Health


A universal school food program would enable all of our children to have access to healthy food at school, enabling them to be prepared for their learning day.

Education and practicing healthy habits can strongly influence dietary choices, especially when people are young and are starting to form their life-long food preferences.

  • A school food program would provide an excellent opportunity for schools to model and bring to life the revised Canada’s Food Guide and would be a natural extension of the new federal Healthy Eating Strategy and Food Policy for Canada.
  • Such a program would support the development of healthy eating patterns for all children, regardless of income, helping them develop a palate for healthy whole foods including fresh vegetables, fruit and plant proteins. A National School Food Program would enable children and youth to develop the skills and literacy needed for a lifetime of healthy eating.

Concerns – the evidence:

  • Less than one-third of children under 12 years of age eat five or more servings of vegetables and fruit daily. [1]
  • In 2012 and 2013 only a small proportion of Canadian children met the 2007 Canada’s Food Guide recommendations; low vegetable and fruit consumption are of particular concern. [2] [3]
  • Over 50% of the total energy intake of children aged 4-18 is from ultra-processed foods. [4] Families struggle to introduce minimally processed healthy foods for a variety of reasons. [5] [6] [7]
  • One-third of students in elementary schools and two-thirds of students in secondary schools do not eat a nutritious breakfast before school. [8]
  • One recent survey found that only 10% of youth in grades 6-12 met fruit and vegetable recommendations. [9]
  • Research shows that the diet quality of Canadian children across the socio-economic spectrum during school hours is poor. [10]
  • The annual economic burden of chronic diseases that can be influenced by poor diet has been estimated anywhere between a staggering $13.8 billion [11] - $26 billion [12].

Benefits – the evidence:

  • Children who have a school breakfast program available consume a better overall diet and consume less saturated and trans fat, sodium and added sugars. [13] School nutrition programs may be an effective way to combat both nutritional deficiencies and excess consumption of non-healthy foods among children and their families. [14]
  • International research on the health and dietary behaviour impacts of school food programs in high-income countries finds modest positive effects overall, including higher vitamin intakes and increased vegetable and fruit consumption, especially in younger children. [15] [16] [17] [18]
  • Whole grains, fruits and vegetables [19] [20] [21] (such as those provided in student nutrition programs) can contribute to reducing the risk of cardiovascular events and chronic diseases such as stroke, heart disease and type 2 diabetes.
  • Children who eat a morning meal are sick less often, have fewer problems associated with hunger, such as dizziness, lethargy, headaches, stomachaches and earaches [22], and do significantly better than their peers in terms of cooperation, discipline, and interpersonal relations.
  • Extensive research from various parts of the world that compares the nutritional quality of food consumed at school that was brought from home versus food acquired through school food programs has found that school food programs provide healthier food overall (regardless of the socioeconomic status of child participants). [23] [24] [25] [26] [27] [28] [29] [30]

Health - References:

[1] Statistics Canada

[2] Black JL, Billette JM. Do Canadians meet Canada's Food Guide's recommendations for fruits and vegetables? Appl Physiol Nutr Metab. 2013;38(3):234-242.

[3] Health Canada. Do Canadian Children Meet Their Nutrient Requirements Through Food Intake Alone? In: Health Canada, ed. Ottawa: Government of Canada; 2012.

[4] Data from the Heart and Stroke’s 2017 report Ultra-processed foods in Canada.

[5] Engler-Stringer R. The Domestic Foodscapes of Young Low-Income Women in Montreal: Cooking in the Context of An Increasingly Processed Food Supply. Health Education and Behavior. 2009;37(2):211-226.

[6] Daniel C. Economic constraints on taste formation and the true cost of healthy eating. Soc Sci Med. 2016;148:34-41.

[7] Slater J, Sevenhuysen G, Edginton B, O'Neilz J. 'Trying to make it all come together': structuration and employed mothers' experience of family food provisioning in Canada. Health Promotion International. 2012;27(3):405-415.

[8] Data from The Chief Public Health Officer’s Report on the State of Public Health in Canada 2008.

