Memorandum submitted by the National Heart
Forum
1. INTRODUCTION
1.1 The National Heart Forum warmly welcomes
the government's proposals for the reintroduction of compulsory
nutritional standards for school meals. Their implementation should
be part of an integrated approach to improving health in schools
through the provision of nutritious food which takes account of
all food that is sold and served in schools and of what children
learn about nutrition and food skills in the classroom. Nutritionally
based standards for school meals coupled with a national initiative
to raise children's consumption of fruit and vegetables have the
potential to make a tremendous impact on children's health.
1.2 The National Heart Forum (NHF) is an
alliance of over 40 national organisations and individuals working
to reduce the risk of coronary heart disease in the UK. Member
organisations represent the medical and health services, professional
bodies, consumer groups and voluntary organisations. Our members
have been extremely concerned over recent years, that the declining
quality of school meals has had a damaging effect on the immediate
and longer term health of children. The NHF has, over many years,
advocated the reintroduction of nutritional standards for school
meals through its member organisations and its participation in
the School Meals Campaign.
1.3 In this memorandum, we set out our main
concerns and recommendations on school meals, some of which formed
the basis of a response to the government's consultation on nutritional
standards, Ingredients for Success. (A copy of this response
is attached as Annex A). We also put forward NHF recommendations
for building health in schools through the introduction of a national
school fruit and vegetable scheme.
2. DIET AND
CORONARY HEART
DISEASE
2.1 Poor nutrition, as a consequence of
an inadequate diet, is a fundamental factor in the development
of coronary heart disease, stroke and many forms of cancer. Coronary
heart disease is the leading single cause of death in the UK and
claims the lives of over 140,000 people every year. Of these,
nearly 20,000 die before they reach the age of 65. International
studies have shown that a population's susceptibility to coronary
heart disease is dependent on the average blood cholesterol levels
in that population. Cholesterol levels are largely determined
by what we eat. In the UK, where our diet is high in fat and low
in fruit and vegetables, average blood cholesterol levels are
high. Poor diet is also influential in the development of obesity—an
independent risk factor for coronary heart disease and other chronic
diseases.
2.2 Research also shows that the risk of
developing chronic disease is established early in life, making
a focus on children and their diets essential to an effective
prevention strategy. Healthy eating habits, notably eating more
fruit and vegetables, established in childhood are likely to persist
into adult life. School meals are, for many children, their only
substantial meal in the day, and are therefore an extremely important
means of building health through better nutrition.
3. PROPOSALS
FOR MINIMUM
NUTRITIONAL STANDARDS
3.1 The NHF has argued for many years for
minimum nutritional standards for school meals which are achievable,
measurable and which will contribute to the immediate and long
term health of children. In a response to the government consultation
Ingredients for Success, we supported the use of guidelines
by the Caroline Walker Trust[1]
which are based on nutrients. The use of nutrient based standards
reflect the recommendations of the Committee on Medical Aspects
of Food Policy (COMA).
3.2 Our members firmly believe that for
all ages, compulsory standards should be based on nutrients rather
than food groups, as proposed in Ingredients for Success.
Standards based solely on an unquantified number of items and
portion size from each food group may distort nutrient intake
in an unhealthy direction. Standards based on nutrients rather
than foods will safeguard against this yet still provide a flexible
means of introducing a varied diet and allowing for local cultural
variations in menu planning.
3.3 The NHF believes that a firm approach
has to be taken, given the recent trend to allow issues other
than health, such as low cost, to take priority.
Monitoring
3.4 The NHF would like to see the nutrition
standards underpinned by a system which monitors and reviews progress
on a regular basis at both a national and a local level. The NHF
believes the proposals set out in Ingredients for Success
would be inadequate to ensure enforcement of the standards. Regular
monitoring within schools should be undertaken using simple validated
tools which already exist for this purpose such as the NHF's School
Meals Assessment Package (based on COMA recommendations). [2]We
would like to propose that OFSTED might extend its inspection
remit to undertake monitoring of the school food service and of
nutritional standards within schools.
