tag:theconversation.com,2011:/ca/topics/school-meals-6505/articlesSchool meals – The Conversation2024-03-18T12:24:52Ztag:theconversation.com,2011:article/2232702024-03-18T12:24:52Z2024-03-18T12:24:52ZFree school meals for all may reduce childhood obesity, while easing financial and logistical burdens for families and schools<figure><img src="https://images.theconversation.com/files/580529/original/file-20240307-16-nylyj3.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1024%2C683&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">School meal waivers that started with the COVID-19 pandemic stopped with the end of the public health emergency.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/plymouth-ma-a-student-at-plymouth-county-intermediate-news-photo/1242013592">Jonathan Wiggs/The Boston Globe via Getty Images</a></span></figcaption></figure><p>School meals are critical to child health. Research has shown that <a href="https://doi.org/10.3390/nu9090924">school meals can be more nutritious</a> than meals from other sources, such as meals brought from home. </p>
<p>A recent study that one of us conducted found the quality of school meals has steadily improved, especially since the 2010 <a href="https://doi.org/10.1001/jama.2020.9517">Healthy, Hunger-Free Kids Act</a> strengthened nutrition standards for school meals. In fact, by 2017, another study found that school meals provided the <a href="https://doi.org/10.1001/jamanetworkopen.2021.5262">best diet quality</a> of any major U.S. food source.</p>
<p>Many American families became familiar with universal free school meals during the COVID-19 pandemic. To ease the financial and logistical burdens of the pandemic on families and schools, the <a href="https://www.fns.usda.gov/coronavirus">U.S. Department of Agriculture issued waivers</a> that allowed schools nationwide to provide free breakfast and lunch to all students. However, these <a href="https://www.fns.usda.gov/cn/offsite-monitoring-after-phe#">waivers expired</a> by the 2022-23 school year. </p>
<p>Since that time, there has been a substantial increase in schools participating in the <a href="https://www.fns.usda.gov/cn/community-eligibility-provision">Community Eligibility Provision</a>, a federal policy that allows schools in high poverty areas to provide free breakfast and lunch to all attending students. The policy became available as an option for low-income schools nationwide in 2014 and was part of the <a href="https://obamawhitehouse.archives.gov/sites/default/files/Child_Nutrition_Fact_Sheet_12_10_10.pdf">Healthy, Hunger-Free Kids Act</a>. By the 2022-23 school year, <a href="https://frac.org/cep-report-2023">over 40,000 schools</a> had adopted the Community Eligibility Provision, an increase of more than 20% over the prior year.</p>
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<figcaption><span class="caption">Many families felt stressed when a federal program providing free school meals during the pandemic came to an end.</span></figcaption>
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<p>We are <a href="https://scholar.google.com/citations?user=ihU7JuoAAAAJ&hl=en">public health</a> <a href="https://scholar.google.com/citations?user=VkqyJPcAAAAJ&hl=en">researchers who</a> study the health effects of nutrition-related policies, particularly those that alleviate poverty. Our newly published research found that the Community Eligibility Provision was associated with a net <a href="https://doi.org/10.1542/peds.2023-063749">reduction in the prevalence of childhood obesity</a>.</p>
<h2>Improving the health of American children</h2>
<p>President Harry Truman <a href="https://www.fns.usda.gov/nslp/nslp-fact-sheet">established the National School Lunch Program</a> in 1946, with the stated goal of protecting the health and well-being of American children. The program established permanent federal funding for school lunches, and participating schools were required to provide free or reduced-price lunches to children from qualifying households. Eligibility is <a href="https://www.fns.usda.gov/cn/fr-020923">determined by income</a> based on federal poverty levels, both of which are <a href="https://www.federalregister.gov/documents/2024/01/17/2024-00796/annual-update-of-the-hhs-poverty-guidelines#">revised annually</a>.</p>
<p>In 1966, the <a href="https://www.fns.usda.gov/cna-amended-pl-111-296">Child Nutrition Act</a> piloted the <a href="https://www.fns.usda.gov/sbp/program-history">School Breakfast Program</a>, which provides free, reduced-price and full-price breakfasts to students. This program was later made permanent through an amendment in 1975.</p>
<p>The <a href="https://www.fns.usda.gov/cn/community-eligibility-provision">Community Eligibility Provision</a> was piloted in several states beginning in 2011 and became an option for eligible schools nationwide beginning in 2014. It operates through the national school lunch and school breakfast programs and expands on these programs.</p>
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<a href="https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Gloved hand placing cheese slices on bun slices" src="https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580532/original/file-20240307-22-r2dnw1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Various federal and state programs have sought to make food more accessible to children.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/cafeteria-worker-puts-together-sandwiches-for-free-meals-as-news-photo/1213018954">John Moore/Getty Images</a></span>
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<p>The policy allows all students in a school to receive free breakfast and lunch, rather than determine eligibility by individual households. Entire schools or school districts are eligible for free lunches if at least 40% of their students are directly certified to receive free meals, meaning their household participated in a means-based safety net program, such as the <a href="https://fns-prod.azureedge.us/sites/default/files/resource-files/NSLPDirectCertification2016.pdf">Supplemental Nutrition Assistance Program</a>, or the child is identified as runaway, homeless, in foster care or enrolled in Head Start. Some states also <a href="https://www.fns.usda.gov/cn/direct-certification-medicaid-demonstration-project">use Medicaid for direct certification</a>.</p>
<p>The Community Eligibility Provision increases school meal participation by <a href="https://doi.org/10.2105/AJPH.2011.300134">reducing the stigma</a> associated with receiving free meals, eliminating the need to complete and process applications and extending access to students in households with incomes above the eligibility threshold for free meals. As of 2023, the eligibility threshold for free meals is 130% of the federal poverty level, which amounts to US$39,000 for a family of four.</p>
<h2>Universal free meals and obesity</h2>
<p>We analyzed whether providing universal free meals at school through the Community Eligibility Provision was associated with lower childhood obesity before the COVID-19 pandemic.</p>
<p>To do this, we measured <a href="https://doi.org/10.1542/peds.2023-063749">changes in obesity prevalence</a> from 2013 to 2019 among 3,531 low-income California schools. We used over 3.5 million body mass index measurements of students in fifth, seventh and ninth grade that were taken annually and aggregated at the school level. To ensure rigorous results, we <a href="https://doi.org/10.1016/j.jeconom.2020.12.001">accounted for differences</a> between schools that adopted the policy and eligible schools that did not. We also followed the same schools over time, comparing obesity prevalence before and after the policy.</p>
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<a href="https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Child scooping food from salad bar onto a tray; other children lean against the wall" src="https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=381&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=381&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=381&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=479&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=479&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580530/original/file-20240307-24-swy6q3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=479&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Free school meals may help reduce health disparities among marginalized and low-income children.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/westbrook-middle-school-fifth-grade-student-salem-bukasa-news-photo/469592304">Whitney Hayward/Portland Portland Press Herald via Getty Images</a></span>
