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

Abstract

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.