Nutrition in Schools: Scottish Nutrient Standards for School Lunches

SECTION 2: PRACTICAL GUIDANCE FOR SCHOOLS AND CATERERS

Eating for Health
What Does This Mean for Caterers?
Menu Planning by Food Group
Recommended Portion Sizes
Sources of Caclium, Folate and Iron

Eating for Health

2.1 The Health Education Board for Scotland developedEating for Healthas a model for healthy eating in Scotland in 1996.
It is nationally recognised and widely used by the food and catering industries as well as by health professionals, teachers and individual consumers, as a guide to the contents of a balanced meal or diet. In England the equivalent model, the Balance of Good Health, was developed in 1994 by the Health Local authority, Department of Health and Ministry of Agriculture, Fisheries and Food.

2.2 Eating for Health shows the proportion of the overall diet that should come from each of the five food groups in order to provide enough of the important nutrients (such as vitamins, minerals and protein) and fibre without too much fat (especially saturates) and sugar. The five food groups are:

bread, other cereals and potatoes
fruit and vegetables
milk and dairy foods
meat, fish and alternatives
foods high in fat, foods and drinks high in sugar.

2.3 Foods in each group provide a similar range of nutrients. For most people:

a third of total food intake should be made up of starchy foods (e.g. bread, pasta, rice and potatoes). These foods should make up a main part of a meal
a further third should be made up from fruit and vegetables. People should aim to eat at least five portions of a variety of fruit and vegetables each day
meat, fish and alternatives (e.g. eggs, nuts, pulses, soya products) and milk and dairy foods provide concentrated sources of essential nutrients. So, only moderate amounts need to be eaten
foods containing a large amount of fat or sugar should make up a relatively small proportion of the total food and drink consumed.

2.4 The model applies to catering for most people over the 5 years of age, including those who are overweight, vegetarians and people of all ethnic groups. Children under 5 years of age need to learn to eat healthily, but too much emphasis on cutting down fat intake and increasing the amount of fibre eaten is inappropriate for this age group - it can result in a bulky diet and children may not be able to eat sufficient amounts of food to meet their energy and nutrient needs. By around 5 years of age children should be progressing towards a diet based on the principles of Eating for Health.

What Does This Mean for Caterers?

2.5 Eating for Health is a useful tool for caterers in menu planning as it shows the overall balance that should be aimed for in the lunches served. Dishes or meals usually contain foods from more than one of the five food groups. Eating for Health can be applied by identifying the main food items or ingredients in the composite dish or meal and thinking about how these fit in with the proportions suggested and by altering the proportions, e.g. serving slightly smaller portions of the main dishes with extra fruit, vegetables or bread. Whatever the type of catering provided, the principles of balance and variety apply.

2.6 Healthier catering for children means:

offering child-size portions of a variety of meals, not just a range of fried favourites
offering foods from the food groups:
fruit and vegetables
meat, fish and alternatives
bread, cereals and potatoes
milk and dairy foods
limiting fat-rich foods such as sausages, burgers, pies, crisps, chips or other fried food
for young children, offering small fruits and yoghurts which are usually popular
not offering too many sugar-rich foods and drinks
offering milk, unsweetened fruit juice and water
limiting the amount of salt added to foods.

Choosing Healthier Ingredients

2.7 The choice of commodities can have a significant effect on the nutritional content and the balance of meals and foodstuffs. Many suppliers have responded to the increasing demand for healthier ingredients, which are now easier to find. Pre-prepared products are available that can be cooked by one of three methods - oven bake, grill, shallow/deep fry. Labels should be checked on pre-prepared dishes to look for lower fat and salt varieties.

Reducing the Fat Content

2.8 Whilst the choice of ingredients is very important, several cooking methods and preparation techniques can be used to reduce the fat content of dishes.

2.9 Easy ways to cut down on fat in food preparation include:

trimming visible fat from meat
removing the skin and fat from poultry before cooking or serving (except for roasts)
preparing lower fat vinaigrette dressings.

2.10 'Healthier' cooking practices to reduce fat include:

routinely grilling, steaming, stir-frying or oven baking rather than frying or roasting with added fat
using spray oils
dry frying or dry roasting spices
skimming fat from the surfaces of liquids, including gravy, before serving
sweating onions in cling film (microwaveable) in a microwave instead of sautéing them in oil
avoiding letting food sit in fat when roasting or oven cooking by roasting on a rack or trivet and grilling on a rack rather than a flat oven tray
creating soups and sauces from puréed vegetables or reductions instead of roux thickenings
not enriching with butter
using a thin batter for fish or oven baking pre-coated products
using a whisked sponge method or mix for puddings instead of the creamed method
not tossing items (e.g. pasta) in butter but using a small amount of oil to prevent bulk quantities from sticking.

