Positive Health Online

A Mori poll released last November does not make happy reading. 200,000 children in England and Wales had eaten no fruit or vegetables in the past seven days. On average, the poll found, children eat less than two portions of fruit and vegetables per day – a long way from the recommended five.

A report on school dinners by the Consumer's Association[1] made some equally depressing findings. It revealed that vitamins A and B2, folic acid, zinc, magnesium, calcium and potassium were commonly low in school children's diets. The report also revealed "an alarming lack of fruit and vegetables and a great reliance on chips, pizza and baked beans". It found that, although many schools are now offering salad, fruit and vegetables, the majority of pupils were choosing the unhealthier options. Looking at a local London council's school dinner menu brochure, I see pasties, sausages, pizza and processed meat substitutes feature frequently enough to form the staple diet if chosen.

Schools and parents face a huge challenge in persuading children to choose healthy foods. When do you ever see carrots or apples advertised? Yet children are constantly bombarded with advertisements for junk food and drink. Parents try to resist pester power as they walk around supermarkets full of sugary cereal with toys inside the box or tinned spaghetti displaying pictures of a popular band. Not to mention the fast food chains with the exciting play areas.

A recent, many would say less than welcome, marketing development is the promotion of foods in schools in return for sponsorship of, for example, books or computer equipment. One such scheme organized by a leading crisp manufacturer encourages children to collect vouchers in exchange for crisps. This seems to contradict the National Consumer Council Guidelines for commercial activities in schools[2] which state that "unhealthy activities" should not be encouraged. Equally inconsistent are the two adverts for sausage rolls from a well known bakery on both sides of the aforementioned local council school menu brochure which is, at the same time, making a point of endorsing healthy eating.

So, in the face of all these challenges, what is a parent to do? Many of the parents I meet in my South London practice worry about the amount of junk food their children are eating both at school and home. But most are also rushed off their feet and do not have much time for food preparation. It is then that the pre-packed food becomes an attractive option and with it the accompanying parental guilt. They usually find these suggestions a huge help:

• Always have a full fruit bowl at home. As well as the standard apples, oranges, grapes and bananas, include some more exotic and interesting fruit for a change, budget permitting, for example mango, kiwi, blackberries or blueberries. The parents need to set a good example themselves by choosing fruit instead of a biscuit for a snack!;

• Give children a filling breakfast to reduce the desire for mid-morning snacking and maintain concentration for longer. Egg and wholegrain toast is ideal. Porridge or muesli are the most sustaining of the cereals. Throw some sesame or sunflower seeds into cereal to provide iron and zinc;

• Keep a good stock of healthy snacks in the cupboard, both for home consumption and eating in the playground instead of crisps and chocolate. Hunt for cereal bars in supermarkets and health food shops which are free of added sugar, hydrogenated fats and additives. Plain chocolate coated rice cakes contain a small amount of sugar but are much preferable to chocolate biscuits. Dried fruit, such as pears, go down well and apricots are a good source of vitamin A. Nut and raisin mixes (homemade with unsalted cashews, hazelnuts, Brazils, pecans and a few chocolate chips to make it more exciting) are filling snacks. Nuts get a bad press these days because of nut allergies. But true allergy is relatively rare and nuts are a very good source of minerals, such as zinc and magnesium, protein and the healthy fats. Don't emphasize peanuts though;

• Have plenty of raw crudites in the fridge, such as carrot batons, cucumber sticks, sugar snap peas and sweet potato sticks. Kids can snack on these with a dip, such as humus;

• Smoothies are a good way to pack in the fruit and vegetables as well as calcium. Live yoghurt, sweetened soya milk and soft fruit, such as strawberries or raspberries, make a popular drink for kids, especially if served in an interesting glass with a straw. A few slices of frozen banana or some silken tofu produce an extra creamy texture. It's fine to use tinned fruit, so long as it is in natural juice – this is easily pulped if you are using a liquidizer/food processor rather than a juicer. Vegetable juices may be more of an acquired taste for some kids but worth a try. Carrot juice packs a particularly powerful punch of nutrient. Try organic bottled carrot juice;

• Judging from the local school menu, potatoes are ubiquitous, so these can be omitted in favour of other more fibre-rich wholegrain carbohydrates, such as brown rice, quinoa, corn pasta and cous cous;

• Healthy puddings include soya fruit yoghurts, stewed fruit and soya milk based chocolate and vanilla custard style desserts;

• The importance of getting children used to fruit and vegetables early on in life can't be emphasized enough. Patience and persistence are often needed here. A study[3] carried out in a Brixton school found that cartoon characters encouraging children to repeatedly taste fruit and vegetables greatly increased total consumption;

• Let children eat vegetables with ketchup (if it's the sugar free one from the health food shop, even better) if that's the only way!

Finally, it's important for parents to keep a balanced outlook. Fussing excessively about what children are eating only leads to raised stress levels for the whole family. The key is to provide as much healthy food as possible when you do have control and when you don't, stop worrying.

References

1 Which? March 2003.
2 National Consumer Council. 'Best Practice Principles for Commercial Activities in Schools'. October 2001.
3 Department of Health. March 2003.