Children's Lunchboxes Research Articles

Parents' Understanding of Fulfilling Balanced Nutrition in Preparing Lunch Boxes for Group B Children

Nutritional problems become a complex problem for children. This study aims to provide an in-depth description and analysis of parents' understanding of fulfilling balanced nutrition through preparing lunch boxes for group B children. This type of research is a case study qualitative research. The subjects in this study were the school principal, homeroom teacher in class B-1, homeroom teacher in class B-2, and parents. Data collection in this study was carried out through observation, interviews, and documentation. Data analysis techniques use data triangulation techniques. Based on the results of data analysis, several findings were obtained in this study. First, the contents of the children's lunch box used healthy and nutritious food, but different from the balanced nutritional standards needed by children. Both parents' understanding of balanced nutrition is quite good. It can be seen in parents’ awareness of preparing their children's lunch. Third, the role of schools is very good in supporting the development and introduction of nutrition for parents and children. From these three findings, it can be concluded that children's lunch boxes contain healthy and nutritious food. It is related to the level of parents’ understanding and good support from schools regarding the development and introduction of nutrition for children.

Does colour variety accurately quantify nutritional value in children's lunchboxes? A pilot study

ObjectivesIn advocating a diet rich in fruit and vegetables, public health authorities emphasise dietary colour variety to ensure adequate nutrient consumption. The relationship between food colour variety and nutritional value in children's lunches attending one school was evaluated. Study designObservational cross-sectional study. MethodsEighty-two children had their lunchboxes photographed over one day. Foods were scored using the Nutri-score labelling system, assigning foods a letter based on nutritional content. Composite Nutri-scores were calculated as average total Nutri-score per food per lunchbox. Eleven observers used a colour chart to assign colours to foods from a sample of lunchboxes; intra-class correlation was calculated. Associations between nutrient scores and colour variety were estimated. ResultsLunchboxes contained an average of 4 ± 1 colours. Number of colours did not vary by age or sex. Two thirds of lunches had composite Nutri-scores of C or better, with better scores in older children. There was no association between colour variety and composite Nutri-score. Fruit, vegetables, whole grains and fats were associated with greater colour variety. Vegetables and meat, fish and eggs were associated with better scores; refined grains, dairy, snacks, fats and condiments were associated with worse. ConclusionsAlthough this study did not demonstrate a relationship between colour variety and nutritional score, findings suggest that lunches containing fruit and vegetables tended towards greater colour variety than those without. This indicates that adjusting guidelines to incorporate food colour variety may be of use in future iterations of dietary guidelines for children.

A snapshot of school children's lunchboxes in South Australia through a food and sustainability lens

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Are mothers under lunchbox pressure? An exploration of the experiences of Victorian mothers preparing lunchboxes for their children.

A healthy diet is particularly important during childhood. Research suggests that more than 95% of Australian primary school aged children do not eat a diet consistent with the Australian Dietary Guidelines, putting them at risk of poor health. Interventions to improve the quality of children's lunchboxes may help address this issue. However, there is limited understanding of the factors impacting lunchbox preparation. This study explored the experiences of 10 mothers of Victorian primary school students. Mothers took part in semi-structured interviews exploring their views on lunchbox preparation and food choices. The study used a Constructivist Grounded Theory methodology and data were analysed using an inductive, thematic approach. Analysis of the interviews yielded four main themes. (i) Mothers experienced a range of non-nutritional barriers that impacted the food choices they made for their children. (ii) Children's preferences influenced parental food choices. (iii) Mothers experienced and/or perceived judgement about the food choices they make for their children. And (iv) Mothers identified a lack of support and information from schools about what was appropriate for school lunch. Findings of this study indicate that mothers are concerned with balancing nutrition and child preferences within the broader context of guidelines, perceived or real judgement and income constraints. SO WHAT?: The school environment may be an ideal setting to promote healthy eating but support for parents is needed. This is the first study in Victoria exploring mothers' perspectives on lunchbox preparation and provides initial information on which future research can build.

An mHealth Intervention to Reduce the Packing of Discretionary Foods in Children's Lunch Boxes in Early Childhood Education and Care Services: Cluster Randomized Controlled Trial.

