Section 3 Food and Health
THE CHALLENGE: To use school food and drink and food education to drive dietary change and therefore improve the diets of children and young people. To ensure that school food is an exemplar for healthy eating, and that food education supports children and young people to make the right food choices.
Did you know … soft drinks contribute the most added sugar to the diets of children and young people?
Why this matters
Despite huge strides forward in food education and school food provision over the past few years, particularly the Schools (Health Promotion and Nutrition) (Scotland) Act 2007 and the Nutritional Requirements for Food and Drink in Schools (Scotland) Regulations 2008, the diet of children and young people living in Scotland still falls short of the recommendations for a healthy balanced diet.  The eatwell plate  shows the types and proportions of foods that make up a healthy, balanced diet.
Schools in Scotland have a duty to ensure that they are health-promoting, and that they adopt a whole school approach by integrating health promotion in every aspect of school life. They are ideally placed to make a positive influence on the dietary choices and health of children and young people. By serving exemplary food and drink across the whole school day, and by extending food education to include the wider community, they can play a central role in achieving the Scottish Dietary Goals.  In doing so they can help reduce the unsustainable burden of obesity and serious diet-related conditions like diabetes, heart disease and certain cancers.
Schools can help address health inequalities. Children and young people from low income communities are particularly vulnerable and in Scotland, the prevalence of obesity and overweight is significantly associated with deprivation.  Research shows that children and young people living in the most deprived areas of Scotland eat less fruit and vegetables and consume more sugary foods and drinks than those in the least deprived areas. 
Accessing healthy, affordable food can be a real challenge. For some children and young people, especially those entitled to free school meals, a meal provided in school may be their only nutritious meal of the day.
Did you know … children aged two to 15 consumed an average of 2.7 portions of fruit and vegetables per day in 2012, compared to the recommended five portions?
Meeting the standards
The Regulations covering the nutritional requirements for food and drink in schools in Scotland, as well as associated guidance, are clearly and helpfully set out in Healthy Eating in Schools.  This details the food and nutrient standards and provides additional guidance for achieving the standards for school meal provision. It covers the provision outwith the school meal period, including breakfast services, tuck shops, morning and afternoon break services, vending, community cafes and after school clubs.
The Regulations and guidance, which are based on science and evidence, are set with the overall aim of improving the diet of Scotland's children and young people. By following the Regulations and guidance for all school food and drink, schools reduce the amount of high fat, high sugar and salty foods consumed on school premises and encourage consumption of food such as fruits, vegetables, oily fish and whole grain foods required for a healthy, balanced diet as illustrated by the eatwell plate.
What training is in place to support all staff's understanding of relevant aspects of food and health, including the requirements of the Schools Health Promotion and Nutrition Act?
Provision of drinking water and drink standards
The importance of hydration should not be overlooked. Access to free drinking water is important and the Act requires 'that drinking water is made available for every pupil, free of charge'. Consumption of water should be encouraged. It is interesting that research showed that more than 60 percent of children and young people buying lunch outwith school chose water as their lunchtime drink, most days or every day. 
Drinks standards, which restrict the provision of sugary drinks for example, are clearly set out in Healthy Eating in Schools. Sugar intake amongst children and young people is of particular concern with consumption of soft drinks and confectionary contributing 16 percent to a child's recommended daily intake of sugar. 
Did you know … oily fish must be served in schools at least once every three weeks?
Helping children and young people to make the best food and drink choices
The Regulations allow for a healthy diet and while certain foods and drinks are restricted, children and young people still need to make their own choices from the food and drink on offer. They need to develop an understanding of the importance of healthy food choices - this becomes even more important when they buy lunch outside of school. Curriculum for Excellence provides many opportunities for children and young people to learn about food and health in a wide variety of interesting and cross-curricular ways and is central to developing an understanding about food and health. See Section 4: Food and Learning for some inspiring examples.
Providing food that meets the Regulations and ensuring that children and young people have a sound understanding of the importance of making good dietary choices can only go so far to changing their behaviour. In order to compete with the high street, schools need to consistently offer food that is attractive, tasty and good value, and a dining experience which meets their expectations. Section 5: School Food and Drink Provision and Section 6: The Dining Experience cover these issues in more detail.
This document is supported by a number of other measures aimed at improving the food choices made by children and young people, and therefore improving their health. These include work to support partners to positively influence the wider food environment Beyond the School Gate and a framework for voluntary action to support healthy choices.
What steps have you taken to encourage children and young people to try more healthy, fresh and in-season foods, in and out of school?
Health improvement is a key aim of the Scottish Government and continues to provide challenges when it comes to changing behaviour of the wider Scottish population. It is clear that a range of organisations and partners have an interest in improving health, such as the NHS, local authorities, community and third sector partners, although the connections are not always clear as services can be structured differently and responsibilities shared across organisations. It is important for schools and catering services, and others interested in promoting health improvement, to find such connections within their local area, to consider how they can contribute jointly to the shared aims expressed in this document. Public health, GP surgeries, hospital services, leisure and cultural services, environmental health and licencing services and planning, roads and transport departments in local authorities can all support schools and catering services improve the experiences and opportunities for children to promote healthier choices in school.
Did you know … it is advisable to limit fruit juice to mealtimes? When fruit is juiced or blended, sugars are released from the cells of the fruit which can cause damage to teeth.
One local authority's partnership approach to a school based healthy weight programme: High 5 Health & Wellbeing Programme
High 5 is an innovative and flexible health & wellbeing programme, delivered over 8 sessions, by primary school teachers. It was developed through a partnership approach between Education Service teachers and NHS health improvement staff. It contributes to national targets for 'Child healthy weight interventions' but involves the whole class.
High 5 contributes to food literacy, physical literacy and emotional literacy. As such, it changes not only what pupils know about nutrition, but how they feel about food. It also helps to develop critical consumer skills so that pupils are more resilient to the potentially harmful influences of the media, such as food marketing and the fashion industry. Teachers receive CPD sessions in how to run the programme, facilitated by local health improvement specialists. The programme involves school cooks in classroom learning through food tasting sessions linked to specific lesson plans; discussions between the cook and pupils; and a meal evaluation tool called 'Rising Stars' that allows pupils to compare and contrast the nutritional value of school meals with packed lunches.
By March 2014, 9,900 children will have participated in the High 5 programme which will be embedded as part of schools' planning within Curriculum for Excellence to ensure that it continues to impact positively on pupils' health and wellbeing.
How is responsibility and accountability for food and health in school shared between relevant parties?
Food education and partnership working across a community
One primary school is working to create a café driven by sustainable, healthy choices that will operate as a fully functioning business owned and managed by the children, and open to all classes and parent groups. The project is aiming to: develop knowledge of sustainable food choices; encourage lasting changes to lifestyle; ensure parental involvement; and establish partnership links with, for example, the Royal Highland Education Trust ( RHET), community education partners and a local college. By firmly embedding food and education and health and wellbeing links across the curriculum using interdisciplinary learning in a meaningful contextualised environment, the café, and its kitchen, will aim to equip children with skills for learning, life and work. By demonstrating how the café could be sustained beyond the funding period, the project received support from the Food for Thought: Education Fund, a partnership between Scottish Government, Education Scotland and Scottish Business in the Community.
Email: Lynne Carter, firstname.lastname@example.org