School lunch menus and 11 to 12 year old childrenʹs food choice in three secondary schools in England—are the nutritional standards being met?

Objectives To determine if the lunchtime food provided to schoolchildren adheres to nutritional standards and to examine the influence of childrenʹs food choice on nutrient intake at lunchtime. Subjects/setting Seventy-four children aged 11–12 years were recruited from three secondary schools. The school populations spanned a spectrum of socio-economic deprivation. Lunchtime food and nutrient intake was assessed over a 5 day period. Design Cross-sectional study of menu composition and childrenʹs food choice in relation to nutrient intake. Methods Dietary recording was by an indirect weighing method of menu composition and nutrient intake over a 5 day period. Statistical analysis was carried out using general linear modelling techniques including: t-test, one-way ANOVA and ANCOVA. Results One school met the standards on food group provision. Intakes of total fat, saturated fatty acids and monounsaturated fatty acids were greater in boys. Intake of folate was greater in girls. There were between-school differences (independent of gender) for intake of fatty acids, starch, calcium and folate, with socio-economic deprivation associated with a lesser nutrient intake. Children could have chosen meals higher in calcium, iron, folate and zinc and lower in starch and fat, from the extensive cafeteria menu of between 26 and 42 food. For some nutrients, providing ‘healthier’ food influences intake of those nutrients whilst for other nutrients, childrenʹs food choice predominates. The majority of children did not meet the recommended targets for lunchtime nutrient intake, especially for micronutrients. Conclusions Food provision in two out of three schools did not meet government guidelines and socio-economic deprivation was associated with worse food provision. Children from deprived areas were more likely to choose those foods of limited nutritional value than those from more privileged backgrounds. The statutory nutritional standards on their own, without a pricing policy to encourage healthier food choice or restrictions in food choice towards less healthy food are unlikely to catalyse the dietary changes that are so needed to ensure improved nutrient intakes amongst schoolchildren in England.