BackgroundInterventions in early childhood education and care (ECEC) services have the potential to improve children’s diet at the population level.ObjectiveThis study aims to test the efficacy of a mobile health intervention in ECEC services to reduce parent packing of foods high in saturated fat, sugar, and sodium (discretionary foods) in children’s (aged 3-6 years) lunch boxes.MethodsA cluster randomized controlled trial was undertaken with 355 parent and child dyads recruited by phone and in person from 17 ECEC services (8 [47%] intervention and 9 [53%] control services). Parents in the intervention group received a 10-week fully automated program targeting barriers to packing healthy lunch boxes delivered via an existing service communication app. The program included weekly push notifications, within-app messages, and links to further resources, including websites and videos. The control group did not receive any intervention. The primary outcomes were kilojoules from discretionary foods and associated nutrients (saturated fat, free sugars, and sodium) packed in children’s lunch boxes. Secondary outcomes included consumption of kilojoules from discretionary foods and related nutrients and the packing and consumption of serves of discretionary foods and core food groups. Photography and weights of foods in children’s lunch boxes were recorded by trained researchers before and after the trial to assess primary and secondary outcomes. Outcome assessors were blinded to service allocation. Feasibility, appropriateness, and acceptability were assessed via an ECEC service manager survey and a parent web-based survey. Use of the app was assessed via app analytics.ResultsData on packed lunch box contents were collected for 88.8% (355/400) of consenting children at baseline and 84.3% (337/400) of children after the intervention. There was no significant difference between groups in kilojoule from discretionary foods packed (77.84 kJ, 95% CI −163.49 to 319.18; P=.53) or the other primary or secondary outcomes. The per-protocol analysis, including only data from children of parents who downloaded the app, also did not find any statistically significant change in primary (−1.98 kJ, 95% CI −343.87 to 339.90; P=.86) or secondary outcomes. Approximately 61.8% (102/165) of parents in the intervention group downloaded the app, and the mean service viewing rate of weekly within-app messages was 26% (SD 14.9). Parents who responded to the survey and participating services agreed that it was appropriate to receive lunch box information via the app (40/50, 80% and 6/8, 75%, respectively).ConclusionsThe intervention was unable to demonstrate an impact on kilojoules or associated nutrients from discretionary foods packed in children’s lunch boxes. Low app downloads and program message views indicate a need to explore how to improve factors related to implementation before further testing similar mobile health interventions in this setting.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12618000133235; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374379

Using behavioural insights to reduce sugar in primary school children's packed lunches in derby; A cluster randomised controlled trial

Children's packed lunches contain more sugar than school-provided meals. Interventions to improve the provision of healthier packed lunches have modest effects on lunch contents. This cluster randomised controlled trial tested an intervention to encourage healthier provision of packed lunches by parents of primary school children in Derby. Schools were randomised to intervention (n = 8) or control (n = 9) using blocked random allocation. In the intervention group, parents of children who brought packed lunches to school in years 3–6 (age 7–11 years) received three bundles of materials (including packed lunch planner, shopping list, information on sugar content of popular lunchbox items and suggestions for healthier swap alternatives) in bookbags/lunchboxes over a 4-week period. Control parents received no materials. Photos of lunchbox contents were taken at baseline, immediately post-intervention and at three-month follow-up. A parental survey aimed to assess capability, opportunity and motivation for packing a healthier lunchbox. No intervention effects were observed for primary outcomes (presence and number of sugary snacks or chilled sugary desserts). The intervention had a significant impact on one secondary outcome (increased number of healthier “swap” items suggested in intervention materials) immediately post-intervention, but this effect had disappeared at three-month follow-up. No intervention effects were found on survey variables. Parent comments revealed that materials were either received positively (as they reinforced existing behaviours) or negatively (as they were not perceived to be helpful or appropriate). The results of this study suggest that providing educational materials and resources to parents of primary school children in Derby was not sufficient to increase provision of healthier packed lunches. Future research should investigate how behavioural science can support families to improve the nutritional content of primary school children's lunchboxes.

A cross-sectional study of packed lunchbox foods and their consumption by children in early childhood education and care services.

