Healthy nutrition in schools

Katica Antonic Degac

A healthy diet during childhood and adolescence is known to reduce the risks of both immediate nutrition-related health problems (obesity and dental caries) and noncommunicable diseases in later life (cardiovascular disease, diabetes and cancer). Schools offer an opportunity to promote a healthy diet and establish dietary habits to be carried through life and channelled into the wider community.

A number of worrying trends among children contribute to the development of poor dietary habits.

  • Snacking and skipping breakfast have become problems among young people. Avoiding breakfast increases the consumption of snack products high in fat and sugar. Snack consumption is related to the decline in fruit and vegetable consumption among school-aged children.
  • Changes in the structure of the family and increasing peer pressure influence both eating habits and food consumption patterns. During childhood and adolescence, group behaviour becomes the norm, affecting attitudes towards food and product choice. The promotion of healthy eating habits should focus on both over- and underconsumption, and prioritize the need to develop healthy attitudes towards food and well-being.

School environment makes a difference

Focusing on positive action in a number of key areas in schools can be of critical importance.

  • One of the critical elements for health promotion and healthy nutrition at school is the environment for school meals. No matter how schools supply such meals, services should focus on providing an environment that supports the consumption of healthy, nutritious food. Children should have time to make sensible choices in a supportive atmosphere. Meals should be prepared in a way that follows sensible guidelines and maximizes their nutritional composition. Involving children in preparation can have a positive effect.
  • Breakfast clubs may be appropriate to the setting and a good way of increasing young people’s consumption of breakfast. Evidence suggests that breakfast clubs can increase children’s attendance, positive behaviour and academic achievement in school. Their effects could be even more important for poor families and neighbourhoods.
  • Vending machines should be minimized and/or offer healthier products that support the whole-school approach to health. A complete ban on junk food is desirable but difficult to achieve in the short term, so healthier products should be made more affordable and their consumption encouraged.
  • Fruit, vegetable and milk subscriptions via partnerships with local farmers and retailers can promote the consumption of local produce and increase the nutritional status of children’s diets. Subsidized programmes have been successful in many countries, especially in the European Union, where national fruit schemes provide each child with a free piece of fruit each school day. Schemes have been implemented in 24 countries so far.
  • Fluid intake is important for young children, and their access to water should be prioritized. Soft drinks with added sugar should be minimized or, preferably, eliminated.


Building networks for healthy school policy

One of the ways in which WHO/Europe supports countries to promote healthy eating and physical activity in schools in a positive and sustainable way is through the Schools for Health in Europe Network. It offers training resources that introduce the health-promoting-school approach as a new way of developing school health policy.

With a network of Member States, WHO launched the Nutrition-Friendly Schools Initiative. It aims to provide a framework for designing school-based intervention programmes that address the double burden of nutrition-related ill health, and to stimulate links between the various school-based intervention programmes addressing malnutrition in all its forms.