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Nutrition in Schools: Scottish Nutrient Standards for School Lunches

SECTION 1: SCOTTISH NUTRIENT STANDARDS FOR SCHOOL LUNCHES

Introduction
Achieving the Nutrient Standards
Drinking Water
Food and Drink Choices
Special Diets and Allergies
Children and Young People with Special Needs
Minority Ethnic Communities and Special Religious Dietary Requirements
Scottish Nutrient Standards for School Lunches

Introduction

1.1 Diet in childhood plays an essential role in growth and development, current well-being, educational performance and avoidance of chronic disease throughout life. Current knowledge on optimal diet for children is set out in the Dietary Reference Values Report (1991) and it is this report that forms the scientific basis for the design of the Scottish Nutrient Standards.

1.2 The proportion of the daily nutrient provision that should be achieved from a single daily lunch has been extensively reviewed by the Caroline Walker Trust Expert Working Group on School Meals (1992), the outcome of which were the Nutritional Guidelines for School Meals. These Guidelines cover the nutrients and micronutrients (vitamins and minerals) currently of most concern in school children's diets and remain largely appropriate for calculating the nutrient standards for Scottish school children. These Guidelines were therefore adopted as the basis of the recommended nutrient standards. In addition, the following view was taken:

• fruits and vegetables should be considered as part of the nutrient standards, with around 30% being supplied by school lunch (World Health Organization Recommendations on Diet, Nutrition and the Prevention of Chronic Disease 1990)
• sodium provision should be no more than 30% of the Dietary Reference Value (SACN, DoH, in print 2002).

1.3 It is recognised that the consumption of a diet based on bread, cereals and other starchy foods, fruits and vegetables, and low amounts of fat, sugar and salty foods is a fundamental consideration in catering provision. The provision of food and drink, which meets these nutritional standards, is a key part of achieving a healthy dietary intake, but it is recognised that food provides considerably more than biological requirements. To perceive school food only in terms of nutrient delivery would be a missed opportunity for the development of social and life skills and for culinary richness.

Achieving the Nutrient Standards

1.4 Nutrient standards can be achieved in a variety of ways which will involve consideration of menu planning (the composition of recipes used, the cooking and serving process), the product specification of individual food items, portion sizes and the frequency with which nutrient-dense foods are served during the school week. The Scottish Executive is commissioning the development of nutritional analysis software that will assist in the self-evaluation of nutrient standards. Section 3 of this guidance will be provided as soon as the software becomes available. It is also important that good practice in menu design and food provision which demonstrates the achievement of these standards is shared. The Scottish Executive will be working with the Scottish Health Promoting Schools Unit to ensure that arrangements are set up that allow this to happen.

Menu Planning

1.5 To meet individual tastes the nutrient standards should be met by a choice of foods. Key points and menu-planning guidance is provided in Section 2. The descriptions of foods and frequencies served are given as basic guidance for catering practice. What is essential is the achievement of the nutrient standards. A flexible approach building on catering wisdom and experience, skills and local tastes is important in allowing a wide range of food and menu options to be available.

Portion Sizes

1.6 Portion size guidelines are necessary to assist caterers in planning lunches that meet nutrient standards for energy and other nutrients as well as to satisfy young appetites. Hungry children are more likely to snack on high fat and sugar confectionery. Guidance on portion sizes is provided in Section 2. In many cases schools will find that the portion sizes are substantially different from current practice. Larger portions of starchy food (bread, potatoes, pasta) and larger portions of fruits and vegetables will be required to meet the Scottish Nutrient Standards.

Product Specifications

1.7 Product specifications are being developed by the Food Standards Agency to help plan menus to meet the Nutrient Standards and to raise the quality of manufactured products used in school lunches. They will be developed according to a rolling programme covering the relevant food groups listed in Section 2. Consultation, including consulting with the food industry, on the practicality, palatability and affordability of achieving such specifications will be an integral part of developing the specifications. Section 4 of this guidance will be provided as the product specifications become available.

Drinking Water

1.8 It is recognised that children need access to adequate amounts of fluids within the school day. Drinking water, which is free, fresh and chilled, should be provided with drinking cups or glasses within the dining room.

Food and Drink Choices

1.9 Promotion of appropriate food and drink choices is the responsibility of the whole school community. Within the dining room context there are specific issues that should be considered, including the following:

• awareness of appropriate choices (e.g. poster or other point of sale promotional materials, signposting and other visual cues)
• access to appropriate choices (e.g. counter positioning, easy access to promoted choices, less easy access to less favourable choices)
• availability of appropriate choices (e.g. ensuring sufficient provision of promoted items, especially such items as non-fried potatoes and salad)
• acceptability (e.g. promoted foods should taste good, be well cooked and attractively presented)
• affordability (e.g. appropriate pricing policy should be considered).

Special Diets and Allergies

1.10 Medically prescribed special dietary requirements should always be accommodated. The principle of variety and choice should apply equally to children on special diets as part of a wider child-centred approach. Each education authority is required to develop a policy for delivering, in partnership with parents and carers, medically prescribed diets and appropriate provision for children with special educational needs while taking account of catering staff needs, diabetes and allergies.

Catering Staff Needs

1.11 Catering staff should be appropriately advised of the specific nature of the dietary requirement and children requiring special diets should be made known to the caterer. Diet guidance sheets should be provided by a State Registered Dietitian in the form of detailed diet sheets or meal plans for the child concerned. This will indicate to the caterer the food choices that are suitable or should be excluded.

