School Food Environment Research Articles

Teachers' perception of their students' dietary habits in Addis Ababa, Ethiopia: a qualitative study.

Poor dietary choices and consumption of unhealthy foods are major determinants of malnutrition among adolescents in Ethiopia. The school food environment is a valuable setting for exploring adolescents' eating habits. Teachers have an important role in understanding factors that impact students' dietary choices. The aim of this study is to explore secondary school teachers' perceptions towards adolescents' dietary habits in Ethiopia. The study employed a qualitative research design. Four focus group discussions, involving a total of 13 teachers, were conducted at governmental and private schools in Addis Ababa, Ethiopia. Additionally, observations of the food environment in these four schools. The transcripts from the focus group discussions and photographs from observations were analyzed using thematic analysis. Triangulation of data sources and persistent observation of the data were employed to enhance the study's trustworthiness. The study was approved by the Norwegian Center for Research Data and the Addis Ababa Health Bureau, and all participants provided informed consent. Teachers perceived adolescents' dietary habits as unhealthy, characterized by the consumption of unsafe foods, limited variety, and reliance on processed foods. Factors negatively influencing adolescents' dietary habits include a lack of awareness about a healthy diet among both students and parents. Low familial income levels were also identified as a barrier to eating a healthy diet. The unavailability of healthy foods and the advertising of unhealthy and processed foods as well as peer influence were hindrances to a healthy diet both at school and home. This study provides additional evidence of the nutrition transition which is linked to the double burden of malnutrition among adolescents in low-income countries. Factors affecting adolescent diets at school are multileveled. Incorporating nutrition education into the school curriculum will likely improve dietary awareness mitigating peer influence. Regulating the school food environment and enforcing advertisement laws targeting adolescents can promote healthier school food environments. Providing short term nutrition trainings for biology or science teachers and strengthen their role in delivering nutrition education to children and their families, along with implementing measures to address food insecurity and restricting availability of unhealthy food at school need to be regarded as priorities.

Stakeholder Perspectives on the School Food Environment: Insights from South African Learners-A Pilot Study.

Leveraging learner-driven insights to enhance the SFE can significantly influence food choices by decreasing the consumption of unhealthy foods and increasing access to healthier options. Using learners' voices as important stakeholders in the school food environment (SFE), this qualitative research study aimed to gain a deeper understanding of their perspectives, identify barriers and enablers to fostering a healthy SFE in South African public schools, and explore the link between the SFE and learners' food choices. Six focus group discussions (FGDs) with 4-6 participants were held in six schools, including three primary and three secondary schools in the KwaZulu-Natal Department of Education's iLembe district, SA, with learners aged 12-14 and 15-18 years, respectively. Learners were asked how schools could help them eat healthier and how their SFE benefitted them. The data were analysed using thematic data analysis methods. The FGDs generated 14 themes and subthemes. Emerging information suggests a lack of control over the sale of unhealthy food despite the existence of guidelines. This is further exacerbated by the marketing of unhealthy foods, which prevents learners from selecting healthier options. Furthermore, they stated that promoting the school food programme (SFP) and changing attitudes towards healthy food intake through comprehensive nutrition education are useful ways to enhance the SFE. The findings of this study underscore the critical role of learner insights in shaping effective strategies to improve the SFE.

Intermediate and secondary school food environment in New Zealand: Food and drink menu assessment.

