Health effects of skipping breakfast • Breakfast contributes to daily energy and nutrient intake for school-aged children • Missing breakfast can have negative effects on children • “Children who miss breakfast have significantly worse daily nutrient intakes, including higher intakes of total fat, and lower intakes of dietary fiber and micronutrients than those who eat breakfast” (Mhurchu, 2010). • Because breakfast provides a large amount of both vitamin D and calcium, children that skip it will be below the level of recommended intake of calcium (American Academy of Pediatrics, 2012). • Children will consume less daily energy, vitamins, and minerals which they are not able to make up for at other meals (Miller, Forgac, Cline, McBean, 1998). • “Breakfast provides 16% of children's daily energy intake, around one-third of calcium, iron, thiamine, riboflavin and folate intakes, and one-fifth of zinc intake” (Mhurchu, 2010).

7. Health effects of skipping breakfast • People believe that skipping breakfast helps with weight loss when in actuality it causes weight gain • A study done in 2008 showed that those who ate a daily breakfast had a lower BMI then those who did not eat a daily breakfast(American Academy of Pediatrics, 2012). • Decreases students concentration and they have less energy when at school • Studies show that kids who eat breakfast function better overall (Miller, Forgac, Cline, McBean, 1998). • “Hungry children may lack the energy and motivation to become involved in classroom activities, while malnutrition and micronutrient deficiencies have been shown to impact physical, mental, and social health, and reduce cognitive functioning” (Mhurchu, 2010). • Eating a healthy breakfast effects children’s mental functioning as well as physical functioning • “School breakfast programs have benefits in relation to nutrition, school attendance, academic performance and psychosocial function” (Mhurchu, 2010).

8. Health effects of skipping breakfast • By skipping breakfast children have greater levels of hunger later on in the day which leads to overeating (Kral, Whiteford, Heo, Faith, 2011). • Studies have shown that those that skip breakfast as children and adults tend to have higher fasting insulin levels, increased triglycerides, total cholesterol and LDL levels, and increase in waist circumference (Smith, Gall, McNaughton, Blizzard, Dwyer, Venn, 2010). • Since skipping breakfast leads to overeating, this could lead to obesity and result in diabetes and heart disease

9. Demographics • 8-12% of all schooled aged children skip breakfast • By adolescence 20-30% have completely given up eating breakfast in the morning • 17% of adolescents aged 12-19 years old are overweight or obese which is causing future health problems • Studies preformed showed that between 1965-1991 there was a decrease of breakfast consumption between 5% of preschoolers, 9% of 8-10 year olds and 13-20% of adolescents • Of 11-15 year olds only 54% of boys and 42% of girls ate a daily breakfast

10. Social Determinants Too busy to make a breakfast in the morning Up too late which means they would prefer to sleep in longer then get up to eat breakfast Way to lose weight

11. Social Determinants of Diet Knowledge and attitudes Skills Social support Societal and cultural norms Food and agricultural policies Food assistance programs Economic price systems

12. Physical Determinants of Diet Access to and availability of healthier foods Places where people eat Marketing’s influence on food choices

13. Effects on the Community • Promoting healthy breakfast consumption for children creates a positive impact on a community • Having a healthy breakfast program in schools provides a positive role model for children for healthier eating (Tanaka & Miyoshi, 2012). • Having higher academic outcomes and school attendance is important to most communities • “Breakfast consumption is associated with a range of positive outcomes, including better school attendance, academic performance, nutrient intake, fitness, and healthier body weight” (Mhurchu, 2010).

14. Statistics related to skipping breakfast and obesity Agreater number of eating episodes each day was associated with a lower risk of obesity Skipping breakfast was associated with increased prevalence of obesity , as was greater frequency of eating breakfast or dinner away from home. Several characteristics of dietary behavior such as eating frequency, the temporal distribution of eating events across the day, breakfast skipping, and the frequency of meals eaten away from home, together referred to as “eating patterns,” may influence body weight. Skipping breakfast was associated with a significantly higher risk of obesity. Subjects who regularly skipped breakfast had 4.5 times the risk of obesity as those who regularly consumed breakfast. (Ma et al., 2003)

