Nutrition

21st February 2003 at 00:00
On the children's set menu today we have crisps, biscuits, sweets, white bread, chocolate and chips - all washed down with a fizzy soft drink. These highly processed, "hand-held" foods are designed for easy grazing between lessons or for munching in front of the telly. And, for some youngsters, they'll do for breakfast, lunch and tea as well. Big food manufacturers and supermarkets give these products the hard sell. Additives, colourings, sporting heroes and advertising are enlisted to get young mouths watering and young minds developing brand loyalty. It works - to the anger of those who want children to eat better. Campaigning groups, charities and some schools want food nearer the top of the politicians' menu - urgently.

THIRSTY WORK

Schools are awash with soft drinks "high in sugar, almost devoid of any nutritional value, and often full of additives", says Joe Harvey, director of the Health Education Trust. Seventy per cent of primary-aged children regularly consume fizzy soft drinks, according to the Government's National Diet and Nutrition Survey of 2000. That is 10 per cent more than those who regularly drink water. The average primary pupil consumes about 30 glasses of soft drinks a week, compared to about 10 of milk.

The shameful truth, says Mr Harvey, is that most schools have a Dickensian lack of access to drinking water. Ten per cent of pupils have no drinking facilities at all, while more than half have to put their mouths round a tap in the toilets or drink from cupped hands. Many simply do not drink at school because they dislike using the toilets so much.

The effects of dehydration range from simple thirst, to headaches, constipation, urinary tract infections and, in the long term, renal disease. None of which will help children concentrate - research has shown that becoming even 1 to 2 per cent dehydrated can interfere with mental ability. Some people are standing up for H20. Merseyside's Be Cool in School campaign urges schools to give children easy access to water at all times through water fountains or coolers or, cheapest of all, by letting them have bottles of tap water on their desks.

CONSUMING PASSIONS

Adult portions of saturated fat, sugar and salt are going down children's throats daily - probably double what they actually need, according to the diet and nutrition survey. This study of 1,700 four to 18-year-olds found that while 92 per cent were eating more than adult maximum levels of saturated fat, they were consuming less than half the recommended five portions of fruit and vegetables each day. One in five ate none - an alarming state of affairs that prompted the Government to introduce a scheme entitling under-sevens to free fruit in schools (see resources).

Their diets were also low in fibre, but full of additives, which recent research indicates can cause mood changes.

Not surprising, then, that the number of obese children is soaring and that more than half of four to 18-year-olds have tooth decay. Too much fat, sugar, and salt and not enough of just about everything else increases the risk of developing heart disease, some cancers, high blood pressure and type 2 diabetes. Unbalanced diets may affect concentration, performance and behaviour in the classroom.

Food writer Sophie Grigson says that we have a duty to teach our children about decent food. Then, perhaps, they may be able to resist another helping of those "loathsome nuggets made of the lesser parts of chicken raised in cages on a massive scale, then mulched up fine and glued together again".

THE POWER OF ADVERTISING

In an average Saturday morning's television viewing, a child will watch 64 food commercials, the vast majority for fizzy drinks, sugar-packed cereals and sweets. "If manufacturers were trying to undermine children's health they could hardly be more effective," says Dr Tim Lobstein of the independent Food Commission, a not-for-profit organisation that wants to see a national nutrition policy for children.

Manufacturers and advertisers dispute such claims. But a survey conducted by the Food Commission in 2000 revealed that, for every healthy product targeted at children, there were more than 10 "nutritional disasters". And this in a survey that excluded all sweets, soft drinks and crisps. A third of 358 child products being sold by leading retailers were so poorly labelled that no nutritional assessment could be made. Of the rest, 77 per cent had high levels of fat, sugar and salt.

