Healthy eating in our schools – are we doing enough?

vegetablesNearly a year ago, Education Minster Anne Tolley announced the scrapping of a mandate for healthy foods in schools: “As part of the National Government’s commitment to reducing compliance for schools, I have decided to remove the clause in National Administration Guideline (5) which states ‘where food and beverages are sold on schools’ premises, to make only healthy options available.”

This announcement sparked widespread concern among health experts, and some of the key concerns were outlined in a paper published in the New Zealand Medical Journal in February 2009, by Jennifer Utter and colleagues, School is back in New Zealand – and so is the junk food. Utter comments on the fact that selling junk food will contribute to the current generation of young people facing a lifetime burden of obesity, diabetes and other chronic diseases because of poor nutrition, and she concluded, “it’s not too late to reinstate the clause as one part of a comprehensive policy to prevent obesity and diabetes.”

One year on, has anything changed? The Science Media Centre decided to contact a number of organisations and health experts to ask their view about the current situation in terms of foods currently provided to children in schools, about the importance of healthy eating for children, and about what’s now needed in terms of food policies in schools.

The comments we received are outlined below, along with a full list of references and sources for further information.

What sort of food is currently available in schools and is it all healthy?

Dr Jennifer Utter from the University of Auckland comments:

“Surveys of school canteens generally find that energy-dense and nutrient-poor foods like
pies, sausage rolls, chips and crisps, cakes and donuts, and sweet drinks are common in school canteens. Fewer than half of all schools have fruit on the menu and if healthier options were available, they are more expensive.

More than 50% of children and 60% of adolescents buy food from the school canteen. Making healthy food choices at school given these options is nearly impossible.”

Bronwen King, a Christchurch Public Health Nutritionist, comments in conjunction with the Schools and Fruit in Schools Teams in Christchurch:

“The schools that have maintained the changes they made as a result of National Administration Guideline (NAG) 5 and those using the food and beverage classification system as their guide have healthy food services.  Those that did not make changes, or have reverted back to old habits as a result NAG 5 section 3 being repealed are selling food that is not looking after the health and well being of the children e.g. pies, crisps, sausage rolls and cream buns.  These schools are also likely to have brought back chocolate fund raisers and McDonalds vouchers for rewards (both counterproductive to healthy attitudes and behaviour around food).

Since repealing of NAG 5 section 3 there has been a huge number of parents ringing up the school saying “now you can bring back the pies!”  Our team is amazed by the power of parents, and how adamant some of them about wanting unhealthy options available.  In schools where positive health changes were made, there were even parents passing fast food over the fence to their children.  This highlights the fact that our education system must have a role in shaping healthy food habits.  It cannot just leave this job to parents as clearly, there are a lot of parents who are not doing this adequately.

Where a school has had one-on-one input from fruit in schools team, there are many positive changes. When the changes are made gradually, the school community has adapted and accepted them.

Essentially, there is a huge discord between what is being taught in the curriculum and what is being reflected and modelled within the school community.  Anne Tolley’s action in removing NAG 5 section 3 means there is no mandate for healthy school environments that would support the key curriculum messages around food and nutrition.  A good analogy would be a doctor giving anti smoking advice while smoking him/herself!”

Ruth Crawford, from the New Zealand Nurses Organisation (Nurses for Children and Young People Aotearoa section), comments:

“There is a wide variety of foods available, but after the removal of the legislation around Healthy Food in schools requirement we have noticed a significant increase in high sugar and high fat foods available in some canteens.

Foods available in schools vary per school.  Some schools that are on the journey of Health Promoting Schools (HPS) programme make changes and are more proactive in the choices of foods offered at school as are the Fruit in Schools (FIS) schools.  Unfortunately I think this is because of the programme on offer more than a lifestyle of the school change in some instances but others with the right principal, staff and community buy in are successfully keeping healthy food choices in the forefront.  On the other hand some schools still maintain options such as pastry and pies,  as well as the odd healthy option, but often these canteens are privately contracted/run and have some direction from the school but not as much as the school-owned ones where the school can have strong input into the menu.”

Jenny Stewart (National Programme Manager – Schools & Early Childhood Education) from The National Heart Foundation, comments:

“New Zealand schools offer a range of food to our children with healthy options such as wraps and sushi to unhealthy options such as pies and confectionary.”

Sarah Hanrahan, a Registered Dietitian with the New Zealand Nutrition Foundation, comments:

“The range of food on offer in New Zealand schools varies dramatically. With the removal of the National Administration Guidelines clause requiring schools to sell only healthy food early in 2009, some schools opted to stay with offering only healthy choices while anecdotal evidence suggests many others reverted to their previous menu. New Zealand studies carried out prior to the implementation of the National Administration Guideline  showed the most commonly available foods in schools at this time were pies, juice and sausage rolls1, all foods to be enjoyed as a treat but not foods to form the daily basis of school lunch.”