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<p>We found that schools participating in the Community Eligibility Provision had a <a href="https://doi.org/10.1542/peds.2023-063749">2.4% relative reduction</a> in obesity prevalence compared with eligible schools that did not participate in the provision. Although our findings are modest, even small improvements in obesity levels are notable because effective strategies to reduce obesity at a population level <a href="https://doi.org/10.1038/s41574-019-0176-8">remain elusive</a>. Additionally, because obesity <a href="http://dx.doi.org/10.15620/cdc:106273">disproportionately affects</a> racially and ethnically marginalized and low-income children, this policy could contribute to reducing health disparities.</p>
<p>The Community Eligibility Provision likely reduces obesity prevalence by substituting up to half of a child’s weekly diet with healthier options and simultaneously <a href="https://doi.org/10.1016/j.jhealeco.2022.102646">freeing up more disposable income</a> for low-to-middle-income families. Families receiving free breakfast and lunch save approximately $4.70 per day per child, or $850 per year. For low-income families, particularly those with multiple school-age children, this could result in meaningful savings that families can use for other health-promoting goods or services.</p>
<h2>Expanding access to school meals</h2>
<p>Childhood obesity <a href="https://doi.org/10.1542/peds.2021-053708">has been</a> <a href="https://doi.org/10.1001/jama.2020.14590">increasing over</a> the past several decades. Obesity often <a href="https://doi.org/10.1111/obr.12334">continues into adulthood</a> <a href="https://theconversation.com/obesity-in-children-is-rising-dramatically-and-it-comes-with-major-and-sometimes-lifelong-health-consequences-202595">and is linked</a> to a range of <a href="https://doi.org/10.2105/ajph.2016.303326">chronic health conditions and premature death</a>. </p>
<p>Growing research is showing the benefits of universal free school meals for the health and well-being of children. Along with our study of California schools, other researchers have found an association between universal free school meals and reduced obesity in <a href="https://doi.org/10.1086/723824">Chile</a>, <a href="https://doi.org/10.1016/j.ssmph.2022.101072">South Korea</a> and <a href="https://doi.org/10.1016/j.pubecp.2022.100016">England</a>, as well as among <a href="https://doi.org/10.1002/pam.22175">New York City schools</a> and school districts in <a href="https://doi.org/10.1162/edfp_a_00380">New York state</a>.</p>
<p>Studies have also linked the Community Eligibility Provision to <a href="https://doi.org/10.3368/jhr.57.3.0518-9509R3">improvements in academic performance</a> and <a href="https://doi.org/10.3102/00028312231222266">reductions in suspensions</a>.</p>
<p>While our research observed a reduction in the prevalence of obesity among schools participating in the Community Eligibility Provision relative to schools that did not, obesity increased over time in both groups, with a greater increase among nonparticipating schools.</p>
<p>Universal free meals policies may slow the rise in childhood obesity rates, but they alone will not be sufficient to reverse these trends. Alongside universal free meals, identifying <a href="https://theconversation.com/fixing-the-global-childhood-obesity-epidemic-begins-with-making-healthy-choices-the-easier-choices-and-that-requires-new-laws-and-policies-207975">other population-level strategies</a> to reduce obesity among children is necessary to address this public health issue.</p>
<p>As of 2023, <a href="https://www.americanprogress.org/article/5-states-addressing-child-hunger-and-food-insecurity-with-free-school-meals-for-all/">several states have implemented their own</a> universal free school meals policies. States such as California, Maine, Colorado, Minnesota and New Mexico have pledged to cover the difference between school meal expenditures and federal reimbursements. As more states adopt their own universal free meals policies, understanding their effects on child health and well-being, as well as barriers and supports to successfully implementing these programs, will be critical.</p><img src="https://counter.theconversation.com/content/223270/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jessica Jones-Smith receives funding from the National Institutes of Health. </span></em></p><p class="fine-print"><em><span>Anna Localio does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Since nutrition standards were strengthened in 2010, eating at school provides many students with healthier food than is available cheaply elsewhere. Plus, reducing stigma increases the number of kids getting fed.Anna Localio, Ph.D. Candidate in Health Services, University of WashingtonJessica Jones-Smith, Associate Professor of Health Systems and Population Health, Epidemiology, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1981242023-04-04T11:03:37Z2023-04-04T11:03:37ZA brief history of school meals in the UK: from free milk to Jamie Oliver’s campaign against Turkey Twizzlers<p>Mashed potato, gravy, custard. When British people hear the words “school dinners”, it’s not always great memories that come to mind. </p>
<p>That’s not the case for everyone. Indeed France is known for its gourmet school lunches cooked by <a href="https://www.connexionfrance.com/article/People/Interviews/French-chef-serving-Michelin-quality-cuisine-to-school-pupils-Nicolas-Lamstaes-has-created-France-s-first-100-organic-canteen">onsite chefs</a> – bon appétit!</p>
<p>But in the UK people have been complaining about <a href="https://archive.org/details/poorcitizensstat0000vinc">school meals</a> for a long time.
Celebrity chef <a href="https://www.theguardian.com/society/2005/mar/06/schoolmeals">Jamie Oliver</a> campaigned against cheap processed foods like “<a href="https://inews.co.uk/inews-lifestyle/food-and-drink/turkey-twizzlers-bernard-matthews-history-banned-schools-jamie-oliver-new-recipe-taste-test-581342">turkey twizzlers</a>” in the early 2000s. And Margaret Thatcher, the UK’s prime minister in the 1970s, was nicknamed the “<a href="https://www.independent.co.uk/news/uk/politics/margaret-thatcher-regretted-snatching-milk-from-school-children-for-two-decades-a7500171.html">milk snatcher</a>” when she was education secretary because she stopped free milk for children in schools.</p>
<p>Since the COVID-19 pandemic, more children than ever before have become eligible for free school meals. In fact, <a href="https://www.gov.uk/government/statistics/schools-pupils-and-their-characteristics-january-2022">1.9 million children</a> (22.5% of all school-age children in England) were eligible for free school lunches in 2022 – up from 17.3% in 2020. </p>
<p><a href="https://commonslibrary.parliament.uk/research-briefings/cdp-2020-0114/">Free school meals</a> have long been used as a measure of poverty. Children are eligible if they come from families with low incomes or who receive certain benefits. </p>
<p>The provision of <a href="https://www.bmj.com/content/311/7008/818.1">free school meals</a> has become particularly significant as levels of child poverty in the UK have risen. And the pandemic highlighted the importance of ensuring that children from low-income families have access to nutritious meals. The government provided free meal vouchers to <a href="https://hansard.parliament.uk/Commons/2020-10-21/debates/79C0CA8D-CADF-4562-9317-5A51810BB5DE/FreeSchoolMeals">eligible children</a> during school closures.</p>
<p>The issue of <a href="https://theconversation.com/free-school-meals-debate-shows-how-victorian-attitudes-about-undeserving-poor-persist-149130">free school meals</a> and school meals more broadly has also been the subject of controversy over recent years, with <a href="https://www.independent.co.uk/life-style/food-and-drink/kids-children-school-lunches-canteen-unhealthy-a9072816.html">concerns raised</a> about the adequacy of the meals provided and the nutritional quality of the food served. </p>
<h2>From rationing to revolution</h2>
<p>But problems with school meals <a href="https://openlibrary.org/books/OL6074399M/Social_history_of_the_school_meals_service.">goes back much further</a>. In fact they started when the government first began offering meals to schoolchildren <a href="https://www.legislation.gov.uk/ukpga/1906/57/enacted">in 1906</a>. Back then, local education authorities decided whether or not to provide meals and they were only for children who showed evidence of actual malnutrition. </p>
