Do school break-time policies influence children’s healthier snack consumption?

Dental caries, overweight and obesity have diet as their common risk factor. Dental caries is widespread, affecting 60% to 90% of children worldwide. The International Obesity Task Force has stated that 155 million children world-wide are overweight or obese. Consequent to these findings it had been suggested that schools instigate break-time policies to promote healthier snacking to prevent dental caries, overweight and obesity. Objective: to examine if a school break-time policy affected healthier snacking in primary school children. Method: 364 Year 5 children attending 16 schools which were assigned into intervention and control schools were invited to take part in a 3 year evaluation of a break-time policy. The children were asked to keep an actual record of all snacks consumed at school and at home over a twenty-four hour period at baseline and at 36-month follow-up using the ‘Rubbish Bag Collection'. Results: 141 children completed the Rubbish Bag Collection at home and at school at baseline and at 36-month follow-up. 3 categories of actual snacks consumed were recorded – energy-dense and micro nutrient poor snacks (i.e. snacks high in fat and/or high in sugars) and healthy snacks. There was a significant decrease with time in the consumption of fat containing snacks (P=0.004), however children attending intervention schools had an overall significant increase in their consumption of energy-dense and micro nutrient poor fat snacks (P<0.001). There was an overall significant increase in the children's consumption of snacks high in sugar with time (P<0.001). There were no significant effects of break-time policy or time for healthier snack consumption (P=0.79). Conclusion: These findings suggest that the promotion of healthier snacking using a school-based (settings) approach requires additional intervention than the simple instigation of policy. This work was supported by NHS R+D Programme on Primary Dental Care.