Shaping healthier choices in school food environments

When the lunch bell rings, Kayli makes her way across the busy schoolyard, joining her schoolmates heading to the tuck shop. Within minutes, the area is filled with students forming long lines, eagerly waiting to buy something to eat.

Fourteen-year-old Kayli, like many of her friends, does not usually bring lunch to school. She enjoys the freedom of choosing from the wide range of foods and beverages available at the school canteen and from vendors outside the school walls.

After about 15 minutes in line, Kayli emerges with her hands full: a cinnamon bun with a slice of cheese, a bag of spicy tortilla chips, and a bottle of fruit-flavoured soda. She thinks she has lucked out, but a closer look at the nutrition labels tells a different story.

The cinnamon bun is high in sugar, the slice of cheese and tortilla chips contain a lot of sodium, and the fruit-flavoured soda alone exceeds the recommended daily sugar intake for a child. Taken together, Kayli’s lunch, though enjoyable and filling, provides little of the balanced nutrition needed to support her growth. It lacks fruits, vegetables, whole grains, and foods with natural dietary fibre, while being high in sugar and salt, which, if consumed too often, can contribute to unhealthy eating patterns and increase the risk of obesity and non-communicable diseases over time.

Like many children her age, Kayli pays little attention to nutrition labels. She admits she rarely reads them and does not fully understand the information when she does.

Kayli’s lunch may seem like an inconsequential choice but, multiplied across thousands of students each day, these patterns begin to shape lifelong habits.

At home, things are different. Her mother, Joanna, understands the importance of providing her daughter with foods that are nutritious and not high in sugar, salt, or saturated fats. She cooks at home regularly and avoids overindulging Kayli with fast foods.

Packaged snacks

Still, these healthier options often compete with the growing availability and widespread marketing of ultra-processed foods such as packaged snacks, sugary drinks, and highly refined baked goods that are high in the very ingredients that make them less nutritious and that contribute to the increasing rates of non-communicable diseases affecting the country today.

While Joanna would love for Kayli to bring home-cooked food for lunch, it is not always practical.

“The thing is, her school does not provide facilities where students can heat their food, so it doesn’t make much sense for her to bring cooked food from home,” she explained. “It’s not safe, either, if she’s unable to store it at the right temperature.”

In many school environments, Kayli’s experience is the norm rather than the exception. Her situation reflects a wider reality faced by many students across the country.

When children are repeatedly surrounded by unhealthy food choices and constant messaging that makes these options appear normal, appealing, and convenient, it becomes much harder for them to establish healthier habits.

The consequences of poor diets are being seen across the world. Non-communicable diseases now account for 74 percent of global deaths, with more than 10 million deaths each year linked to unbalanced diets and excessive consumption of ultra-processed products high in fats, sugars, and salt.

Closer to home, diet-related non-communicable diseases (NCDs) are the leading cause of death in Jamaica.

Public health challenges

Childhood obesity is emerging as one of the most significant public health challenges of our time. If this trend continues, it will affect not only the well-being of our children but also national productivity and place additional pressure on an already resource-constrained health system.

Healthier food environments

Improving the availability of enjoyable yet nutritious food in schools is an important part of changing this trajectory. When schools support healthier food environments, they make it easier for children, their families, and school staff to choose foods that promote better health and well-being.

This is why school nutrition standards and policies, supported by strong evidence and the commitment of multiple stakeholders, remain an important priority for the Pan American Health Organization and the World Health Organization (PAHO/WHO).

Recently, the Government of Jamaica introduced fiscal measures aimed at reducing preventable illnesses and strengthening the sustainability of the national health system. PAHO/WHO has welcomed this move because of the potential benefits for population health.

Global evidence shows that increasing taxes on sugar-sweetened beverages is one of the most effective strategies for reducing the consumption of these products and lowering the risk of diet-related diseases. These measures are endorsed by WHO as “best buys”, meaning they are considered high-impact and cost-effective interventions that countries at all income levels can implement.

In addition, WHO recommends several actions to improve the food environment in schools. These include establishing clear nutrition standards, ensuring the availability of healthy food options, restricting the marketing of unhealthy products to children, encouraging healthier choices, and adopting pricing strategies that make nutritious foods more accessible and affordable.

These actions are particularly important in the face of pervasive advertising that normalises unhealthy eating and allows industries to target children and young people with products designed to maximise profits, even as preventable illnesses such as obesity and diabetes continue to rise.

Another recommendation is the use of front-of-package warning labels (FOPWL), which is a simple, practical, and effective tool to inform the public about products that can harm health and help guide purchasing decisions.

For parents like Joanna, clearer food labelling could make a difference.

“I try to read the labels, but the print is so fine half the time you can barely make it out. And, even when you do read it, plenty of it still doesn’t make much sense,” she says. “If it is hard for me to put that in perspective, imagine how much harder it is for Kayli.”

PAHO continues to advocate for simple front-of-package warning labels that allow families to quickly identify foods that are high in sugar, salt, and other ingredients of concern. The organisation also supports strong and enforceable policies, including restrictions on the marketing of unhealthy foods and beverages to children.

For Kayli, the choice at the tuck shop is simple. She buys what tastes good and what her money can afford.

For parents, school administrators, and policymakers, the challenge is ensuring that the healthy choice becomes the easy choice for children.

keisha.hill@gleanerjm.com