Do New Zealand school children currently have an optimal food and nutrition intake?

Jennifer Utter comments:

“Children and young people in New Zealand eat too many snack foods, takeaway foods and consume too much fizzy drink while eating too few fruits and vegetables. This has been documented in several of our national health and nutrition surveys and is evidenced by New Zealand’s high prevalence of overweight and obesity. Poor food options at school do not contribute to a healthier diet for school children.”

Bronwen King comments:

“Definitely not.  One in three children is overweight and this trend is set to continue with the increasing consumption of processed, packaged, fast and convenience foods

Increased consumption of processed foods not only leads to excessive kilojoule intake (which is stored as fat) but also micronutrient deficiencies, particularly in iron, calcium and iodine.  This increases risk of degenerative conditions e.g. type 2 diabetes and heart disease as well as compromising immune systems.”

Ruth Crawford comments:

“Surveys have highlighted that on an average children are not attaining the prescribed 5+ intake a day of fruit and vegetables.

Household Economy, family education around healthy eating/lifestyle, convenience, all factors that are working against children having optimal food nutrition intake.”

Jenny Stewart comments:

“The recent NZ Health survey (2006-7)2 showed 26% of adults are obese and 21% of children are overweight with 8% obese.   To add to this, the National Children’s Nutrition survey 20023 showed a percentage of New Zealand children suffered from micro nutrient deficiencies in calcium and iron affecting optimal bone and brain growth.”

What is the impact of, and the importance of, healthy eating for children?

Jennifer Utter comments:

“Poor nutrition is a major contributor to numerous chronic conditions including cardiovascular disease, diabetes, and many cancers. The social consequences of poor nutrition in childhood are significant and long-lasting as well. Children and adolescents consuming an excess of food additives in many processed foods (such as sodium benzoate and artificial food colours) are more likely to develop hyperactivity which negatively affects their learning. Children and young people who experience overweight are more likely to experience stigmatization, discrimination, peer-exclusion and other psychosocial consequences. Overweight and obesity that develops during childhood is likely to persist into adulthood contributing to a lifetime of poor health.”

Bronwen King comments:

“Health is compromised by excess kilojoule intake and this is compounded by not enough physical activity – this leads to obesity which increases the risk of a long list of health conditions. Health is doubly compromised by inadequate intake of micronutrients e.g. calcium (bone growth and strength compromised), iron (brain development and growth compromised), iodine (thyroid function compromised – controls metabolism), fibre (digestive system disorders) etc.

Lack of physical activity affects motor skills which in turn affects the ability of kids to reach their intellectual potential – long term this increases risk of muscular skeletal disorders and impaired functionality while ageing.

There are huge psychological and sociological impacts of being overweight and of not reaching full academic potential – more depression, lesser job prospects which exacerbate depression etc.

The predicted health care costs are staggering.  Currently it is estimated to cost over $40,000 a year for a diabetic patient to undergo dialysis. Given that kids are getting type 2 diabetes earlier and earlier, they are likely to need it while still young and for years! The health care costs are predicted to cripple the health budget by 2020 which will mean less money for education, roads etc.”

Ruth Crawford comments:

“Sets them up for better eating and exercise patterns for the rest of their life.

Healthy eating = Healthy bodies, lifestyles and environment. Nutrition is at the core of our optimal health model.  If nutrition is poor individuals are at an increased risk – 50% of developing CVD, diabetes and other chronic life debilitating illness.”

Jenny Stewart comments:

“Obesity is closely linked with an increased risk of diabetes, cardiovascular disease and some forms of cancer. In the short term an inadequate diet has a detrimental effect on brain development, school attendance, behaviour, emotional wellbeing and overall academic performance4. With our children consuming a large proportion of their food at school this setting provides the opportunity to offer nutritious food combined with nutrition education to make the healthy choice the easy choice.”

Sarah Hanrahan comments:

“Not surprisingly there is evidence of an association between eating from school canteens and more frequent consumption of high fat and high sugar foods6. Research has also shown good nutrition is associated with improved school performance7.”

What action is needed to improve the current situation?

Jennifer Utter comments:

“To improve the quality of foods provided in schools for all children and young people, national regulation restricting the sale of unhealthy foods to school children is necessary as one part of a comprehensive policy to improve the nutrition and health profile of New Zealand’s children and young people. This type of policy would be cost-effective and would have the potential to benefit all children and young people equally.”

