The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland
Background: A universal infant free school meals (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years; as a result, school meal uptake rose sharply. School food in the UK is known overall to be healthier and less processed than food brought from home (pa...
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2024-04-01
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| author | Jennie C. Parnham Kiara Chang Fernanda Rauber Renata B. Levy Anthony A. Laverty Jonathan Pearson-Stuttard Martin White Stephanie von Hinke Christopher Millett Eszter P. Vamos |
| author_facet | Jennie C. Parnham Kiara Chang Fernanda Rauber Renata B. Levy Anthony A. Laverty Jonathan Pearson-Stuttard Martin White Stephanie von Hinke Christopher Millett Eszter P. Vamos |
| author_sort | Jennie C. Parnham |
| collection | DOAJ |
| description | Background: A universal infant free school meals (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years; as a result, school meal uptake rose sharply. School food in the UK is known overall to be healthier and less processed than food brought from home (packed lunches), but it is unknown as to how UIFSM impacted the level and type of ultra-processed food (UPF) consumed. Therefore, this study aimed to evaluate the impact of the UIFSM policy on the processing levels of food consumed during the school lunchtime period among schoolchildren in England and Scotland. Methods: Data from the National Diet and Nutrition Study (NDNS), a nationally representative repeated cross-sectional survey, were used to conduct a difference-in-difference study. The average intake of UPF (% of total lunch grams and % total lunch Kcal) using the NOVA classification was calculated for each school lunch. The lunchtime intakes in the intervention group (4–7 years, n = 866) were compared to the control (8–11 years, n = 808) pre- (2008–2014) and post-intervention (2014–2019) using linear regression, adjusting for sociodemographic variables and total lunchtime intake (grams). Inverse probability weights were used to balance the characteristics across the intervention groups. Results: Before UIFSM, the consumption of UPFs as a proportion of total lunch energy (UPF % Kcal) was similar in the intervention and control groups (67% Kcal vs. 69% Kcal). After adjustment for covariates, UPF consumption decreased by 6.3 pp (95% CI −11.3, −1.3) after UIFSM. The findings were similar for UPF as the percentage of total lunch grams. These effects were driven by increases in minimally processed dairy and eggs and starchy foods and decreases in salty snacks and ultra-processed bread and drinks consumption. The greatest reduction in UPF consumption was in low-income children (−17.2% Kcal; 95% CI −26.5, −7.8), compared to mid- (0.5% Kcal; 95% CI −4.0, 1.0) or high-income children (−5.3% Kcal; 95% CI −13.6, 2.9). Conclusions: This study builds on previous evidence and shows that UIFSM improved children’s dietary intake at school by minimising exposure to UPFs. These results indicate that universal free school meal policies could be an important policy for long-term equitable improvements in children’s diet and subsequent health. |
| format | Article |
| id | doaj-art-07d313bc01ca409a81b313bbc3fe06b3 |
| institution | DOAJ |
| issn | 2504-3900 |
| language | English |
| publishDate | 2024-04-01 |
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| spelling | doaj-art-07d313bc01ca409a81b313bbc3fe06b32025-08-20T02:43:06ZengMDPI AGProceedings2504-39002024-04-0191142410.3390/proceedings2023091424The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and ScotlandJennie C. Parnham0Kiara Chang1Fernanda Rauber2Renata B. Levy3Anthony A. Laverty4Jonathan Pearson-Stuttard5Martin White6Stephanie von Hinke7Christopher Millett8Eszter P. Vamos9Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UKPublic Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UKDepartment of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo 01246-903, BrazilDepartment of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo 01246-903, BrazilPublic Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UKDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London SW7 2AZ, UKMRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UKSchool of Economics, University of Bristol, Priory Road Complex, Bristol BS8 1TU, UKPublic Health Research Centre & Comprehensive Health Research Center (CHRC), National School of Public Health, NOVA University of Lisbon, 1600-1500 Lisbon, PortugalPublic Health Policy Evaluation Unit, School of Public Health, Imperial College London, London W6 8RP, UKBackground: A universal infant free school meals (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years; as a result, school meal uptake rose sharply. School food in the UK is known overall to be healthier and less processed than food brought from home (packed lunches), but it is unknown as to how UIFSM impacted the level and type of ultra-processed food (UPF) consumed. Therefore, this study aimed to evaluate the impact of the UIFSM policy on the processing levels of food consumed during the school lunchtime period among schoolchildren in England and Scotland. Methods: Data from the National Diet and Nutrition Study (NDNS), a nationally representative repeated cross-sectional survey, were used to conduct a difference-in-difference study. The average intake of UPF (% of total lunch grams and % total lunch Kcal) using the NOVA classification was calculated for each school lunch. The lunchtime intakes in the intervention group (4–7 years, n = 866) were compared to the control (8–11 years, n = 808) pre- (2008–2014) and post-intervention (2014–2019) using linear regression, adjusting for sociodemographic variables and total lunchtime intake (grams). Inverse probability weights were used to balance the characteristics across the intervention groups. Results: Before UIFSM, the consumption of UPFs as a proportion of total lunch energy (UPF % Kcal) was similar in the intervention and control groups (67% Kcal vs. 69% Kcal). After adjustment for covariates, UPF consumption decreased by 6.3 pp (95% CI −11.3, −1.3) after UIFSM. The findings were similar for UPF as the percentage of total lunch grams. These effects were driven by increases in minimally processed dairy and eggs and starchy foods and decreases in salty snacks and ultra-processed bread and drinks consumption. The greatest reduction in UPF consumption was in low-income children (−17.2% Kcal; 95% CI −26.5, −7.8), compared to mid- (0.5% Kcal; 95% CI −4.0, 1.0) or high-income children (−5.3% Kcal; 95% CI −13.6, 2.9). Conclusions: This study builds on previous evidence and shows that UIFSM improved children’s dietary intake at school by minimising exposure to UPFs. These results indicate that universal free school meal policies could be an important policy for long-term equitable improvements in children’s diet and subsequent health.https://www.mdpi.com/2504-3900/91/1/424school meal policyultra-processed foodschool food |
| spellingShingle | Jennie C. Parnham Kiara Chang Fernanda Rauber Renata B. Levy Anthony A. Laverty Jonathan Pearson-Stuttard Martin White Stephanie von Hinke Christopher Millett Eszter P. Vamos The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland Proceedings school meal policy ultra-processed food school food |
| title | The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland |
| title_full | The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland |
| title_fullStr | The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland |
| title_full_unstemmed | The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland |
| title_short | The Impact of the Universal Infant Free School Meals Policy on the Ultra-Processed Food Content of Children’s Lunchtime Intake in England and Scotland |
| title_sort | impact of the universal infant free school meals policy on the ultra processed food content of children s lunchtime intake in england and scotland |
| topic | school meal policy ultra-processed food school food |
| url | https://www.mdpi.com/2504-3900/91/1/424 |
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