Is the school food environment conducive to healthy eating in poorly resourced South African schools?

Abstract
Objective To assess the school food environment in terms of breakfast consumption, school meals, learners’ lunch box, school vending and classroom activities related to nutrition. Design Cross-sectional survey. Setting Ninety purposively selected poorly resourced schools in South Africa. Subjects Questionnaires were completed by school principals (n 85), school feeding coordinators (n 77), food handlers (n 84), educators (n 687), randomly selected grade 5 to 7 learners (n 2547) and a convenience sample of parents (n 731). The school menu (n 75), meal served on the survey day, and foods at tuck shops and food vendors (n 74) were recorded. Results Twenty-two per cent of learners had not eaten breakfast; 24 % brought a lunch box, mostly with bread. Vegetables (61 %) were more often on the school menu than fruit (28 %) and were served in 41 % of schools on the survey day compared with 4 % serving fruit. Fifty-seven per cent of learners brought money to school. Parents advised learners to buy fruit (37 %) and healthy foods (23 %). Tuck shops and vendors sold mostly unhealthy foods. Lack of money/poverty (74 %) and high food prices (68 %) were major challenges for healthy eating. Most (83 %) educators showed interest in nutrition, but only 15 % had received training in nutrition. Eighty-one per cent of educators taught nutrition as part of school subjects. Conclusions The school food environment has large scope for improvement towards promoting healthy eating. This includes increasing access to vegetables and fruit, encouraging learners to carry a healthy lunch box, and regulating foods sold through tuck shops and food vendors.