[9] Minaker L, Hammond D. Low Frequency of fruit and vegetable consumption among Canadian youth: findings from the 2012/2013 Youth Smoking Survey​. J Sch Health. 2016; 86: 135-142.

[10] Tugault-Lafleur CN, Black JL, Barr SI. Examining school-day dietary intakes among Canadian children. Applied Physiology, Nutrition and Metabolism. 2017;00:1-9.

[11] Lieffers JRL, Ekwaru JP, Ohinmaa A, Veugelers PJ (2018)​The economic burden of not meeting food recommendations in Canada: The cost of doing nothing. ​PLoS ONE 13(4): e0196333.

[12] Regulations Amending the Food and Drug Regulations (Nutrition Labelling, Other Labelling Provisions and Food Colours). (2016). Canada Gazette Part II, 150(25).

[13] Kerver, J. M., Yang, E. J., Obayashi, S., Bianchi, L., & Song, W. O. (2006). Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. Journal of the American Dietetic Association, 106(1), 46-53.

[14] Bhattacharya, Currie & Haider (2005). Breakfast of Champions?: The School Breakfast Program & the Nutrition of Children & Families. National Bureau of Economic Research.

[15] Kristjansson EA, Robinson V, Petticrew M, et al. School feeding for improving the physical and psychosocial health of disadvantaged elementary school children. Cochrane Database of Systematic Reviews. 2007(1):CD004676.

[16] Van Cauwenberghe E, Maes L, Spittaels H, et al. Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and 'grey' literature. Br J Nutr. 2010;103(6):781-797.

[17] Joshi A, Azuma, A.M., Feenstra, G. Do farm-to-school programs make a difference? findings and future research needs. In. Journal of Hunger and Environmental Nutrition. Vol 32008.

[18] Bontrager Yoder AB, Liebhart JL, McCarty DJ, et al. Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake. Journal of Nutrition Education and Behavior. 2014;46:341-349.

[19] Dalen, J.E. (2013). Diets to prevent coronary heart disease 1957-2013: What have we learned? American Journal of Medicine, 127(5), 364-369.

[20] Heflin, C. M., Siefert, K., & Williams, D. R. (2005). Food insufficiency and women’s mental health: Findings from a 3-year panel of welfare recipients. Social Science and Medicine, 61, 1971-1982.

[21] Seligman, H. K., Laraia, B. A., & Kushel, M. B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. Journal of Nutrition, 140(2), 304-310.

[22] Casey, P. H., Szeto, K. L., Robbins, J. M., Stuff, J. E., Connell, C., Gossett, J. M., & Simpson, P. M. (2005). Child health-related quality of life and household food security. Archives of Pediatrics and Adolescent Medicine, 159(1), 51-56.

[23] Evans CE, Cleghorn CL, Greenwood DC, Cade JE. A comparison of British school meals and packed lunches from 1990 to 2007: meta-analysis by lunch type. British Journal of Nutrition. 2010;104(4):474-487.

[24] Caruso ML, Cullen KW. Quality and cost of student lunches brought from home. JAMA Pediatr. 2015;169(1):86-90.

[25] Neilson LJMR, Macaskill LAMR, Luk JMMR, et al. Students' Food Intake from Home-Packed Lunches in the Traditional versus Balanced School Day. Can J Diet Pract Res. 2016:1-8.

[26] Hur I, Terri B-C, Reicks M. Higher quality intake from school lunch meals compared with bagged lunches. ICAN: Infant, Child and Adolescent Nutrition. 2011;3(2):70-75.

[27] Taylor JP, Hernandez KJ, Caiger JM, et al. Nutritional quality of children's school lunches: differences according to food source. Public Health Nutr. 2012;15(12):2259-2264.

[28] Hubbard KL, Must A, Eliasziw M, Folta SC, Goldberg JP. What's in children's backpacks: Foods brought from home. Journal of the Academy of Nutrition and Dietetics. 2014;114:1424-1431.

[29] Johnston CA, Moreno JP, El-Mubasher A, Woehler D. School lunches and lunches brought from home: A comparative analysis. Childhood Obesity. 2012;8 (4):364-368.

