Diet, nutrition and schoolchildren: An update

Abstract

Summary This paper updates a British Nutrition Foundation (BNF) Briefing Paper on this topic, published in 2011. Healthy eating and being physically active are particularly important for children and adolescents. This is because their nutrition and lifestyle influence their wellbeing, growth and development. There remains considerable room for improvement in the diets of British schoolchildren, according to findings of the government's National Diet and Nutrition Surveys (NDNS), but some improvements have been made in the past decade. Although intakes of saturated fatty acids and non‐milk extrinsic sugars have decreased in recent years, on average, they are still above recommended upper levels. Average contribution of fat to total energy intake has dropped below the recommended upper level of 35%, but fibre intakes remain low. With regard to micronutrients, many teenage girls are consuming low amounts of iron, but there is also evidence of low intakes of vitamin A, riboflavin, calcium, magnesium, potassium, selenium, iodine and zinc. New data on micronutrient status is now available for 11–18 year‐olds, and reveals low levels of vitamin D, riboflavin and iron (mainly in girls). Low vitamin D intake and status is a particular problem in some ethnic minority groups, especially South Asian children. There is also some evidence of socio‐economic inequalities; for example, children from families with higher incomes tend to have higher intakes of fruits and vegetables compared with children from families with lower incomes. This paper also discusses how dietary patterns can influence the micronutrient intake and status of schoolchildren, as well as the risk of overweight and obesity. Since publication of the Briefing Paper in 2011, new physical activity guidelines have been published and, for the first time, these are UK‐wide guidelines. Also for the first time, UK‐wide data on physical activity levels in schoolchildren are available (for 7‐year‐old children). Physical activity levels vary little between the UK regions, with the exception of Northern Ireland where fewer children meet the UK recommendations than in other regions. The data highlight significant differences between boys and girls (with girls generally being less active) and significant differences between ethnic groups. In particular, children from the Bangladeshi, Indian and Pakistani ethnic groups are less likely to meet the recommended levels of physical activity compared with other children. Obesity remains a major problem among British schoolchildren and there is a stark socio‐economic gradient, with levels of obesity being highest in the most socially deprived children. This paper also discusses various health issues in children, including iron deficiency anaemia, oral health, bone development, food allergy and intolerance, and cognitive function in children, updating the previous paper with the latest statistics and evidence. The findings of the NDNS serve to emphasise the importance of a whole school approach to good nutrition embracing the school...

An evidence‐based resource for the management of comorbidities associated with childhood overweight and obesity

“…Routine screening for vitamin D deficiency in overweight and obese children is also recommended (AHRQ, ; Belanchia, Tosh, Hillman, & Peterson, ; Estrada et al., ; Weichselbaum & Buttriss, ). Belanchia et al.…”

“…Assessment for vitamin D deficiency should be done at the time overweight or obesity is diagnosed, using serum 25‐hydroxy vitamin D (25‐OH vitamin D) testing (AHRQ, ; Belanchia et al., ). Deficiency is consistently defined in both the pediatric and adult population as a 25‐OH vitamin D level less than 20 ng/mL (AHRQ, ; Belanchia et al., ; Estrada et al., ; Weichselbaum & Buttriss, ). Because of seasonal variations in sun exposure, use of sunscreen that interferes with vitamin D synthesis, and intake of inadequate dietary sources of vitamin D, supplementation is recommended for children starting at birth (National Institutes of Health, ).…”

School food provision in England: A historical journey

“…). In England, school food provision has regularly made its way into the headlines in recent years due to public concern about the nutritional value of school meals, as well as issues around food insecurity for children and young people (DHSS ; BBC News ; Weichselbaum & Buttriss ). Indeed, the approach used and willingness to implement school food standards within schools in England can be variable (Kitchen et al .…”

School food in England: Are we getting it right?

“…Robust legislation (Statutory Instrument ; The Education Regulations ) introduced compulsory standards in England between 2006 and 2008 to ensure that school catering was healthy, and that caterers and schools sat up and took notice. Further details of the legislation and of the regulations in place in Scotland, Wales and Northern Ireland can be found in the review in this issue by Weichselbaum and Buttriss (, pp. 9–73).…”

“…This fragmented approach is unlikely to yield best value for money or a co‐ordinated solution to the issues. We face a massive child health crisis, mainly in the form of an obesity epidemic (see statistics summarised in Weichselbaum & Buttriss , in this issue). If better school food is key to improvement and is likely to benefit not only child health but also educational and behavioural outcomes, it is beholden on government to put in place a co‐ordinating organisation, cross‐departmental in character, properly funded and staffed over at least three years (and preferably five), to address the issues.…”