To (a) describe lunchbox foods packed and consumed by children attending early childhood education and care services; (b) compare the serves of foods packed and consumed with nutrition guideline recommendations; and (c) explore associations between parent characteristics and serves of food groups packed in lunchboxes. A cross sectional study was conducted on a sample of early childhood education and care services where parents provide food in the Hunter New England region of NSW, Australia. Lunchbox contents were assessed using photography and pre- and post-meal weights. Descriptive statistics were used to describe packing and consumption of core food groups and discretionary foods. Data on food packed and consumed were collected for 355 children's lunchboxes from 17 services (preschools n=14, long day care services n=3). Less than half (44%) of lunchboxes contained vegetables, and 54% contained at least one serve of discretionary foods. Less than 1% of lunchboxes met all setting-specific nutrition guidelines. On average, children consumed 68% of lunchbox contents, with the lowest consumption rate being for vegetables. An association was found between parent education level and packing of discretionary foods (-0.36, P= <.01) but not for packing of fruit or vegetables. Lunchboxes contained an over-representation of discretionary foods and under-representation of vegetables, and children had a low preference for consuming vegetables compared with other food groups. Interventions to support parent packing of lunchboxes in line with nutrition guidelines and strategies to expand child preference for foods such as vegetables are warranted.

A cross-sectional study to determine the energy density and nutritional quality of primary-school children's lunchboxes.

The present study describes the energy content of primary-school children's lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken. A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as 'everyday' (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit. Twelve Catholic primary schools (Kindergarten-Grade 6) located in the Hunter region of New South Wales, Australia. Kindergarten to Grade 6 primary-school students. In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten-Grade 2 packed more servings of 'everyday' foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3-6. Children in Grades 3-6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten-Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03). Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted.

Analysis of the presence of industrial foods in children's lunch boxes

Objective To analyze the presence of processed foods in the lunch boxes of children in a private school nbsp Materials and methods The sample consisted of school lunch boxes from children The quantitative analysis of the presence of processed foods in the lunch boxes and the food purchased in the school canteen was carried out Analyzes were also performed in order to identify the food groups where A in natura or minimally processed B processed and C ultraprocessed as to the frequency in which these foods were present in the research nbsp Results It was observed that both groups A B and C were present in the lunchboxes but the group A ultra processed obtained a higher index of especially the biscuits The group that presented least in the sample were the group B of the processed for those bought in the canteen observed that although the juice was the most consumed by the children the choice of salted was also great showing that the preference Children s food is still inadequate the ideal would be a home prepared parent s snack with healthier options nbsp Conclusion The study concludes that the snacks present in schoolchildren s lunchboxes are inadequate due to the high consumption of processed foods specifically the ultra processed ones the sample also showed that the few children who bought the snacks in the school canteen opted for worthless foods Nutritional demonstrating inadequacies that alert the need to implement nutritional education programs in schools to contribute to improvements in school feeding

Impact of Red Apple Healthy Lifestyles Programme on healthy eating behaviour of low socio-economic participants in rural and regional communities in Australia

The central focus of the Red Apple Healthy Lifestyles Programme (RAHLP) was the delivery of practical activities on healthy eating, cooking, promoting sustainable changes in health and shopping behaviours among low socio-economic families and young people in the rural communities. The study aimed to answer the following question: how do the activities offered by the RAHLP (1) increase the knowledge and skills of participants to better adopt healthy eating behaviours, and (2) increase parents' ability to establish healthy eating behaviours in their children? The study also aimed to identify any barriers to the adoption of healthy eating choices. Convenience sampling was utilised to access a cross-sectional sample of approximately 200 participants and finally a total of 176 people participated in the programme. After participation in the programme, the highest proportion of participants indicated that they are able to identify healthy foods to eat. Eating breakfast insignificantly increased from 69% before the participation to 75% after their participation in the programme, and continued to increase by 86% in 3 months. Confidence levels of participants have been sustained after the 3-month survey with further increases in relation to children's healthy lunchboxes (increasing from 57% to 80%), and understanding suitable food for babies (from 50% to 70%). The stated benefits of the programme by participants are improved knowledge and lifestyle skills, the adoption of healthy eating behaviours, increased parent ability to establish healthy eating patterns among children, and increased self-reliance in relation to aspects of healthy food choices.

