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      Preschool and School Meal Policies: An Overview of What We Know about Regulation, Implementation, and Impact on Diet in the UK, Sweden, and Australia

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          Abstract

          School meals make significant contributions to healthy dietary behaviour, at a time when eating habits and food preferences are being formed. We provide an overview of the approaches to the provision, regulation, and improvement of preschool and primary school meals in the UK, Sweden, and Australia, three countries which vary in their degree of centralisation and regulation of school meals. Sweden has a centralised approach; all children receive free meals, and a pedagogical approach to meals is encouraged. Legislation demands that meals are nutritious. The UK system is varied and decentralised. Meals in most primary schools are regulated by food-based standards, but preschool-specific meal standards only exist in Scotland. The UK uses food groups (starchy foods, fruit and vegetables, proteins and dairy) in a healthy plate approach. Australian States and Territories all employ guidelines for school canteen food, predominantly using a “traffic light” approach outlining recommended and discouraged foods; however, most children bring food from home and are not covered by this guidance. The preschool standards state that food provided should be nutritious. We find that action is often lacking in the preschool years, and suggest that consistent policies, strong incentives for compliance, systematic monitoring, and an acknowledgement of the broader school eating environment (including home provided food) would be beneficial.

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          Most cited references108

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          Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies

          Background In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents. Methods Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6–18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes. Results Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake. Conclusion The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. This paper is published as part of the special Pro Children series in the International Journal of Behavioral Nutrition and Physical Activity. Please see [] for the relevant editorial.
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            Australian dietary guidelines

            (2013)
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              Changing children's eating behaviour - A review of experimental research.

              The interest in children's eating behaviours and how to change them has been growing in recent years. This review examines the following questions: What strategies have been used to change children's eating behaviours? Have their effects been experimentally demonstrated? And, are the effects transient or enduring? Medline and Cab abstract (Ovid) and Web of Science (Thomson Reuters) were used to identify the experimental studies. A total of 120 experimental studies were identified and they are presented grouped within these 11 topics; parental control, reward, social facilitation, cooking programs, school gardens, sensory education, availability and accessibility, choice architecture and nudging, branding and food packaging, preparation and serving style, and offering a choice. In conclusion, controlling strategies for changing children's eating behaviour in a positive direction appear to be counterproductive. Hands-on approaches such as gardening and cooking programs may encourage greater vegetable consumption and may have a larger effect compared to nutrition education. Providing children with free, accessible fruits and vegetables have been experimentally shown to positively affect long-term eating behaviour. The authors recommend future research to examine how taste and palatability can positively affect children's attitudes and eating behaviour.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                11 July 2017
                July 2017
                : 9
                : 7
                : 736
                Affiliations
                [1 ]School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK
                [2 ]Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Emma.Patterson@ 123456ki.se
                [3 ]Centre for Epidemiology and Community Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
                [4 ]Global Obesity Centre, School of Health and Social Development, Deakin University, Geelong VIC 3220, Australia; gary.sacks@ 123456deakin.edu.au (G.S.); natassja.billich@ 123456deakin.edu.au (N.B.)
                [5 ]Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; C.E.L.Evans@ 123456leeds.ac.uk
                Author notes
                [* ]Correspondence: patricia.lucas@ 123456bristol.ac.uk ; Tel.: +44-117-331-0866
                Author information
                https://orcid.org/0000-0002-0469-8085
                https://orcid.org/0000-0003-1208-0936
                Article
                nutrients-09-00736
                10.3390/nu9070736
                5537850
                28696403
                051e1110-05ae-4bfc-ac83-1eb18083544e
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 22 April 2017
                : 03 July 2017
                Categories
                Review

                Nutrition & Dietetics
                school,preshool,children,school meals,nutrition intake,policy
                Nutrition & Dietetics
                school, preshool, children, school meals, nutrition intake, policy

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