What Are Canadian Children Eating at School (and How Can Eating Habits be Improved)?
August 23, 2017
By: Claire Tugault-Lafleur, MA, RD and Jennifer Black, PhD, RD
Evidence suggests that the majority of Canadian children do not meet national dietary recommendations for vegetables, fruit, or dairy products, and their overall diet quality is poor. Schools can be an important place to foster healthy eating habits since children consume one or more meals at school on weekdays. However, no nationally representative studies have examined what children eat at school or whether foods consumed at school contribute to (or reduce) children’s overall diet quality.
There is a groundswell of interest in Canada in developing policies and programs to improve children’s eating habits. For example in October 2016, Health Canada launched a multipronged Healthy Eating Strategy that includes actions to restrict marketing of unhealthy foods and beverages to children and an extensive revision of national dietary guidelines. In June 2017, the Government of Canada also launched a consultation process to develop a national food policy with a focus on improving health and access to affordable food. An understanding of what children eat at school and the contribution of these foods to a child’s daily dietary intake is needed to inform these broader strategies and to help policy makers weigh the evidence about if and how schools should play a role in national food policies and dietary interventions.
To fill important gaps in knowledge about children’s dietary habits at school, our new study in Applied Physiology Nutrition and Metabolism used dietary intake data from the 2004 Canadian Community Health Survey (CCHS), Canada’s most recent nationally representative dietary survey available to date. We analysed dietary intake data from 4,827 children aged 6–17 years to assess the amounts of calories, nutrients, and food groups consumed between school hours (9 am–2 pm) and non-school hours on school days (Monday through Friday). We also assessed overall diet quality using the School Healthy Eating Index (School-HEI), a score based on 11 key components of a healthy diet that examines the totality of foods and beverages consumed by Canadian children during school hours (see Fig. 1).
What do Canadian children eat at school?The overall quality of children’s diets during school hours was sub-optimal. The average School-HEI score was 53 points (out of a possible maximum score of 100), suggesting substantial room for improvement. Lowest School-HEI scores were observed for dark green and orange vegetables, whole fruit, whole grains, and milk products (Fig. 1), whereas students scored highest on scores relating to intake of saturated and unsaturated fats, total grains, and meats and alternatives.
|Fig. 1. School-Healthy Eating Index (S-HEI) scores for Canadian children aged 6–17 years. Each score is scaled as a percentage of the maximum (or "perfect") score for that component. Lowest S-HEI scores were for dark green and orange vegetables, whole fruit, whole grains, and milk products. "Other" foods are foods that are typically minimally nutritious foods such as sugar-sweetened beverages, candy bars, and salty packaged snacks.|
Do foods consumed at school contribute to or reduce children’s overall diet quality on school days?Children reported consuming on average, 746 calories during school hours (9 am–2 pm) or about one-third of their total daily caloric intake. The contribution from grain products, vegetables and fruit (including juice), and meat products during school hours was also close to a third of their daily intakes of these foods. In contrast, dairy products consumed at school contributed to less than one-quarter of the daily intake of these foods. During school hours, children also consumed on average 175 calories from "other" foods—foods not part of the four core food groups from the Canada Food Guide and typically minimally nutritious foods such as sugar-sweetened beverages, candy bars, and salty packaged snacks.
When we compared dietary intakes between time periods (after accounting for differences in how many calories children consumed in an entire day), children consumed relatively more of these "empty calorie" foods during school hours compared to non-school hours. Their intake of dairy products was significantly lower during school hours compared to non-school hours. Not surprisingly, their intakes of key nutrients commonly found in dairy products (vitamin A, D, B12, and calcium) were also significantly lower during school hours compared to non-school hours.
What factors influence diet quality outcomes at school?Associations between socio-demographic factors and school-hour diet quality were modest. Like other Canadian studies, we found a clear decline in the quality (during school hours) of children’s diets as they got older, with older youth (14–17 years) having the lowest diet quality scores compared to their younger peers. We found that children whose parents had completed some post-secondary education had slightly higher (but statistically significant) diet quality scores during school hours compared to children whose parents had not completed any post-secondary education. Dietary intake also differed by province with children residing in Quebec reporting slightly higher (but statistically significant) school-hour diet quality scores compared to their peers residing in many other provinces.
Implications for Canadian school-based nutrition policiesThis is the first Canadian study to describe the contributions of foods consumed during school hours relative to daily dietary intake. Overall, the quality of foods and beverages consumed by Canadian children at school in 2004 was sub-optimal. Given that foods eaten during school hours represent one-third of the total daily calories consumed, the school environment provides an important opportunity to improve dietary practices of Canadian children. Evidence from our study suggests that nutrition policies and programs are warranted to improve consumption of vegetables, whole fruit, whole grains, and milk products for Canadian children, particularly while they are at school. School-based health promotion strategies should target lunch meals for all children, but especially older adolescents who report the poorest diet quality outcomes at school. Next steps in our research will be to explore changes in school-hour diet quality from 2004 to 2015, following the release of the 2015 CCHS Nutrition survey.
The article entitled "Examining school-day dietary intakes among Canadian children" is available on the NRC Research Press website.