Exploring the impact of school food policy on 11–12-year-olds diets in Northumberland in 2000, 2010 and 2022: a repeat cross-sectional study

Abstract

Introduction In England, school food has undergone major changes from no standards in 2000, to food- and nutrient-based standards in 2008, to revised food-based standards in 2014. This thesis explores the impact of these changes on 11–12-year-olds diets. Methods Dietary data were collected using two three-day food diaries and entered into Intake24. Mean diet quality scores were calculated using the diet quality index for adolescents (DQI-A). Changes in mean nutrient intakes were examined. Level of deprivation was calculated using individual child-level postcodes. Linear regression analyses explored the effect of year, school lunch type, level of deprivation, and the interaction of year and school lunch type. Results In total, 371 children participated. While mean DQI-A improved across years, and was statistically significant, children’s diet quality remains poor. There was no evidence of an effect by school lunch type or deprivation on mean DQI-A. In children’s total diet, several nutrients decreased across years, including per cent energy from non-milk extrinsic sugars (%E NMES). Lunch type had a statistically significant effect on some nutrient intakes studied, for example, school lunch (SL) consumers had lower sodium and NMES intakes than packed lunch (PL) consumers. There was no evidence of a year by school lunch type interaction or effect of deprivation on mean total diet nutrient intakes. At lunchtime, there were several year by school lunch type interactions, for example, %E NMES. In 2000, SL consumers had a lower intake than PL consumers, by 2022 this reversed, now SL consumers had a higher intake. There was no evidence that deprivation impacted total diet or lunchtime intakes. Conclusion Despite some improvements to children’s diets, dietary intakes remain poor. Potential solutions could include updating the school food standards and modifying school food and drink availability. Additional policies are needed to address children’s diet beyond school.