NUTRITION AND EDUCATION - A RANDOMIZED TRIAL OF THE EFFECTS OF BREAKFAST IN RURAL PRIMARY-SCHOOL CHILDREN

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented s chool feeding programs, few programs have been rigorously evaluated. W e conducted a randomized, controlled trial of giving breakfast to unde rnourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (we ights-for-age less than or equal to -1 SD of the National Center for H ealth Statistics references) and the adequately nourished group compri sed 407 children matched for school and class (weights-for-age >-1 SD) . Both groups were stratified by class and school, then randomly assig ned to breakfast or control groups. After the initial measurements, br eakfast was provided every school day for 1 school year. Children in t he control group were given one-quarter of an orange and the same amou nt of attention as children in the breakfast group. All children had t heir heights and weights measured and were given the Wide Range Achiev ement Test before and after the intervention. School attendance was ta ken from the schools' registers. Compared with the control group, heig ht, weight, and attendance improved significantly in the breakfast gro up. Both groups made poor progress in Wide Range Achievement Test scor es. Younger children in the breakfast group improved in arithmetic. Th ere was no effect of nutritional group on the response to breakfast. I n conclusion, the provision of a school breakfast produced small benef its in children's nutritional status, school attendance, and achieveme nt. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires inte grated programs including health and educational inputs as well as sch ool meals.