Let them eat

21st December 2001, 12:00am

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Let them eat

https://www.tes.com/magazine/archive/let-them-eat
Why is there so much interest in children’s diet? Rosalind Sharpe investigates. Photography by Foodfolio

Twenty-eight Year 5 pupils at Henry Fawcett primary school, south London, pop cherry tomatoes into their mouths. They chew thoughtfully, one or two faces crease in disgust, then they bend over their evaluation sheets. Food item: “How do you spell ‘tomato’?” Description: “round, red”. Taste: mostly this column fills up with smiley faces, denoting approval. The tomatoes are followed by chunks of kiwi fruit, dried apricot, strawberry and radish, which does not get so many smiley faces.

The occasion is a marathon fruit-tasting session organised by Grab 5!, a project that aims to increase children’s awareness and consumption of fruit and vegetables. For two days, Richard Siddall, Grab 5! co-ordinator in Lambeth (one of three areas where the project is being tested), has been dishing out tasting bowls with samples of fruit and vegetables, evaluation sheets, and a quiz for pupils to try out at home with their families.

The emphasis is on enjoyment, rather than hammering home the message that greens are good for you, and Richard Siddall is pleased with the response.

The aim is that, by sampling a variety of fruit and veg, the children will discover - or remember - that they taste good. And this could influence eating patterns outside of school, and become habitual.

Henry Fawcett head James Walker is also pleased. “This is something we might in future organise ourselves, but it’s a lot easier to have someone come in and do it for us.”

Grab 5! is run by the food charity Sustain. It is one of several projects that have been initiated by charities, Government departments and schools, with the aim of improving children’s eating patterns.

These projects go beyond the curriculum requirement to teach about healthy foods, and seek to intervene directly in children’s diets, by advocating changes in the way they eat, or by providing certain foods. Projects range from breakfast clubs and healthy tuckshops to the new nutritional guidelines for school caterers and the national school fruit scheme, which will deliver a free piece of fruit daily to all four to six-year-olds in state schools from 2004.

Why now?

Teachers’ concern with children’s diets began with mass education in the mid-19th century. According to food historian John Burnett, when confronted with working-class children en masse, teachers were alarmed at the extent of poor health “and quickly concluded that such children’s concentration and learning capacity were inhibited by hunger and malnutrition”.

Teachers took a lead in organising free breakfasts and dinners, and the practice of providing school meals soon became widespread.

Teachers in the UK today are rarely confronted with children who have scurvy or rickets, although it is common for children to arrive at school hungry - surveys have shown that one child in every 10 regularly misses breakfast. But the impetus to intervene in pupils’ diets is based on evidence that there is a new kind of malnutrition, which possibly originates in childhood, but may not be apparent until later in life. There is a well-established connection between diet and so-called “diseases of affluence” - coronary heart disease, stroke, cancer, diabetes and obesity. The culprits usually cited are sugar, salt and high-fat foods, while the protective effects of fruit and vegetables have emerged more recently. The UK has one of the highest death rates in western Europe from chronic illnesses such as heart disease, and also one of the lowest intakes of fruit and vegetables. Increased consumption of healthy food is now held to be the second most important strategy for cancer prevention after reducing smoking. High fruit and vegetable intake has also been found to help control diabetes, discourage obesity, aid bowel function, delay the development of cataracts and improve asthma symptoms.

Why target primary schools?

The first reason is that children’s diets are in some ways worse than those of adults. The recommended daily intake of fruit and vegetables is 400g or five portions (hence Grab 5!). In practice, adults consume around three portions, but children average two - less than 20 years ago.

A Government survey revealed that one-fifth of four to 18-year-olds ate no fruit at all. Among those aged four to six, three in five ate no leafy green vegetables, and only four per cent met the target of five portions.

A recent study by Sustain found that 95 per cent of all foods advertised during children’s TV viewing times were high in combinations of fat, sugar and salt.

The second reason is the mounting evidence that what children eat is important, not just for their mental and physical development, but for their long-term health prospects. According to the Government’s blueprint for improving health, NHS Plan 2000: “Many of the processes linked with the development of cardiovascular disease begin in childhood and the early stages of cancer development may be initiated many years before there are any detectable signs.” Obesity, one of the most visible symptoms of modern malnutrition, now affects up to one in 10 of children aged six.

The third, most powerful, reason is the “diseases of affluence”, which, ironically, mostly affect poorer members of society. NHS Plan baldly states that the life expectancy of a boy born today into the lowest social class is nine years lower than that of a boy born into the most affluent. People on low incomes tend to have diets high in sugar and fat, because these are the cheapest way to fill stomachs.

