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

Abstract

Objective: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.Design: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.Setting:Twelve Catholic primary schools (Kindergarten–Grade 6) located in the Hunter region of New South Wales, Australia.Participants:Kindergarten to Grade 6 primary-school students.Results: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).Conclusions: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.

Greater and More Focused Measures Are Needed to Tackle Diabetes and Obesity Epidemics in the Nations of the Gulf Cooperation Council

“…Foods packed within school lunchboxes may contribute to energy imbalance [77]. In this context, Qatar Academy has implemented a policy that forbids lunchboxes, except for medical reasons.…”

Stakeholder Generated Ideas for Alternative School Food Provision Models in Australia Using the Nominal Group Technique

“…Schools are a key health promotion setting to improve children's health, including diet and activity patterns [4]. Despite this focus on schools as a setting to improve children's nutrition, in Australia children's intakes within school hours are not aligned with dietary guideline recommendations [5][6][7].…”

“…Analyses of primary-aged children's school food intake from the National Nutrition Survey in 1995 identified low vegetable intake and an overrepresentation of energy-dense, nutrient-poor foods in the school setting [7]. While not a nationally representative sample, a study of children's lunchbox contents in 2017 found that energy-dense, nutrient-poor foods contributed 39% of total energy packed, with 63% of children having two or more servings of these foods in their lunchbox, and only 20% of lunchboxes containing vegetables [5]. Evidence of differences in children's lunch quality as determined by socio-economic position are mixed [5][6][7].…”

“…While not a nationally representative sample, a study of children's lunchbox contents in 2017 found that energy-dense, nutrient-poor foods contributed 39% of total energy packed, with 63% of children having two or more servings of these foods in their lunchbox, and only 20% of lunchboxes containing vegetables [5]. Evidence of differences in children's lunch quality as determined by socio-economic position are mixed [5][6][7]. Food-insecure households are found to consume lower quality foods [8], with schools providing access to food relief school breakfast and lunch programs [9].…”

Enhancing the potential effects of text messages delivered via an m-health intervention to improve packing of healthy school lunchboxes

“…exceeding Australian dietary recommendations for primary school-aged children (12) , and over 2800 kJ (13) , equivalent to 40 % of a primary school-aged child's entire daily energy intake (14) . As such, strategies that are successful in achieving even modest improvements in the nutritional quality of foods packed in school lunchboxes could make an important contribution to improving child nutrition (15) .…”