Intermediate and secondary school food environment in New Zealand : lunch food and drink menu assessment : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

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Introduction: The combination of food insecurity and the increase in nutrition-related obesity among adolescents in New Zealand creates a need for collaborative action to improve the food environment. The school environment is ideal for encouraging a healthy lifestyle; however, the healthiness of food available to intermediate and secondary school students (years seven-13) is unknown. This study assessed how food and drink menus from a convenience sample of schools align with the Ministry of Health Food and Drink Guidance for Schools. Methods: New Zealand intermediate, composite, senior, and secondary schools' (years seven-13) food and drink menus were collected in 2020. Menus were classified using the traffic light criteria ('green', 'amber', and 'red'). A toolkit was developed by three nutritionists and one dietitian (with trained staff support) to aid with menu classification. Menu quality was evaluated against school characteristics and policy use. Results: Of the school menus assessed (n=60), 3.3% met the recommendation for the provision of 75% 'green' items. 'Red' items were the main contributors (mean=53.6%). Schools with high socioeconomic status (deciles 8-10; 14.3%; p<0.05) and of small school size (<749 students; 14.1%; p<0.025) were associated with a higher proportion of 'green' items. Community (19.3%) and in-house school (25.9%) food providers provided a lower percentage of 'amber' items than school providers (39.3%; p<0.001). In-house school providers (64.6%) had a greater percentage of 'red' items than contracted school providers (48.2%; p<0.017). Community providers had the highest proportion of 'green' items (16%; p>0.017). Conclusion: The food available in schools (years seven-13) tended to be unhealthy. A national nutrition policy could improve the school food environment, especially in schools with large populations and of low socioeconomic status. So what? Menu quality is a complex socioeconomic issue, and additional support should be considered in intermediate and secondary schools to improve equitable outcomes within school food environments.
adolescents, food availability, intermediate school, lunch menu, New Zealand, policy, secondary school