Nutrition-related obesity is rising among adolescents in New Zealand with an estimated one in eight children being obese. The school environment is an ideal community setting for encouraging a healthy lifestyle as schools contain a diverse population and involve students and parents. However, the healthiness of food available to intermediate and secondary school students (Years 7-13) is unknown. This study assessed how food and drink menus from schools align with policy guidelines for healthy school food environments. A convenience sample of NZ schools' (years 7-13; ages 10-19) menus was collected in 2020. Menus were classified using traffic light criteria. A toolkit was developed by three nutritionists and one dietitian (with trained staff support) to aid with menu classification. Menu quality was evaluated against school characteristics and policy use. Of the school menus assessed (n = 60), 3.3% met the recommendation for the provision of 75% 'green' items. 'Red' items were the main contributors (mean = 53.6%). Schools with high socio-economic status (deciles 8-10; 14.3%; p < 0.05) and small school size (<749 students; 14.1%; p < 0.025) were associated with a higher proportion of 'green' items. Community (19.3%) and in-house (25.9%) food providers provided a lower percentage of 'amber' items than school providers (39.3%; p < 0.001). In-house providers (64.6%) had a greater percentage of 'red' items than school providers (48.2%; p = 0.017). Food available in schools (Years 7-13) tends to be unhealthy. A national nutrition policy could improve the school food environment, especially in schools with large populations and low socio-economic status. SO WHAT?: School demographics have been associated with menu quality but further research within these schools is needed to identify the gaps to improve equitable outcomes within school food environments.

Retrospective analysis of regional and metropolitan school food environments using Google Street View: A case study in New South Wales, Australia with youth consultation.

Food environments surrounding schools have a strong influence on the adolescent's food choices. Moreover, the prevalence of diet-related chronic diseases is higher in regional than metropolitan areas in Australia. Understanding school food environments in these different settings is crucial for informing future strategies to improve adolescent health. Google Street View was used to identify food outlets within 1.6 km around all secondary schools in Wagga Wagga and Blacktown in New South Wales which were selected as regional and metropolitan case study areas. Based on food outlet type, healthfulness categories were assigned, and Chi-squared tests were performed. The Health Advisory Panel for Youth at the University of Sydney (HAPYUS) were engaged to obtain their perspectives on findings. Unhealthful food outlets were consistently most prevalent around schools in Wagga Wagga and Blacktown over 17 years. In 2023, these were predominantly restaurants (19.4% vs. 21.1%), cafés (16.8% vs. 11.1%), fast-food franchise outlets (15.1% vs. 17.4%) and independent takeaway stores (14.1% vs. 9.6%). No significant difference in healthfulness between regional and metropolitan areas was found. Youth advisors recognised price and social reasons as major contributors to food choices. Google Street View was used as a novel resource to examine school food environments in regional and metropolitan areas which have remained consistently unhealthful for nearly two decades. SO WHAT?: Unhealthful school food environments may encourage poor diets and exacerbate rates of adolescent overweight and obesity. Critical government action is needed to improve school food environments.

Co-Creation and Implementation of a Healthy Snacks Policy in Primary Schools: Data from Sintra Grows Healthy.

Policy interventions in the school food environment can improve dietary behaviors. However, the literature describing its development and implementation is scarce. This manuscript aims to describe the process of co-creation, implementation, monitoring, and evaluation of a Healthy Snacks Policy, in the scope of Sintra Grows Healthy intervention. Through a community-based participatory research methodology, the co-creation of the Healthy Snacks Policy comprises six stages: snacks evaluation, feedback sessions, class assemblies, school community assemblies, school cluster policy approval, and process evaluation. Within one school year, a Healthy Snacks Policy was co-created, approved, incorporated in the school regulations, implemented, continuously monitored, and evaluated. Regarding snacks evaluation, 1900 snacks were evaluated at the beginning of the school year and 1079 at the end of the school year. There were three feedback sessions, twenty-two class assemblies, and three school community assemblies. Most teachers perceived that children began to consume healthier snacks (72%); 66% of the children were considered to have started eating healthier; and most families said "yes or sometimes" when asked whether their children started requesting healthier snacks (70%), trying new foods (63%), and noticing improvements in their eating habits (74%). The co-creation of a Healthy Snacks Policy establishes an approach to effectively implement existing guidelines for school food supplies, complying with national priority implementation recommendations.