Could healthy eating initiatives be contributing to obesity? An analysis of primary school children's packed lunches before and after a healthy eating initiative

BackgroundIncreasing rates of obesity have become a major concern for the western world, and one way in which the UK Government has attempted to tackle the issue is to promote healthy eating. For example, the five-a-day campaign encourages increased consumption of fruit and vegetables. The assumption that this change will promote healthy weight is common, although evidence suggests that addition of fruit and vegetables to the diet will not tackle obesity unless fruit and vegetables are replacing high fat and sugary foods. Although it is generally uncontroversial that a diet containing five fruits or vegetables a day has health benefits, the target has become a panacea for many healthy eating interventions. However, increasing of fruit and vegetable consumption could be detrimental if it also increases overall calorific intake. The objective of this research was to investigate whether increased fruit and vegetable consumption resulting from a healthy eating intervention affected calorific intake. Using a healthy eating initiative for children of primary school age, we aimed was to measure whether children who increased their lunchbox fruit consumption after the intervention, showed any change in their calorific intake. MethodsAn observational study of children's lunchboxes measured food consumed before a healthy eating intervention and at 3-month follow-up. Three intervention schools (n=63) were matched with three control schools (n=64). Portions of fruit and vegetables and total calories consumed were calculated with a comprehensive online food database (Weight Loss Resources). A subgroup of children from the intervention schools, who showed increased fruit and vegetable consumption and for whom it could be judged that the intervention had been successful, were analysed to investigate the effect on their calorific intake. Comparisons were made with the remaining intervention schoolchildren and the control group. Additionally, the general relation between changes in fruit and vegetable consumption and calorific intake was explored in data from all participants. FindingsMean fruit and vegetable consumption increased slightly in the intervention schools and decreased slightly in the control schools between baseline and follow-up. Mean calorific consumption showed a slight increase in both the intervention and control groups, but mixed measure ANOVAs and paired t tests showed none of these differences to be significant. However, the group with increased fruit and vegetables consumption (n=35) showed a significant increase in calorific consumption between baseline (mean 400 kcals, SD 100) and follow-up (431 kcal, SD 103; p=0·031). No significant differences were recorded for either children without increased fruit and vegetable consumption or the control group. A positive correlation was identified between increased fruit and vegetable consumption and calorific intake for all children (r=0·203, n=127, p=0·022). InterpretationThe significant increase in calories for the group with increased fruit and vegetable consumption after the intervention suggests that this increased consumption had not displaced other foods. The positive correlation also suggests that fruit and vegetable consumption generally is not displacing higher calorific foods. This finding does not support assumptions that have been made about the relation between fruit and vegetable consumption and healthy weight. By contrast, interventions that aim to increase fruit and vegetable consumption could be adding to overall calorific consumption. The implications of encouraging the population to eat more fruit and vegetables need to be established. FundingThis research was self-funded by CH as the independent research undertaken for her MSc in Psychological Research Methods with the Open University.

Opening up Australian preschoolers' lunchboxes

Early childhood services have been identified as key settings for promoting healthy eating and obesity prevention. However, little is known about the obesity-related behaviours of preschool-aged children or food-related policies in these settings. The purpose of this study was to describe the contents of preschoolers' lunchboxes to inform future interventions. Cross-sectional survey of 259 children attending preschools in the Sydney West and Sydney South West regions of New South Wales in 2008. Lunchbox data were collected using a purpose-designed audit tool. Food and beverages were classified as fruit, vegetables, dairy, breads and cereals, 'extra' (energy-dense) foods, 'extra' drinks or water. Sandwiches and home-cooked meals were the most frequently identified food item, found in 92% of children's lunchboxes, followed by fresh fruit. However, 60% of lunchboxes contained more than one serve of extra food or drink. While nutrition guidelines allow one to two serves of extra foods per day for preschool-aged children, the majority of children appear to consume most of this allocation during their school day, potentially contributing to over-consumption of extra foods and excess kilojoule intake. Preschool food policies may help to guide the content of children's lunchboxes, however this study emphasises the need for better communication and enforcement of these policies, as well as broader public policy changes.

Use of Field-Portable XRF Analyzers for Rapid Screening of Toxic Elements in FDA-Regulated Products