Poorer people eat on average half as much fruit as the better off. In some households, the total weekly consumption of fruit and vegetables is equivalent to less than one Brussels sprout per person per day.To break this cycle, children, especially those from low-income backgrounds, need to start eating differently and to form lasting habits of healthy eating. Hence the flurry of schemes.

The Henry Fawcett project is in a deprived area of inner London, with half the children on free school meals, 20 per cent starting with no English, and a 15 per cent pupil turnover. These children are prime targets for Government health-improvement strategies, and James Walker needed no convincing that nutrition should be a priority. “We are obsessed by short-term measures of achievement,” he says. “We need to take a broader view. If learning good eating habits will stand these children in good stead in 30 or 40 years’ time, that may be as important as getting a high proportion of them above SATs level 4.”

The nursery children share fruit every day, with a weekly voluntary contribution of 30p from parents. With support from the local Health Action Zone, plans are advanced for a breakfast club, and a fruit tuckshop run by parent volunteers is under discussion.

Walker is also thinking of taking delegated responsibility for his school’s catering budget, an option available to primary heads since April 2001, and wants to pull various initiatives together in a school food policy, to embrace catering, packed lunches and even the treats teachers use as rewards.

This approach links the messages that are taught in the curriculum with the food that is provided in the school throughout the day.

HOW SCHOOL DIETS ARE CHANGING

Starting this year, there is a legal requirement for school meals to meet national nutritional standards. Primaries now also have the option of taking delegated financial responsibility for their catering services. While that means extra work, good catering could become an added “draw” for the school. The Child Poverty Action Group (CPAG) claims that one million children living in poverty are not entitled to, or do not claim free meals. If this is a cause for concern, call CPAG on 0207 837 7979.

National School Fruit Scheme From 2004, a daily piece of fruit will be provided, free of charge, for every four to six-year-old in a state school - amounting to 2.2 million pieces of fruit every day. The scheme has been designed to minimise the workload for schools, but storage space will need to be found for three deliveries a week, and staff will have to wash and serve the fruit each day.

School Nutrition Action Groups

These are groups that advocate a co-ordinated, whole-school approach, embracing everything from catering to teaching, and advise on all aspects of school food services. The Chips are Down booklet provides a comprehensive guide to food policy in schools: pound;15 from SNAGS at the Health Education Trust, 18 High Street, Broom, Alcester, Warwickshire, B50 4HJ, or call 01789 773915.

Grab 5!

This campaign to raise awareness and consumption of fruit and vegetables among seven to 11-year-olds through school activities is being piloted in just three areas. But any school can tap into the ideas and materials the campaign is generating. Visit www.grab5.com or call 020 7837 1228.

Breakfast Clubs In the US, these have been found to reduce absenteeism and improve punctuality, as well as help children work better. The UK Government has piloted a number of clubs and is evaluating their effect on health and attainment, but many schools have them. SNAGS can help schools set one up, but prefers to do so in the context of a review of the school’s overall approach to food.

Drinks

In 60 per cent of schools, the only source of drinking water is from taps located in the school toilets. Alternatives are to install water fountains or coolers, or allow children to bring labeled, refillable plastic bottles of water into the classroom.

A FEW MINOR QUIBBLES

Fruit

Children receive better school meals, some of them get a free piece of fruit, and they all learn why they should eat up their greens. But given the number of schemes, the amount of teachers’ time they are likely to take up and the money being spent on them (the National School Fruit Scheme has been allocated an extra pound;42 million of lottery money), it is legitimate to ask what they hope to achieve and whether these projects are the best way to set about it. Put simply, their aim is to change ingrained eating habits for good. So can they succeed?

Martin Caraher, an academic working on food and public health at the Centre for Food Policy at Thames Valley University, says there is little evidence to show school food programmes have a lasting effect on children’s eating habits, and that much larger issues affect our diet than can be addressed by such schemes.

One is income. A quarter of UK children live in poverty. As affluence increases, diet improves, so, logically, the best way to reduce bad health would be to reduce inequalities in income. Then there is the question of access to fresh foods. Between 1986 and 1997, small shops closed at the rate of eight a day, displaced by the increasing popularity of supermarkets. Perhaps the pound;42 million being invested in the Fruit Scheme would be better spent on restoring a greengrocer’s to every high street?

What about the Common Agricultural Policy, which some argue keeps the price of fruit and vegetables artificially high? And what about the manufacturers and advertisers of cheap calories, the salty, sugary snacks we gorge on - do they bear any responsibility?

This is an over-simplification of the issues - many factors influence what we eat, and some of them are beyond our control. Gently bumping up schoolchildren’s fruit intake may not make that much difference.

“No one is knocking these schemes for what they do,” says Martin Caraher. “It’s just the research has not been done to show whether or not they work and, if they do, how best they can achieve their aims. We also need to look beyond the school gates, and not put all this on to teachers.”

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