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School Food and Drinks 167
●● In 8–9 year olds, 9 per cent of girls and 7 per cent Increasing the iron content of a diet is described in
of boys reported that they were too heavy, and 13
per cent and 12 per cent, respectively, reported
trying to lose weight.
●● In 10–12 year olds, 10 per cent of both boys and
girls reported that they thought they were too
heavy, and 23 per cent of girls and 15 per cent of
boys were trying to diet. The actual prevalence
of obesity in this group was 7 per cent.
Hill (2006) found both overweight boys and girls
desire weight loss and are unhappy with their
body shape. He suggested this body dissatisfaction
was a result of picking up on parental attitudes to
weight and shape, the idealization of thinness
promoted in the media and peer behaviour.
Dental caries
Children are more susceptible to dental caries than
adults, although the incidence of caries in children
in the UK decreased following the introduction of
fluoride toothpaste in the 1970s. However, high
and frequent consumption of sugar and acidic
drinks contributes to (Walker 2000):
●● 53 per cent of 4–18 year olds having dental
decay
●● 66 per cent having erosion of either their
primary or permanent teeth.
When sugary food and drinks are limited to four
eating occasions per day (e.g. three meals and one
snack), the risk of dental caries is much lower
(Moynihan and Petersen 2004).
Anaemia
Iron-deficiency anaemia is much less common in
children over 5 years than in preschool children
but does occur, particularly in:
●● children who are vegetarian
●● girls after menarche
●● children with malabsorption due to an
underlying disease
●● children with a poor dietary intake due to
dietary restriction.
Chapter 5.2, page 147.
Non-haem iron uptake from eggs, nuts, pulses,
cereals and vegetables can be maximized by
including a good source of vitamin C with meals,
such as citrus fruit, other fruits and tomatoes, and
avoiding drinking tea with meals, which reduces
iron absorption.
Low vitamin D levels
Blood analyses in the National Diet and Nutrition
Surveys have shown that significant numbers of
school children have low vitamin D levels. Sunlight
on exposed skin when outside in the summer
months, not diet, is the main source of vitamin D
in the UK. Hence these low levels probably reflect
the increased time children spend playing inside
rather than outside.
The UK Department of Health does not
recommend a set amount for children over 5 years
of age. Other countries do set dietary
recommendations of vitamin D for older children
(e.g. between 5 and 10 µg/day for children in most
European countries and 15 µg vitamin D for all
children in the United States). The Scientific
Advisory Committee on Nutrition (SACN) in the
UK is currently reviewing the evidence and if they
do set a recommended dietary intake then it is
likely children would have to take a supplement of
vitamin D as very few foods in the UK are fortified
with it. This is in contrast to the United States,
Canada and some Scandinavian countries, where
several basic foods such as milk and orange juice
are fortified with it.
School Food and Drinks
School lunches
Historically, school meals had to comply with set
nutritional standards but, following the abolition
of school meal standards in 1980, cheap,
low-nutrient foods were often served to children as
catering firms aimed to keep costs down. In 2001,
England introduced school meal standards based
on the food groups and changed the budget holder