Eating for Health: a Diet Action Plan for Scotland

SCHOOLS

6.23 Because of their role in shaping the habits and behaviour of pupils, schools are in a unique position to encourage and facilitate healthy eating. However, the efforts of schools to encourage pupils to adopt a healthy balanced diet will be undermined if parents do not seek similarly to ensure that their children eat sensibly. Parents, therefore, have a key role in stimulating their children's interest in, and awareness of, the need for healthy eating and in reinforcing the work undertaken by schools in this. School Boards also have an important contribution to make in this area and the Group considers that the attention of Boards should be drawn to their locus in promoting healthy eating and to the Action Plan. The "partnership" approach is reflected too in the structure of the School Nutrition Action Groups discussed in paragraph 6.31. Parents' active participation in these Groups is vital.

6.24 Health education is a recognised part of the school curriculum and there is substantial national advice to schools about health education and promotion. A number of education authorities have produced guidelines to help schools develop effective practice in line with the national advice provided by The Scottish Office Education and Industry Department and the Health Education Board for Scotland. It may also be helpful to education authorities and self governing and independent schools to have available to them the advisory material produced by the Guidelines for Educational Materials Project Team of the Nutrition Task Force in England and, in due course, the proposed guidelines which the Group recommends should be commissioned by the Health Education Board for Scotland (see paragraph 10.5).

6.25 Provision is made for the principles of healthy eating to be taught as part of wider health education and promotion throughout the entire period of education - in pre-school establishments where children are introduced to the very basic aspects of healthy eating; in primary schools as part of environmental studies; and in secondary schools as part of personal and social education, in home economics and science programmes and through specific health studies courses. The home economics programmes have a particularly vital role to play in promoting healthy eating among young people and in the prevention of diet-related disease, since the courses teach pupils to apply their knowledge about healthy eating to food preparation and provide opportunities for them to evaluate their own eating patterns and to consider ways of improving these. In the first 2 years of secondary education (S1/S2) home economics is part of the core curriculum. From S3/S4 onwards, however, it is optional and the lessons learned in earlier years about practical food preparation for healthy eating can be diminished with the passage of time. The Group considers, therefore, that there is a need to maintain this focus on healthy eating and that a short course on practical food preparation should be introduced for all pupils post S2.

6.26 The Group established that, despite this seemingly comprehensive framework and the increasing involvement of school nurses in health education and promotion, the delivery of health education in Scotland is patchy, possibly because of insufficient pre-service training for teachers in this topic, lack of the up-to-date knowledge necessary for effective teaching of healthy eating, and the pressures of an already very full curriculum. There is a need, therefore, for all staff involved in health education to receive appropriate training in nutrition and diet. It should be noted, however, that The Scottish Office Education and Industry Department guidelines on environmental studies (which include health education), published in March 1993, are still in the process of implementation and come towards the end of the programme for 5 to 14 year olds, due for completion in 1999. It is to be hoped, therefore, that the guidelines will eventually make a positive contribution to the delivery and effectiveness of health education in our schools.

6.27 While pupils generally have a reasonable understanding of healthy eating, they are far less effective in applying that knowledge in practice and sustaining healthy eating patterns. They are easily influenced by other forces such as advertising and role models. Glaring inconsistency also exists between some schools' dietary aims and policies and their actual practices, in particular where school meals provision does not offer healthy choices and tuck shops and vending machines supply unhealthy products high in fat, salt, and sugar. The aim must be for all schools, both primary and secondary, to provide high quality food which is attractive to children and which results in consistent nutritious balanced meals and snacks.

6.28 Better school meals could be secured through the contracting process which accompanies competitive tendering. The Group considers that this avenue offers particular scope for achieving a real improvement in their nutritional quality. To help with this, the Group devised a set of model guidelines for catering specifications which can be taken into account when determining contract specifications for, inter alia, school meals provision. The Model Nutritional Guidelines for Catering Specifications for the Public Sector in Scotland are reproduced in the Annex to this Section of the Report. The Guidelines also have potential application elsewhere within the public sector, and more widely, and are discussed further in Sections 7, 9 and 10 of the Action Plan.