2.11 In summary, the key to healthier catering is to:

make small but significant changes to best- selling items
increase the amount of starchy foods
increase the amount of fruit and vegetables
increase the fibre content of dishes where practical and acceptable
reduce fat in traditional recipes
change the type of fat used
select healthier ways to prepare dishes
be moderate in the use of sugar and salt.

2.12 Key actions to achieve these goals are to:

make starchy foods (e.g. rice, pasta, bread, potatoes) a main part of most meals
offer a good selection of fruit and incorporate it into dishes, where practical and acceptable
offer fibre-rich varieties of bread and cereals
include plenty of pulses and vegetables in dishes
use lower fat cooking methods and ingredients
reduce the amount, and alter the types, of fat used in food preparation
use fewer fats that contain a high proportion of saturates by substituting these with fats and oils with a high content of unsaturates, where possible
use salt and salty foods in moderation
use added sugar in moderation.

(Adapted from Catering for Health produced by the Food Standards Agency Scotland and the Scottish Executive Health Department.)

Menu Planning by Food Group

Group 1 (Bread, other and Cereals and Potatoes)	Guidance for Primary and Secondary Schools	Supplementary Guidance for Secondary Schools	Rationale
Bread, other Cereals and Potatoes	Every school lunch should contain a portion or portions of food from this group.		Starchy foods are usually inexpensive and provide energy, fibre, vitamins and minerals. Children should be encouraged to fill up on these foods. Portions should be large enough to satisfy young appetites. See Section 2.13 on portion sizes.
Bread	A variety of extra bread, including brown and wholemeal, should be available daily as a meal accompaniment for all pupils, at no additional charge. Crusty bread, quarters of bread rolls and buns are popular and can be offered in baskets at the counter.		Provides for the varying appetites and energy requirements within this wide age group.
	Garlic bread should be served a maximum of twice a week.		Limiting high fat options will help to reduce the total amount of fat in the menu.
	Bread can be provided in a variety of forms to replace fried products including naan, pitta and crusty bread.		This is to provide variety and alternatives to fried potatoes.
	The maximum sodium content of bread will be specified in the product specifications.		Bread contributes significant amounts of sodium to the diet. Setting this sodium restriction will contribute to UK-wide reduction of sodium in bread.
Rice, Pasta and Noodles	Rice and pasta should each be offered a minimum of once a week. Noodles should be offered where appropriate, e.g. with stir-fry or sweet-and-sour dishes.		This is to provide variety and alternatives to fried potatoes.
Potatoes	The following products should be served a maximum of twice a week in primary (and ideally in secondary) schools: roasts, chips, smiley faces and other shaped products, e.g. Alphabites, croquettes and waffles.	It is recognised that chips will continue to be available each day in some secondary schools, but these schools are encouraged to work towards the primary school standards. However, non- fried alternatives to chips, e.g. mashed, boiled and baked potatoes should be available daily and actively promoted.	Limiting fried and high fat options helps to reduce the total amount of fat in the menu. While trying to influence choice, with the prevalence of the cash cafeteria system in many secondary schools, it is recognised that limiting the availability of chips in some secondary schools to twice a week may be unrealistic at present.
	Local Authority Purchasing Officers should be encouraged to buy chips with as low fat content as possible.
	The maximum fat content of potato products will be specified in the product specifications. If possible, all potato products should be oven baked rather than fried.		Children selecting fried options from the menu more than twice a week are likely to exceed the nutrient standard for total fat. Menu planners may therefore find fried food, including chips, can appear on the menu no more than twice per week.
	Where a fried item is offered, a non-fried alternative should also be offered.		Providing alternatives to fried potatoes is the first step to achieving the nutrient standard for fat.

