Department of Applied Health Sciences, Murray learning Centre, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
NIHR Birmingham Biomedical Research Centre, Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, B15 2TH, UK.
Int J Behav Nutr Phys Act. 2024 Oct 24;21(1):123. doi: 10.1186/s12966-024-01672-w.
Many countries have introduced school food standards to improve the dietary intakes of school-aged children. England has school food standards (SFS) legislation in place but little is known about how well secondary schools comply with this. We aimed to assess compliance with the SFS legislation in English secondary schools and explore the impact of the SFS on pupils' nutritional intake.
We conducted a cross-sectional study with English secondary schools from 2019 to 2022. We compared SFS compliance and pupil nutritional intake in schools mandated or not mandated to comply with the SFS legislation, and explored the association between school compliance and pupil nutritional intake. We assessed the percentage of SFS (%SFS) complied with by reviewing school food menus and observing food served in school canteens. We assessed pupil nutritional intake using a 24-hour dietary recall measure (Intake24) and estimated intakes of free sugar (primary outcome) and other nutrients/foods. We used adjusted multilevel models to compare pupil intakes in the SFS-mandated and SFS-non-mandated schools, and to explore the association between school SFS compliance and pupil intakes.
36 schools (23 not mandated and 13 mandated to comply with the SFS) and 2,273 pupils participated. The median %SFS complied with was 63.9% (interquartile range 60.0-70.0%). This was similar for SFS-non-mandated (64.5%) and SFS-mandated schools (63.3%). Compliance was highest for standards applying to lunchtime (median = 81.3%) and lowest for those applying across the whole school day (median = 41.7%). It was also lower for standards restricting high fat, sugar and energy-dense items (median = 26.1%) than for standards aiming to increase dietary variety (median = 92.3%). Pupils from SFS-mandated schools had a lower mean lunchtime intake of free sugar (g) (adjusted mean difference: -2.78g; 95% CI: -4.66g to -0.90g). There were few significant associations between %SFS complied with and pupil nutritional intake.
English secondary schools do not fully comply with SFS legislation regardless of whether they are mandated to comply. Schools and caterers may require monitoring and support to fully comply. There is little evidence that SFS compliance is associated with better pupil nutritional intake. Food environments outside of school also need to be considered.
ISRCTN68757496 (17-10-2019).
许多国家都出台了学校食品标准，以改善学龄儿童的饮食摄入。英国已经出台了学校食品标准（SFS）立法，但对于中学遵守这些标准的情况知之甚少。我们旨在评估英国中学对 SFS 立法的遵守情况，并探讨 SFS 对学生营养摄入的影响。
我们进行了一项横断面研究，对象为 2019 年至 2022 年的英国中学。我们比较了遵守和不遵守 SFS 立法的学校的 SFS 遵守情况和学生营养摄入情况，并探讨了学校遵守情况与学生营养摄入之间的关系。我们通过审查学校食品菜单和观察学校食堂供应的食物来评估 SFS 遵守情况的百分比（%SFS）。我们使用 24 小时膳食回顾法（Intake24）评估学生的营养摄入，并估计游离糖（主要结果）和其他营养素/食物的摄入量。我们使用调整后的多水平模型比较了 SFS 强制遵守和非强制遵守学校的学生摄入量，并探讨了学校 SFS 遵守情况与学生摄入量之间的关系。
有 36 所学校（23 所未强制遵守，13 所强制遵守）和 2273 名学生参与了研究。遵守的 SFS 百分比中位数为 63.9%（四分位距 60.0-70.0%）。未强制遵守和强制遵守的学校之间的遵守情况相似（分别为 64.5%和 63.3%）。适用于午餐的标准的遵守率最高（中位数=81.3%），适用于整个学校日的标准的遵守率最低（中位数=41.7%）。适用于限制高脂肪、糖和高能量密度食物的标准的遵守率（中位数=26.1%）也低于旨在增加饮食多样性的标准（中位数=92.3%）。强制遵守 SFS 的学校学生午餐时的游离糖摄入量（g）平均值较低（调整后的平均差异：-2.78g；95%CI：-4.66g 至 -0.90g）。%SFS 遵守情况与学生营养摄入之间几乎没有显著关联。
无论是否强制遵守，英国中学都没有完全遵守 SFS 立法。学校和餐饮服务提供商可能需要监测和支持才能完全遵守。几乎没有证据表明 SFS 遵守情况与学生的营养摄入更好相关。学校以外的食品环境也需要考虑。
ISRCTN68757496（2019 年 10 月 17 日）。
