Breakfast programs in New York City schools have come under attack for feeding schoolchildren who might have already eaten at home.
While the programs provide healthy choices such as cereal, yogurt and fresh fruit, they also offer French toast and syrup and huge New York style bagels with cream cheese. On top of that, some kids admit to eating twice - once at home and once at school - which experts say reflects a national culture of consumption and could be contributing to childhood obesity.
"If there's food, we eat it. We don't have to be hungry, and it doesn't have to be meal time," said Dr. David Katz, director of the Yale University Prevention Research Center. "If we're raising kids to think of food that way, then we really do have to worry about some kids having breakfast twice."
More than one-third of children and teenagers are overweight or obese, according to the U.S. Centers for Disease Control and Prevention. The extra weight, caused in part by an excess of calories and a lack of exercise, increases the risk of cardiovascular disease and diabetes, as well as psychological problems linked to low self-esteem.
"Throughout most of history, calories were hard to get and physical activity was unavoidable. But we've developed a world where physical activity is hard to get and calories are unavoidable. And our culture hasn't adjusted accordingly," said Katz.
The goal of the breakfast programs is to feed students whose families struggle to put that first meal of the day on the table consistently.
"Hunger in the U.S. often means food insecurity, it doesn't necessarily mean emaciation," said Katz. "We really do have dueling nutritional problems in this country. We have kids who are both hungry and obese."
Katz said part of the problem is the less-healthy treats on the New York City Department of Education's morning menu, such as the crispy waffles with syrup, muffins and cheese strings.
"Cheese strings? That's not breakfast, that's a fun snack," said Katz. "If you're not hungry enough to eat an apple, you're not hungry. Other food might be more fun, but that's not the purpose of the program."
But Keith Ayoob, director of the Rose R. Kennedy Center Nutrition Clinic at Albert Einstein College of Medicine in New York City, said the programs aren't the problem.
"There is a mountain of research that shows school breakfasts, and particularly breakfast in the classroom, have a positive outcomes," he said, describing a drop in truancy, behavior problems and visits to the school nurse as well as an improvement in grades. "School breakfasts are not making kids overweight. If they're eating two breakfasts, parents need to know that and adjust accordingly at home."
Speaking to the New York Academy of Medicine Thursday, Ayoob defended breakfast programs and stressed the importance of parents keeping track of what their kids are eating.
"We don't want some kids going hungry just because some kids are overeating," he said. "A child getting two breakfasts is a much easier fix."