%0 Journal Article
%T The Impact of Food and Nutrient-Based Standards on Primary School Children¡¯s Lunch and Total Dietary Intake: A Natural Experimental Evaluation of Government Policy in England
%A Suzanne Spence
%A Jennifer Delve
%A Elaine Stamp
%A John N. S. Matthews
%A Martin White
%A Ashley J. Adamson
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0078298
%X In 2005, the nutritional content of children¡¯s school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children¡¯s total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4¨C7 years (n = 385 in 2003¨C4; n = 632 in 2008¨C9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children¡¯s mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change £¿128 mg, 95% CI: £¿183 to £¿73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (£¿1.8%, £¿2.8 to £¿0.9) and saturated fat (£¿1.0%; £¿1.6 to £¿0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 ¦Ìg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children¡¯s total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children¡¯s diet.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078298