Deborah Chen | Robust school nutrition policy critical to Jamaica’s future

When entering the school, children are almost guaranteed to walk down an aisle, greeted with bright colours, enticing smells and vendors competing for their attention to purchase something, anything, from their stalls. Your child has already started to spend their lunch allowance for the day.

Snacks, juices and confectionery are on display. Foods high in sugar, sodium and fat (HFSS) bombard the school gates, even before your child enters the school compound. Most parents trust that the school canteens will provide healthy choices to their children; however, they are not remiss in being lavishly stocked with ultra-processed HFSS snacks.

The newest catchphrase in the food industry targeting parents and children alike is ‘Lunch Box Approved’ label on packages. We would like to know – who approved these items for a child’s lunch box? What makes a food item ‘lunch box approved’? This is concerning.

Consistent evidence has linked ultra-processed food intake to excess body fat, overweight, and obesity in adults and children ( The British Medical Journal, 2022). According to UNICEF’s Childhood Overweight Report for Latin America and the Caribbean (2021), 30.9 per cent of Jamaican children and adolescents aged 5-19 years are overweight.

Children are highly influenced by their peers and their eating environment. They are at a stage where they are impressionable, and it is important that the school environment reflects support for a healthy diet. Recent studies show that 23.3 per cent of Jamaican students aged 13–17 years are overweight and/or obese and more than 66 per cent of Jamaican adolescents aged 15–19 years consume fast food most days of the week.

Dr Ilana Dickson, consultant paediatrician, said in an interview in May 2022: “We are seeing more rates of diabetes and high blood pressure in our adolescents, we’re seeing a lot of these adult diseases that are bleeding now into paediatrics.” She exclaims that when she went into paediatrics she didn’t think she would be treating adult high blood pressure and diabetes, for example, as she recalls treating a seven-year-old patient with fatty liver secondary to obesity. She expounded that almost every system in the body is affected by a child being overweight or obese.

MANDATORY PHYSICAL ACTIVITY

Discussions surrounding mandatory physical activity in schools birthed the Jamaica Moves in Schools initiative, one of the flagship programmes of the Ministry of Health and Wellness (MOHW), to help tackle non-communicable diseases (NCDs) in the country. The programme, which was introduced in 2017, is geared at heightening awareness and creating increased opportunities for physical activities and healthy eating at the nation’s schools.

In 2018, Cabinet approved the interim guidelines for beverages in schools, which will help to improve the dietary intake of children but also set the stage to reduce the burden of NCDs, which account for 78 per cent of Jamaicans who die each year. These guidelines pursued the gradual reduction of sugar from 6g/100ml starting January 2019 all the way down to 2.5g/100ml effective January 2023 (this year).

The National School Nutrition Policy (SNP) produced by the Government of Jamaica through the Ministry of Education and Youth (MOEY) in association with the MOHW and collaborating ministries and agencies, aims to guide the process for the provision of good nutrition coupled with wellness. The policy will seek to ensure that children entering educational facilities are exposed to good nutrition and healthy lifestyles.

In May 2022, Cabinet approved the SNP which is in its green paper stage. The green paper document was placed online for public review and comments. Since then, there have been numerous public consultations with school principals, vendors and concessionaires, parents, and students; they have been given details of the policy and a chance to air their concerns. Next steps will include submission to Cabinet for approval prior to the policy being tabled as a white paper.

The Heart Foundation of Jamaica congratulates the bold steps taken towards protecting and preserving the health of our children, and by extension the future of our nation. We strongly encourage the submission of this policy sooner rather than later.

The COVID-19 pandemic hampered many of these actions as we are just now seeing an upturn for activities to be back on track. It is interesting that some individuals, including parents, teachers, principals and vendors, fail to see the direct correlation between the food our children eat and the growth of our economy. Echoes of “let children be children” continue to be the chorus sung as the adults of today reminisce on the loads of sweets and unhealthy snacks consumed back in the day.

HEALTHY ENVIRONMENT

Schools are meant to provide a healthy environment for children’s minds and bodies. Children spend many hours at school and eat a large portion of their meals there. Unhealthy school food environments prevent children from making good eating decisions and inculcating healthy food habits. Easy access to unhealthy foods in and around schools, along with aggressive marketing for those foods, correlates with students consuming more of those unhealthy foods.

The WHO and FAO have long advocated for the use schools to promote healthy eating habits and lifestyles. The appeal to tackle nutritional status through schools lies in the fact that the schools provide a ready environment for reaching large groups of children and the school community. According to WHO, scientific evidence has long established the effectiveness of school-based interventions in changing eating behaviour and preventing overweight and obesity (PAHO, 2014).

On February 9, we launched our ‘Out of Our Schools’ campaign, which is in strong support of the SNP. The campaign seeks to increase public support and encourage policymakers to speedily implement a healthy SNP.

We at the Heart Foundation do recognise that practical and effective steps need to be taken in tandem with the establishment of the policy, as seen with the gradual restriction of sugary drinks in schools and the renewed launch of the Jamaica Moves in Schools programme.

The numbers speak for themselves. The time to act is now. Children with insufficient diets are reported to have more problems with health, academic learning, and psychosocial behaviour. Malnutrition can result in long-term neural issues in the brain, which can impact a child’s emotional responses, reactions to stress, learning disabilities, and other medical complications ( Public School Review, 2022).

Our children are depending on us to create a safe and healthy environment for them to grow, thrive and become productive adults. The sustainability of our economy is heavily dependent on what we sow now. The SNP seeks to focus on: the food services environment, the provision of meals, physical activities environment, health promotion and curriculum development.

Persons continue to argue that healthier food items are more expensive, leaning towards the fact that their children would need to pay more money for less food. Of course, the SNP is not a panacea for long-term hunger or children’s lifestyle habits outside of the school environment. However, it stands as a starting point to improve the health of our children and in turn the nation.

Meanwhile, someone needs to shed some light on ‘Lunch Box Approved’ ...

- Deborah Chen is the executive director of the Heart Foundation of Jamaica. Send feedback to ghapjm@gmail.com.