Masters Theses

Date of Award


Degree Type


Degree Name

Master of Science



Major Professor

Betsy Haughton

Committee Members

Sonya Jones, Lisa Jahns, Gene Fitzhugh


Objective The purposes of this study were two-fold: 1) to assess the school breakfast environment at four rural Appalachian schools for the contribution of foods to calories, fat, and fiber; and 2) to assess the dietary intake of students in these schools in relation to where breakfast was consumed (home, school, or both places) and by student weight status.

Setting Four rural Appalachian schools with fourth and fifth grade students in East Tennessee.

Subjects 255 fourth grade children completed a 24-hour dietary recall with a trained NDS-R interviewer and were weighed and measured by the Coordinated School Health Program.

Design Assessment of baseline data from an intervention study targeting 4th and 5th grade students in one rural East Tennessee county, Youth Can!, was used. School food service managers submitted school menus and production sheets for 18 days, and vendor bid sheets for analysis of the school breakfast environment. NDS-R software was used to analyze each breakfast food item for calories, fat, and fiber content per serving and production sheets were used to determine amounts of each breakfast food item served. Dietary recalls for days when school breakfast could be consumed were analyzed for energy and target nutrients using NDS-R software. Weight status was calculated as at risk of or overweight and not at risk of overweight based on BMI percentile for age.

Statistics Descriptive statistics were used to describe the school breakfast environment in terms of calories, fat and saturated fat (grams, percent calories) and fiber (grams) from foods sold on a per person basis. Food items also were grouped by the five meal components of the School Breakfast Program and ranked according to the total items served. Relationships between dietary intake and breakfast location and child weight status were evaluated using analysis of variance. Relationships between breakfast location and child weight were examined using chi-square tests.

Results On average in these school environments fat provided slightly less than half the calories (43%); 15% of calories were from saturated fat. The top ranked foods for servings sold for each meal component were biscuits, sausage, 2% milk, orange juice, and gravy. Children consuming breakfast at home and school had significantly higher percent breakfast contribution to the entire day for energy and calcium compared to children who only ate breakfast at home or school. While children who ate breakfast at home had significantly lower percent breakfast contributions to the entire day for percent calories from fat, protein compared to children who ate at school. Children who ate breakfast only at school had lower percent breakfast contribution to the entire day for iron and vitamin A compared to children who ate breakfast only at home. Breakfast consumption regardless of location had no impact on child weight status.

Conclusion The high fat content school breakfast environment reinforces the importance of healthy school food policies and technical support and resources for food service programs to provide low-fat meal options. However, children are not consuming all the breakfast items being served at school. Further research is needed to determine the impact physical activity and socio-economic status have on weight.

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