Never a truer word... from Scorpions and Centaurs flickr photostream

Schools are a key battleground for public health professionals and policy-makers trying to improve young people’s diet in the UK and internationally. The Department for Education recently released a new English School Food Plan (SFP) which was produced by the founders of the Leon restaurant chain. The SFP advocates for important legislative reforms to promote the provision and take up of healthy school food, including universal free school meals in primary schools, the extension of breakfast clubs, new Ofsted ‘food’ inspections and compulsory tuition about food until age 14. However, the report also calls for a ban on packed lunches. Where young people’s choice is restricted too much, further black markets in school food may emerge and such prohibitive approaches do little to address wider disparities across the social and structural contexts of food, social class and education.

Despite suggesting some simplification of the complex food and nutrient-based standards imposed on English school canteens since 2008, the SFP supports tight restrictions on the sale of less healthy products (such as chips) and prohibiting the sale of chocolate, other confectionary and sweetened drinks in all state-maintained schools by law. If implemented in full, the SFP would in fact intensify current regulation of state-maintained schools through the call for a further ban on packed lunches. While much of the plan is supported by research, there is no evidence to support the continued prohibition of products such as chocolate or that packed lunch bans will improve students’ diets. In fact this could do more harm than good, especially in the poorest communities.

Our own qualitative research suggests that these supposedly ‘common sense’ restrictions are insufficient and have already had unintended, potentially harmful consequences through the underground trade of banned goods in secondary schools. In some school contexts, students’ dissatisfaction with their school canteens and food options can lead to extensive black markets in confectionary, ‘junk’ food and energy drinks – a new counter-school cultural response to constraints imposed on their food and other ‘choices’ within school. The perceived high cost and poor value of healthy school food provided in rushed, over-crowded, anti-social canteens appears to have created a ‘perfect storm’ for these new black markets. While some public health legislation focused on the control of certain behaviours can be highly effective (e.g. banning smoking in public spaces), outright prohibition more often fuels new underground economies and greater harms (such as the National Prohibition Act in 1920s America).

Our research also suggests that the proliferation of supermarkets, with high street stores now often located very near secondary schools, has been central in fuelling this illicit supply of high-calorie items. Supermarkets, especially those near schools, are effectively the ‘wholesaler’ in an underground supply chain. Students, typically from low-income families, provide a convenience store service where they resell products within schools for a profit. Despite using economic arguments about the financial viability of ‘half-empty’ canteens to justify a packed lunch ban, the SFP neglects supermarkets based near schools. While state-maintained school canteens are subject to increasing legislative controls, retailers are only subject to voluntary responsibility deals, which have merely supported the continuation of previous self-regulatory schemes.

Furthermore, although the SFP rightly emphasizes the importance of head teachers in improving school food and the take up of school dinners, the central role of the students themselves for improving the school environment is not fully recognised. There are some good international examples of how to involve young people in changing their school food environments to improve health. The Middle School Physical Activity and Nutrition (M-SPAN) project trialled in the USA involved students and staff modifying the school environment and reported significant benefits at two-year follow up, including a reduction in boys BMI. The sentinel site for obesity prevention in Victoria, Australia has developed systems to promote the implementation of locally owned, data-led approaches to help communities change themselves with the development of child and school-level programmes for improving diet. None of these developments are cited in the report.

If the many excellent recommendations in the English SFP are to be effective then further ingredients are needed too. First, young people need a greater voice and more choice over what they eat at school and, particularly, in designing the school-food environment to make sure it is appealing to them. New participative interventions should be piloted and trialled as a priority in the UK. Second, the role of supermarkets sited near schools cannot continue to be ignored. Local authorities in England are responsible for managing the proliferation of fast food outlets around schools. However, this largely ignores supermarkets and there is no coordinated action and policy support from central government. As with alcohol and tobacco, greater government intervention in the food industry as well as in schools is now likely to be necessary to prevent the health harms and associated costs of poor diet.

About the Authors: Adam Fletcher is a Senior Lecturer in Social Science and Health based in the Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) at Cardiff University. Farah Jamal is a Research Fellow at the Institute for Health and Human Development, University of East London. Chris Bonell is a Professor of Sociology and Social Policy in the Department of Children, Families and Health at the Institute of Education, University of London.