The rural school meal as a site for learning about food

The Ecuadorian School Food Environment: Association With Healthy and Unhealthy Food and Beverage Consumption and BMI

BACKGROUND

Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.

OBJECTIVES

2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617).

METHODS

Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.

RESULTS

The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).

CONCLUSION

The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.

Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway

Background

There are no national arrangements for free school meals provision in Norway despite this being an important opportunity to improve children’s and adolescents’ nutritional status and ultimately their physical and cognitive development. During a one academic year (2014–2015), a group of Norwegian sixth graders were served a free healthy school meal in a project called ‘The School Meal Project’.

Objective

To explore students’ and teachers’ experiences of receiving free school meals after the free school meal in 2015 and 5 years later.

Design

In-depth, semi-structured interviews with separate groups in 2015 and in 2020 were conducted face to face or via telephone or digital platforms. The findings are based on 13 students (aged 12–16) and 5 teacher interviews.

Findings

Thematic analysis identified four main themes that describe the perceived benefits of receiving free school meals: 1) the meal as a social event where students made new friends and learned new skills; 2) as an aid to forming healthy eating habits; and as an opportunity to 3) improve school functioning and 4) increase social equality among students.

Discussion

Our analysis suggests that the free school meal may influence healthy behaviors not only at the individual level but also at the social-, physical-, and macro-levels. Methodological limitations, including self-selection bias, should be considered when interpreting our findings.

Conclusion

This study provides unique insights into the social benefits for students of receiving free school meals. Our findings illustrate the potential of free school meals: eating healthy foods, sharing a meal together, and interaction between students and teachers at mealtime, to promote health, learning, and equality. In order to maximize these benefits through national implementation of free school meals, more understanding is needed of possible facilitators and barriers related to the provision and uptake of free school meals.

Integrating nutrition into the education sector in low- and middle-income countries: A framework for a win-win collaboration

Malnutrition—both undernutrition and overnutrition—is a public health concern worldwide and particularly in low‐ and middle‐income countries (LMICs). The education sector has high potential to improve immediate nutrition outcomes by providing food in schools and to have more long‐term impact through education. We developed a conceptual framework to show how the education sector can be leveraged for nutrition. We reviewed the literature to identify existing frameworks outlining how nutrition programs can be delivered by and through the education sector and used these to build a comprehensive framework. We first organized nutrition programs in the education sector into (1) school food, meals, and food environment; (2) nutrition and health education; (3) physical activity and education; (4) school health services; and (5) water, sanitation, and hygiene (WASH) sector. We then discuss how each one can be successfully implemented. We found high potential in improving nutrition standards and quality of school foods, meals and food environment, especially through collaboration with the agriculture sector. There is a need for well‐integrated, culturally appropriate nutrition and health education into the existing school curriculum. This must be supported by a skilled workforce—including nutrition and public health professionals and school staff. Parental and community engagement is cornerstone for program sustainability and success. Current monitoring and evaluation of nutrition programming in schools is weak, and effectiveness, including cost‐effectiveness, of interventions is not yet adequately quantified. Finally, we note that opportunities for leveraging the education sector in the fight against rising overweight and obesity rates are under‐researched and likely underutilized in LMICs.