POP305 Food programmes in schools

Settings-Based Approach to Health Promotion

  • A settings-based approach focuses on promoting health for larger groups rather than individualized, personalized health advice.

    • It is defined as a holistic and multidisciplinary method to address ill health within settings where people live, work, and play.
    • The goal is to maximize health promotion for many individuals simultaneously.
    • A "setting" is an environment actively used by people, shaped by physical barriers and organized by specific roles or structures (e.g., workplaces, hospitals, sports clubs, cities).

  • Reference to the Ottawa Charter, which provides a foundational framework for health promotion.

Importance of School Food Environments in New Zealand

Background Information on Obesity in New Zealand

  • New Zealand has the second highest prevalence of obesity among OECD countries.
    • Recent health survey data indicates that approximately 30% of children are classified as overweight or obese.
  • Healthy eating habits decline as children grow older due to various influences outside of the family environment.
    • Increased independence leads to higher consumption of unhealthy foods (e.g., fast food, sugary drinks).
    • Reduced intake of recommended amounts of fruits and vegetables.

Reasons for Focusing on Schools

  • Most children attend school for significant amounts of time (five days a week, several hours a day, for multiple years).
  • Evidence suggests that early interventions for obesity can foster lifelong healthy habits.
  • Schools serve as key environments for practicing healthy eating, promoting social acceptability around food consumption.
    • Around one-third of total daily energy intake occurs in schools, through lunches and snacks.
  • Research indicates a correlation between a healthy school environment and lower rates of obesity, alongside improved class behavior.

Research Insights on School Food Policies

  • A study using the School Food Environment Review and Support Tool surveyed about 800 schools to assess healthiness and existing policies.
    • 40% of the schools reported having a food or nutrition policy, but many were seen as weak and lacking enforcement of restrictions on unhealthy foods.
    • 70% of schools sell food and drinks, with a prevalence of unhealthy options.
    • Fundraising often involved unhealthy food products.
Positive Aspects of School Policies
  • Approximately 70% of primary schools offered milk and water, and many had integrated vegetable gardens or nutrition education.
  • Limited sponsorship from food companies, along with low marketing of unhealthy foods around schools.
Challenges Identified in School Canteen Menus
  • A 2020 study assessed school canteen menus against the Ministry of Health's food and drink guidelines using a traffic light system:
    • Green: healthy items, Amber: items that should be avoided but are acceptable occasionally, Red: items that should not be sold.
    • Unfortunately, more than 80% of items sold were categorized as Amber or Red, indicating a lack of healthy options.
    • Lower decile schools had fewer green options compared to higher decile schools.

School Food Programs in New Zealand

  • Programs focus on providing healthy food, each with different targets, funding, and implementation methods:
    • Ko au te Ko au: Started around COVID-19, delivering nutritious lunches to students in schools facing socio-economic barriers. It aims to support child development, health, food security, and educational achievements by providing daily school lunches.
    • Kick Start Breakfast: An initiative providing nutritious breakfast items (e.g., baked goods and milk) to schools across all year groups. Schools can sign up to participate based on facility capacity; distributions occur approximately twice a year.
    • Kipscan: An NGO-based program providing packaged, shelf-stable foods on an as-needed basis to schools, catering to students in need.
    • Food in Schools: Organized by Health New Zealand, this initiative provides daily distributions of fruits and vegetables to primary schools.

Evaluation of Food in Schools Program (2023)

  • An evaluation surveyed 40 principals to assess the effectiveness of the Food in Schools initiative.
    • Principals reported positive insights on how the program supports a healthy environment and promotes healthy eating.
    • 92% of principals agreed that the program is effective in promoting healthy environments and cultural connection.
    • Emphasis on the normalization of fruit and vegetable consumption among students, with minimal embarrassment associated with accessing food.
    • Acknowledged benefits for teachers in managing student behavior due to reduced hunger in children.
    • 95% of principals indicated that complementary programs (e.g., Ko au te Ko au) are necessary and beneficial.
Other Strategies for Healthy School Environments

  • Strategies discussed for creating a healthier environment within schools included:

    • Banning sugar-sweetened beverages.
    • Involving caregivers in health education.
    • Implementing nutrition education in the curriculum.

  • Evidence indicates multi-component programs yield the best results for improving eating habits.

    • An umbrella review studied the effectiveness of various strategies in promoting fruit and vegetable intake, concluding that food provision strategies and gaming initiatives are particularly effective.

Transition to University Food Environments

Challenges Faced by Students

  • University marks a significant life change that can disrupt established eating habits due to:
    • Moving from home, increased studying time, financial constraints, and stress related to academic demands.
  • Food insecurity is defined as uncertain access to nutritious and safe food, leading to adverse effects on physical, mental health, and academic success.
  • A survey conducted at the University of Auckland revealed high levels of food insecurity among students:
    • Only 2.6% of surveyed students met guidelines for fruit and vegetable intake.
    • Frequent skipping of meals, especially breakfast, was notably higher among food-insecure students.

Potential University Initiatives for Food Promotion

  • Previous research has identified potential university initiatives to promote healthy eating, including:
    • Budget meals and discounted options for students.
    • Food pantries for students in need.
    • Marketing strategies that prioritize health and avoid unhealthy food promotions.
Cross-Sectional Survey of University Food Environment
  • A cross-sectional survey in 2017 used the Food Environment Quality Index to assess food outlets on campus, highlighting:
    • Availability of healthy options (6 healthy, 2 unhealthy outlets out of 28 total).
    • Higher prices for healthy foods compared to unhealthy counterparts leading to lower accessibility.
Student and Staff Opinions on Food Environment
  • Surveys indicated that students and staff prefer more freshly prepared foods, a greater variety, and lower costs.
    • A demand for improved availability of fresh fruit and hot food options.
    • Most agreed that a reduction in energy-dense, nutrient-poor foods offered was necessary.

Research on Campus Food Environment and Health

  • The Unifood tool is planned to assess various aspects of university food environments, including:
    • Food outlets, policies, and overall campus facilities.
    • Previous Australian data reveals a median score of 46 out of 100, indicating room for improvement in governance and comprehensive meal offerings.
Recommendations for Effective Policy Implementation
  • Emphasize the importance of multi-component strategies to improve food environments at both schools and universities.
  • Engage with students and staff to gather feedback on their food needs and preferences to ensure that initiatives are effective and tailored to actual demand.
Future Research Considerations
  • Ongoing research aims to understand how the transition from school to university affects healthy eating and food security among students.
    • Focus groups and interviews are planned to engage current and past students about their experiences and gather insights that could steer future initiatives.