6.29 The provision of meals in primary schools requires particular attention because children at this age need early training in good dietary practices. The provision, at all meals, of a limited range of menus with vegetables and fruit included in the price of the meals should be explored as a matter of priority as this approach has proven successful in other countries in changing and improving children's dietary habits.

6.30 The Group welcomes the variety of initiatives which is now beginning to be introduced by schools. These must be continued and extended. Such activities include breakfast clubs, healthy eating vending machines and smart card systems for school meals such as that operated by Highland Council. This last initiative encourages pupils at Highland schools to eat sensibly by utilising hi-tech electronic smart cards and rewards pupils choosing a balanced meal with bonus points which can be turned into free sports activities, donations to charity or contributions to their schools' budgets. Some 14,000 school children in Highland already participate in the scheme and the potential for innovative and imaginative schemes of this kind is obvious.

6.31 Schools may also find it useful to set up School Nutrition Action Groups. These are multi-disciplinary groups, involving pupil and catering representatives in addition to parents and school management, established within a school to tackle food related education and health issues. They help schools deal with topics such as "healthy" tuckshops, "unhealthy" food choices made by pupils and breakfast provision. Appendix 4 of the Model Nutritional Guidelines describes more fully the functions of these Groups.

6.32 The dietary needs of children in schools in areas of low income are particularly important. A partnership approach, under the health alliance arrangements, involving the Health Boards, local authorities and community action could facilitate dietary promotions and initiatives within schools. Such activity might best be initiated by the Directors of Public Health in each of the Health Boards.

6.33 It is clear, therefore, that while the concept of schools having a direct role in promoting healthy lifestyles is accepted as a general principle (and some good work is beginning to flow from this) schools' potential contribution to achievement of the dietary targets will be prejudiced unless action is undertaken now in those areas where the difficulties appear to be most acute.

Action Points

The Scottish Office Education and Industry Department and local authorities should continue working to raise the profile of health education within the curriculum. The Department should vigorously encourage development of policies on health education, including nutrition and diet, and the progression of these through school development plans. These should be monitored, evaluated and reported upon by local authorities through their quality assurance procedures and by The Scottish Office Education and Industry Department through HM Inspectors of Schools.
The Scottish Office Education and Industry Department should draw the attention of School Board chairpersons to the Action Plan, its targets and the benefits sought for children's health. The Scottish Office Education and Industry Department should also utilise the School Boards' News as a vehicle for developing dietary awareness within schools.
The Scottish Office Education and Industry Department should consider distributing to education authorities, self governing and independent schools the advisory material produced by the Guidelines for Educational Materials Project Team of the Nutrition Task Force in England and such guidelines as the Health Education Board for Scotland prepare to assist production of consistent dietary and nutritional materials.
The Scottish Consultative Council on the Curriculum, working with The Scottish Office Education and Industry Department, should introduce a short course on practical food preparation for healthy eating for all pupils post S2. This course should be supported by nationally produced materials and resources.
Local authority education departments should ensure that all staff involved in health education receive appropriate training in nutrition and diet.
The Scottish Office Education and Industry Department should ensure that all trainee teachers receive adequate training in health education, including nutrition and diet, appropriate to their course.
The Scottish Office Education and Industry Department should distribute and commend to education authorities and self-governing and independent schools The Model Nutritional Guidelines for Catering Specifications for the Public Sector in Scotland which can be taken into account when determining contract specifications for school meals.
In relation to meals provision in primary schools, the opportunity to provide, at all meals, a limited range of menus with vegetables and fruit included in the price of the meals should be explored as a matter of priority.
Schools should take steps to ensure that tuck shops and school vending machines re-inforce the health promotion and health education messages of the school by providing a range of healthy food choices. HM Inspectors of Schools should include the monitoring of the provision by both in their inspections of health promotion and health education and publish their findings in inspection reports.
Schools should be encouraged to set up School Nutrition Action Groups which offer a multi-agency approach to tackle food-related education and health issues.
Health Boards should explore the potential for partnership arrangements to facilitate the introduction of healthy eating initiatives tailored specifically to the dietary needs of children in schools in low income areas. Such action should integrate with the initiatives proposed to assist low income communities in Section 5 of the Action Plan.