Bronwen King comments:

“Simple – bring back NAG 5 section 3.  We also think compulsory food policy in schools is essential.

What we need is strong leadership from the top and tough measures, not the soft options they are dishing out now.  Unless we get this, we will all pay the price. The implications of kids not reaching their academic potential, increased mental health issues, increased lifestyle disease, increased waiting lists etc are huge – they will impact on all of us!”

Ruth Crawford comments:

“Blanket legislation across all schools and pre-schools from Government would ensure that the school environment only provided and advocated healthy food choices and the rationale why. Compulsory Healthy Food Policy brought about by the Ministry of Education (supported by Ministry of Health) sounds great!! Compulsory change if done with consultation and slowly does work.

This is such a huge issue. We know the research behind good food……How do you put a further food policy in school if parents are the suppliers of the lunch boxes? It will not be resolved with a simple media message. Unless schools provide free lunches as in UK to lower income families and have canteens in schools it is going to be an ongoing issue.”

Jenny Stewart comments:

“The Heart Foundation is working to combat this issue through its comprehensive health promotion programme, the Healthy Heart Award in Schools – Tohu Manawa Ora: Kura. The programme offers support and resources to ensure a whole school approach to making changes to their nutrition policy and environment, school food service, curriculum and delivering professional development to teachers. Schools can showcase their efforts through an interactive website Digivillage8. The programme rewards schools with a Bronze, Silver or Gold Award, positive publicity and the sense of achievement.  Our evaluation studies and teacher feedback from schools have shown improvements in children’s food intake has improved behaviour and learning9.

Sarah Hanrahan comments:

“With so many children eating from school canteens it is important that the food offered is nutritious, healthy and consistent with classroom teaching.  Furthermore the food we eat as children often sets the platform for how we eat as adults.  Food available in schools can be a valuable educational tool supporting healthy eating messages and exposing the children to a range of foods they may not have at home.”

References

1. Utter J, Schaff D, Ni Mhurchu C, Scragg R. Food choices among students using the school food service in New Zealand. The New Zealand Medical Journal. 2007;120(1248)

2. Ministry of Health.  A  Portrait of Health: key results of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health, 2008.

3. Ministry of Health. NZ Food NZ Children: Key results of the 2002 National Children’s Nutrition Survey. Wellington: Ministry of Health; 2003.  Available from:

4. Quigley and Watts Ltd. A Rapid Review of the Literature on the Association Between Nutrition and School Pupil Performance. Wellington, Quigley and Watts, 2005.

5. World Cancer Research Fund / American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: A global perspective. Washington DC; 2007.  Available from:

6. Carter MA, Swinburn B. Measuring the ‘obesogenic’ food environment in New Zealand primary schools. Health Promotion International. 2004;19(1): 15-20

7. Fu ML, Cheng L, Tu SH, Pan WH. Association between unhealthful eating patterns and unfavourable overall school performance in children. Journal of American Dietetic Association. 2007;107(11):1035-43

8. Digi.Village. An interactive digital platform that showcases NHF education programmes.

9. Clinton, J, Dobson R & Mahoney, F. (2007). The School Food Programme Evaluation – Final Report.  Centre for Health Research and Policy. The University of Auckland.

(10.) Joint WHO/FAO expert consultation. Diet, nutrition and the prevention of chronic diseases. Geneva: World Health Organization; 2003.  Available from:

More information about food in schools

1. Press release from Anne Tolley announcing the removal of the clause in NAG 5 in relation to the sale of food and beverages on school premises.

2. Utter J., Scragg R., Percival T., Beaglehole R. School is back in New Zealand – and so is the junk food. NZMJ, 122 (1290) 5-8.

(A copy of this paper is available in the SMC resource library.)

3. Information about the National Heart Foundation school programme

4. Information about FOE activities

5. Information about the NZ Nutrition Foundation

Further information and expert comment

To talk to these or any other scientists about issues raised here, please contact the Science Media Centre on tel: 04 499 5476 or email: smc@sciencemediacentre.co.nz.

Notes to Editors

The Science Media Centre (SMC) is an independent source of expert comment and information for journalists covering science and technology in New Zealand. Our aim is to promote accurate, bias-free reporting on science and technology by helping the media work more closely with the scientific community. The SMC is an independent centre established by the Royal Society of New Zealand with funding from the Ministry of Research, Science and Technology. The views expressed in this Science Alert are those of the individuals and organisations indicated and do not reflect the views of the SMC or its employees. For further information about the centre, or to offer feedback, please email us at smc@sciencemediacentre.co.nz.