P036 INFLUENCE OF FOOD ENVIRONMENT IN AND AROUND SCHOOLS ON FOOD CHOICES AND PRACTICES OF STUDENTS: A MIXED METHODS STUDY – ANTICIPATORY FINDINGS

Background: The health behaviors of adolescents are significantly influenced by their living environments, with schools serving as crucial settings for promoting healthy behaviors. The school food environment, encompassing areas where food is provided and consumed within and around schools, plays a key role in shaping adolescents’ dietary choices. However, there is a notable scarcity of evidence regarding the school food environment in Pakistan. This study aims to examine the school food environment and associated factors, including the availability, accessibility, and affordability of foods within and around schools for adolescents, the facilitators and barriers school vendors face while offering healthy food options, and the perspective of policymakers on the role of food environments. Objectives: • To assess the school lunchtime food practice and sources of adolescents in schools in Karachi • To explore facilitators and barriers to offering healthier food options to adolescents through school vendors both within and outside school premises • To explore the perspectives of adolescents regarding the food choices available to them Methods: A mixed methods concurrent study design i.e. a cross-sectional study, interpretive descriptive qualitative study. Six schools, comprising three government and three private schools from District Central of Karachi, will be recruited. Students from grades 6 and 7 who provide consent and assent will be included, with an anticipated sample size of 430 participants. Descriptive statistics will be utilized to analyze quantitative data and a manual thematic analysis approach will be employed to analyze qualitative data. Results: The anticipated outcome of this study is to understand the school food environment holistically taking into consideration the practices and perspectives of key stakeholders i.e. school-going adolescents, vendors, and policymakers. Conclusion The groundwork done through this research project will help develop evidence-based healthy school food environment programs/interventions that can be feasibly deployed in government and private schools in Pakistan. The research outcomes will foster collaborative efforts among various stakeholders to co-create and implement viable solutions.

School health and nutrition environments: A multicountry survey in five countries of sub-Saharan Africa region-Burkina Faso, Ethiopia, South Africa, Sudan, and Tanzania.

Schools are increasingly regarded as a key setting for promoting the health, well-being, and development of children and adolescents. In this multicountry cross-sectional survey, we describe the health, nutrition, and food environments of public primary schools in five urban settings in Africa region: Ouagadougou, Burkina Faso; Addis Ababa, Ethiopia; Durban; South Africa, Khartoum, Sudan; and, Dar es Salaam, Tanzania. We evaluated the school health and nutrition (SHN) environments in three main areas: (1) the availability of health-related policies, guidelines, and school curricula, (2) the provision of health, nutrition, and water, sanitation, and hygiene (WASH)services in schools, and (3) the school food environments and eating habits of adolescents. We used stratified random sampling to recruit 79 schools from five countries. Trained fieldworkers collected standardized questionnaire data from 79 school administrators, 765 food vendors, and 4999 in-school adolescents aged 10-15 years. In our study, 24 out of 79 school administrators were aware of their school's health-related policies and guidelines while 30 schools had a specific SHN curriculum. In general, health, nutrition, and WASH services were inadequate. Possibly due to a lack of school kitchens, 14.4% of students bought snacks and unhealthy foods from food vendors. Our study indicates that schools' food and nutrition environments are insufficient to improve adolescent health and nutrition in the African region, including limited coverage of SHN policies, suboptimal facilities and nutrition services, and unregulated food environments. Schools in sub-Saharan Africa need to improve their health and nutrition environments.

The Ghana School Food Environment Is Associated With Dietary Diversity and Anemia: Findings From the 2022 National Nutrition and Health Survey of In-School Adolescents

The Ghana School Food Environment Is Associated With Dietary Diversity and Anemia: Findings From the 2022 National Nutrition and Health Survey of In-School Adolescents

Understanding Adolescent Food Purchasing Decisions, Food Insecurity Coping Strategies and Their Aspirations for the School Food Environment: A Photovoice Study

Understanding Adolescent Food Purchasing Decisions, Food Insecurity Coping Strategies and Their Aspirations for the School Food Environment: A Photovoice Study

