Objective: To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. Design: The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. Setting: Vancouver, Canada. Subjects: A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. Results: Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. Conclusions: More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

The purpose of this study was to provide a descriptive profile of food-related advertising, messaging, and signage in Vancouver schools and to examine differences in the prevalence and characteristics of promotions between elementary and secondary schools.All food-related promotions were photographed in 23 diverse Vancouver public schools between November 2012 and April 2013. Key attributes, including the location, size, and main purpose of each promotion, as well as the type of food and/or beverage advertised and compliance with provincial school nutrition guidelines, were coded. Descriptive statistics assessed the prevalence and characteristics of promotions. Cross-tabulations examined whether the promotional landscape differed between elementary and secondary schools.All secondary and 80% of elementary schools contained food or beverage promotions (median = 17, range = 0–57 promotions per school). Of the 493 promotions documented, approximately 25% depicted “choose least” or “not recommended” items, prohibited for sale by provincial school nutrition guidelines. Nearly 1/3 of promotions advertised commercial items (e.g., brand name beverages such as Pepsi), in violation of the Board of Education's advertising policies and only 13% conveyed nutrition education messages. Close to half of all promotions were created by students for class projects, many of which marketed minimally nutritious items.In Vancouver schools, food-related promotions are common and are more prevalent in secondary than elementary schools. Students are regularly exposed to messaging for nutritionally poor items that are not in compliance with provincial school nutrition guidelines and which violate school board advertising policies. Stronger oversight of food-related promotional materials is needed to ensure that schools provide health promoting food environments.

Objective: To examine associations between students' socio-economic status (SES) and school-day dietary intake, and the roles of parents and peers in shaping these associations. Design: A cross-sectional survey measured school-day intake of vegetables, whole grains, low-fat milk, packaged snack foods and sugar-sweetened beverages. Logistic regression models examined associations between SES (parental education and food insecurity status) and dietary outcomes during or en route to or from school, and examined whether peer modelling or parental norms potentially mediated the associations between SES and dietary outcomes. Setting: Twenty-six public schools in Vancouver, Canada in 2012. Subjects: Nine hundred and fifty students in grades 5-8. Results: Students whose parents completed some college, compared with those completing high school or less, were significantly more likely to consume vegetables daily (unadjusted OR = 1·85; 95 % CI 1·06, 3·22) and students whose parents completed college or university were significantly less likely to consume sugar-sweetened beverages daily (unadjusted OR = 0·67; 95 % CI 0·47, 0·94). Food secure students were also significantly less likely to consume sugar-sweetened beverages daily compared with food insecure students (unadjusted OR = 0·52; 95 % CI 0·29, 0·92). Parental norms, but not peer modelling, emerged as a potential mediator of the association between SES and vegetable intake. SES was not significantly associated with the remaining dietary outcomes. Conclusions: Higher SES was significantly associated with two of five school-day dietary outcomes and predicted higher likelihood of daily nutritious food choices at school. The present study suggests that there is room for improvement in school-day dietary quality for students from all SES backgrounds in Vancouver.

Findings suggest that research and intervention strategies should address modifiable school-level exposures and policies to improve dietary practices for both elementary and secondary school-aged youth, while at the same time addressing sociocultural factors associated with eating behavior.

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