Group 2 (Fruits and Vegetables)	Guidance for Primary and Secondary Schools	Supplementary Guidance for Secondary Schools	Rationale
Fresh, Frozen, Canned and Dried Varieties and Fruit Juice	Every school lunch whether hot, cold, or a packed lunch should contain two portions of food from this group.		Fruit, vegetables and salads provide vitamins, minerals and fibre and experts recommend five portions of fruit and vegetables a day.
	The menu as a whole should provide a choice of at least 2 vegetables and2 fruits in addition to fruit juice every day and throughout the lunch service. At least one of these vegetables should be served free of added fat including salad dressings.		Habitually low consumption of fruits and vegetables remains one of the most damaging features of the Scottish diet.
Vegetables	Fruit and vegetable choices should be actively promoted and consideration given to providing vegetables inclusively in the price of every meal. They should also be served in an appealing and easy to eat way.		A child may be put off choosing vegetables if they have to pay extra for them. Children often enjoy cold and raw vegetables best and salad and fruit bars are also popular.
	Vegetable-based soup should contain a minimum of one portion of vegetables per serving and can then count as one portion. Maximum sodium content of soup will be specified in product specifications.		Soup is a good vehicle for vegetables, popular with many children. It is understood that some schools currently prohibit the serving of soup because of concerns about scalding. Practical solutions to operational issues arising from health and safety concerns should be found so that children are not denied this route to increasing their vegetable intakes.
	Baked beans should be served as a vegetable a maximum of twice a week. Canned spaghetti and similar products should not be served in place of a vegetable.		Unlike most vegetables, baked beans do not contain Vitamin C. Processed tomato sauce should not be counted as a vegetable portion.
	If beans or pulses form the protein part of a main course, a vegetable that is not beans or pulses should also be available.		This increases the variety for the vegetarian option.
Fruit	Where there is choice, a dessert which provides at least one portion of fruit should be offered every day. Where there is no choice, a fruit-based dessert such as fresh fruit, fruit tinned in juice, fruit salads, fruit crumble, fruit jelly or fruit pie should appear on the menu a minimum of three times a week. Pies, crumbles and other composite fruit dishes should contain a minimum of one portion of fruit per serving.		This increases the fruit content of the lunch.

Group 3 (Milk and Milk Products)	Guidance for Primary and Secondary Schools	Supplementary Guidance for Secondary Schools	Rationale
Milk and Milk Products, Yoghurts and Milk-based Desserts	Most school lunches should contain a portion or portions of food from this group.		Milk and milk products are an excellent source of several nutrients including protein, vitamins and calcium, important for good bone development.
Milk	Plain or flavoured drinking milk should be available as an option every day. Semi-skimmed and skimmed milks have the same amount of calcium as whole milk and should be provided for drinking as well as for cooking.		Milk is a good alternative to sugary fizzy drinks and semi-skimmed milk provides less fat. The use of semi-skimmed milk is in line with existing recommendations, e.g. the Scottish Diet Action Plan.
Cheese	Cheese should be served as the main protein item instead of meat or fish a maximum of twice a week.		Where a portion of cheese is served as the main protein item, it also counts as a portion of food from the meat, fish and alternative sources of protein food group, but can be higher in fat than other products in this group.
	Cheese to be served as cheese and biscuits, as part of a salad or as a filling for sandwiches and baked potatoes should have as low a fat and sodium content as possible. The maximum fat and sodium content of cheese will be specified in the product specifications.		Cheese is a high fat food and the product specification will help to reduce the total amount of fat in the menu.
	Vegetarian alternatives to cheese should be available a minimum of three times a week.		This provides variety for vegetarians.
	Where there is no choice, cheese as a sandwich filler should be offered a maximum of three times a week.		This provides variety and reduces fat intake.

Group 4 (Meat, Fish and Alternatives)	Guidance for Primary and Secondary Schools	Supplementary Guidance for Secondary Schools	Rationale
Meat, Fish and Alternatives, e.g. Eggs, Peas, Beans and Lentils	Every school lunch should contain a portion or portions of food from this group.		Meat, fish and alternatives such as eggs, beans and pulses are a major source of protein.
Beef, Pork, Lamb and Poultry	Red meat (beef, pork and lamb) based meals should be served a minimum of twice a week.		Red meat is a good source of iron.
	Lean meat should be used in dishes containing meat and this will have a fat content of about 10%. Caterers should take steps to reduce the fat content of their meat dishes as much as possible.		This will help to improve the quality of meat used in recipes whilst reducing the overall fat intake.
	The maximum fat and sodium content of stews, casseroles, meatballs and curries will be specified in the product specifications.		The product specifications will help meet nutritional standards.
Processed Meat Products and Pies	Processed meat products, i.e. hot dogs, frankfurters, sausages, beefburgers, meatballs, haggis and shaped poultry products(e.g. nuggets), pastry topped pies and other pastry products (e.g. bridies, sausage rolls, Cornish pasties, Scotch Pies) should be served a maximum of once a week. The vegetable content of composite dishes such as pies should be increased where possible. Potato-topped pies will have a lower fat content and should be encouraged in preference to pastry-topped pies.		Overall, meals should provide no more than 35% total energy from fat therefore inclusion of high fat dishes should be limited. Processed meat products are likely to be high in fat. If manufacturers can produce a suitable range of lower fat products this recommendation may be reviewed as part of the ongoing process of establishing product specifications.
Composite Dishes	The maximum fat and sodium content of lasagne, moussaka, macaroni cheese, spaghetti bolognese, tuna pasta bake, ravioli and other composite dishes will be specified in the product specifications. Vegetable content should be increased where possible.		Product specifications will help meet nutritional standards.
Fish	Fish, in addition to tuna fish, should appear on the menu a minimum of once a week.		This will provide variety in the menu.
Fish	Oil-rich fish (sild, sardines, kippers, salmon, mackerel and herring) should be served once a week. Mackerel salads and pâtés are often popular.		Oil-rich fish contain valuable, protective fatty acids that are deficient in the Scottish diet and their use should be encouraged. Many children are unfamiliar with these foods and should be encouraged to try them through the use of tasters.
Processed Fish Products	The maximum fat and sodium content of fish portions, fish fingers and shaped fish products will be specified in the product specifications. Any fish products that do not meet these specifications should be served a maximum of once a week.		Overall, meals should provide no more than 35% total energy from fat therefore inclusion of high fat dishes should be limited. Fish should be presented in a form that children will eat.
Pizza	Maximum fat and sodium content for pizza will be specified in the product specifications and its frequency on the menu determined by its ultimate specification. Vegetable toppings should be encouraged and used wherever possible.		Pizza is often higher in fat than many other composite dishes.
Vegetarian Products	Vegetarian products resembling meat products, e.g. sausages and burgers made from textured vegetable protein (TVP) should have a similar protein content to meat products. Maximum fat and sodium content will be specified in the product specifications.		These products will be the main source of protein for vegetarians and must therefore be available in a sufficient quantity in any meat replacements. Vegetarian products should meet the same specifications for fat as processed meat products.
Stir-in Sauce	Maximum fat and sodium content will be specified in the product specifications for stir-in sauces for bolognese, stews, curries and other ethnic dishes.		Limiting the fat and sodium content of these products will help in achieving the nutrient standards.