<p>It wasn’t until the second world war that the number of pupils who got <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674026780">school meals</a> began to rise significantly. But even then, the meals weren’t great. Indeed, during this time, the government introduced rationing, which had a significant impact on school meals. As a result, meals were often limited to basic, low-cost ingredients such as vegetables, potatoes and bread.</p>
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<p>In the post-war years, school meals underwent significant changes. The introduction of new technologies such as electric ovens and refrigerators meant that schools could provide more varied and nutritious meals and menus began to include meat, fish and desserts.</p>
<p>The 1970s saw a renewed focus on healthy eating and the introduction of official guidelines for school meals. These guidelines aimed to provide a balanced diet that included plenty of fruit, vegetables and whole grains.</p>
<p>But in <a href="http://www.educationengland.org.uk/documents/acts/1980-educationhttp://www.educationengland.org.uk/documents/acts/1980-education-act.htmlact.html#06">the 1980s</a>, things went downhill. The Conservative government under Margaret Thatcher introduced a policy of privatisation, which led to many schools <a href="https://weownit.org.uk/blog/profit-should-have-no-place-school-meal-provision">outsourcing their catering services</a> to private companies. </p>
<p>This move was criticised by many who felt that these companies were more interested in making a profit than providing healthy and nutritious meals to children.</p>
<h2>Feeding the future</h2>
<p>Since thenm, there have been several initiatives (including Jamie Oliver’s) to improve the quality of school meals in the UK, including the introduction of strict nutritional standards and the promotion of locally sourced and sustainable ingredients. But concerns about the quality of some meals still remain. Indeed many children continue to bring <a href="https://news.sky.com/story/packed-lunches-worse-for-kids-than-school-dinners-11908182">packed lunches</a> to school instead.</p>
<p>This is why as part of our <a href="https://www.sheffield.ac.uk/education/research/school-meals-service-past-present-and-future">new research project</a> we want to understand the problems with the school meals service and find ways to make it better. We’ll be looking at the experience of school feeding across generations and working with schools in the UK to study school meals today. The goal is to create a better school meals service that can meet the needs of the 21st century.</p>
<p>Overall, improving school meals in the UK will require a multi-faceted approach that addresses funding, food quality and sustainability. Most importantly, we need politicians to take a long-term, historically-informed approach to policymaking, so that past mistakes can be learned from and this knowledge used to inform decisions about school meals going forward. It’s our hope that this research will go some way towards achieving better nutritional standards for future generations.</p><img src="https://counter.theconversation.com/content/198124/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gurpinder Singh Lalli has received funding from ESRC. </span></em></p><p class="fine-print"><em><span>Gary McCulloch receives funding from the ESRC and has received funding from the Leverhulme Trust and the Society for Educational Studies. </span></em></p><p class="fine-print"><em><span>Heather Ellis receives funding from the ESRC and the AHRC and has received funding from the Society for Educational Studies.</span></em></p>From soup and semolina to Jamie’s school dinners: the changing face of school meals in the UK.Gurpinder Singh Lalli, Reader in Education for Social Justice and Inclusion, University of WolverhamptonGary McCulloch, Brian Simon Professor of History of Education, UCLHeather Ellis, Vice-Chancellor's Fellow, School of Education, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1687102021-09-29T11:02:22Z2021-09-29T11:02:22ZChildren who eat more fruits and vegetables have better mental health – new study<figure><img src="https://images.theconversation.com/files/423775/original/file-20210929-16-1fegcfg.jpg?ixlib=rb-1.1.0&rect=45%2C0%2C5068%2C3345&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Primary and secondary school students who ate five servings of fruit or veg daily had better mental wellbeing.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/primary-school-kids-eat-lunch-cafeteria-432895708">Monkey Business Images/ Shutterstock</a></span></figcaption></figure><p>Around <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health">10%-20% of adolescents</a> globally suffer from a mental health condition, such as anxiety or depression, according to the World Health Organization. It’s also been shown that half of all mental health conditions <a href="https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health">start by age 14</a>. Given how important and formative adolescence is in a person’s life, finding ways of protecting or improving mental wellbeing in children and young people is extremely important.</p>
<p>We already know how valuable good nutrition and diet are for physical health – which is why experts recommend we aim for five servings of fruits and vegetables a day (“<a href="https://www.nhs.uk/change4life/food-facts/five-a-day">five-a-day</a>”). More recently research has also started to suggest that nutrition could influence mental health. While more research is still needed in this area, our <a href="https://nutrition.bmj.com/content/early/2021/08/27/bmjnph-2020-000205">recent study found</a> found that eating a more nutritious diet, rich in fruit and vegetables, and having healthier breakfasts and lunch habits were associated with better mental wellbeing in children. </p>
<p>To conduct our study, we used data from the Norfolk Children and Young People Health and Wellbeing Survey. This collected data on mental wellbeing and different things that impact it – such as socioeconomic status and age – from children at over 50 schools in Norfolk. This allowed us to investigate the importance of fruit and vegetable consumption and meal choices (such as what students ate for breakfast or lunch) with mental wellbeing in this age group. </p>
<p>Our analyses looked at 1,253 <a href="https://www.tandfonline.com/doi/full/10.1080/02667363.2015.1008409">primary school pupils</a> aged 8-11 years and 7,570 <a href="https://warwick.ac.uk/fac/sci/med/research/platform/wemwbs/">secondary school pupils</a> aged 12-18 years. Using different questionnaires for the two groups, we assessed their mental wellbeing by asking them them to score how often they had the feelings described in statements such as “I’ve been feeling good about myself” or “I’ve been feeling loved”. The scores for each statement were added together to give a total score. The higher this total score is, the greater a child’s mental wellbeing.</p>
<p>We also asked students questions on their age, gender, health, living situation and adverse experiences (such as being bullied, or experiencing arguing or violence at home) alongside questions about what kinds of foods they typically ate. This was important so that instead of investigating nutrition and wellbeing on their own, we were able to take into account other factors that can impact a person’s wellbeing score. By doing this, we were able to show that the link between a healthier diet and better mental wellbeing still existed even after taking all these other factors into account.</p>
<h2>Nutritious meals</h2>
<p>In the secondary school group, higher fruit and vegetable consumption was associated with higher mental wellbeing scores – around 8% higher for those who ate five servings daily compared to those who ate none.</p>
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<img alt="Teenage students in black uniforms queue to be served their school lunch." src="https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/423776/original/file-20210929-27-9w4fg3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A healthy breakfast and lunch were also important for mental wellbeing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/teenage-students-being-served-meal-school-778344325">Monkey Business Images/ Shutterstock</a></span>
</figcaption>
</figure>
<p>We also found that the wellbeing score varied depending on what type of breakfast or lunch participants ate. Compared to secondary school children who ate a conventional breakfast (such as cereal, toast or a cooked breakfast, like eggs), those who didn’t eat any breakfast had an almost 6% lower mental wellbeing score. Those who consumed only an energy drink for breakfast had an almost 7% lower wellbeing score. </p>