[30] Stevens L, Nelson, M. The contribution of school meals and packed lunch to food consumption and nutrient intakes in UK primary school children from a low income population. In. Journal of Human Nutrition and Dietetics. Vol 242011.




Student Wellbeing and Success


Healthy, universal school food programs give children and youth access to nutritious and safe food in a non-stigmatizing manner where they can enjoy eating in the company of their peers. A National School Food Program would support student mental health and success.

Concerns – the evidence:

  • When children attend school hungry or undernourished their energy levels, memory, problem-solving skills, creativity, concentration, and other cognitive functions are all negatively impacted. They are also more likely to repeat a grade.

Benefits – the evidence:

  • Studies on school food programs and academic achievement, attendance, tardiness, and drop-out rates point to important impacts of school food programs. Attendance and tardiness appear to be most affected, but some studies have found improvements in academic achievement with the introduction of school food programs. [1] [2] [3] [4] [5] [6]
  • An evaluation of a morning meal program in the Toronto District School Board found that students who consume a morning meal most days show at least a 10% increase in skills such as independent academic work, initiative, conflict resolution, class participation and problem-solving at school. [7]
  • Students who eat breakfast on most days were more on track for high school graduation compared to those who did not eat breakfast. [8]
  • Student nutrition programs have positive impacts on children’s mental health, including reductions in behavioural and emotional problems, bullying, aggression, anxiety, and depression. [9]
  • School food programs can contribute to teaching about culinary heritage, social norms around food, and environmental sustainability. [10] [11] [12]

Student Wellbeing and Success - References:

[1] Turner L, Chaloupka FJ. Continued Promise of School Breakfast Programs for Improving Academic Outcomes. JAMA Pediatrics. 2015;169(1):13-14.

[2] Anderson ML, Gallagher J, Ritchie ER. School Lunch Quality and Academic Performance. National Bureau of Economic Research Working Paper Series. 2017;No. 23218.

[3] Symons CW, Cinelli B, James TC, Groff P. Bridging Student Health Risks and Academic Achievement Through Comprehensive School Health Programs. Journal of School Health. 1997;67(6):220-227.

[4] Florence MD, Asbridge M, Veugelers PJ. Diet Quality and Academic Performance*. Journal of School Health. 2008;78(4):209-215.

[5] Murphy J, Pagano ME, Nachmani J, Sperling P, Kane S, Kleinman RE. The relationship of school breakfast to psychosocial and academic functioning: Cross-sectional and longitudinal observations in an inner-city school sample. Archives of Pediatrics & Adolescent Medicine. 1998;152(9):899-907.

[6] Hollar D, Lombardo M, Lopez-Mitnik G, et al. Effective Multi-level, Multi-sector, School-based Obesity Prevention Programming Improves Weight, Blood Pressure, and Academic Performance, Especially among Low-Income, Minority Children. Journal of Health Care for the Poor and Underserved.

[7] Muthuswamy, E. (2012). Feeding Our Future: The First and Second-Year Evaluation. Toronto District School Board.

[8] Muthuswamy, E. (2012). Feeding Our Future: The First and Second-Year Evaluation. Toronto District School Board.

[9] Kleinman, R. E., Hall, S., Green, H., Korzec-Ramirez, D., Patton, K., Pagano, M. E., & Murphy, J. M. (2002). Diet, breakfast, and academic performance in children. Annals of Nutrition and Metabolism, 46(1), 24-30.

[10] Larson N, Story M. A Review of Environmental Influences on Food Choices. Annals of Behavioral Medicine. 2009;38(1):56-73.

[11] Oostindjer M, Aschemann-Witzel J, Wang Q, et al. Are School Meals a Viable and Sustainable Tool to Improve the Healthiness and Sustainability of Children s Diet and Food Consumption? A Cross-national Comparative Perspective. Crit Rev Food Sci Nutr. 2016:0.

[12] Moffat T, Thrasher D. School meal programs and their potential to operate as school-based obesity prevention and nutrition interventions: case studies from France and Japan. Critical Public Health. 2014;26(2):133-146.




