QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Online Supplemental Material All Versions of this Article: 139/9/1744    most recent jn.109.108662v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Arsenault, J. E. Articles by Villamor, E. PubMed PubMed Citation Articles by Arsenault, J. E. Articles by Villamor, E.

---

Community and International Nutrition

Provision of a School Snack Is Associated with Vitamin B-12 Status, Linear Growth, and Morbidity in Children from Bogotá, Colombia^1–3,

⁴ Department of Nutrition, and ⁵ Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115; ⁶ Department of Nutrition, National University of Colombia, Bogotá, Colombia; ⁷ National Institute of Health, Bogotá, Colombia; ⁸ San Rafael Clinic, Bogotá, Colombia; and ⁹ Department of Community Health, Warren Alpert Medical School, Brown University, Providence, RI 02903

In 2004, Bogotá's Secretary of Education (SED) initiated a snack program in public primary schools. A midmorning food ration was provided free of charge to children to supplement 30 and 50% of their daily requirements of energy and iron, respectively. The purpose of this study, an observational investigation of 3202 children ages 5–12 y, was to examine whether the snack program improved children's nutritional and health status. We measured micronutrient levels (plasma ferritin and vitamin B-12, and erythrocyte folate), anthropometry, and reported morbidity during the first semester of the 2006 school year. After adjusting for socioeconomic status and other school interventions, children at schools receiving the snack (n = 1803) had greater increases in plasma vitamin B-12 (42 pmol/L; P < 0.0001) from baseline to 3 mo of follow-up than children at schools not receiving the snack (n = 1399). They also experienced a smaller decrease in height-for-age Z-scores than children who did not receive the snack (P = 0.001). Provision of the SED snack was associated with significantly fewer reported days with morbidity symptoms (e.g. cough with fever, diarrhea with vomiting), 44% fewer doctor visits (P = 0.02), and 23% fewer days of school absenteeism (P = 0.03). The snack was not related to ferritin or folate levels. In conclusion, provision of a school-administered snack was related to improved vitamin B-12 status and linear growth and decreased reported morbidity. Although provision of the snack was not related to BMI changes over a 4-mo period, snack components such as candy and sugar-sweetened beverages should be replaced with healthier options, as the rates of child overweight in Colombia are not negligible.

^* To whom correspondence should be addressed. E-mail: evillamo{at}hsph.harvard.edu.

Manuscript received 10 April 2009. Initial review completed 29 May 2009. Revision accepted 18 June 2009.

Published online 8 July 2009.