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Name:Sandra Caldeira

Address:Joint Research Centre, IHCP, Public Health Policy Support, Via Enrico Fermi 2749, TP 127, 21027 Ispra (VA), Italy

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As the Commission’s in-house science service, the Joint Research Centre’s mission is to provide EU policies with independent, evidence-based scientific and technical support throughout the whole policy cycle.

Working in close cooperation with policy Directorates-General, the JRC addresses key societal challenges while stimulating innovation through developing new methods, tools and standards, and sharing its know-how with the Member States, the scientific community and international partners.

Serving society Stimulating innovation Supporting legislation

Country profiles on

national school food policies

across the EU28

plus Norway and Switzerland

JRC96428

ISBN 978-92-79-57962-2 (PDF)

ISBN 978-92-79-57961-5 (print)

ISBN 978-92-79-75124-0 (Epub)

doi:10.2791/635636 (PDF)

doi:10.2791/12806 (print)

doi:10.2791/830157 (Epub)

© European Union, 2015

Reproduction is authorised provided the source is acknowledged.

Title picture © Randy Faris/Corbis. All other images © European Union, 2015

How to cite: Country profiles on national school food policies across the EU28 plus Norway and Switzerland; doi:10.2791/635636.

The Joint Research Centre (JRC), as the European Commission’s in-house science service, is active in the area of nutrition and public health, with one particular focus on children’s health. In close collaboration with DG SANTE, the JRC draws on its experience in public health policy support, its independence of private and commercial interests as well as its networking and collaboration capacities to facilitate improvements in school food policy development, implementation, monitoring, and evaluation. Improvements in these domains help children adopt healthy diet and lifestyle habits while allowing significant strides towards reducing the burden of childhood obesity in Europe.

This publication contains 34¹ country factsheets on national school food policies in the EU28² plus Norway and Switzerland. The series was developed from a mapping exercise to objectively describe European school food policies in all their facets, the results of which have been summarised in a JRC Science & Policy Report by Storcksdieck genannt Bonsmann et al.³ To provide further insight into the various school food policies in place across Europe, these factsheets answer questions such as: What are the common objectives of school food policies in Europe? Which nutrient-based standards are used for lunch-time meals? Which countries restrict food marketing in schools, and how? Country by country, the factsheets give details about policy objectives, evaluation measures, food- and nutrient-based standards or guidelines, restrictions on vending services and food marketing in schools, and whether food and nutrition education is a mandatory part of the national curriculum. The information is complemented by key figures on population size and the prevalence of childhood overweight and obesity in different age groups.

It is our hope that these factsheets inspire and inform pupils, parents, chefs and all those interested in promoting health at school. Below we describe the methodology of the policy mapping as well as the sources used to provide relevant country level statistics. The latter comprises information on:

• The size of the population and the number of school-aged children (5-19 years).

– Data from EUROSTAT, year 2013.

• The prevalence of overweight and obesity in children (6-9 years; only where available) and adolescents (15 years).

– Data from the Childhood Obesity Surveillance Initiative (COSI)⁴ and from the Spanish ALADINO study⁵ for ages 6-9 and from the Health Behaviour in School-aged Children (HBSC)⁶ for age 15.

The school food policy information provided reflects the respective national situation as of February 2014.

1. School food policy search strategy and verification

To identify the (most recent) school food policies in place in the EU (initially EU27, later EU28) as well as Norway and Switzerland, we applied the tiered search strategy described below:

Step 1–WHO European Database on Nutrition, Obesity and Physical Activity (NOPA)⁷

The NOPA database is a searchable online repository of corresponding policy documents and developments in the countries of the WHO European Region. On the NOPA website, we selected the 30 countries specified above and restricted the search to ‘Nutrition related’ and ‘Obesity related’. The list of results was checked for mentions of school food policies and any respective links used to access source documents.

Step 2–National ministerial websites and Notifications from Member States to the EC

For countries for which NOPA did not hold a link to or made no mention of school food policy in the first place, we checked the websites of the national ministries commonly responsible for school food policy (e.g., Health, Education, Nutrition, Agriculture, Youth). In some cases, notifications from Member States to the European Commission gave insight into the school food policy situation.

Step 3–Scientific literature and reports

The third source was scientific literature, which we searched via Pubmed⁸ and Google Scholar.⁹ References to school food policy documents were exploited. Additionally, the Implementation progress report of the Strategy for Europe on nutrition, overweight and obesity related health issues¹⁰ as well as a report¹¹ by the UK School Food Trust included relevant information from several Member States.

Step 4–Professional contacts

Where Steps 1 to 3 did not yield sufficiently useful results and in case of need for language support, we sought the help of contacts with knowledge of the respective national situation (e.g., dieticians of the Thematic Network DIETS/DIETS2¹²).

The validity of all source documents identified with the above strategy was confirmed by representatives of each Member State, i.e. HLG members checked policy references and pointed to other and additional sources where appropriate.