Environment


When designed with sustainability goals in mind, school food programs provide a strong opportunity for students to experience food literacy education about our food systems including where food comes from, how to choose local and sustainable food, how to minimize food waste (a huge contributor to climate change), and how to compost.

  • A program that follows and promotes the 2019 Canada’s Food Guide Snapshot would help students develop a palate for fresh vegetables, fruit and plant proteins, which is consistent with a diet that emits low amounts of greenhouse gasses.
  • School food programs​ could reduce, through proper planning and infrastructure, negative environmental impacts ​by facilitating the reduction and management of food waste, a major source of greenhouse gas emissions.
  • School food programs can contribute to teaching about culinary heritage, social norms around food, and environmental sustainability. [1] [2] [3]

Environment - References:

[1] Larson N, Story M. A Review of Environmental Influences on Food Choices. Annals of Behavioral Medicine. 2009;38(1):56-73.

[2] Oostindjer M, Aschemann-Witzel J, Wang Q, et al. Are School Meals a Viable and Sustainable Tool to Improve the Healthiness and Sustainability of Children s Diet and Food Consumption? A Cross-national Comparative Perspective. Crit Rev Food Sci Nutr. 2016:0.

[3] Moffat T, Thrasher D. School meal programs and their potential to operate as school-based obesity prevention and nutrition interventions: case studies from France and Japan. Critical Public Health. 2014;26(2):133-146.




Economic Growth and Agriculture


A Universal National School Food Program would support Canadian farmers and local food producers and create economic multipliers.

When local food procurement targets are set and local food is served in school food programs, the local multiplier of the increased local food purchases will impact regional food production, household and business earnings, long-term gross domestic product, and part-time jobs created or sustained.

Benefits – the evidence:

  • A preliminary University of Guelph study suggests that a national program could contribute $4.8 billion to the local economy by 2029 if 30% was spent on local food purchases as well as stimulate the development of as many as 207,700 new jobs. This could be achieved by establishing local food procurement targets to guide purchasing decisions. Targets could be developed by each province / territory so as to be appropriate to their specific region and circumstances.




Women and Families


A National School Food Program would have a positive impact on all families, particularly women who invest a significant amount of time preparing food for school.

Families struggle to introduce minimally processed healthy foods for a variety of reasons. [1] [2] [3]

Provision of healthy school lunches is challenging in the context of parents working long hours [4] [5], and families are struggling to adopt healthy food behaviours [6].

Parents may rely on highly processed foods, that are low in key nutrients but high in salt, sugar and fat, to cope with demands on time. [7]

Women and Families – References:

[1] Engler-Stringer R. The Domestic Foodscapes of Young Low-Income Women in Montreal: Cooking in the Context of An Increasingly Processed Food Supply. Health Education and Behavior. 2009;37(2):211-226.

[2] Daniel C. Economic constraints on taste formation and the true cost of healthy eating. Soc Sci Med. 2016;148:34-41.

[3] Slater J, Sevenhuysen G, Edginton B, O'Neilz J. 'Trying to make it all come together': structuration and employed mothers' experience of family food provisioning in Canada. Health Promotion International. 2012;27(3):405-415.

[4] Griggs TL, Casper WJ, Eby LT. Work, family and community support as predictors of work–family conflict: A study of low-income workers. Journal of Vocational Behavior. 2013;82(1):59-68.

[5] Bauer KW, Hearst MO, Escoto K, Berge JM, Neumark-Sztainer D. Parental employment and work-family stress: Associations with family food environments. Social Science & Medicine. 2012;75(3):496-504.

[6] Bauer KW, Hearst MO, Escoto K, Berge JM, Neumark-Sztainer D. Parental employment and work-family stress: Associations with family food environments. Social Science & Medicine. 2012;75(3):496-504.

[7] Slater J, Sevenhuysen G, Edginton B, O'Neil J. 'Trying to make it all come together': structuration and employed mothers' experience of family food provisioning in Canada. Health Promot Int. 2012;27(3):405-415.





The Research

 

Coalition for Healthy School Food

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