1. - a unique web-based instrument for the evaluation and improvement of school meal quality Emma Patterson BSc Human nutrition, PhD Project manager Essen, Germany 5th September 2012

2. Why is the school lunch so important? ◊A child will eat almost 2000 lunches at school in Sweden ◊For 5 days a week, it should provide 30% of all daily nutritional requirements ◊Potential effects on attention, learning ◊A pedagogic tool – a practical way to teach about diet, health etc. ◊May counteract social inequalities in health

3. School meals: a long history in Sweden ◊Practice began in the late 1800s, aimed at children from poor families ◊For decades, Sweden and Finland have been unique in serving free cooked meals in primary school ◊“A free school lunch for every child” was enshrined in law in 1997

4. A new, updated, school law ◊From 1st July 2011 a new version of this law applies ◊“A free nutritious school lunch for every child” ◊No monitoring system in place

5. What does “nutritious” mean? ◊Means according to Swedish nutrition recommendations – similar to WHO recommendations – i.e. complying with upper and/or lower limits for energy, nutrients ◊Can also follow food-based guidelines – Fatty fish, low-fat milk, low-fat margarine

6. What does the law mean in practice? ◊For schoolchildren – A right to a nutritious school lunch ◊For schools – A reason to consider the school lunch as an integral part of the school day – Will have to document for the Schools Inspection Agency that they comply with the new law

7. What is School Food Sweden? ◊Free, web-based system ◊Helps the person responsible for school food at the school to thoroughly evaluate provision ◊Provides tailored feedback to each school ◊Aimed at all Swedish primary schools (ca 4000) and local authorities (290) ◊Collaboration; developed by researchers (no commercial interests)

8. A holistic approach to the school meal ◊The school meal is about more than just nutritional content ◊The aim is to gather information not just on the nutritional content of school meals but also on other relevant aspects ◊The school meal quality is therefore evaluated in the following areas:

9. Level 3 Organisation Level 2 Service & pedagogy Environmental impact Level 1 Food choice and provision Nutritional adequacy Safe food Staff questionnaire Student questionnaire School meal quality – holistic approach

10. School report How does it work? 1 2 3

11. Food choice and provision Number of dishes daily Bread, sallad buffet etc. Breakfast, snacks, kafeteria y Nutritional adequacy Types of meals Types of foods Serving frequency Amounts Safe food Education Routines (hygiene, special diets) Level 1 Level 1 Food choice and provision Nutritional adequacy Safe food

12. Nutritional adequacy ◊Vitamin D ◊Iron ◊We developed and validated nutrient-specific food-based criteria for each ◊Criteria predict if school is likely to fulfill/unlikely to fulfill Swedish Nutritional Recommendations ◊Fat quality ◊Fibre

13. Level 2 Service & pedagogy Environmental impact Service & pedagogy Scheduling Service & meal environment ”Pedagogic lunch” Student involvement Environmental impact Food/packaging waste Food choices (meat, fish etc) Organic food Level 1 Food choice and provision Nutritional adequacy Safe food Level 2

14. Organisation Goals & guidelines Responsibility Competencies & resources Uptake & consumption Level 3 Organisation & policy Level 2 Service & pedagogy Environmental impact Level 1 Food choice and provision Nutritional adequacy Safe food Level 3

15. Guest perspective

16. Spring/autumn 2011 Development process Spring 2010 Autumn 2010 Spring 2012

17. What do we now know? ◊We now have a picture of school food at national level for the first time ◊Baseline data from 191 schools gathered spring 2011

18. What now? ◊Research: data facilitates study of the associations between school meal quality, students’ uptake, diet, health and academic achievement ◊Monitoring: Future reports will allow us to highlight progress of school food quality nationally ◊Expansion: Demand exists for similar systems for hospitals, preschools, elderly care facilities etc.

19. More information: www.skolmatsverige.se info@skolmatsverige.se emma.patterson@ki.se