<p>Scores were similarly low for those who didn’t eat lunch compared to those who did. These associations were also similar in primary school children.</p>
<p>Our research also revealed that, on average, in a class of 30 secondary school children, four would have nothing to eat or drink before school, and three had nothing to eat or drink for lunch. We also found that only 25% of secondary school children ate five or more fruits and vegetables a day – and one in ten ate none. </p>
<p>These statistics would be concerning even without the link we have found with mental health, as poor nutrition is likely to impact on <a href="https://onlinelibrary.wiley.com/doi/10.1111/jhn.12407">school performance</a> as well as <a href="https://apps.who.int/nutrition/topics/growth_and_development/en/index.html">growth and development</a>. While more primary school children ate breakfast and lunch, there was similarly poor fruit and vegetable intake. </p>
<p>To put our findings into perspective, having no breakfast or lunch was associated with a similarly detrimental effect on mental wellbeing as children witnessing regular arguing or violence at home. But as our study was observational, it’s difficult for us to prove the cause of poor mental wellbeing until trials are done to explore these links, fully understand why they exist, and really be certain whether better nutrition will improve mental wellbeing in children. </p>
<p>Our findings show that good quality nutrition needs to be available to all children and young people to improve mental wellbeing and help them reach their full potential. To do this, we could encourage more funding for breakfast clubs, make sure that all children eligible for <a href="https://www.gov.uk/apply-free-school-meals">free school meals</a> use them, and that these meals contain at least two portions of fruits or vegetables. To achieve this, these approaches need to be supported by school policies and public health strategies.</p><img src="https://counter.theconversation.com/content/168710/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ailsa Welch received funding from UEA Health and Social Care Partners ( on behalf of the members of the Childhood Wellbeing group of the UEA Health and Social Care Partners) for Dr Richard Hayhoe to perform the statistical analysis and draft the publication on which this article is based.</span></em></p><p class="fine-print"><em><span>Richard PG Hayhoe does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>One in ten secondary school students didn’t eat a single serving of fruits or vegetables daily.Ailsa Welch, Professor of Nutritional Epidemiology, University of East AngliaRichard PG Hayhoe, Senior Lecturer in Public Health, Anglia Ruskin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1619572021-07-20T18:45:06Z2021-07-20T18:45:06ZFree school meals for all children can improve kids’ health<figure><img src="https://images.theconversation.com/files/411933/original/file-20210719-19-1pzcy0m.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5366%2C3572&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many children, especially from low-income communities or communities of color, eat up to half their daily calories in school. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/cafeteria-worker-serving-healthy-food-to-children-royalty-free-image/498579063?adppopup=true">SDI Productions/E+ via Getty Images</a></span></figcaption></figure><p>Recognizing that millions of U.S. children are at <a href="https://theconversation.com/18-million-us-children-are-at-risk-of-hunger-how-is-the-problem-being-addressed-and-what-more-can-be-done-151821">risk of hunger</a>, <a href="https://www.foodservicedirector.com/operations/maine-california-embrace-universal-free-school-meals">Maine and California</a> have approved funding to offer free school meals to all students within their state. Meanwhile, a <a href="https://www.sanders.senate.gov/wp-content/uploads/Universal-School-Meals-Program-Act-of-2021.pdf">bill proposed in Congress</a> aims to make free school meals a permanent fixture in all states.</p>
<p>The <a href="https://www.sanders.senate.gov/wp-content/uploads/Universal-School-Meals-Act-Summary.4.28.21.pdf">Universal School Meals Program Act</a> would provide free healthy meals and snacks to all children in public and nonprofit private schools regardless of income. </p>
<p>Currently, the U.S. Department of Agriculture <a href="https://www.fns.usda.gov/cn/child-nutrition-response-84">has allowed</a> school districts to provide meals free of charge to families during the pandemic. Previously set to expire in September, the policy has been extended <a href="https://www.usda.gov/media/press-releases/2021/04/20/usda-issues-pandemic-flexibilities-schools-and-day-care-facilities">through the 2021-2022 school year</a>. This marks the first time in the <a href="https://www.fns.usda.gov/nslp/program-history">75-year history</a> of the National School Lunch Program that all U.S. public school children are getting equal access to school meals, with no questions asked.</p>
<p>As a <a href="https://www.eatright.org/food/resources/learn-more-about-rdns/qualifications-of-a-registered-dietitian-nutritionist">registered dietitian nutritionist</a> and <a href="https://scholar.google.com/citations?hl=en&user=2ujk8c8AAAAJ&view_op=list_works&sortby=pubdate">researcher</a> who specializes in child <a href="https://theconversation.com/what-is-food-insecurity-152746#:%7E:text=Food%20insecurity%20is%20fundamentally%20an,obstacles%20like%20poverty%20and%20discrimination.&text=Food%20insecurity%20can%20be%20exacerbated,of%20healthy%20and%20affordable%20food.">food insecurity</a>, I frequently see how <a href="https://doi.org/10.3390/nu11071574">access and availability</a> to nutritious foods can shape kids’ health. </p>
<p>When children return to schools in the fall, the ongoing policy waivers provide an opportunity to examine how <a href="https://doi.org/10.1016/j.jand.2020.03.006">universal free school meals</a> impact nutrition in school meal programs and health inequities among children.</p>
<h2>Better health</h2>
<p>Good nutrition plays a crucial role in <a href="https://doi.org/10.1002/pam.22175">strong academic outcomes</a>. School meals have been shown to reduce childhood <a href="https://www.ers.usda.gov/amber-waves/2017/august/usda-s-national-school-lunch-program-reduces-food-insecurity">food insecurity</a> and childhood <a href="https://doi.org/10.1001/jamapediatrics.2014.2048">overweight and obesity</a> while improving <a href="https://doi.org/10.1016/j.jand.2016.04.010">overall diet quality</a>. </p>
<p>School meals are often more nutritious than meals eaten <a href="https://doi.org/10.1001/jamanetworkopen.2021.5262">elsewhere</a> or even <a href="https://doi.org/10.1017/S136898001900017X">home-packed lunches</a>. Studies have shown that access to school meals can <a href="https://doi.org/10.1093/jn/nxy267">improve attendance</a>, <a href="https://www.cdc.gov/healthyschools/health_and_academics/pdf/factsheetDietaryBehaviors.pdf">academic performance</a> and <a href="https://doi.org/10.3386/w24986">behavior</a>.</p>
<h2>Less stigma</h2>
<p>Many children, especially those from low-income and minority families, eat up to <a href="https://doi.org/10.1016/j.pmedr.2016.11.016">half their daily calories</a> at school. For these families, the cost of school meals, usually between <a href="https://schoolnutrition.org/aboutschoolmeals/schoolmealtrendsstats/">US$2.48 and $2.74</a> depending on grade level, can add up quickly over a week, month or school year.</p>
<p>Children with <a href="https://www.fns.usda.gov/cn/unpaid-meal-charges">outstanding meal debts</a> could be <a href="https://www.eater.com/2019/5/22/18634237/lunch-shaming-students-meal-debt-american-schools">shamed</a>, refused a meal or provided a lower-cost alternative meal – such as a cheese sandwich, fruit and milk rather than the standard meal served to other students. </p>
<h2>Needed relief</h2>
<p>School meal programs are run like a business and depend heavily on federal <a href="https://www.fns.usda.gov/cn/rates-reimbursement">reimbursements</a> from the U.S. Department of Agriculture. When families can’t or don’t pay for meals served, schools may need to use their own funds to cover the losses. The Department of Agriculture <a href="https://frac.org/wp-content/uploads/frac-unpaid-meal-fees-policy-guide.pdf">prohibits using federal funds</a> to pay off unpaid meal debt. The Universal School Meals Program Act would <a href="https://www.sanders.senate.gov/wp-content/uploads/Universal-School-Meals-Act-Summary.4.28.21.pdf">eliminate around $10.9 million of existing</a> unpaid school meal debt reported by <a href="https://schoolnutrition.org/uploadedFiles/6_News_Publications_and_Research/8_SNA_Research/2019-school-nutrition-trends-summary.pdf">75% of U.S. school districts</a>. </p>
