Is the school food environment conducive to healthy eating in poorly resourced South African schools?

Abstract

Objective: To assess the school food environment in terms of breakfast consumption, school meals, learners' lunch box, school vending and classroom activities related to nutrition. Design: Cross-sectional survey. Setting: Ninety purposively selected poorly resourced schools in South Africa. Subjects: Questionnaires were completed by school principals (n 85), school feeding coordinators (n 77), food handlers (n 84), educators (n 687), randomly selected grade 5 to 7 learners (n 2547) and a convenience sample of parents (n 731). The school menu (n 75), meal served on the survey day, and foods at tuck shops and food vendors (n 74) were recorded. Results: Twenty-two per cent of learners had not eaten breakfast; 24 % brought a lunch box, mostly with bread. Vegetables (61 %) were more often on the school menu than fruit (28 %) and were served in 41 % of schools on the survey day compared with 4 % serving fruit. Fifty-seven per cent of learners brought money to school. Parents advised learners to buy fruit (37 %) and healthy foods (23 %). Tuck shops and vendors sold mostly unhealthy foods. Lack of money/poverty (74 %) and high food prices (68 %) were major challenges for healthy eating. Most (83 %) educators showed interest in nutrition, but only 15 % had received training in nutrition. Eighty-one per cent of educators taught nutrition as part of school subjects. Conclusions: The school food environment has large scope for improvement towards promoting healthy eating. This includes increasing access to vegetables and fruit, encouraging learners to carry a healthy lunch box, and regulating foods sold through tuck shops and food vendors. Keywords School food vendorsSchool tuck shop Lunch box School feeding South AfricaSouth Africa experiences the double burden of undernutrition and overweight. A national survey showed that 20?7 % of 1-to 9-year-old children were stunted, 8?1 % were underweight, 5?8 % were wasted, and 14?0 % were either overweight or obese (1) . Overweight/obesity increases progressively as children become older (2) , and the second national youth risk behaviour survey showed that 20 % of secondary-school learners were overweight and 5 % were obese (3) . Overweight/obesity is even more prevalent during adulthood and, in 2003, 54?9 % of adult women and 29?8 % of adult men were either overweight or obese (4) .

Results from South Africa’s 2014 Report Card on Physical Activity for Children and Youth

“…Although some parents encouraged their children to make healthy purchases, for example, 37% of parents advised their children to purchase of fruit at school and 23% advised the purchase healthy foods, 24% of parents were not aware of the types of foods their children purchased at school. 44 The grade thus remained a C.…”

“…Other smaller regional studies in younger age groups support this observation to varying degrees. 43,44,46 Many children were now receiving fruit and vegetables through the National Schools Nutrition Program (NSNP). 42 This was made possible by an increase in the average meal cost allowance per student per day since the last report card and the addition of a guideline to allow for fresh vegetables or fruit to be served daily.…”

“…Similar findings were noted in specific settings. 43,44,46 Children gave various reasons for not bringing a lunchbox to school, with more than 1 in 4 children not having food at home to put into the lunchbox. 9 Of those who did, only a small proportion included fruit.…”

Nutrition education practices of primary school teachers in a resource-constrained community in Gauteng, South Africa

“…About one-third of the teachers in our study had not had any opportunities for in-service nutrition training. A South African study that considered the school food environment in relation to healthy eating revealed that most of the teachers showed interest in nutrition, but only 15% had received nutrition training (Faber et al 2013). It was further confirmed that providing training for teachers in all the learning areas of LO could facilitate healthy behavioral outcomes .…”

“…This finding is contrary to the U.S Department of Education survey on the teaching of nutrition, where one-third of the teachers taught nutrition as a separate subject, while the same proportion also taught nutrition by integrating it into other subjects (Celebuski and Farris 2000). In another South African study, 56% and 21% of educators taught nutrition as part of LO and NST, respectively (Faber et al 2013). …”