KickStart Breakfast programme report inconclusive

Lindsay Mitchell points out that there is a lot of uncertainty in a report on the KickStart Breakfast programme in Lots of ‘ifs’ and ‘maybes’

The report: KickStart Breakfasts and Indicators of Child Health in Linked Administrative Data

The existing evidence base

International evidence is that eating a healthy breakfast can lead to improvements in academic performance, appears to improve overall diet quality, and may protect against weight gain.

Existing New Zealand evidence establishes that school breakfast programmes reduce student hunger. Small New Zealand studies suggest provision of milk in schools increases the proportion of children meeting recommended guidelines for dairy intake and improves bone health.

Results from international and New Zealand studies assessing whether school feeding programmes have positive impacts on other student outcomes are mixed, but generally positive.

Evidence from research on dairy consumption and child health suggest that school food programmes that boost dairy intake could have positive effects on a range of measures of child health, with the potential to improve oral and bone health in particular.

What this study adds

This study was commissioned to provide a quantitative assessment of the impact of the KickStart programme on students’ outcomes. The Statistics New Zealand Integrated Data Infrastructure was used in this study.

Informed by the existing evidence base, and by the data available, we focussed on measures of students’ oral and bone health.

We found that after controlling for a range of other factors, students aged under 13 enrolled in schools and kura with higher uptake of KickStart – measured in terms of the average number of breakfasts served per student, per week across three school years – were significantly less likely than their peers to have hospital outpatient visits for dental
surgery.

Etc.

But there is a lot of uncertainty. Mitchell points out some ifs and maybes.

“We see no evidence of a significant association between KickStart intensity and the two administrative indicators of fracture. One possible explanation is that KickStart intensity had no association with bone health. Another is that students who received more KickStart were more active as a result of increased energy intake. Falls may have increased at the same time as the likelihood of fracture upon falling was reduced as a result of improvements in bone health.”.

-KickStart may have improved the nutritional quality of the breakfasts consumed by students. This mechanism is suggested by a study by Bhattacharya et al. (2006) which examined the United States School Breakfast Program.

-The effect of the breakfasts may have been to displace consumption of unhealthy snack foods, including sugary food and drinks, as suggested by the cross-sectional study conducted by Utter and colleagues (2007).

– Reduced pressure on home budgets as a result of KickStart may have allowed families and whānau to purchase higher quality foods to eat at other times of the day and week. Such spillover effects are suggested by the Bhattacharya et al. (2006) study, which found that both adults and preschool children had healthier diets and lower percentages of calories from fat when the School Breakfast Program was available to school-aged children in the household.

If Kickstart caused improvements in diet and caused sugary food and drinks to be displaced, this would suggest that benefits might also include reduced obesity and improvements in learning, health and development (Thornley et al., 2017a), including reductions in rheumatic fever (Thornley et al., 2017b).

There are more uncertainties:

We are unable to draw conclusions about the degree to which reduced outpatient visits for dental surgery were caused by KickStart alone.

…there are plausible mechanisms that could link KickStart and reduced hospital outpatient visits for dental surgery

The limited information available through existing linked de-identified administrative data meant that we were unable to examine some of these wider potential benefits.

No clear association was found between increased exposure to KickStart and administratively sourced measures indicative of bone fractures in students aged under 13.

And that’s before getting to the Introduction. Jumping to…

Conclusion

Schools and kura are overwhelmingly positive about the KickStart programme and report positive effects on students’ health and wellbeing and engagement with school. Our analysis of linked administrative data shows that after controlling for a range of confounders, students enrolled in schools and kura with higher uptake of KickStart – measured in terms of the average number of breakfasts served per student per week across three school years – are significantly less likely than their peers to have hospital outpatient visits for dental surgery.

While plausible causal mechanisms exist, we are unable to draw conclusions about the degree to which this association reflects the causal impact of KickStart.

A report that is unable to draw conclusions seems of limited use.

8 Comments

  1. chrism56

     /  June 9, 2018

    The mere fact that the “pilot” programme was unable to show any positive effects will be disregarded when the push comes to extend it to all “poor” schools, then made compulsory. It is all about feelings, making the socially aware feel virtuous, and facts are just irrelevant. To prove that, what has been the benefit of free tuition fees?

    • Alan Wilkinson

       /  June 9, 2018

      NZ universities drop in world rankings via reduced staff/student ratios?

      • chrism56

         /  June 9, 2018

        Yes – and they blamed that drop on staff being laid off because numbers in those departments (mostly useless degrees for the job market) had dropped.

        • PartisanZ

           /  June 9, 2018

          Remembering, of course, that “useless degrees for the job market” is another industry-creation scheme – Corporeducation – to divert the middle-and-working-class flotsam and jetsam of neoliberal ‘re-regulation’ into ‘education’ and ‘upskilling’ …

          One of the fingers in the leaking dyke of Rogerednomics, Ruthanasia and ‘Government on Behalf of corporate-capitalist-political elites’ for so-called ‘Free Market’ Globalisation …

          Now that the New-Right paradigm has settled back to its fullest possible employment level – mandatory 4%+ unemployed to maintain low wages – the Corporeducation industry it created to mask its own shortcomings must now be ‘downsized’ …

          • chrism56

             /  June 9, 2018

            Have you ever tried writing in English PZ? – it might be a new experience. but you’d then have a chance of putting together a readable communication. Your last missive is all just namecalling and cliched gobbledygook.

    • PartisanZ

       /  June 9, 2018

      Rule feelings out of human decision-making and you have inhumanity … a numbers game … commonly known as orthodox economics …

      Conversely, to expect a ‘Breakfast in Schools’ program to significantly affect health and educational outcomes in an extremely complex ‘intersectional’ society where myriad factors are at play … not least the generalized rule of inhuman economics … stretched inequality and challenged health and education systems … is probably in itself an indication of economic ideology overruling common sense …

      Common sense would do something about the causes …

      • Gezza

         /  June 9, 2018

        Breakfast in Schools programmes were needed to ensure some kids not getting fed at home got fed at school.

        • Kitty Catkin

           /  June 9, 2018

          A deputy head I knew said that it was almost invariably poor organisation rather than poverty,

          How much do two weetbix (generic, less than $4 a kilo) cost with a splash of milk ?

          For some reason, eating breakfast was seen as uncool when I was at secondary school, much as wearing a raincoat was. I can’t remember why.