Analytical instrumentation continues its amazing evolution, especially in regard to generating ever more sensitive, faster, and reliable measurements. Perhaps the most difficult challenges are making these instruments small enough to use in the field, equipping them with well-designed software that facilitates and simplifies their use by nonexperts while preserving enough of their analytical capabilities to render them useful for a wide variety of applications. Perhaps the most impressive and underappreciated example of instruments that meet these criteria are field-portable X-ray fluorescence (XRF) analyzers. In the past, these analyzers have been routinely used for environmental applications (lead in paint and soil, metal particulates in air samples collected onto filters), geology studies (ore and soil analysis, precious metal identification), and recycling industries (alloy identification). However, their use in the analysis of toxic elements in food, food ingredients, dietary supplements, and medicinal and herbal products, especially within the FDA and regulatory environments, has been surprisingly limited to date. Although XRF will not replace atomic spectrometry techniques such as ICP-MS for sub-parts per million level analyses, it offers a number of significant advantages including minimal sample preparation, high sample throughputs, rapid and definitive identification of many toxic elements, and accurate quantitative results. As should be obvious from many recent news reports on elevated levels of toxic elements in children's lunchboxes, toys, and supplements, field-portable XRF analyzers can fill a very important niche and are becoming increasingly popular for a wide variety of elemental analysis applications. This perspective begins with a brief review of the theory of XRF to highlight the underlying principle, instrumentation, and spectra. It includes a discussion of various analytical figures of merit of XRF to illustrate its strengths and limitations compared to existing methods such as ICP-MS. It concludes with a discussion of a number of different FDA applications and case studies in which XRF has been used to screen, identify, and in some cases quantify toxic elements in various products. This work clearly demonstrates that XRF analyzers are an exceedingly valuable tool for routine and nonroutine elemental analysis investigations, both in the laboratory and in the field. In the future, it is hoped that both field-portable and laboratory-grade XRF analyzers will see more widespread use for investigational and forensic-type applications of food and other regulated consumer products.

Food safety issues and children's lunchboxes

Approximately 60% of school children in the U.K. eat packed lunches on a regular basis. While extensive research investigating the health and quality of food in these lunchboxes has been conducted, there is very little parallel research into food safety issues. This study set out to examine the food safety issues associated with the daily cycle of lunchbox use among primary school children. In particular, the role of the actual lunchbox as a potential vehicle of cross-contamination was investigated. Using a self-completion questionnaire, parental attitudes towards food safety and their awareness of key food safety issues were identified with respect to children's lunchboxes. Using a data logger, temperature measurements were taken of a typical lunchbox over a school term to provide information about the temperature profile throughout the daily cycle of use. A lunchtime observation study provided detail about individual lunchboxes, their visual cleanliness, the types of debris left by children and the microbiology of the lunchbox itself. The study found that while the majority of parents were aware of the potential food safety risks associated with their child's lunchbox, they recognized that poor temperature control during the school day increased the food safety risks but they did not always take appropriate steps to manage this risk. Despite there being no direct evidence of immediate food safety risks from this study, temperature control was a key food safety issue. The method and frequency of cleaning were also highlighted as areas of particular concern.

Lead in Your Child’s Lunch Box

The Illinois Public Health Lead Poisoning Prevention Act states that "no person shall use or apply lead bearing substances: (d) in or upon any toys, furniture, or other articles used by and chewable by children." Yet the Center for Environmental Health claimed that some lunch box manufacturers were endangering the health of children by making lunch boxes with materials that contained lead. The purpose of this study was to determine whether or not children's lunch boxes commonly contained lead. Forty lunch boxes were tested with a rapid lead test solution and 14 (35%) were positive, confirming the frequent presence of this potentially toxic metal.

Fruits and vegies in lunchboxes – accuracy of a prospective 24-hour food record for primary school children

Issues addressed: To explore the accuracy of reported fruit and vegetable contents of primary school children's lunchboxes compared with observed lunchbox contents as an indicator of overall accuracy of completion of a 24-hour food record developed for the Tooty Fruity Vegie (TFV) project. Method: Parents or older children completed the TFV food records, including a section about foods packed in children's lunchboxes. As children arrived at school the next day, trained observers compared lunchboxes' actual fruit and vegetable contents against reported information. Comparisons were made for 241 children (76% response rate). Pearsons correlations tested agreement between amounts of fruits and vegetables reported on TFV food records and those observed in corresponding lunchboxes. Paired t-tests assessed differences between the two methods. As many children had no fruits and/or vegetables in their lunchboxes, analyses were conducted: 1) for all children; and 2) for only those with fruits and vegetables. Results: Amounts of fruits and vegetables observed in children's lunchboxes were very similar to those reported in TFV food records, with non-significant mean differences of less than 0.005 serves for both. Lunchbox observations remained highly correlated with TFV food records even when only children with fruits or vegetables were included. Conclusion: The TFV food record accurately measured fruits and vegetables in children's lunchboxes. While offering reasonable confidence in overall reported fruit intakes, further research is needed to confirm the accuracy of overall reported vegetable intakes. (author abstract)