Evaluation of a Free Milk in Schools Program in New Zealand: Effects on Children's Milk Consumption and Anthropometrics

Examining the New Zealand school food environment: what needs to change?

Habitual dietary intakes and nutrition behaviours developed during childhood and adolescence pave the way for similar behaviours to manifest in adulthood. Childhood obesity rates have now reached a point where one in six children globally are classified as overweight or obese. Schools have the unique ability to reach almost all children during key developmental stages, making them an ideal setting for influencing children's nutrition behaviours. Evidence suggests the school food environment is not always conducive to healthy food choices and may be obesogenic. The aim of this narrative review is to explore factors that influence the healthy food and drink environment in and around schools in New Zealand. The review focused on evidence from New Zealand and Australia given the close resemblance in education systems and school food guidance. Using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, the school food environment was categorised into the following domains: economic, political, physical and socio-cultural factors. Findings suggest that food policies are not utilised within schools, and guidelines to improve the school food environment are not well implemented. Canteen profit models, lack of staff support and resources, and higher availability of low-cost unhealthy foods are among barriers that hinder implementation. This review highlights recommendations from existing evidence, including canteen pricing strategies, restriction of unhealthy foods and using peer modelling in a time-scarce curriculum to improve the school food environment. Key areas for improvement, opportunities to enhance policy implementation and untapped avenues to improve the food and nutrition behaviours of children are highlighted.

Nourishing Hawke's Bay: He wairua tō te kai - food security, health behaviours and wellbeing in children in regional New Zealand

Our current food system is failing to deliver on equitable health outcomes, wellbeing and food security and the Hawke's Bay region of New Zealand has high inequities and one the highest levels of childhood obesity nationally. This articlereports baseline quantitative data from 2087 students (aged 9 or 13) from 41 primary and secondary schools, including schools participating in the Ka Ora, Ka Ako Healthy School Lunch programme. Students answered an online survey covering food security, general wellbeing (WHO-5), eating behaviours and physical activity and were measured/weighed for body size. 16.8% of students experienced food insufficiency in the home and 31.3% of 13-yr-olds did not eat breakfast. Overall, only 12.9% met the national vegetable intake guidelines and 39.6% met fruit intake guidelines. Students in high advantage schools (decile 8-10) were twice as likely to meet the vegetable intake guidelines. 47.1% of 13-year old girls were at risk of reduced wellbeing. 54.6% of students had a healthy weight and 44.5% experienced overweight or obesity; in low advantage (decile 1-3) schools 64.4% experienced overweight or obesity. The data form a baseline for an evaluation of multiple public health initiatives underway in Hawke's Bay to improve food environments and nutritional wellbeing.

Effect of milk supplementation on the status of micronutrients among rural school children aged 5–19 years in a tribal predominating district of India

Background

In the tribal state of Jharkhand, there have been very few studies on micronutrient deficiency and how it is addressed among school children. This study was conceived and undertaken to assess the effect of milk supplementation on the micronutrient status of school children.

Design

A comparative observational study was conducted among school children of a tribal district in India during 2017–2018. Two groups of schools/clusters were randomly selected, one with milk supplementation and the other without supplementation. A total of 318 children from the two groups of schools were recruited for biochemical analysis of certain micronutrients, such as calcium, vitamin D, vitamin B₁₂ and iron (haemoglobin level), using cluster random sampling. Data were analysed using SPSS V.20.0 software, and multiple logistic regression analysis was done to determine the predictors of serum calcium and vitamin B₁₂ level among school children.

Results

Almost all children from both groups had vitamin D deficiency. A higher risk of lower serum vitamin B₁₂ level (OR 2.59, 95% CI 1.61 to 4.16) and calcium level (OR 3.36, 95% CI 1.74 to 6.49) was observed in children of the control group. The difference in the proportion of anaemia in the two study groups was found to be statistically insignificant. Milk consumption was found to be the only significant predictor of normal vitamin B₁₂ and calcium level in the present study.

Conclusions

In this study, it was concluded that milk consumption may help in improving the calcium and vitamin B₁₂ status of school children of a tribal state, whereas it does not have any significant effect on vitamin D level.

School-based nutrition interventions can improve bone health in children and adolescents

Objectives

Osteoporosis is a major global health problem, and optimizing bone health during childhood and adolescence with adequate calcium and vitamin D intake is a recommendation to prevent the disease. School milk programs may be a viable approach to help children and adolescents increase calcium and vitamin D intakes while improving their bone health.

Methods

A review of the literature was conducted on school milk programs, including examination of details regarding these studies and their participants, and assessments of their effects on bone health in children and adolescents.

Results

Nearly all studies reviewed showed significant increases in the bone health behaviors and outcomes that were measured, such as bone mineral density, milk consumption, and calcium and vitamin D intake.

Conclusions

School milk programs can be effective in improving bone health in children and adolescents, and public health policies should be considered to help support and fund effective programs that promote bone health and prevent osteoporosis in population health.