UK school meals: no better
According to the UK National Diet and Nutrition SurveyReference Gregory, Lowe, Bates, Prentice, Jackson and Smithers1, in 1997 the contribution to the daily intake of energy and several nutrients from school lunch was around 25–30% of the total. This has meant a great deal to the three million schoolchildren in England who eat in school. Recent years have seen attempts to change the British school meals towards healthier options. From the paper in the present issue by Nelson et al. Reference Nelson, Lowes and Hwang2, it is evident that school lunch choices are now less healthy than what is eaten outside school. Apparently, we cannot expect children to do healthy choices over ‘tasty’ choices or well-known choices.
The authors conclude that limiting the range of foods to healthier options is probably essential to achieving better dietary intake among schoolchildren. But a firmer grip on what is served may lead to fewer children actually eating in school. A delicate dilemma indeed. We look forward to more results from the Nutrition Group of the UK School Meals Review Panel.
Fruit and vegetables: knowledge helps
Some suggestions on how to improve fruit and vegetable consumption are found in three other papers in this issue. The paper by Ashfield-Watt et al. Reference Ashfield-Watt, Welch, Godward and Bingham3 describes how the success of community interventions on fruit and vegetable intakes is highly predicted by other habits, such as smoking. This community intervention points out awareness of the optimal intake of fruit and vegetables as one important factor for increased intake in a community intervention.
Another factor is of course availability. The paper by Jago et al. Reference Jago, Baranowski and Baranowski4 again reveals fruit and vegetable availability being a key proximal determinant of consumption. However, Watters et al. Reference Watters, Satia and Galanko5 point to the need to focus on predisposing factors, such as knowledge, self-efficacy and attitudes.
Breastmilk substitutes: breaking the code
One-third of investigated community health-care facilitiesReference McInnes, Wright, Haq and McGranachan6 in the Glasgow area were still in 2005 displaying materials that did not comply with the World Health Organization's International Code of Marketing of Breast-milk Substitutes7. This is a disturbing finding. The experience in Sweden is that reported violations of the Code rarely lead to action from the authorities.
Renfrew and colleagues, in a critique of the evidence base of interventions to promote and support breastfeeding, conclude that more research is needed, especially on policy and practices in the UKReference Renfrew, Spiby, D'Souza, Wallace, Dyson and McCormick8.
