Packed lunches: just 1% are healthy

“Only one in 100 pupils' packed lunches meets basic dietary standards,” reported The Times . The news story is based on a study that looked at what primary school children typically took to school in their packed lunches and how this compared to the nutritional standards set for school meals.

The research did find that only a very small proportion of packed lunches met all the nutritional criteria set out in the standards for school meals, but no research was done on how packed lunches may affect children’s health. This research provides evidence for policy makers of the need to produce practical educational material on how to prepare healthy and nutritionally balanced packed lunches.

Where did the story come from?

This research was carried out by Charlotte Evans and colleagues from the University of Leeds. The study was commissioned by the Food Standards Agency and published in the Journal of Epidemiology and Community Health.

The press published balanced reports of the research, focusing on the observation that only 1% of pupils’ packed lunches met the nutritional standards that are set out for school meals.

What kind of research was this?

In this cross-sectional study researchers carried out a survey of children’s packed lunches at school, and assessed their nutritional value. The aim was to see whether packed lunches typically meet the new standards for school meals proposed by the School Meals Review Panel (SMRP), formed in 2005.

The government has largely implemented these suggestions, prohibiting or restricting schools from serving foods high in salt, sugars and fats, or made with poor-quality meat. Other changes, including the mandatory introduction of protein-rich food, low-fat starchy food, vegetables, fruit and dairy food, and standards for nutrient content, have also been made.

What did the research involve?

In 2006, the researchers sent letters to 176 randomly selected primary schools in the UK. Of these, 89 agreed to participate (76 in England, 4 in Scotland, 6 in Wales and 3 in Northern Ireland). To ensure that the samples were representative, the schools in England were categorised according to their overall performance in standard aptitude tests at key stage 2 and the proportion of their children who were eligible for free school meals.

One class from year four (aged 8 to 9) was randomly selected from each school. From these classes, children who took a packed lunch to school at least one day a week were asked to participate and were followed up for one year.

In June of that year, a trained administrator visited each of the schools to collect information on the children’s packed lunches. Data were collected from 1,294 children who went through a ‘lunch box evaluation’ questionnaire with the administrator. The food was weighed before and after lunch, to see how much the children had not eaten. The administrator weighed sandwiches whole, and then estimated the amounts of filling in them.

What were the basic results?

Data were collected from 663 boys and 631 girls. Food most likely to be included in a packed lunch included sandwiches, confectionery, savoury snacks and sweetened drinks. On average, children consumed 76% of their packed lunch.

Fourteen children (1.1%) met all of the standards for school meals and 66 (5.1%) children’s packed lunches met five healthy standards. These five healthy standards were a sandwich with protein filling (or alternative starchy and protein food), some vegetables, fruit and a dairy product. Overall, the median (average) number of these healthy items in the children’s lunchboxes was three. In the sandwiches, 67.5% had a protein-rich filling.

The researchers examined whether there was a difference between what girls and boys had for lunch. They found that girls consumed 4g more vegetables, 12g more fruit and 10g more milk-based desserts than boys. Boys consumed on average 2g more cakes and biscuits.

On average, children at schools where a lower proportion of pupils received free school meals consumed 4g more vegetables each.

A comparison of nutrients in packed lunches with school meals standards for England revealed that fewer than half of children met the standards for energy, saturated fat, non-milk extrinsic sugars, non-starch polysaccharides, sodium, vitamin A, folate, iron or zinc.

How did the researchers interpret the results?

The researchers concluded that “few packed lunches met the school meal standards. Children were given packed lunches low in fruit and vegetables, although most included a sandwich. The majority of packed lunches included savoury snacks, confectionery or both. Since 2004, there may have been some improvements in the nutritional profile of packed lunches due to changes in the composition of some manufactured foods; however, there have been no improvements in children’s packed lunches in terms of the types of food provided”.

Conclusion

This was a well-conducted study that gives a snapshot of the types of food that primary school pupils take to school in their packed lunch. Researchers compared the nutritional content of the food, and how much was not eaten, and found that the packed lunches did not meet the standards set for school meals.

Child health was not an aim of this study, and the researchers did not follow up the effects of packed lunches on children’s health. If it had been possible, it would have been useful if the researchers had determined the reasons behind the contents of the packed lunches. For example, who made the lunch, if they were restricted by time, if there were financial issues or if they did not know the healthiest options for a child’s lunch.

This type of research provides evidence for policy makers of the need to produce practical educational material on how to prepare a nutritionally balanced packed lunch for children.