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Abstract: Background: Childhood nutrition is important in optimising growth, development and future health. The present study compared dietary intakes of Australian children aged 4–8 years with (i) Australian Guide to Healthy Eating (AGHE) food group recommendations and (ii) age‐specific Nutrient Reference Values (NRVs), in addition to (iii) describing food group intakes of children meeting key NRVs. Methods: Data were obtained from a representative sample of children (n = 789) from the National Nutrition and Physical Activity Survey between May 2011 and June 2012. Parent‐reported 24‐h recall dietary data were disaggregated into five core food groups, along with energy‐dense, nutrient‐poor (EDNP) foods, with intakes being compared with AGHE recommendations. Food group intakes were compared for children meeting the NRVs for 10 nutrients used for the development of AGHE food groups. Chi‐squared and t‐tests were performed to determine differences in food group intakes with P < 0.05 considered statistically significant. Results: Only one child met the recommended daily servings for all AGHE core food groups and none met both core and energy‐dense, nutrient‐poor (EDNP) food group recommendations. The lowest level of alignment (percentage meeting recommendations) was for vegetables (4.6%) and the highest was for fruit (47.7%). Mean (SD) daily intake of EDNP foods [4.7 (3.2) serves day−1] accounted for 38.4% of total energy intakes. Children meeting key NRVs (n = 395) consumed greater daily servings of fruit [2.2 (1.7)], dairy [2.2 (1.2)] and EDNP foods [5.0 (3.4)] compared to the total sample (n = 789). Conclusions: Significant discrepancies exist between contemporary dietary patterns of Australian children and national recommendations. Future AGHE revisions should incorporate greater diversity of consumption patterns, including sub‐categories of EDNP foods. [ABSTRACT FROM AUTHOR]

Abstract: Background: The eating patterns of school‐aged children rarely meet recommendations: meal frequency is irregular and the consumption of vegetables is lower and sugar‐sweetened products higher than recommended. Although school is an excellent arena for nutrition education to support pupils eating patterns, teachers usually lack efficient tools. The present study aimed to develop a curriculum for nutrition education to be used by teachers and to examine its efficacy in the school environment with respect to the eating patterns of pupils. Methods: The curriculum was developed in collaboration with school teachers using self‐determination theory as a theoretical standpoint. The Health at Every Size concept and sensory‐based food education were utilised in the curriculum. Self‐reported questionnaires were used to assess the feasibility and impact of the curriculum. Fourteen teachers implemented the curriculum during 2012–2013 with 194 pupils aged 10–13 years (fifth and sixth grades). The control schools included 140 pupils of the same age not following the curriculum. Results: The teachers reported that the curriculum was easy to integrate in the school environment. The fifth graders improved their breakfast frequency, increased their consumption of vegetables and reduced their consumption of ice cream, sweets and sugar‐sweetened drinks. No improvement was found in the fifth graders at the control schools. In the sixth graders, no dietary changes were detected in the intervention or control schools. Conclusions: The pupils in the fifth grade appeared to comprise a responsive target group for nutrition education at schools. The curriculum offers a promising approach for developing healthy eating patterns among fifth graders. Collaboration with teachers in developing the curriculum likely enhanced its feasibility and teacher commitment for implementation. [ABSTRACT FROM AUTHOR]

Background Free nutritionally balanced school lunches are offered to all schoolchildren in basic education in Finland in each school day. Having school lunch on a regular basis has been found to reflect overall eating patterns. However, skipping part of or even the entire lunch is common. The present study investigated the determinants of the regular consumption of a nutritionally balanced school lunch among schoolchildren, with special reference to the role of sense of coherence ( SOC). Methods In total, 887 children (457 girls and 424 boys), aged 10-17 years from three municipalities in Eastern Finland, filled in a web-based questionnaire in class during a school day and reported eating patterns, body height and weight and perception of body image. SOC was measured by using the 13-item scale. The statistical analysis was carried out with logistic regression modelling and the chi-squared test. Results In addition to female gender, frequent shared family meals, perception of body image as appropriate and younger age, SOC was a significant determinant of regularly eating a nutritionally balanced school lunch in the final multivariate modelling. Strong SOC was also associated with more regular meal frequency and health-promoting snack choices. Conclusions To promote healthy eating patterns among school-aged children, special attention should be paid to children with weak SOC because they may need specific support and encouragement. They might lack sufficient belief in their own capability and/or do not have adequate support from their family to influence their eating and other lifestyle patterns. [ABSTRACT FROM AUTHOR]

