Page 132 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 7. General Discussion
Netherlands Nutrition Centre, may support schools.
A supportive school environment that communicates one coherent message about healthy dietary behaviour, is another important recommendation for practice. Schools are the owners of their school food environment: if they want to create a positive, healthy climate for their students, they should offer an overall healthy food environment at school. Here, it is important that schools not only promote healthy food in the canteen, but also create a positive climate to eating healthily, like an agreeable area where students can consume their lunch, promoting social interactions during lunch time and ensuring that students have enough time for their lunch [34]. In addition, the presence of and consistency across the nutritional school policy emphasises the importance of a healthy dietary behaviour throughout the day. All different policies, like the aspiration of the school canteen, kinds of foods students receive at school activities and are allowed to bring to school, should be in line with the overall healthy message of the school [228].
Another important recommendation for schools is to combine the changes in the school food environment with nutritional education and other health promotion interventions in order to create a supportive school climate were youth can learn how to behave healthy [191]. Teaching nutritional education can support the healthy school canteen, as children also have to increase their knowledge about a healthy dietary pattern and to learn practical food skills, for instance what foods are nutritious and how to prepare a healthy meal. To increase the benefits of health promotion, attention for other health related themes like physical activity or well-being is also important [191]. With regard to our study, consideration how our results may be transferable to other health themes within the Dutch Healthy School Approach is of interest. Previous research has already shown that the school-based implementation strategies for physical activity and nutritional policy were similar [51]. The implementation strategies we used, including ownership, collaboration and personalised approach, could support implementation of other health themes. The involvement of the Netherlands Nutrition Centre in our studies and its coordination of the nutritional theme within the Healthy School Approach may facilitate this knowledge exchange.
Aligning food related interventions inside and outside school
Our studies show that supportive implementation can facilitate implementation of healthier canteen guidelines inside schools. However, students’ food choices, and thereby the success of school canteens, are also influenced by other physical environments (Figure 7.1) like the food environment around school and the foods/drinks brought from home [19, 139]. Creating a system-based approach involving schools and the broader physical food environment, like shops around schools, is likely to contribute to a successful healthy school canteen and healthier food choices of students [228]. This may include collaborations with places were students work, for example the supermarkets in the schools’ neighbourhood, and also other environments that students visit, such as sport facilities or cultural settings. If multiple organisations provide healthy food and drinks, this may become the social norm[192]. School canteen advisors or the local government can facilitate collaborations between multiple organisations to exchange knowledge and learn from each other, and food related assignments of school can be linked to food environments outside schools using for instance, the Canteen Scan to assess the food availability and accessibility in a location close to school.
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