15. Healthy People Goals 2020 • Increase the proportion of schools with a school breakfast program • Currently 68.6 percent of schools overall had a school breakfast program in 2006. • The target goal for 2020 is that 75.5 percent of school have a breakfast program • Increase the proportion of physician visits made by all child or adult patients that include counseling about nutrition and diet • Currently 12.2 percent of all physician office visits include counseling about either nutrition or diet as of 2007 • The target goal for 2020 is 15.2 percent of physician office visits include counseling about nutrition or diet • Increase the proportion of students in grade 9 through 12 who get sufficient sleep • Currently 30.9 percent of students in grades 9 through 12 get sufficient sleep which is considered 8 or more hours • The target goals for 2020 is 33.2 percent of student in grade 9 through 12 get sufficient sleep

16. Nutrition and Weight Status for Healthy People 2020 Reflects strong science supporting the health benefits of eating a healthy diet and maintaining a healthy body weight. Objective: Change to a healthy diet and weight while including individual behaviors while encompassing the policies and environments that support an individuals behaviors. Examples: schools, work settings, and communities.

17. Nutrition and Weight Status for Health People 2020 Goal: Promote healthy diet and healthy weight Increase household food security Eliminate hunger Promote growth and development of children Reduce risk for many health conditions including: obesity, malnutrition, iron-deficiency anemia, heart disease, hypertension, type 2 diabetes, dyslipidemia, and osteoporosis. (U.S. Dept. of Health and Human Services, 2013)

18. Educating the Public Despite the wide availability of school breakfast programs and the preponderance of evidence that breakfast consumption has positive effects on the students ability to learn and function in the school setting, many students do not eat breakfast. A survey of students at a large Midwestern high school identified the main barriers to breakfast consumption as not having enough time in the morning to eat and not feeling hungry before school (Olsta, 2013).

19. Goals Ways to Achieve the Goals One way to achieve the goal of every student eating breakfast, is to make it free or reduced cost regardless of what the parents income is. Some children in the US today are even missing lunch because they do not qualify for reduced lunch because of their parents income, but the parents can not afford lunch. Another way to accomplish this goal would be to allow students to eat their breakfast in class.

20. Support How to get Community Support One way to get community support is to organize school fundraisers. A proven way to get community support is to get the schools to participate in Box Tops for Education. Another way to promote Box Tops for Education is to advertise in the community news papers that your particular school is participating in this program to raise money for the School Breakfast Program.

21. Measuring Success Measuring success of school breakfast programs involves the accumulation and evaluation of contributing factors that have resulted in an outcome, either positive or negative. Some factors worth considering include: how many students participate in the program, changes in attendance, improvement in grades, and changes noted in behavior patterns. Participation hurdles such as cost to schools and families have been found significant.(Klienman, Hall, Green, Korzac-Ramirez, Patton, Pagano & Murphy, 2002)

22. Evaluation Information should be obtained from school staff and shared with parents. Self evaluation by students is a valuable tool in assessing individual perspective. Improvements may be made based on the results of surveys that have been distributed to staff and family members. Feedback from staff, parents and administrators is imperative for evaluation. Quarterly and then yearly reviews will be beneficial when implementing ongoing improvements to the program.

23. School Breakfast Evaluation PART 1 Administrators/Principals General Information 1) Where is School Breakfast served? Cafeteria _______ Classroom _______ Other _______ If other, please describe location: _______________________ 2) Has school attendance improved since implementing the School Breakfast Program (SBP)? Yes ______ No ______ If yes, by what percentage: _____________________ 3) How would you rate your overall satisfaction of the SBP? 1 2 3 4 5 Poor Below Average Average Above Average Excellent Tardiness 4) What was your school’s tardiness percentage before you started the SBP (prior 3 months)? ________ 5) What is your school’s tardiness percentage now? ________ Discipline Referrals 6) Did you have any discipline referrals before you started the SBP (prior 3 months)? Yes _____ No _____ If yes, how many? ________ 7) Did you have any discipline referrals during the three months the SBP was operating? Yes _____ No _____ If yes, how many? ________ Program Evaluation - 4 School Breakfast Evaluation (USDA)

24. Conclusion • Breakfast is the most important meal of the day because it gives us the energy and nutrients to start the day out right • To help children decrease their risk for health complications related to not eating breakfast it is important for us to provide them with the tools to do so • Providing a breakfast based school program for all schools will make a huge dent in meeting the Healthy People 2020 Goals • As always funding is an issue but the use of the Box Tops program and getting the community involved will help tremendously • By providing education to the public and giving these children the resources they need we will be able to make eating a healthy breakfast a part of every kids day.

