Page 11 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

“I said to the manager: ‘I notice one thing; you don’t have any whole wheat bread on
offer. It is all white bread’. The next day, the manager offered only whole wheat bread, 1 just as a test. When the students came in, only few asked for white bread. The others
just took the healthier offer for granted.”
(Quote from a school canteen advisor during the needs assessment)
Unhealthy eating habits during adolescence
In many countries, including the Netherlands, the eating habits of most adolescents can be improved. The majority of adolescents consume insufficient fruit and vegetables, and their intake of sugary beverages and snacks high in sugar and fat is above the recommended intake [1-3]. In the Netherlands, among adolescents (14-18 year), the average daily intake for fruit and vegetables is with 80 and 95 gram per day, less than half of the recommended daily intake (200 and 250 grams respectively) [4]. The intake of sugary beverages is twice as high among adolescents than among adults (600 and 300 gram p/day respectively) [5]. This unhealthy dietary pattern in adolescents is of great concern as it is associated with an increased risk for many chronic non-communicable disease such as type 2 diabetes, cardiovascular diseases, several types of cancer and overweight and obesity [6, 7]. This may, in turn, cause physical and psychosocial health problems and a reduced quality of life during adolescence, and also during adulthood [8-10]. Although much effort has been made to encourage a healthy dietary pattern among adolescents over many years, the prevalence and burden of overweight and obesity among them remains alarmingly high in the Netherlands [11, 12]. This makes stimulating a healthy dietary pattern in this age group very important.
Adolescents are known to be prone to adapt unhealthy behaviours possibly because their cognitive regulation is still developing and their decision-making process is more easily influenced by emotions and social factors [8, 13]. This makes them more susceptible to engaging in risky behaviour. Besides, adolescents are moving on to more autonomy. They are developing their own identity, have to deal with more responsibilities, and are developing habits, including dietary ones, that are sustained over time [10, 14]. For this reason, intervening in dietary behaviour during adolescence provides opportunities to create healthy eating habits that are likely to persist into adulthood.
The necessity of a healthy food environment
Food choices are determined by both individual and environmental factors [15]. Over the past decades, our food environment has changed in such a way that consumers are stimulated to eat ultra-processed foods and drink sugar-sweetened beverages. Since these products are high in calories, fat, salt and sugar and low in fibre and essential nutrients, such as certain fatty acids, amino acids, vitamins and minerals, they do not contribute to a healthy dietary pattern. Nevertheless, their availability, promotion and marketing has increased enormously over the years [16]. The combination of palatability, low prices and convenience make it hard for individuals, particularly adolescents, to resist these foods [17]. Besides, health often plays a minor role in adolescents’ food choices because they are not yet able to see the long-term consequences of their behaviour [18]. Also, both the negative and positive health effects of food choices are not immediately noticeable to them. In addition, social norms play an important role at their age, and their choices are
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