Dr Lobstein says it is time that heart disease and obesity were regarded as infectious diseases, communicated "not directly through a bacterium, but through the physical and cultural norms of society. The infectious agents are the fats and sugars, and the vectors that carry these ingredients are, for example, the snack foods and soft drinks which are spread widely through society, their consumption encouraged with multi-billion dollar marketing budgets". In the United States, for example, an estimated $2 million (pound;1.24 million) is spent annually promoting fruit and vegetables, compared to $10 billion (pound;6 billion) spent by the food industry on advertising.

Yet, according to the Department of Culture, Media and Sport, a ban on children's food advertising is just not going to happen. Instead, there is Media Smart, an initiative targeted at primary pupils to educate them in the ways of 21st-century persuasion. The scheme is supported by, among others, Cadbury Trebor Bassett and Kellogg's in an attempt, says Culture Secretary Tessa Jowell, to make the polluter pay. Schools are vulnerable, too. The Food Standards Agency could not find one that did not take part in some form of commercial food promotion. Vending machines can earn a large secondary between pound;15,000 and pound;40,000 a year. Heads are tempted by the "free" exercise books that come courtesy of a company called JazzyMedia - with the blessing of the National Association of Head Teachers. (When JazzyMedia plugged Vimto soft drinks on its books, it claimed a 76 per cent "brand awareness lift".)

SCHOOL DINNERS

Today you are going to dine at EatAnything comp. You only have an hour, but you will have to queue for 15 minutes. Overworked and underpaid staff may treat you brusquely. Your portion is rather measly and the room has a municipal feel. Will you go back? Probably not.

Children judge their school meals service in the same way adults judge a restaurant, says Joe Harvey, whose trust runs the school nutrition action group programme (see resources). Queueing, portion size, ambience, cleanliness, price, and how they are treated by staff all matter. If the service is to improve - and if they are to eat healthier food - children must be involved. "There's not a decent business in the world that doesn't consult with its customers," he says.

Most children, like adults, know what they are supposed to eat, but, like most of us, it makes no difference. "Information has never had an impact on behaviour," says Joe Harvey. "You need to say, 'Look guys, we're trying to put together a food service that you are going to use and enjoy, and one that offers balance and variety, because your health is important to us'.

In a mixed comp, some youngsters will want more salad and fruit, and some will be happy with pie and beans. The point is that you give access to a wide variety of food, present it attractively and make damn sure the stuff you are interested in pushing is not expensive. Then you get the feedback; the process is almost more important than the outcome."

A former teacher, Mr Harvey has spent 10 years persuading heads, health professionals and caterers to include pupils in the food debate. About a quarter of schools now have a whole-school approach to nutrition that irons out contradictions between what appears on the plates, what is sold in tuck shops and vending machines, and what is taught in class. It's important, he says, not just nutritionally, but psychologically. Food services are an integral part of pastoral care and welfare. "A breakfast club is as much about showing you care for the children as it is about feeding them. And if you run a lousy lunch hour you can see what problems the staff get first lesson in the afternoon."

THATCHER, THATCHER...

Lousy lunch hours have been all too common over the past 20 years. Margaret Thatcher did more than snatch the milk from schoolchildren. The Conservatives abolished nutritional guidelines for school meals in the 1980s and forced local authorities to choose the most competitive catering services on offer. The cash cafeteria started appearing in secondary schools with the disappearance of the need to offer balanced meals. All subsidies had gone by the early 1990s and a few local authorities stopped providing hot meals, handing out packed lunches instead.

Now, however, regulation is back on the menu for the 2.5 million school meals served daily. Nutritional guidelines, admittedly basic ones, were reintroduced in 2001. They lay the foundations, says Joe Harvey, and mean caterers can resist pressure to, say, serve chips five times a week because that's what the school down the road does. Meal budgets have been delegated to secondaries and made optional for primary and special schools (see case study).

Quality could also be improved by setting a minimum value for a free school meal, which can vary by 30-40p across the country. It should rise from, roughly, pound;1.20 for a primary pupil to pound;1.60, and from, roughly, pound;1.50 to pound;1.90 for a secondary student. This would double the amount that can be spent on ingredients.