Diabetes

1.12 All children with diabetes are advised to eat regular meals and snacks. All children with diabetes should have a meal plan which has been prepared especially for them by a State Registered Dietitian. It is essential that the guidance on the meal plan is strictly adhered to.

Allergies

1.13 Food allergies are estimated to affect up to 2% of the adult population and are more prevalent in infants and children. A number of foods have been linked to food allergy, the most common of which are milk, wheat, peanuts, fish, soya, eggs and shellfish. A wide range of symptoms has been reported which vary in severity from a mild reaction to a very rapid and severe response.

1.14 Allergy to some foods, such as peanuts, peanut products, other nuts and shellfish can be particularly acute. People suffering from a severe food allergy need to know the exact ingredients in their food as even a tiny amount of the allergenic food could kill them.

1.15 All pupils who have been diagnosed as having a food allergy should have a detailed diet sheet/meal plan prepared by a State Registered Dietitian. This will indicate the range of foodstuffs that should be excluded as well as those that are suitable.

Children and Young People with Special Needs

1.16 Children and young people with special needs may have particular problems associated with eating. It is important that anyone involved in caring for children and young people with eating difficulties is trained to ensure that they can give the best and most appropriate assistance. These problems should not be a barrier to enjoyment and participation in meals and food choice or to learning about healthy eating. No additional charge should be passed on to parents.

Minority Ethnic Communities and Special Religious Dietary Requirements

"Traditional foods and eating patterns of black and ethnic minority communities are part of the reality of the multiethnic and multicultural nature of British society today. Food is one of the most noticeable aspects of an individual's cultural identity and is closely linked with religious, social and economic circumstances. All over the world, societies have developed traditional eating patterns over centuries. They are based on foods available locally and influenced by cultural and religious beliefs. To produce a detailed and accurate profile of the food habits of each ethnic group in Britain is a very lengthy process and even then it would be unlikely to include all groups and variations within and between them." (Hill 1994).

1.17 This statement is equally true for other faith communities. What is required is an ongoing development of knowledge and awareness around the needs of pupils from minority ethnic and religious communities. One important way to achieve this is through partnership approaches. It is important that education authorities ensure that schools and caterers have access to suitable information, support and resources to ensure these needs are met in a sensitive, informed and appropriate manner.

Scottish Nutrient Standards for School Lunches

1.18 The Scottish Nutrient Standards for School Lunches set out to ensure the provision of a meal that provides largely a third of a child's daily nutritional needs. These standards (Tables 1 and 2) are set for both the provision of food i.e. what the menu offers, and for the consumption of food i.e. what the child actually eats. The first of these, what the menu may offer, can be achieved by the caterer, but to influence the second will take a whole-school approach. It is recognised that these standards will take time to implement. It is expected that all schools will make rapid progress, but a final implementation date of December 2004 for primary and special schools and of December 2006 for secondary schools is expected.

1.19 In the tables the energy and nutrient requirements for children aged 5-18 years are presented as average values for males and females in three age groups. These guidelines provide figures for the recommended nutrient content of an average school lunch provided for children over one school week. In practical terms this is the amount of food provided, divided by the number of children eating it, averaged over a week. All the nutrient intakes in the tables are based on the average of the recommended intakes for boys and girls. The child's daily nutritional needs are expressed in terms of:

• dietary reference value (DRV) (or daily requirement)
• the reference nutrient intake (RNI) (the estimated amount of a nutrient that will meet the needs of most of the population)
• estimated average requirement (EAR) (in the tables EAR is used for energy to show the average requirement for energy for boys and girls).

1.20 The recommendations of energy intakes are based on children achieving a balance between energy intake and energy output allowing for growth and development. It is clear that children who are physically inactive will require less energy to meet physiological requirements and that excess energy will be a major contributor to the development of excess body weight. Both diet and physical activity are part of a holistic approach to maximising children's health.

1.21 To protect and to promote the health of children, three nutrients are considered particularly significant. Calcium is important for bone growth. Iron is important for preventing anaemia, especially in secondary-age schoolgirls. Folates are particularly important, again for secondary-age schoolgirls. It is recognised that some nutrients are supplied in high amounts in only a limited range of foods. To assist caterers, guidance on rich sources of folate, calcium and iron are provided in Section 2.

1.22 The higher level of 40% of RNI for iron and folate has been adopted. In practice, levels have previously proved hard to achieve. However, because of the high health impact of a deficiency, efforts should be re-doubled to ensure adequate intakes.

Table 1: Nutrient Standards for School Lunches for Pupils in Primary Schools (Revised Nov 2003)

Estimated average requirement
² These are added sugars rather than the sugar that is integrally present in food (e.g. table sugar, honey, sugar in fruit juice and soft drinks)
³ Here calculated as 8g per 1,000 kcal
⁴ Reference nutrient intake
⁵ Scientific Advisory Commitee on Nutrition (2003) Salt and Health. London HMSO

Table 2: Nutrient Standards for School Lunches for Pupils in Secondary Schools

Estimated average requirement
² These are added sugars rather than the sugar that is integrally present in food (e.g. table sugar, honey, sugar in fruit juice and soft drinks)
³ Here calculated as 8g per 1,000 kcal
⁴ Reference nutrient intake
⁵ Scientific Advisory Commitee on Nutrition (2003) Salt and Health. London HMSO

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