How to cite this article Upton D. Upton P. & Taylor C. (2012) Fruit and vegetable intake of primary school children: a study of school meals. J Hum Nutr Diet. Abstract Background: Despite an increasing focus on the nutritional content of school meals and initiatives such as the School Fruit and Vegetable Scheme, children are not meeting the recommended levels of fruit and vegetable consumption. The present study aimed to examine children's fruit and vegetable consumption in 15 primary schools across the West Midlands region. Methods: A total of 1296 children, aged 4-11 years, were observed for five consecutive days and the consumption of all food items was measured using the weighed intake method. Differences in the mean intake of fruit, vegetables and foods high in fat and sugar between Key Stages 1 and 2 were determined. Results: Two-thirds of the children in the present study did not consume any fruit at lunchtime and only 3% of children consumed at least one portion as part of their school meal. The proportion of children consuming some quantity of vegetable at lunchtime was more than double that consuming fruit. Children in Key Stage 1 consumed significantly more vegetables on average than children in Key Stage 2 ( P ≤ 0.05); however, no significant differences were found for the consumption of fruit. Conclusions: Despite the introduction of food-based standards for school meal provision; children are not consuming adequate portions of fruit and vegetables at lunchtime. The importance of strategies used by catering staff to promote the consumption of fruit and vegetables should be harnessed to encourage children to taste fruit and vegetables provided. Further research is recommended to increase the evidence base on strategies aiming to promote fruit and vegetable consumption in children. [ABSTRACT FROM AUTHOR]

How to cite this article Keyte J., Harris S., Margetts B., Robinson S. & Baird J. (2012) Engagement with the National Healthy Schools Programme is associated with higher fruit and vegetable consumption in primary school children. J Hum Nutr Diet. 25, 155-160 Abstract Background: Improving children's diets is currently a government focus. However, fruit and vegetable consumption, a key target, is still far below the government guidelines of five portions per day. The present study aimed to assess the impact of engagement with the National Healthy Schools Programme (NHSP) on fruit and vegetable consumption in a sample of primary school children. Methods: A sample of 511 children, aged 7-9 years, who were attending 10 randomly selected schools in Hampshire, completed the Day in the Life Questionnaire, a validated 24-h recall method of dietary assessment. Fruit and vegetable intake in pupils attending schools engaged with the NHSP was compared with that of pupils attending schools not engaged with the programme. Results: Children attending schools engaged with the NHSP ate a median of two (interquartile range, 0-8.0) portions of fruit and vegetables, compared to one portion (interquartile range, 0-8.0) consumed by pupils attending a school not engaged with the programme ( P = 0.001). Gender was also a significant predictor of fruit and vegetable consumption, with girls being 1.68 times more likely to consume 2.5 or more portions of fruit and vegetables. After adjustment for free school meal eligibility (as a measure of socio-economic status) and gender, pupils attending schools engaged with NHSP were twice as likely to eat 2.5 portions of fruit and vegetables or more per day. Conclusions: Engagement with the NHSP may be an effective way of increasing fruit and vegetable consumption in primary school children. Further evaluation of the programme is recommended to determine which aspects of the NHSP are successful in achieving this. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that rising obesity among children is partly attributable to sugary foods and soft drinks driving an increase in energy intake (EI). Yet historical data on sugar intake are sparse. The present study calculated total sugar intake de novo among 3296 children aged 10–11 and 14–15 years in 1983 and compared EI, macronutrients and sugar sources with data from 459 children of same age in the 1997 National Diet and Nutrition Survey. Methods: Secondary analysis of 7-day weighed diet records and anthropometric data from two British surveys. Compositional data on sugars applied to individual food codes to calculate sugar intake and sources for 1983. Trends examined before/after adjustment for low/high energy reporting (LHER) defined as EI : basal metabolic rate <1.16 or >2.65. Results: Mean EI (kJ day−1) was 7% lower in 1997 than in 1983, mainly as a result of lower fat intake. After excluding LHER, mean EI was 3% lower in 1997. Mean body mass index (BMI) increased by 0.7–1 kg m−2 (2–3 kg). Total sugar intake averaged 115 g day−1 in 1983 and 113 g day−1 in 1997 (122 versus 127 g day−1 excluding LHER, P = 0.08). Excluding LHER, fat energy was lower in 1997 (35.4% versus 37.8%) and sugars slightly higher (23.6% versus 22.3%). Sugar sources showed a marked shift away from table sugar with smaller falls in milk, biscuits and cakes, counterbalanced by an significant increase in sugar from soft drinks and, to a lesser extent, fruit juice and breakfast cereals. Conclusions: Althugh the study design precludes drawing causal inferences regarding nutrient intake and obesity, a higher prevalence of under-reporting and lower levels of physical activity in 1997 could explain the paradox of lower reported EI and rising BMI. [ABSTRACT FROM AUTHOR]

