Examining the New Zealand primary school food environment : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Albany, New Zealand

Abstract

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱 Schools reach most children during key developmental stages, making the school food environment a key factor in shaping nutrition behaviours. However, limited data exists in New Zealand (NZ) on school food environments, the healthiness of canteens, and barriers to policy implementation.

𝗔𝗶𝗺𝘀 𝗮𝗻𝗱 𝗢𝗯𝗷𝗲𝗰𝘁𝗶𝘃𝗲𝘀 To examine the healthiness of NZ primary school food environments by investigating how national guidance, school-level policies and practices, and surrounding foodscapes influence school food provision.

𝗠𝗲𝘁𝗵𝗼𝗱𝘀/𝗗𝗲𝘀𝗶𝗴𝗻 An assessment of the healthiness of 133 primary school canteen menus was conducted at the introduction of the guidance. Three-years later, follow-up menus (n=89) were analysed to assess changes in school food availability. Health-promoting practices and barriers to policy implementation were examined through an online survey of 239 primary schools; of these, 80 schools also provided canteen menus which were assessed to investigate the association between school-based food and nutrition policies and barriers on food availability. Geospatial mapping of retail food outlets around these schools assessed the impact of the external food environment on school food availability.

𝗥𝗲𝘀𝘂𝗹𝘁𝘀 At baseline (n=133 school menus), 41% of menu items were in the ‘amber’ category and 40% in ‘red’, while healthy ‘green’ items comprised 12.8%. At follow-up (n=89), ‘amber’ items decreased from 44.4% to 33.8% (p=0.005), but ‘red’ items showed little change (35.4% to 37.5%). In a separate sample of 80 schools, policies had no significant effect on the proportions of ‘green’, ‘amber’, or ‘red’ items available. Approximately, 38.9% of menus from schools requiring ‘plain milk and water only’ still included sugar-sweetened or red-classified drinks. Reported barriers did not predict policy presence (OR=1.034, p=0.841) or menu composition. The external food environment was highly obesogenic, averaging 45 outlets around schools, with 3.8 times more unhealthy than healthy outlets (p<0.001).

𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 Compliance with national guidance remains low in NZ primary schools, with most canteen items in the less-healthy ‘amber’ or unhealthy ‘red’ categories and minimal improvement over three years. School-level policies, reported barriers, and the external foodscape showed no significant effect on food availability. These findings indicate that voluntary guidance and school-level policies alone are insufficient to enhance the food environment. Mandatory guidelines with consistent monitoring and implementation support are needed to improve school food availability.