The results were presented during a closing symposium attended by dozens of professionals, ranging from healthcare and welfare professionals to policy advisers. Among others, they listened to Wilma Jansen, senior researcher and knowledge coordinator at the Municipality of Rotterdam, and Annemieke Wargers, a researcher at Erasmus MC. The researchers talked about the pilot project that ran during the past school year at five Rotterdam primary schools in neighbourhoods with many residents in vulnerable situations. For half a year, the children were offered a healthy school lunch four days a week.
Much to be gained
“For 20 years, Rotterdam has been committed to reducing overweight among children,” Wilma explained. “We have focused on exercise, drinking water and snacks at schools. Nevertheless, the percentage of children who are overweight remains high. There is still much to be gained in the area of healthy nutrition. National and international studies show that a healthy school lunch can contribute to healthier eating habits among children. That is why we asked Erasmus MC to investigate its effects and to examine whether organising school lunches is feasible.”
More vegetables
The study shows that, thanks to the healthy school lunch, children clearly eat more vegetables and drink fewer sugary beverages. On the other hand, children do not always participate because they prefer their own lunch. Parents and teachers mentioned more reasons to participate than not to participate. Important motivations include the fact that the child receives healthy food and that every child gets the opportunity to eat the same food.
Equal opportunities for everyone
The importance of equal opportunities was emphasised by alderman Faouzi Achbar, whose portfolio includes Welfare and Sport. At the opening of the symposium, he talked about his own experiences as a teacher with unhealthy food in the classroom. “Equal opportunities for everyone also have to do with access to healthy food. If you give a car no fuel or the wrong fuel, it will not move forward. When children eat more healthily, they have more energy and concentration to learn and develop.”
How feasible is it?
The question is whether it is feasible to introduce a healthy school lunch permanently for all Rotterdam children. Children, parents and primary schools are willing to do so. Time investment, funding, organisational burdens and a lack of facilities are points of concern for primary schools wishing to introduce a healthy school lunch. Nevertheless, 38% of primary schools already organise some form of lunch. Rotterdam can learn from others when tackling these obstacles. That is why Erasmus MC, the Municipality of Rotterdam and OBS Delfshaven primary school are participating in the European Healthy Wave project. This project examines successful experiences with healthy school meals for all European children. As part of this project, Rotterdam has been paired with Milan, where healthy school lunches for pupils have been the norm for decades.
Utrecht: support is crucial
Policy advisers from the Municipality of Utrecht explained their Healthy Weight at School approach at De Fruitvis. In addition to a healthy school lunch, it includes more exercise, food education and parental involvement. “Just as in Rotterdam, there are major differences between neighbourhoods,” Cheryl Glazenburg explained. “Investing unequally to create equal opportunities is what we do. We first support the most vulnerable children.” A lesson from Utrecht is that support from parents and within the school is crucial. “Only then does the social norm shift. Healthy nutrition and more exercise are increasingly becoming part of schools’ DNA. It takes time to change habits.”
Impressive results in Limburg
Another inspiring example was presented by Maria Jansen. The emeritus professor at Maastricht University was involved in the healthy primary school of the future. This concept was introduced in 2013 at two schools in Parkstad, a region in southeastern Limburg facing numerous social challenges. For four years, children received a healthy school lunch every day and an extra hour of exercise supervised by educational staff. As a result, their BMI decreased significantly. There was also less bullying and concentration improved. This led, among other things, to better results in mathematics. By now, 30 Limburg schools are working with this successful concept.
The role of parents and teachers
During the panel discussion, participants discussed what should happen next with the healthy school lunch. There was a lively debate about the role of parents and teachers. “The teacher is the ultimate role model for children and plays a crucial role,” said paediatrician Paul van de Laat of Franciscus Gasthuis & Vlietland. He also stated that the importance of healthy nutrition should receive more attention in medical education. Karin de Jager, senior health policy adviser at the Municipality of Rotterdam, said that the municipality is working to achieve this. She believes that health and sustainability should also receive more attention in chef training. “And nutrition should also become a more important part of teacher training,” said Ralph van Meijgaard of lunch provider Voedseleducatie010.
“The government must invest!”
The closing statement was: ‘A healthy school lunch is possible even without government funding’. All participants disagreed: funding from the national government is indispensable. Only then can the healthy school lunch be introduced nationwide, as it has been in many other European countries. Maria Jansen once had the cost of nationwide implementation of the healthy primary school of the future calculated. “1 billion euros per year. While healthcare costs in the Netherlands amount to 110 billion euros per year. Every euro you invest in prevention yields four to seven times as much in return. The government is being foolish if it does not invest in a healthy school lunch!”