The Health Education Trust wants schools' food policies to come under the remit of Ofsted. Currently, the only involvement inspectors have with food is what they share in the dining hall.

NUTRITIONALLY STARVED

Two million UK children are at risk of going hungry or, at best, surviving on a poor and monotonous diet, the Child Poverty Action Group said a year ago. People living on income support know what constitutes a healthy diet; they just cannot afford one. A family of four on income support would need to spend pound;61 of their weekly pound;163 to satisfy basic healthy eating guidelines. In fact, they spend about pound;25 a week on food, says the CPAG, and this is often raided to pay bills.

The charity, which backs the Health Education Trust's school nutrition action groups, is campaigning for free school meals for all children who need them, pointing out that only one in five youngsters is eligible, even though one in three lives in poverty. It says that one million are missing out on their only hot meal of the day. The stigma attached to free meals means that every day 350,000 lunches go uneaten. Yet with a little sensitivity the stigma can be eradicated. While some schools make free-meals pupils wait till the paying children have been served, others have introduced swipe cards for everyone.

MINERALS AND VITAMINS

Lack of iron is the most common nutritional disorder in the country, according to research released last year. In inner cities and among certain ethnic groups, about a quarter of toddlers are thought to be deficient.

Teenage girls - about 10 per cent of whom are vegetarian - are also at risk. The UK is not unique. The World Health Organisation says that, globally, lack of iron is one of the top 10 preventable threats to health, with poor water and tobacco.

In the UK, the main causes are a reduction in consumption of red meat and babies being weaned on to cow's milk too early. Iron is needed to produce haemoglobin, a prime component of red blood cells which carry oxygen around the body. Not having enough can cause lethargy, frequent infections, poor weight gain and delayed development and behavioural problems.

Intakes of vitamins A, B and particularly D also need to be watched. The body uses vitamin D to help it lay down calcium for bones, and the main source is sunlight. With outdoor play losing out to the telly, many children have low levels of vitamin D, especially during the winter. Among Asian youngsters, long known to be vulnerable to this deficiency, the bone disease rickets is on the increase. Suspected causes are an early diet of cow's milk and chapati bread, which is not fortified with vitamins, plus the traditional Muslim dress for girls which stops sunlight reaching their skin.

OUT OF THE FRYING PAN

The Conservatives, in addition to abolishing school meal standards, also refused to put cooking on the national curriculum. Food is now taught mainly in design and technology, with the emphasis on the technological aspects of its production. It is a "dire" situation, says Anita Cormac, director of Focus on Food, a campaign run jointly by the Royal Society of Arts and Waitrose to get children cooking (see resources). Launched in 1998, teacher training is a top priority, as are better facilities in schools.

The campaign runs a food week in June - about a third of UK schools took part last year - and owns the popular Cooking Bus. This is equipped to run masterclasses, sometimes with celebrity chefs, for 16 pupils. Teachers report that children are more prepared to try new foods after avisit from the bus, and the high-quality dishes they prepare on board are intended to make them more discriminating. "Children are always amazed when this glittering pantechnicon arrives in the playground," says Anita Cormac, "especially those who don't even realise it is possible to make bread."

DID YOU KNOW?

* Twenty per cent of four to 18-year-olds eat no fruit or vegetables

* The average primary pupil consumes about 30 glasses of soft drinks a week, compared to about 10 of milk

* Ten per cent of pupils have no water drinking facilities at school, while more than half have to put their mouths round a tap in the toilets or drink from cupped hands

* On an average Saturday morning, a child will watch 64 food commercials on TV, most of them for fizzy drinks, sugar-packed cereals and sweets

* Vending machines can earn a large secondary between pound;15,000 and pound;40,000 a year

* The stigma attached to free meals means that every day 350,000 lunches go uneaten in UK schools

Additional research:Tracey Thomas Next week: Dyslexia

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