“Give us fresh fruit.” Students’ Perceptions of the School Food Environment Compared to Skin Carotenoid Levels

“Give us fresh fruit.” Students’ Perceptions of the School Food Environment Compared to Skin Carotenoid Levels

Relationship Between School Food Environment and Eating Behaviors of Primary School Children in Dodoma: A Cross-Sectional Study

ABSTRACT This cross-sectional study assesses the relationship between school food environment and eating behaviors of primary school children in Dodoma among 248 primary school children aged 6–13 years. School characteristics information and socio-demographic characteristics were collected. Multilevel modeling was employed to assess the individual-level variance in eating behaviors. Most of the variances in the investigated eating behaviors were at the personal level. Significant associations (p < .05) were between protein-rich food intake and fats and sugar-rich food with the death of either parent. And association between intake of vitamin and mineral-rich foods and the number of people living in household.

Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs.

The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. PROSPERO registration no. CRD42022303255.

A mixed-method study of parents’ views of food and nutrition in Australian primary schools

PurposeSchools have long been perceived as an ideal setting to support the healthy eating behaviours of children. The aim of the study was to examine the views of Australian primary school parents regarding school food and nutrition, including education, practices and policy.Design/methodology/approachAn online survey was conducted among 787 parents in March 2021, which included closed and open-ended questions.FindingsThe results indicated the inconsistent implementation of policies and/or varying practices among different schools. Parents’ views were slightly associated with some demographic and personal measures including their SES levels, education, age, the main language spoken at home and universalism values. Parents viewed healthy food provision through canteens, policies and informing parents, fruit and vegetable breaks and kitchen and garden programs as the main contributors to the promotion of healthy eating. They believed unhealthy options in canteens, school fairs, events and birthdays are the major contributors to the formation of unhealthy eating habits among children at schools. Results revealed the efforts to establish health promoting school food environments in Australian primary schools; however, inconsistencies and discrepancies among schools should be addressed to ensure equity among all children.Practical implicationsThe findings may provide directions for policymakers and school managers and can inform future reforms and initiatives in Australian primary schools and elsewhere.Originality/valueThis is the first study that has examined Australian parents’ views of school food policy, practices and environments using a mixed-methods design.

Price, social life and proximity influence food choices: Engaging young people as co-researcher collaborators to better understand their surrounding school food environments

Food environments around secondary schools are a strong influence on adolescents’ food purchasing habits1. We conducted a repeat cross-sectional study using Google Street View to examine school food environments in regional and metropolitan NSW, Australia over 17-years. Findings showed that unhealthful food outlets such as fast-food franchises, consistently dominated school food environments over 2007-2023. Increasing levels of poor nutrition among youth has been raised as a concern2 by the Health Advisory Panel for Youth at the University of Sydney [HAPYUS] - an established group of 16 adolescents aged 13-18 years residing in NSW3. To gain further insight into the study findings and how it may impact adolescents’ health, it is critical to include voices of adolescents in this research. The aim of this sub-study was to engage with members of our youth advisory group and conduct a consultation exercise on these study findings, drawing upon their lived experiences of school food environments. In Aug-2023, we engaged four youth advisors from HAPYUS. Study authors provided an overview of the study and its findings to the youth advisors via a Zoom call. Youth advisors formulated a 500-word statement on their perspectives and lived experiences of food environments surrounding their high schools over the subsequent 4 weeks. Adolescents agreed that physical proximity to unhealthy food outlets around schools was a key contributor to unhealthy eating habits however also recognised social and economic factors which play a significant role in shaping poor diets. The following quotes from their combined statement reflect social and economic concerns: i) “[We] observed on a daily basis young people were opting to travel to the closest food court for fast food, or in some extreme cases, even order fast food via a meal delivery app, to be delivered to the school - as opposed to choosing the closest outlet” ii) “Overpriced foods in schools with some drinks costing 2x more than a heavily discounted KFC meal, no meaningful difference between foods sold at canteens and those sold at fast food outlets - heavily processed, packaged snacks, pre-made reheated foods” iii) “Most unhealthy food outlets choose a location that is not only close to schools but also close to major shopping centres and food courts… ideal for an after-school social catchup as it appears to accommodate the needs of a large group of people.” Consultation findings revealed the importance of social and economic factors that must be analysed in addition to adolescents’ physical proximity to food outlets around their schools. Youth advisors call for governments to take immediate action to implement policies that ensure schools have cheap and healthy foods at canteens to mitigate against the purchase of foods from nearby unhealthy food outlets.