4. PROVISION
OF SCHOOL
LUNCHES
4.1 The NHF has been very concerned with
the decline of the school meals service in recent years. We would
like to see all LEAs and school governing bodies which have discontinued
a paid lunch service, required to resume the service by the time
the compulsory nutritional standards are enforced.
4.2 The NHF recommends that initiatives
should be put into place to improve the take up of free school
meals to reach the one in five children who are not receiving
the free school meals to which they are entitled. [3]
4.3 There are about 2.8 million children
living in poverty in the UK, yet only around 1.8 million children
have entitlement to a free school meal. [4]The
NHF supports extending the entitlement to free school meals to
reach this estimated one million children. For a high proportion
of these children, a free school lunch would be their only substantial
meal of the day.
5. TOWARDS A
WHOLE SCHOOL
APPROACH TO
FOOD AND
NUTRITION
5.1 The NHF is very concerned that action
on nutritional standards should form part of a wider whole-school
approach to food which addresses what is sold in the school tuck
shops and vending machines, and what is taught about nutrition
and health in the classroom. There is a wealth of guidance available
to schools and LEAs on adopting a whole-school approach from the
co-ordinating body of the School Nutrition Action Groups,
the Health Education Authority's Health Promoting Schools Award
and the WHO's European Network of Health Promoting Schools.[5]
Food and nutrition on the curriculum
5.2 We would like to see the school curriculum
include not just food technology training, but practical food
skills including cooking and buying skills that will build children's
confidence and competency in preparing nutritious meals. To ensure
that these skills are not marginalised, lessons should be compulsory,
not optional for all children.
6. A NATIONAL
FRUIT AND
VEGETABLE SCHEME
FOR SCHOOLS
6.1 The NHF strongly advocates the case
for a national school fruit and vegetables scheme whereby free
or subsidised vegetables and fruit are provided for children at
lunch or break time. This concept has been a key policy recommendation
of the NHF over recent years, and in 1998 was identified as an
important measure for reducing health inequalities through better
nutrition in schools by the Independent Inquiry into Inequalities
in Health under Sir Donald Acheson[6].
Inequalities in consumption patterns between higher and lower
socioeconomic groups are nowhere greater than for fruit and vegetables.
Such a scheme, modelled along similar lines to the school milk
scheme, could reach as many as five million children in the first
school year alone. In addition, the demands of children on their
parents could potentially push up intakes in the rest of the family.
6.2 The mechanisms to enable such a scheme
are partly in place. The EU Surplus Fruit and Vegetable Scheme
enables schools in some areas to receive free produce. Joined-up
thinking between EU and national policy makers, and the food industry
could remove the barriers to extending this scheme to non-produce
growing areas of the country and address the practical issues
around the delivery of such a scheme.
7. CONCLUSIONS
7.1 The NHF believes that the reintroduction
of compulsory, nutritionally based and monitored standards for
school meals is long overdue. Their implementation should be part
of an integrated approach to improving health in schools through
the provision of nutritious food. This should take account of
all food that is sold and served in schools and what children
learn about nutrition and food skills in the classroom. A national
free vegetable and fruit scheme would be a significant win in
the battle to raise consumption of essential nutrients which are
known to provide protection against the major preventable diseases
of later live—coronary heart disease and cancer.
1 Caroline Walker Trust: Nutrutional Guidelines for
School Meals. Report of an Expert Working Group. Back
2
National Heart Forum School Meals Assessment Package, NHF, 1995 Back
3
Department for Education and Employment 1997. Statistics of Education. Back
4
Department for Education and Employment 1997. Statistics of Education Back
5
All in initiatives cited in "School Meals Campaign School
Food Action-a guide to healthy eating initiatives at school",
1996. Back
6
Acheson D. 1998. Independent Inquiry into Inequalities in Health,
London: The Stationery Office. Back
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