<p>In addition to school meal debt, during the first full year of the pandemic, schools served <a href="https://www.fns.usda.gov/data/february-2021-keydata-report">fewer meals</a>, resulting in further losses in revenue. The meals served <a href="https://schoolnutrition.org/uploadedFiles/6_News_Publications_and_Research/8_SNA_Research/Impact-of-Covid-19-on-School-Nutrition-Programs-Back-to-School-2020.pdf">were more costly</a> due to packaging and personal protective equipment for staff. As a result, more than <a href="https://schoolnutrition.org/aboutschoolmeals/schoolmealtrendsstats/">50% of school meal programs</a> reported a financial loss in 2019-2020. An even greater number of programs report expecting a loss for the <a href="https://schoolnutrition.org/aboutschoolmeals/schoolmealtrendsstats/">2020-2021 school year</a>. </p>
<h2>Return on investment</h2>
<p>A <a href="https://doi.org/10.3390/nu13020670">national study</a> found that schools participating in universal free meal programs reduced their per-meal costs while maintaining nutritional quality of meals served. School meals can <a href="https://agriculture.vermont.gov/sites/agriculture/files/documents/Farm_to_School_Institution/Economic%20Contribution%20of%20Farm%20to%20School%20in%20Vermont%20.pdf">stimulate local economies</a> because they can <a href="http://www.farmtoschool.org/Resources/EconomicImpactReport.pdf">drive purchases from local farmers</a> and ranchers and <a href="https://www.ucpress.edu/book/9780520300033/the-labor-of-lunch">create jobs</a> in school nutrition, food production, sales and distribution. </p>
<p>[<em>Over 100,000 readers rely on The Conversation’s newsletter to understand the world.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=100Ksignup">Sign up today</a>.]</p>
<p>For school districts, switching to a universal model of meals for all children – regardless of income – is likely to reduce <a href="https://www.fns.usda.gov/child-nutrition-reporting-burden-analysis-study">administrative burdens</a>. Schools would no longer have to waste time on applications and meeting reporting requirements like they have to do under the current reimbursement model. They could focus on healthy meals and nutrition education instead. </p>
<p>I believe the return on investment from universal school lunches would benefit our country’s economic recovery from the pandemic as well as the health and well-being of our country’s children.</p><img src="https://counter.theconversation.com/content/161957/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Matthew J. Landry receives funding support from the National Institutes of Health. He is affiliated with the Academy of Nutrition and Dietetics where he serves as a volunteer member of the Legislative and Public Policy Committee. He is also a member of the Society for Nutrition Education and Behavior where he serves as an appointed member of the Advisory Committee on Public Policy. These organizations had no role in this article and the views, thoughts, and opinions expressed in the text belong solely to the author.</span></em></p>Expanding free lunch programs could also reduce stigma for students, lower administrative burdens for schools and create jobs for communities.Matthew J. Landry, Postdoctoral Research Fellow, Stanford UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1333412020-03-13T12:05:04Z2020-03-13T12:05:04ZAmerica’s poorest children won’t get nutritious meals with school cafeterias closed due to the coronavirus<figure><img src="https://images.theconversation.com/files/320221/original/file-20200312-111227-gask9p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An East Brainerd Elementary School lunch, Chattanooga, Tennessee</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/lunch-options-available-to-students-at-the-east-brainerd-news-photo/1178703124">The Washington Post via Getty Images</a></span></figcaption></figure><p>Schools aren’t only places where kids learn. They are also places where kids eat. </p>
<p>Thanks to the <a href="https://www.fns.usda.gov/nslp">National School Lunch Program</a>, 30 million U.S. children – some 60% of all school-aged kids – regularly eat some combination of breakfast, lunch and afternoon snacks at school. Federal subsidies ensure that school meals are affordable for all children to <a href="https://www.encyclopedia.com/social-sciences/applied-and-social-sciences-magazines/statement-president-upon-signing-national-school-lunch-act">stave off hunger and malnutrition</a>. </p>
<p>But what is happening to meals provided by the nation’s largest child nutrition program as public schools shut their doors to contain the spread of the coronavirus pandemic? </p>
<p>Based on <a href="https://scholar.google.com/citations?user=LULSgaYAAAAJ&hl=en&oi=ao">my research</a> on how <a href="https://doi.org/10.3102%2F0013189X18797609">schools provide meals for poor children</a>, I worry that these closures might leave some of the nation’s poorest children without access to nutritious meals.</p>
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<h2>School meals address hunger</h2>
<p>Despite persistent concerns about the <a href="https://ssrn.com/abstract=1593844">nutritional quality of school lunches</a> and wasted cafeteria food, serving school meals clearly improves students’ consumption of <a href="https://doi.org/10.1016/j.jada.2008.11.005">calcium, meat and vegetables</a> and a wide array of essential vitamins and minerals.</p>
<p>This nutritional boost is particularly vital for the 18% of U.S. kids whose parents sometimes or frequently <a href="https://www.childtrends.org/indicators/food-insecurity">can’t afford enough nutritious food</a> for the whole family. These children <a href="http://handle.nal.usda.gov/10113/42320">get approximately a quarter of the calories they consume</a> from school meals.</p>
<p>Empty cupboards and missed meals substantially <a href="https://doi.org/10.1377/hlthaff.2015.0645">threaten children’s healthy development</a>. Research <a href="https://doi.org/10.1002/pam.20506">tracking the long-term effects of 1960s-era policy efforts that expanded</a> the National School Lunch Program indicates that when kids regularly eat lunch, they’re more likely to finish high school and perhaps go on to college.</p>
<p>Further, over the last few years <a href="https://www.fns.usda.gov/school-meals/community-eligibility-provision">a new federal program</a> designed to provide free lunches to all students in schools that enroll large proportions of low-income children appears to be working. <a href="https://dx.doi.org/10.2139/ssrn.3333530">Test scores</a> are rising and <a href="https://www.nber.org/papers/w24986">student behavior</a> is improving at the schools taking part in it. </p>
<p>Under federal law, no student pays more than US$2.90 for their lunch. But about <a href="https://nces.ed.gov/programs/digest/d18/tables/dt18_204.10.asp?current=yes">half of public school students pay far less</a>. Families whose household income is less than 185% of the poverty line, currently about $48,000 per year for a family of four, pay up to 40 cents for each meal. Students whose families of the same size get by on less than 130% of that same mark, or below $34,000, pay nothing at all. </p>
<p>More than two-thirds of the <a href="https://www.fns.usda.gov/pd/child-nutrition-tables">children who eat school meals</a> get them for free or at a steep discount.</p>
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<h2>How to feed kids when schools close</h2>
<p>Many low-income families of course can get some additional help through other kinds of federal aid.</p>
<p>That includes the <a href="https://theconversation.com/scaling-back-snap-for-self-reliance-clashes-with-the-original-goals-of-food-stamps-128839">Supplemental Nutrition Assistance Program</a>. But SNAP’s <a href="https://www.fns.usda.gov/snap/recipient/eligibility">complex eligibility requirements</a> <a href="https://doi.org/10.2105/AJPH.2019.305365">exclude many Americans</a> who are are having trouble getting food on their tables.</p>
<p>What’s more, <a href="https://doi.org/10.3102%2F0002831218761337">SNAP benefits are limited</a>. For example, a family of four can get no more than $646 in this aid per month, typically falling short of covering the full cost of all nutritional needs.</p>
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<p>Absent fundamental changes to the nation’s <a href="https://theconversation.com/us/topics/safety-net-2185">safety net</a>, I believe school leaders should make sure that schools keep playing an important role in student nutrition – even when schools are closed to protect public health.</p>