Feeding our Future: school food and local agriculture in the Pacific

Utilising local and traditional foods in schools presents a significant opportunity within our region to ensure food and nutritional security, support local livelihoods by driving markets and employment opportunities, increasing food literacy, and help students to understand the role of, and develop a preference for these foods. School meals programs (SMP) are increasingly touted as a strategy for food system transformation(1), however, are not widely used in the Pacific Islands(2). Yet, there is increasing interest and momentum towards understanding school food and nutrition environments and the use of SMP in this region, especially with models that support and promote the integration of local, traditional climate-resilient, nutrient rich foods. When a large scale SMP may not be possible, other school food and nutrition activities can be utilised to support nutritious food choice. Evidence collected over the last five years provides information on the current situation, activities, and capacity for providing food in schools across the Pacific Islands (2,3,4). Activities across the region vary from national SMP to gardening programs, nutrition education, providing canteens/tuckshops and other ad hoc activities, for example events for World Food Day. Some activities have a requirement for the use of local food, while some prioritise local foods in gardening programs and work with local farmers. Recently it has been shown that youth are exposed to, and have access to significant amounts of ultra-processed foods (UPF) around schools(3). Mapping of the foods available to students within a 400m radius of 88 schools in Fiji found that sugar sweetened beverages were available in 80%, and lollies/confectionary in just over 60% of outlets. Fresh fruit was available in just over 20% of outlets, while fresh vegetables were available in less than 20% of outlets(3). While there are many challenges to providing local, traditional, nutritious foods in schools, including access to financial, human, and physical resources, stakeholders have told us that one of the most significant is how modernisation and colonisation of food systems have resulted in a preference for hyperpalatable UPF and how this makes it more challenging to incorporate local produce in a way that is accepted by students. This provides an opportunity to further explore and share ways to integrate local, traditional, climate-resilient, nutrient rich foods in schools to support children and adolescents to value, utilise, prefer, and advocate for these foods. There is a need to support the utilisation of traditional, local foods in schools by advocating for policy (at various levels, right from a school level upwards) that drives the use of these foods and creates more supportive school food environments.

The barriers and enablers to providing healthy food in New Zealand secondary school canteens

Establishing healthy lifelong eating habits in young people is important for short and long-term health(1). Schools are ideal setting to improve diet. However, research shows that many school food environments are unhealthy(2). In New Zealand (NZ), the canteen is a popular food provision, particularly in secondary schools. This research aimed to explore the barriers and enablers to providing healthy food and beverages in NZ secondary school canteens. In 2022, 6 secondary schools were purposively selected to participate in semi-structured interviews about foods and beverages sold in schools’ canteens and the factors that influenced this. In total, 11 stakeholders representing six schools and one staff member of an external catering company completed interviews. The interviews were transcribed and analysed using a reflexive thematic analysis approach(3). Four themes were developed. Theme 1 Action-oriented school policies that are based on healthy eating principles can facilitate healthier canteens highlighted the use and characteristics of policies. The subtheme highlighted that Mandatory policies are more enforceable. Theme 2 Multiple component opt-in programs or interventions facilitate a healthier school food provision shows that opt-in government interventions (e.g. Ka Ora, Ka Ako, the NZ free school lunch initiative) with funding, monitoring, and incentives can improve food provision. The subtheme Health-enhancing changes inthe school environment has flow-on effect to canteens showed that these changes can affect the entire school food environment. Theme 3 Healthy canteens get lost in the “pecking order” of what’s important highlights that while schools and key stakeholders may believe healthy eating is important, other factors related to well-being and education were more important to prioritise within the school’s limited resources. Theme 4 People’s values, attitudes and beliefs may help and hinder the healthiness of canteens and explores the role champions have in influencing the healthiness of the canteen. Champions were those with a positive, proactive attitude, value healthy eating and are capable. Subtheme 1 Meet student preferences while providing healthy food was a common barrier many champions worked hard to overcome. The final subtheme identified how A collaborative approach within schools and their communities can overcome barriers to healthy canteens. Government mandates and interventions can positively impact the canteen and other food provisions. This research supports a recommendation for schools to create and implement school policies around food encompassing a whole-school approach.