Group 5 (Foods containing Fat and Foods and Drinks containing Sugar)	Guidance for Primary and Secondary Schools	Supplementary Guidance for Secondary Schools	Rationale
Foods containing Fat and Foods containing Sugar	The use of foods from this group should be limited. There should be no active promotion or advertising of full fat crisps, confectionery or fizzy, sugary soft drinks within the dining room.		Foods from this category are consumed to excess by Scottish children, providing excess fat, sugar and salt in the diet.
Sweetened Soft Drinks	Fizzy, sugary soft drinks should not be served as part of school lunch in primary schools and should not be encouraged in secondary schools. Carbonated water, plain water, milk and fruit juices are considered appropriate drinks. Flavoured waters are popular with children and low sugar versions are acceptable. There is a desirability to gradually wean Scottish children away from a predilection for sweet flavours. There is a popular movement amongst children to drinking plain water and this should be encouraged.	It is recognised that sweetened soft drinks will be available each day in some secondary schools. However, they should not be served as part of a combination meal or meal deal or packed lunch. These schools may find that a staged progression from sugary fizzy drinks to diet versions and the promotion of lower sugar squashes and flavoured waters is helpful. The promotion of chilled bottled water as well as the adequate provision of freely available drinking water is considered very important.	To achieve the nutrient standard for sugar and for the protection of dental health, it is considered that there is no place for sugary, carbonated (fizzy) drinks as part of school lunches.
Confectionery, e.g. Chocolate, Sweets	Where confectionery is still being sold, it should be set away from the food service points. A working distinction is made between manufactured confectionery and home baking.		This will discourage purchase as part of a meal and help to achieve the nutrient standard for sugar and for the protection of dental health.
Puddings, Cakes, Biscuits, Jam, Jelly and Ice Cream	Where there is no choice, all desserts on offer should be fruit and/or milk-based(including yoghurt). Caterers are, however, encouraged to review home-baking recipes to lower fats and sugars and include nutrient-rich, whole- food ingredients.		Desserts and puddings are a useful way of boosting the total energy in children's diets while providing important nutrients. They can also help to increase fruit intake. Specifications will help to lower fat intake.
Butter and Spreads	Only polyunsaturated and monounsaturated fats, spreads and oils and low fat spreads should be used.		This will contribute to a reduction in the fat intake in line with the Scottish Diet Action Plan targets. As part of a healthy diet, it is also important to reduce the amount of replacing saturated fats eaten, by them with unsaturated fats(with an emphasis on monounsaturates).
Cooking Fats and Oils	Only polyunsaturated and monounsaturated fats, spreads and oils should be used.
Savoury Potato Snacks, Crisps and Corn Snacks	Crisps should be offered as part of a combination meal option/meal deal or packed lunch a maximum of twice a week. Many pack sizes are too large and the fat content per 100g is excessive. The maximum pack size, fat and sodium content will be specified in the product specifications.		Crisps are commonly consumed throughout the day, e.g. at break times and eating multiple packets should not be encouraged.

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