<p>And <a href="https://civileats.com/2020/03/06/coronavirus-is-closing-schools-heres-what-it-means-for-millions-of-kids-who-rely-on-school-meals/">schools are indeed looking for ways to provide meals</a> to students whose schools are closed due to the pandemic. The USDA has identified one path. It is letting schools that participate in <a href="https://www.fns.usda.gov/sfsp/summer-food-service-program">a summer meals program for kids from low-income areas</a> to <a href="https://www.fns.usda.gov/cn/child-nutrition-program-waiver-request-guidance-and-protocol-revised">serve meals even if they close due to this pandemic</a>.</p>
<p>While this strikes me as a helpful step, I don’t think that it will be enough.</p>
<p>That’s because the schools eligible to take part in the summertime program serve <a href="https://www.ers.usda.gov/topics/food-nutrition-assistance/child-nutrition-programs/summer-food-service-program.aspx">just a tenth of the children who participate in the school lunch program</a>. Unless Congress acts to provide emergency funds to cover the cost of feeding students whose schools have closed – and fast – it will be up to local communities and their food banks to fill the nutritional gap.</p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>.]</p><img src="https://counter.theconversation.com/content/133341/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thurston "Thad" Domina receives funding from the National Institute of Child Health and Development.</span></em></p>The millions of US children whose parents can’t always afford enough nutritious food for their families get about a quarter of their calories from what they eat at school.Thurston Domina, Professor, Educational Policy and Organizational Leadership, University of North Carolina at Chapel HillLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/955692018-04-25T13:42:49Z2018-04-25T13:42:49ZBefore banning fast food shops near schools, give pupils a reason to dine in<figure><img src="https://images.theconversation.com/files/216309/original/file-20180425-175069-p3a2fb.jpg?ixlib=rb-1.1.0&rect=53%2C30%2C4999%2C3323&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/primary-school-kids-eat-lunch-cafeteria-432895708">Shutterstock.</a></span></figcaption></figure><p><a href="https://www.theguardian.com/society/2018/apr/23/ministers-urged-to-ban-fast-food-outlets-from-opening-near-schools">A ban</a> on fast food shops operating within 400 metres of schools has been called for by the Royal College of Paediatrics and Child Health. At a time when nearly one third of children aged two to 15 <a href="https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action/childhood-obesity-a-plan-for-action">are overweight or obese</a>, this measure sends a strong message to young people and their families, about the importance of cutting down on fast food. Even so, I doubt it would work.</p>
<p>Young people from poorer backgrounds <a href="https://www.theguardian.com/inequality/2017/dec/01/schoolchildren-poor-areas-exposed-fast-food-takeaways">are more likely</a> to go past food shops on their way to or from school, compared with pupils from wealthier backgrounds. Having the opportunity to buy food or drink makes people more likely to do so, so it’s important to consider access to food shops, when searching for ways to encourage young people to eat better. </p>
<p>But many young people go out to buy food before, during or after school at shops further than 400 metres away. Some will run to the shops during their lunch break, to get the food they want. Independent shops, in particular, understand their school-aged customers’ preferences, which are typically to buy something that fills them up quickly, at a price they can afford. </p>
<p>And it’s not just fast food shops which sell goods that are high in fat, salt or sugar; supermarkets also attract pupils with meal deals and other marketing promotions, which means that a group of friends can chip in to buy a multi-pack of donuts, for example, at a price that appeals to them.</p>
<h2>Reality bites</h2>
<p>If government is serious about enacting this kind of regulation, it would need to extend the ban to all food outlets within an 800-1,000 metre radius of schools. Otherwise, the policy will do little to change where young people buy their food and drink. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=371&fit=crop&dpr=1 600w, https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=371&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=371&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=467&fit=crop&dpr=1 754w, https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=467&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/216311/original/file-20180425-175058-31hy2l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=467&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Worth crossing the road for, apparently.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/doctorow/1808768706/sizes/l">gruntzooki/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Students from lower income families want their money to stretch as far as possible, so they are canny consumers when it comes to finding the best value chips, crisps or soft drinks. </p>
<p>Of course, this is not the food and drink that public health professionals such as myself would like young people to consume. But the reality is that most teenagers prioritise spending time with their friends over setting out to find healthier food or drink options.</p>
<h2>Consulting with caterers</h2>
<p>But there’s still a lot schools can do to help. Basic things, such as ensuring tables and chairs in the cafeteria are not broken; providing cool, fresh jugs of water; not pushing young people outside once they have eaten and taking the time to find out what students actually want to eat and drink. </p>
<p>These simple solutions come up time and again <a href="https://www.tandfonline.com/doi/full/10.1080/0305764X.2015.1110114">in research</a>, and still many schools find it difficult to consult with young people about improving the food and dining environment, in a way that will appeal to them. </p>
<p>Yet the big companies with contracts to provide food and drink in schools, such as <a href="http://cn.education.sodexo.com/6.3.1.php">Sodexo</a>, are increasingly willing to spend time producing strategies together with young people. School governors, head teachers and in-house catering staff need to prioritise working with contract caterers to come up with <a href="https://twitter.com/hashtag/cityfoodsym?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Ehashtag">new, inclusive ways</a> of persuading young people that school is the cool place to eat.</p><img src="https://counter.theconversation.com/content/95569/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Wendy Wills receives funding from Food Standards Scotland, the Food Standards Agency and the ESRC. </span></em></p>With obesity affecting so many students, it’s better to give them cheap, appealing food and drink choices at school.Wendy Wills, Professor of Food and Public Health, University of HertfordshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/608752016-06-22T14:25:28Z2016-06-22T14:25:28ZGhana’s school feeding scheme is slowly changing children’s lives<figure><img src="https://images.theconversation.com/files/126731/original/image-20160615-14057-15cyyi1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Children struggle to learn when they're hungry.</span> <span class="attribution"><span class="source">Reuters/Bruno Domingos </span></span></figcaption></figure><p>Millions of Ghanaian children <a href="http://uni.cf/1UOReAB">live in poverty</a>. About one in ten – roughly 1.27 million – come from households that are so poor they <a href="http://uni.cf/1UOReAB">can’t afford</a> the amount and type of food that’s needed to stave off malnutrition. </p>
<p>Without proper food, children are prone to stunted growth or are underweight for their age. And their schooling suffers, too: <a href="http://unesdoc.unesco.org/images/0014/001429/142929eo.pdf">research</a> has <a href="http://unesdoc.unesco.org/images/0017/001780/178022e.pdf">repeatedly shown</a> that children struggle to learn when they are not properly fed and nourished. </p>
<p>A school feeding programme introduced by the Ghanaian government more than a decade ago has gone some way to tackling the problem of hunger. The programme has reached millions of children – and it’s been proved to keep them in school far longer than their hungry peers. Now some more work is needed to make the project sustainable and to ensure it doesn’t constantly have to rely on donor funds.</p>
