How can we make a million school lunches a week healthier?
The prevalence of childhood obesity is higher in Wales than in any other part of the UK. It is topped only by Malta when compared to other European countries. Children in the most deprived areas of Wales are around 80% more likely to be obese than those in the least deprived areas.
Food eaten in school makes up 17% of meals and snacks for primary school children and the Welsh Government has committed to offer free school meals for all primary school children within three years. This will make 196,000 additional children eligible for free school meals. If, after the introduction of universal free school meal provision, the same percentage of children take up free school meals as those that are currently eligible, Welsh schools will be serving more than a million school lunches per week. In light of the high rates of obesity in children in Wales, it is more important than ever that these meals are healthy.
In May, Nesta brought together stakeholders from across the school food system — including local and central government, the health sector, catering companies, schools and academia — to discuss challenges in providing a healthy school food environment in Wales and opportunities for innovative solutions to help improve it.
Here’s what we learned.
While regulatory standards for creating healthy school meals in Wales do exist, compliance is not routinely monitored. This means it is impossible to get a good picture of the current state of school food in Wales.
Stakeholders generally agreed that more consistent and regular monitoring would incentivise higher standards – and provide valuable data which could help target improvements. There may be opportunities for better use of existing data (eg, from digital payment providers) as well as of well designed digital tools to reduce the burden of school food monitoring.
Participants agreed that scientific evidence and dietary advice has changed since the current school food standards for Wales were developed in 2013 and standards may be in need of updating. One particular area of concern was portion sizes. Participants pointed out that current regulations do not give specific portion size recommendations for different ages of primary school children. This means the recommendations are the same for four year olds as they are for 11 year olds — a limit of 530 calories (+/- 5%) for a school lunch is set for all ages – despite different aged children having significantly different energy requirements. While both Scotland and Northern Ireland reviewed and updated their school food standards in 2020, neither added age-specific portion size recommendations.
While food provided by schools may not always be as healthy as it could be, there was general agreement that it was often healthier than packed lunches. This suggests there may be an opportunity to increase the healthiness of food eaten by more children by increasing uptake of school meals.
Several participants suggested parents' perceptions of school food – perhaps reflecting their own experience as a child – was a contributing factor limiting uptake. Exploring parents’ perceptions of school food and how these can be changed would be a valuable step in understanding how we can increase uptake of school food and improve the diets of children in Wales.
One participant also highlighted the importance of clarity around our goals when developing school food standards or interventions to improve meal healthiness. Policy-makers focussing just on reducing childhood obesity may attempt to reduce the number of calories children consume through school meals. However those concentrating on ensuring children living in poverty don’t go hungry, may attempt to increase the number of calories eaten.
Policy makers with both these goals in mind may take a different approach, focusing on decreasing the energy density rather than the absolute number of calories eaten. Energy density is the number of calories in a given weight of food. Crisps are a high-energy density food, with about 500 calories of energy per 100g; carrot sticks are more than 10 times less energy dense with only 40 calories per 100g. This approach can help ensure children get more of the important nutrients they need from school dinners and feel fuller for longer (which may help reduce unhealthy snacking later in the day).
Any steps taken to improve the healthiness of food offered in schools will ultimately be a failure unless children actually eat and enjoy it. It’s important to see food through children's eyes, for example, using interesting shapes and bright colours to make healthy food more appealing or even co-designing menus with pupils. Several schools in Wales already have existing structures through which pupil engagement and co-design could take place.
A healthy school food environment is not just about the food but also how it is served and eaten. There is a concern that the current system promotes unhealthy eating habits as it encourages children to not finish their meals – typically leaving the healthiest items on the plate, such as vegetables, salad and fruit – because they are eager to get outside to play for the rest of the lunchtime period.
There may be an opportunity to design processes and environments that are time and space efficient but also encourage healthy eating habits – and still allow for play and social opportunities.
While it is possible to make small but worthwhile improvements to the healthiness of school food through individual targeted interventions, such as the addition of salad bars, the biggest and most sustainable improvements will likely come from larger scale systems change. A first important step will be to understand who the key actors are in the school food system in Wales – from farmer to pupil – the relationships between them and other factors that influence their behaviour.
Participants recognised examples in Wales of innovation and good practice to improve the healthiness of school food environments. However, such innovations are often developed within an individual school or local authority and not spread elsewhere.
There is an opportunity to help good practice and innovations to scale through better evaluation and wider sharing. Where possible this learning should be backed up with funding and supportive policy and legislation.
Nesta is exploring how its unique set of capabilities can be most usefully applied to support the design, testing and scaling of innovative ideas to improve the healthiness of food eaten throughout the school day. As we do this we will continue to engage with stakeholders – including local and central government, the health sector, catering companies, schools and academia. If you would like to work with us, please get in touch with Jonathan Bone.