Children are helped with healthy food at school, according to a four-year study at eight primary schools in Limburg. Pupils in two schools in deprived areas who were given a healthy diet and exercised more, maintained a stable weight, while children in primary schools gained weight without this intervention. The results of the study were published Tuesday in PLOS ONE.
At the two Healthy Primary Schools of the Future in Landgraaf, children had a slightly lower Body Mass Index (weight and height ratio) than the average for their age. In the control schools without a special diet and exercise program, the BMI was actually higher. The effect was even stronger for abdominal circumference – an important predictor for cardiovascular disease and diabetes.
The publication comes in the month that Minister Carola Schouten (Poverty Policy, ChristenUnie) releases money to give children in poor neighborhoods breakfast at school, after reports in NRC about hungry students. That makes the results even more relevant, says Onno van Schayck, professor of preventive medicine at Maastricht University and leader of the study. “Overweight and hunger are two sides of the same coin.”
What is the most important lesson from this research?
“Doing nothing is not an option. If you do nothing, children in schools in poor neighborhoods will become more overweight. We saw that girls in healthy schools with normal weight were on average 180 grams lighter per year than in the control group and overweight girls 235 grams. For boys, it was 135 and 175, respectively. The effects may not seem so great. But the most overweight children, who need this intervention most, benefit the most. If you do this for all schools in poor neighborhoods, it will yield major benefits for Public Health.
It RIVM has calculated that in twenty years more than 90 percent of the government targets for overweight (from an expected 60 percent in 2040 for adults to 38 percent, ed.) can be achieved if you implement this intervention in all primary schools and continue afterwards. In twenty years’ time there will be fewer Dutch people with chronic diseases of affluence. For 40 million euros, we have calculated, all primary school students in poor neighborhoods could benefit from this approach for a year.”
Apart from drinking water and milk, it seemed difficult to maintain a healthy diet.
“Parents reported using questionnaires and it is difficult to observe eating behavior in this way. Still, by measuring weight and waist circumference, we saw effects. Perhaps the children ate healthier than reported. In any case, children in healthy schools drank much more water, and drinking water instead of sugary soft drinks helps to prevent obesity.”
At the schools in Limburg, parents paid 1.75 euros per child per day. That is not affordable for families in financial need, is it?
“Before the start, we asked parents: how much are you willing to give? That came out at 1.75 euros, because that cost them giving them a lunch box. Please note: these schools in Landgraaf and Kerkrade are located in the poorest neighborhoods in the Netherlands.”
In the news now are the children who come to school without having breakfast or eating. At the same time, children in poor neighborhoods are on average fatter. Can you cope with that hunger?
“Hunger and obesity are two sides of the same coin. We have investigated the ‘double burden of malnutrition’ in Tanzania, among other places, where half of child deaths are caused by malnutrition. Where there is extreme malnutrition, obesity often also occurs. When there is no money, you fill your stomach with cheap calories. In Tanzania that is millet porridge, in the Netherlands it is perhaps the cold chips that children take to school. This crisis puts the finger on the sore spot. We slide into poor neighborhoods to a country like Tanzania.”
Isn’t that too bold?
“When you see a fat child, you may think that nothing is wrong. But while they get an abundance of carbohydrates and saturated fat, they are deficient in protein, vitamins and fiber. Type 2 diabetes and cardiovascular disease come years later. Being overweight is an invisible killer.”
#Overweight #hunger