Children's food preferences are strongly associated with their consumption patterns. Identifying the factors that influence preferences is therefore crucial to the development of effective interventions to improve children's diets. Perhaps the most important determinant of a child's liking for a particular food is the extent to which it is familiar. Put simply, children like what they know and they eat what they like. From the very earliest age, children's experiences with food influence both preferences and intake, and research suggests that the earlier and broader that experience, the healthier the child's diet. Laboratory studies of children's food acceptance have indicated that repeated opportunities to taste unfamiliar foods results in increased liking and consumption. In order to investigate whether these results can be replicated in real-world situations, a series of naturalistic studies testing the efficacy of exposure-based interventions have been carried out. In a school-based study large increases in liking and intake of raw red pepper were seen in 5- to 7-year olds and two further studies, in which mothers used exposure techniques to increase children's acceptance of vegetables, achieved similar results. If future large-scale interventions prove to be successful, training could be offered to health professionals or directly to parents themselves. [ABSTRACT FROM AUTHOR]

An abstract of the article "Improving the quality of packed lunches in primary school children," by N. Cooper and C. Jones is presented.

An abstract of the article "An evaluation of an intervention to improve water consumption in primary school children," by L. Briggs and B. Menger is presented.

An abstract of the article "The effect of an intervention to improve water consumption on pupils, parents and teachers," by L. Briggs and B. Menger is presented.

Increasing fruit and vegetable (FV) intake can optimise nutrition, enhance health and reduce obesity risks (Lock et al., 2005). Despite public-health initiatives to promote these benefits, consumption in UK children remains poor (National Health Service, 2009). This study explored primary-school children's perspectives of FVs aiming to gain insight into the personal, social and cultural factors that may influence inadequate intakes. Three focus groups comprising of six randomly selected, 7-9 year old children (three boys, three girls) were conducted representing three demographically diverse primary schools in Plymouth, England. Qualitative data was generated through group discussions, tasting sessions, writing exercises and grouping activities. Three observers documented behaviour throughout. Conversations were digitally voice recorded and manually transcribed verbatim. To ensure reliability and validity, four researchers analysed each transcript and observational data to identify significant themes, frequencies and patterns (Hancock, 2002). No formal statistics were applied. The project obtained ethical approval via the University of Plymouth School of Health Professions. Perceptions were found to be associated with four major themes: positive health benefits, knowledge, sensory properties and food safety. Preference was linked to familiarity, a uniform appearance and favoured tastes/textures (e.g. sweet). FVs considered 'out of date' or covered in soil, were viewed as a possible health risk. Reported usage patterns of FVs for meals/snacks were similar across all groups and lacked variety. Enjoyable experiences were associated with positive attitudes towards consumption. Family and peer influences were noted in observational and self-reported data. Lower socio economic status (SES) and age was associated with reduced familiarity, knowledge, and willingness to try. Older children and those with higher SES exhibited heightened awareness of health benefits and cited texture and quality as a determinant of consumption in addition to taste. Results relating to preference and determinants of consumption were comparable with previous research (Rassmussen et al., 2006). Preference, attitude, knowledge experience and behaviour differed between focus groups. Further replication and a greater sample size are required to investigate the extent to which differences can be attributed to focus group disparity in age (7-9 years), cognition and/or demographics (Zeinstra et al., 2007). Public health strategies that increase positive childhood FV experiences and promote FVs as fun, enjoyable and satiating rather than just 'healthy', may be advantageous in promoting consumption. Further research initiatives targeted at primary school children might also consider family/peer group influences and home FV usage in relation to variety and meal patterns. Hancock, B. (1998) Trent Focus for Research and Development in Primary Health Care: Introduction to Qualitative Research. Nottingham: Trent Focus. Lock, K., Pomerleau, J., Causer, L., Altmann, D.R. & McKee, M. (2005) The global burden of disease attributable to low consumption of fruit and vegetables. Bull. World. Health. Organ., 100-8. National Health Service: Information Centre for Health and Social Care. (2009) Health Survey for England 2008 Trend Tables. Available at: [Accessed on 26 June 2010]. Rasmussen, M., Krolner, R., Klepp, K.I., Lytle, L., Brug, J., Bere, E. & Due, P. (2006) Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part 1: quantitative studies. Int. J. Behav. Nutr. Phys. Act., 22. Zeinstra, G.G., Koelen, M.A., Kok, F.J. & de Graaf, C. (2007) Cognitive development and children's perceptions of fruit and vegetables; a qualitative study. Int. J. Behav. Nutr. Phys. Act., 30. [ABSTRACT FROM AUTHOR]