25. References American Academy of Pediatrics. (2012, November 27). The case for eating breakfast. Retrieved from http://www.healthychildren.org/English/healthy-living/nutrition/pages/The-Case-for-Eating- Breakfast.aspx? Gleason, P. (1995). Participation in the national school lunch program and the school breakfast program. (61 ed., pp. 213S-220S). Plainsboro, NJ: Mathematical Policy Research Inc. Retrieved from http://ajcn.nutrition.org/content/61/1/213S.full.pdf Hoyland, A., Dye, L., & Lawton, C. (2009). A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutrition Research Reviews, 22(2), 220-243. Retrieved from http://0-newfirstsearch.oclc.org.libcat.ferris.edu/

26. References Klienman, R., Hall, S., Green, H., Korzac-Ramirez, D., Patton, K., Pagano, M., & Murphy, J. (2002). Diet, breakfast, and academic performance in children. (46 ed., Vol. 01, pp. 24- 30). Bethesda MD: US National Library of Medicine. Retrieved from http://0- www.ncbi.nlm.nih.gov.libcat.ferris.edu/pmc/articles/PMC327 Kral, T. V., Whiteford, L. M., Heo, M., & Faith, M. S. (2001, February). Effects of eating breakfast compared with skipping breakfast on ratings of appetite and intake at subsequent meals in 8-to 10-y- old children. American Journal of Clinical Nutrition, 93(2), 284-291. Retrieved from http://ajcn.nutrition.org/content/93/2/284.long Mhurchu, C. N., Turley, M., Gorton, D., Jiang, Y., Michie, J., Maddison, R., & Hattie, J. (2010). Effects of a free school breakfast programme on school attendance, achievement, psychosocial function, and nutrition: A stepped wedge cluster randomised trial. BMC Public Health, 10(738). http://dx.doi.org/10.1186/1471-2458-10-738

27. References Miller, G. D., Forgac, T., Cline, T., & McBean, L. D. (1998, February). Breakfast benefits children in the US and abroad [Editorial]. Journal of the American College of Nutrition, 17(1), 4-6. Retrieved from http://www.jacn.org/content/17/1/4.full Ortega, R. M., Requejo, A. M., Lopez-Sobaler, A. M., Andres, P., Quintas, E., Navia, B., . . . Rivas, T. (1998, February). The importance of breakfast in meeting daily recommended calcium intake in a group of schoolchildren. Journal of the American College of Nutrition, 17(1), 19-24. Retrieved from http://www.jacn.org/content/17/1/19.full

28. Reference Smith, K. J., Gall, S. L., McNaughton, S. A., Blizzard, L., Dwyer, T., & Venn, A. J. (2010, December). Skipping breakfast: Longitudinal associations with cardiometabolic risk factors in the childhood determinants of adult health study. American Journal of Clinical Nutrition, 92(6), 1316-1325. Retrieved from http://ajcn.nutrition.org/content/92/6/1316.long Tanaka, N., & Miyoshi, M. (2012). School lunch program for health promotion among children in japan. Asia Pacific Journal of Clinical Nutrition, 21(1), 155-158. Retrieved from http://0- www.ncbi.nlm.nih.gov.libcat.ferris.edu/pubmed/22374573 USDA. (n.d.). Michigan school breakfast challenge. Retrieved from http://www.michigan.gov/documents/mde/Discover_School_Breakfast_Toolkit_w_MI_cover_2527 07_7.pdf

29. Reference U.S. Dept. of Health and Human Services (2013, April 4). Re: Healthy people 2020, Improving the Health of Americans. Retrieved from: http://www.healthypeople.gov/2020/default.aspx Y, M., ER, B., EJ, S., GW, R., JR, H., NL, C., . . . IS, O. (2003). Association between eating patterns and obesity in a free-living US adult population. American Journal of Epidemiology, 158(1), 85-92. http://dx.doi.org/10.1093/aje/kwg117