<h2>Millions of children reached</h2>
<p>The <a href="http://www.schoolfeeding.gov.gh/">Ghana School Feeding Programme</a> was initiated in 2005 by the country’s government in collaboration with the Dutch government. Its primary objectives are to increase school enrolment, attendance and retention among children in kindergartens and primary schools. It also, of course, aims to reduce hunger and malnutrition. </p>
<p>The programme started as a pilot project with ten schools, one from each of Ghana’s ten regions. This was later increased to 298 schools, reaching about 234,000 children in 138 schooling districts. In March 2016, it was reaching more than 1.7 million children every day – about 30% of all Ghanaian primary and kindergarten pupils.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/126476/original/image-20160614-29216-1wo1pma.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Children line up for a meal at their school in Ghana.</span>
<span class="attribution"><span class="source">Supplied</span></span>
</figcaption>
</figure>
<p>Each day, children receive a hot, nutritious meal. This is made up of locally produced foods like rice, dried African locust bean seeds, African carp and sesame leaves, and of fortified food rations supplied by the World Food Programme. The rations include 150g of fortified corn-soy blend, 3g of iodised salt and 10g of palm oil per child per day.</p>
<p>There is also a second feeding category: girls in selected schools in Ghana’s three northern regions are <a href="https://www.wfp.org/stories/ghana-girls-reach-their-full-potential-take-home-rations">given</a> food to take home each time they attend school for 85% of the month. This food <a href="https://www.wfp.org/stories/ghana-girls-reach-their-full-potential-take-home-rations">includes</a> rice, maize, vegetable oil and iodised salt.</p>
<p>The ration programme for girls started in 1999 and has been gradually absorbed into the bigger school feeding programme. It has yielded remarkable results: girls’ enrolment in these selected schools has <a href="https://www.ghanabusinessnews.com/2016/03/04/world-food-programme-to-support-school-feeding-programme/">grown</a> from 9,000 to 42,000 between 1999 and 2016. Retention rates have doubled to 99%. This scheme is essential in tackling gender disparity in education, particularly in northern Ghana’s food-insecure and deprived communities where girls’ education is <a href="https://www.modernghana.com/news/399838/50-northern-region-girls-receive-wfpges-scholarships.html">not often prioritised</a> by families. </p>
<p>Sadly the ration programme for girls is being slowly <a href="http://documents.wfp.org/stellent/groups/public/documents/newsroom/wfp207421.pdf">phased out</a> – its managers believe their work is done given the huge spike in retention rates. Now the focus will be entirely on the bigger school feeding scheme, which has also been very successful. It has, according to my <a href="http://www.equityforchildren.org/wp-content/uploads/2016/05/Abuja-PaperCompendium.pdf">own research</a>:</p>
<ul>
<li>increased school enrolment by 20%;</li>
<li>reduced truancy and absenteeism;</li>
<li>lowered school drop-out rates; and</li>
<li>improved individual academic performance and the participating schools’ overall performance too.</li>
</ul>
<p>These are all excellent, positive results. But there’s still work to be done. </p>
<h2>Plotting the next steps</h2>
<p>One of the biggest problems facing the programme is a lack of funding. It cannot be rolled out more widely because there just isn’t enough money.</p>
<p>Schools that aren’t currently part of the programme are struggling. A survey conducted in Ghana’s Sekyere Kumawu district found that non-beneficiary schools were actually losing pupils. The same study <a href="http://jcss.our.dmu.ac.uk/files/2013/03/JCSS-Ghana-School-Feeding-Winter-2015.pdf">revealed</a> that pupils were switching to the schools that offer the scheme in order to receive the benefits. </p>
<p>The government and stakeholders need to put mechanisms in place that will strengthen the existing programme, allow it to expand into other schools and make it sustainable. The government must wean the programme of its reliance on donor funds. It can learn here from the experiences of South Africa’s national school feeding programme, which is funded by the country’s National Treasury. This approach ensures that the government takes ownership of the programme and plans for its sustainability.</p>
<p>Policy will be important: the programme falls under Ghana’s National Social Protection Strategy, but should be bolstered with a strong legal and policy framework that clearly maps the way forward. This legislation should delineate the guidelines for implementation and institutional mechanisms to make sure the programme delivers what is necessary.</p>
<p>Finally, a robust monitoring and evaluation framework will be needed to ensure that the programme’s organisers learn from their failures and successes. This way adjustments can be made along the way so that Ghana’s children can keep getting the meals they need at school.</p><img src="https://counter.theconversation.com/content/60875/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Addaney does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Ghana’s school feeding programme has reached millions of children in the past 11 years. It does important work, but needs more support to grow and become sustainable.Michael Addaney, Assistant Researcher at the Quality Assurance and Planning Unit, University of Energy and Natural ResourcesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/573792016-04-14T03:26:33Z2016-04-14T03:26:33ZFor poor children, two healthy meals a day can keep obesity away<figure><img src="https://images.theconversation.com/files/118562/original/image-20160413-22081-58dwv9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">School nutrition programmes help reduce the risk of children developing obesity.</span> <span class="attribution"><span class="source">Tiger Brands Foundation</span></span></figcaption></figure><p>Schoolchildren who receive a nutritious lunchtime meal are less likely to be overweight or suffer from childhood obesity. And those who receive both breakfast and lunch are three times less likely to suffer this fate. </p>
<p>Tackling childhood obesity is important because it may result in adult obesity and these children developing non-communicable diseases such as diabetes, hypertension and heart disease later in life.</p>
<p>Obesity is not necessarily driven by overeating, as is commonly thought. Children can also develop obesity when they are eating poor quality and inexpensive food that may be high in fats and refined carbohydrates. </p>
<p>Globally, about 44 million children are overweight or obese. In South Africa, about 28% of children between the ages of two and 14 are <a href="http://www.hsrc.ac.za/en/research-outputs/view/6493">overweight or obese</a>.</p>
<p>Our <a href="http://www.uj.ac.za/faculties/humanities/csda/Documents/TBF%20Nutrition%20Report%202015%20FINAL%20WEB%20VERSION.PDF">study</a> has shown that childhood obesity is relatively easy and cost effective to prevent. Two in-school nutrition programmes – one of which included both breakfast and lunch – had a marked effect on reducing overweight and obesity levels among schoolchildren.</p>
<h2>Effects of in-school nutrition programmes</h2>
<p>Our findings are from a comparative study at schools in the Lady Frere and Qumbu districts of the Eastern Cape province.</p>
<p>We wanted to independently assess the relative effects of an in-school breakfast programme and the Department of Basic Education’s <a href="http://www.education.gov.za/Programmes/NSNP/tabid/632/Default.aspx">National School Nutrition Programme</a>. The impact of these programmes has never been assessed before. </p>
<p>Children receiving the National School Nutrition Programme get a mid-morning lunch meal consisting of a protein, carbohydrate and vegetables. The breakfast is made up of a fortified cereal before the school day starts. </p>
<p>We compared the height and weight measurements of children at three types of schools:</p>
<ul>
<li><p>those who started receiving the lunchtime meal shortly after the study started; </p></li>
<li><p>those who had been receiving the lunchtime meal for some time; and </p></li>
<li><p>those who received both the lunchtime meal and an in-school breakfast.</p></li>
</ul>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/118563/original/image-20160413-22078-1uwu77x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">As part of the study some students received breakfast and lunch at school.</span>