Cultivating Wellbeing: Traditional Wisdom and Sustainability in Fiji’s Green Schools

This method abstract details the Green School Program, piloted across three schools in maritime Fijian islands, addresses critical issues faced by Fijian and Pacific Island communities. These encompass malnutrition, food security, health hazards, and the urgency of integrating traditional knowledge, governance, and social-ecological systems approaches into creating healthier school environments. Non communicable diseases have emerged as a pervasive concern within Pacific Island communities, creating a challenge for public health systems, driven greatly by dietary habits(1). This complex health landscape underscores the need to safeguard traditional knowledge and agri-food practices and develop neo-traditional approaches to local food systems(2). Furthermore, the Green School Program recognizes the essential role of schools as community hubs, enabling enhancing heathy school environments by embracing traditional wisdom and sustainable farming practices and foods, ultimately empowering communities to address these multifaceted challenges(3). Developing the school environment as a sustainable setting for governance framework led by women and the school administration, rooted in traditional knowledge and practices. Additionally, it aims to design facilities that support efficient organic farming while integrating these into school activities. Economic sustainability through the sale of surplus farm products, as well as the enhancement of sustainable land-use management, health, wellbeing, and cultural identity. The program unfolds within a distinctive community-based framework with the establishment of robust governance, with a notable emphasis on the leadership of women and mothers who play a pivotal role in steering the green school initiative and ensuring community ownership. Collaborative governance spans multiple stakeholders, including school management, community-based school committees, youth groups, women groups, and traditional leaders. This inclusive engagement ensures both shared responsibility in program design and ownership during implementation phases. Sustainable facilities are strategically designed to include biodigesters, water storage and irrigation systems, composting, organic fertilizers, and seedling nurseries, enhancing the program’s capacity to create healthier school food environments while embracing traditional practices and values. The program has witnessed the active engagement of women in governance roles, promoting community unity and ownership. Traditional knowledge integration has enhanced crop diversity and sustainability. Economic sustainability has been achieved through surplus farm product sales, reducing dependency on external funding sources. Health improvements are evident, with reduced exposure to indoor air pollution from open fires. Cultural identity preservation and increased student engagement are also notable outcomes. The Green School Program’s holistic approach, rooted in traditional knowledge and sustainable practices, has yielded positive outcomes in governance, agriculture, nutritional food security, health, and cultural identity preservation. The program’s success demonstrates the potential for community-based initiatives to address critical issues and empower remote island communities. These results provide valuable insights into sustainable development approaches that prioritize community wellbeing and cultural heritage preservation in similar contexts.

