Thursday, June 07, 2018

Lots of 'ifs' and 'maybes'

In 2009 KickStart breakfast programmes were introduced into schools. Fonterra provided milk and Sanitarium cereals. Government provided subsidy. MSD published an evaluation study today.

It appears there is robust modelling to show some improvement in dental outcomes (though modest). But I smile over other findings.

Attempts to find better bone health for instance:

"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."
Then there is more speculation:

 -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.(My emphasis)
From this it is then inferred:

 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). (my emphasis)

I hope all of these improvements come to pass and feel somewhat sorry that the researchers were unable to conclude very much at all.

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