<span class="attribution"><span class="source">Tiger Brands Foundation</span></span>
</figcaption>
</figure>
<p>Almost 35% of learners at schools that had not been receiving the lunchtime meal were either overweight or obese when they were measured against the <a href="http://www.who.int/childgrowth/standards/bmi_for_age/en/">Body Mass Index-for-age</a> recommendations made by the World Health Organisation. </p>
<p>In comparison, only 17% of learners at schools that had been receiving the lunchtime meal were classified as overweight or obese. </p>
<p>And of the children at the schools that received both the breakfast and the lunch, only 11.5% of learners were overweight or obese.</p>
<p>The effects of the school nutrition programmes can be seen more dramatically at the schools that started receiving the lunchtime meal in the course of the study.</p>
<p>When the children were first measured, the overweight and obesity levels were alarmingly high. By the end of the year – after the children had been receiving the lunchtime meal for at least three terms – the overweight and obesity levels had dropped by 8%.</p>
<h2>A good return on investment</h2>
<p>According to <a href="http://www.statssa.gov.za/publications/Report-03-19-00/Report-03-19-002012.pdf">Statistics South Africa</a> 30% of children live in households that have inadequate or severely inadequate access to food. These children therefore experience moderate or persistent hunger. </p>
<p>With the current drought and increased food prices, it is becoming more and more expensive and difficult for families, especially those in poor communities, to afford and opt for healthier food baskets.</p>
<p>As a result, poorer people are more likely to consume the foods that drive obesity. This in turn contributes to increased risk for non-communicable diseases. Children who grow up in these communities have no option but to consume food that lacks the right balance of nutritious meals. They are at high risk for obesity and “hidden hunger”. Hidden hunger is a micronutrient deficiency related to consuming low quality, nutritionally deficient meals.</p>
<p>Obesity – including childhood obesity – places a heavy cost burden on the health-care system of a country, given its association with heart disease and other non-communicable diseases.</p>
<p>But the lunchtime meal costs R2.73 per primary school learner per day. The breakfast has a similar cost. Although these are relatively low cost, the significant drop in obesity rates shows that they are high-impact interventions that could protect children from later obesity. </p>
<p>Taking into account the likely cost savings for the health-care system, interventions such as these represent an excellent return on investment. </p>
<p>With high levels of poverty that result in food insecurity and increasing food costs, in-school nutrition programmes are not only an important poverty alleviation mechanism that taps into the moral duty we have to ensure that children are fed; they have also been shown to deliver longer-term health benefits for the children, and for the country as a whole.</p><img src="https://counter.theconversation.com/content/57379/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The study was funded by the Tiger Brands Foundation which provided the in-school breakfast at selected schools,</span></em></p>In-school nutrition programmes can reduce the chances of children suffering from childhood obesity.Lauren Graham, Senior Researcher at the Centre for Social Development for Africa, University of JohannesburgLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/162882013-07-24T05:02:02Z2013-07-24T05:02:02ZIt is not fair to say free school meals in India are deadly<figure><img src="https://images.theconversation.com/files/27920/original/rv8jw6c3-1374576615.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The benefits of free school meals far outweigh any harm caused. </span> <span class="attribution"><span class="source">rajkumar1220</span></span></figcaption></figure><p>In the aftermath of the death of 22 schoolchildren in the state of Bihar in India, the <a href="http://mdm.nic.in/">Mid Day Meal</a> (MDM) scheme, which provides free school lunches to more than 120 million children, has attracted widespread criticism. It has been described as a “<a href="http://www.guardian.co.uk/commentisfree/2013/jul/17/india-bihar-school-meal-deaths">deadly state-run charity</a>”. Attention has tended to focus on <a href="http://www.independent.co.uk/news/world/asia/indian-governments-flagship-free-school-meal-scheme-worthy-in-its-aspirations-but-plaguedby-a-string-of-scandals-8714676.html">past stories of illness</a>, corruption and scandal. However, these reactions obscure the sheer scale of the scheme and the progress it has made.</p>
<p>The National Programme of Nutritional Support to Primary Education (NP-NSPE), commonly know as the MDM Scheme, was launched in 1995, but has roots in Chennai as far back as 1925. As a centrally sponsored scheme run by the Government of India, it provides cooked and nutritious food of a <a href="http://www.sccommissioners.org/FoodSchemes/MDMS.html">minimum of 300 calories</a> to primary and secondary school children.</p>
<p>This scheme is by far the largest nutrition programme in the world. To run it on such a scale, considering the vast quantities of food, fuel and infrastructure required to supply more than a million schools is in itself is a success story.</p>
<p>All children in the first eight years of state-run schools education are provided with free meals. This regular source of supplementary nutrition for children has improved nutritional status of these children. There are children from poor socio-economic backgrounds who would not even receive a meal a day were it not for this scheme. Studies have shown reductions in skin infection and anaemia, and marked improvements in body mass index as a result.</p>
<p>As well as combating malnutrition, the programme has encouraged school attendance, ensuring that what children are fed has direct effects on their learning capabilities, as they are able to concentrate better. Numerous studies have demonstrated this direct correlation between the lunch program and increased student enrolment, attendance, attention spans and exam scores. </p>
<p>The meals also provide opportunities in health education. Children are taught about washing their hands before and after eating and about the importance of clean water and good hygiene.</p>
<p>Social equality is also promoted as children from various social backgrounds all receive and share a common meal. The scheme can therefore help to break the barriers of caste and class among schoolchildren. This is also relevant in when it comes to gender equality, as the meal helps to remove the barriers that prevent girls from going to school by providing all children with the same meal. Child labour practice can also be minimised if children come to school regularly. This alone allows a significant amount of inequality to be addressed.</p>
<p>The scheme also necessitates widespread employment for women, which enables enhancement of their economic freedom.</p>
<p>All this is not to say that the scheme does not need improvement. But to label a scheme “deadly” because of one event would be incredibly short-sighted. We should use the tragic event of last week as an opportunity to improve it.</p>
<h2>What can be done</h2>
<p>More strict and continuous evaluation should be a matter of course. Spot inspections of schools should be held to check the quality as well as the quantity of food served, and food samples should be analysed to check their nutritional content.</p>
<p>The private sector should be involved in the MDM scheme in order to promote its effective and efficient functionality. A training programme for cooks should be implemented, and nutritionists could be appointed to oversee its operation at district level.</p>
<p>We all should be more attentive and dedicated so that further incidents don’t occur in the future, but this sad event should not cloud the vast nutritional, educational and social improvements that the MDM scheme has already achieved.</p><img src="https://counter.theconversation.com/content/16288/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rita Raghuvanshi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In the aftermath of the death of 22 schoolchildren in the state of Bihar in India, the Mid Day Meal (MDM) scheme, which provides free school lunches to more than 120 million children, has attracted widespread…Rita Raghuvanshi, Dean, College of Home Science, G.B. Pant University of Agriculture and TechnologyLicensed as Creative Commons – attribution, no derivatives.