Using Google Street View to examine changes in food environments around secondary schools in regional and metropolitan areas of New South Wales, Australia

Food environments surrounding secondary schools are a known influence on the purchasing and consumption habits of adolescents(1). Understanding their obesogenic potential is important for informing strategies to create more healthful food environments for adolescents, particularly for those living in regional areas, and is a key component of Australia’s National Obesity Strategy(2). This repeated cross-sectional study examined the food environment surrounding secondary schools in regional and metropolitan New South Wales from 2007-2023. Google Street View was used to collect data regarding food outlets within a walkable distance (1.6 km) of all secondary schools in Wagga Wagga and Blacktown, our regional and metropolitan case study areas respectively, over 17 years. A Food Environment Score(3) tool was used to characterise the healthfulness of food environments by categorising food outlets into Food Outlet Type categories (e.g. Cafés, Fast-Food Franchises, Restaurants etc.) and Healthfulness categories (“Healthful”, “Less Healthful”, “Unhealthful”). Descriptive statistics were used to characterise changes in the food environments by Food Outlet Type and Healthfulness categories from 2007-2023. Chi-Squared tests were used to determine any significant differences in the proportion of healthful, less healthful and unhealthful food outlets between the regional and metropolitan study areas and between 2007 and 2023 in both areas. In both Wagga Wagga and Blacktown, the most common food outlet types surrounding secondary schools from 2007-2023 were classified as less healthful or unhealthful. As of 2023, less healthful food outlets [restaurants (19.4%), cafes (16.8%)] and unhealthful food outlets [fast-food franchises (15.1%), independent takeaway (14.1%)] were the most common food outlet types in Wagga Wagga, making up 52% and 36% of all identified food outlets respectively. These outlet types have remained the most prevalent over the 17-year period, though restaurants and cafes have since surpassed fast-food franchises and independent takeaway stores, by proportion, which were the most common in 2007. Similarly in Blacktown, 2023, less healthful [restaurants (21.1%), cafés (11.1%)] and unhealthful [fast-food franchises (17.4%)] were the most common food outlets, making up 41% and 37% of all identified food outlets. Restaurants, cafés and fast-food franchise outlets were consistently observed to be the most prevalent in Blacktown food environments over the 17-year study period. No significant difference was found when comparing the healthfulness profiles of regional and metropolitan food environments nor were significant changes observed between 2007 and 2023 in Wagga Wagga and Blacktown (p &gt; 0.05 for all). The prevailing high proportion of less healthful and unhealthful food outlets near secondary schools in regional and metropolitan areas upholds the need for public health policies and planning strategies to address the obesogenic potential of school food environments.

Healthy, Inclusive and Sustainable Catering in Secondary Schools-An Analysis of a Transformation Process with Multiple Tensions.

Interest in catering for public sector schools is increasing due to its potential role in addressing the prevailing problems of malnutrition, food insecurity and non-sustainable food habits. Based on the case of secondary schools in Berlin, this study aims to explore this potential by focusing on the process of transformation towards healthy, inclusive and sustainable school catering. It employs a multi-perspective analysis based on the two concepts of food environment and social cohesion. Results are based on quantitative and qualitative data collected via an online survey of pupils from 25 secondary schools in Berlin as well as field notes from six stakeholder events. The survey findings were analyzed by descriptive means and provide explanations for the fact that most of the pupils (66.7%) never eat lunch at school. Based on the qualitative analysis of the stakeholder events, key tensions between actors from the federal state, municipal, school and private levels could be identified. Major areas of conflict arise due to (1) a lack of public funding and catering standards, (2) incompatible demands and preferences, (3) a lack of resources and opportunities for complementary education and participation, and (4) peer and parental influence. Transforming school food environments requires integrative strategies with interventions introduced by multiple actors operating on different levels.

The Relationship Between Schools and the Food and Beverage Industry in Guatemala: In-Depth Interviews with School Principals

ABSTRACT Schools are considered a point of sale (POS) channel to reach students with ultra-processed foods and beverages (UPFB) advertising and products. We sought to determine the type of relationship between schools and the UPFB industry in Guatemala City. During 2020, we interviewed 20 school principals. Descriptive statistics and inductive thematic coding were used for the analysis. Schools struggle with commercialism by engaging in unregulated relationships with the industry where they become a place of commercial value mediated by events sponsorship and exclusive contracts based on trust, among other strategies. School commercialism needs to be restricted to improve school food environments.