2. School food policy data extraction and verification

To extract the policy content in a systematic and comparable way, we used a subset of the SNIPE¹³ questionnaire developed by Public Health Nutrition Research Ltd, UK (see Annex I of the School Food Policy mapping report¹⁴ for a summary of the development of SNIPE). Where necessary, Google Translate was used to translate source texts into English before extracting relevant content items.

The questionnaire template was set up in Microsoft Excel®, version 14. The feasibility of the questionnaire and the template for data collection were tested in a pilot trial in which the data from six different school food policies were extracted. Analysis and discussion of the pilot results led to a revision of the questionnaire (see Annex II of the School Food Policy mapping report14 for the final questionnaire version).

The final data matrix consists of 34 columns to represent the policies identified for the 30 countries considered. The semi-open questionnaire contains 20 questions with a number of pre-specified answers, resulting in 148 rows to complete per policy. Apart from the pre-specified answers there often also was an option labelled ‘Other’ to include further information in an open-ended format. All country data were reviewed by the respective HLG contact, and the final data analysed as described below. The total data collection process lasted from May 2013 to February 2014.

3. School food policy data analysis and visualisation

Frequency percentages were calculated and visualised directly from the data matrix in Excel®, using the total number of 34 policies as the reference point. Colour-coded European maps were created using the Eurostat Intranet tool IMAGE.

This work is part of the JRC’s support to the EU Action Plan on Childhood Obesity 2014-2020 and is done in partnership with DG SANTE and the High Level Group on Nutrition and Physical Activity as well as Public Health Nutrition Research Ltd. and the World Health Organization Regional Office for Europe. Author contributions: Stefan Storcksdieck genannt Bonsmann, Flaminia Mussio, Manuel Florensa-Molist and Sandra Caldeira. The authors would like to acknowledge Jonas Fooken for critical review.

School food policy (voluntary) | “Gezond eten op school Praktijkgids voor de uitbouw van een evenwichtig voedings- en drankenaanbod op school”
Developed by | Ministry of Education and Flemish Institute for Health Promotion and Disease Prevention
Year of publication | 2008
Web link(s) | http://ond.vlaanderen.be/voedselveiligheid/voedselkwaliteit/Gezond%20eten%20op%20school%20KBS%202008.pdf

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 344,546 | 6,404,726 | 16%
10 to 14 years | 336,105
15 to 19 years | 358,105
Total 5 to 19 years | 1,038,756

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Belgium

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (6 years) | 19.3% | 6.0% | 18.0% | 5.8%
Boys (7 years) | 23.4% | 9.1% | 23.1% | 9.5%
Boys (8 years) | 22.1% | 8.1% | 21.9% | 7.9%
Boys (9 years) | 27.4% | 10.9% | 27.3% | 11.2%
Girls (6 years) | 18.4% | 5.1% | 18.2% | 5.2%
Girls (7 years) | 24.3% | 8.0% | 24.1% | 8.5%
Girls (8 years) | 22.7% | 6.3% | 22.4% | 6.7%
Girls (9 years) | 27.1% | 8.9% | 26.6% | 9.0%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Make the healthy choice the easy choice; efficient food education; understanding food labelling; sustainable food behaviour

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Other measures:

• Nutrition and health education; regulation and communication regarding school food; networking with third parties involved in school food; participation by students, staff and parents; http://www.vigez.be/uploads/documentenbank/f9c7c6490988b8b449de67cf9835b9a1.pdf

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Other standards/guidelines:

• Food safety (HACCP); 10-day menu cycle; enough time for meal intake; food allergy and other medical conditions considered in food offer; religious and ethical aspects considered; vegetarian offer

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See Annex I for more details on the food-based standards/guidelines in BE-Flanders.

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BE-Flanders

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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BE-Flanders

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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BE-Flanders

School food guideline mentions importance of educating children and adolescents about healthy eating and lifestyle; 1. Education: 1.1. At school, a physical activity and diet project (possibly extending across subject or class) is developed that discusses exercise and healthy diet in the lessons; 1.2. Students and parents get tips and pointers towards the planning of balanced meals and the proper execution of movements and sports; 1.3. There is information given to parents (and teachers) on exercise and healthy diet (eg in the form of an information evening); 1.4. Teachers have the opportunity to follow a training course in relation to an integrated exercise and nutrition policy at school; 1.5. Attention is paid to safety (exercising correctly, traffic)

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Flanders food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Weekly menu offers a variety of vegetables; lunch meal contains a large portion of vegetables (half the plate); at least 2/wk fresh fruit for dessert | x
Specified number of times (red) meat served | Not specified as red meat: 4x lean, 4x moderately fat meat per 10 days; limit fatty meats; meat portion is 100 g | n/a
Specified number of times other sources of protein served | Replace meat with plant protein source 1/wk | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | 2x per 10 days fish (lean and oily) | n/a
Restrictions on availability of fried, deep-fried or processed products | Less than 1/wk deep-fried dish | Only offered non-daily or only occasionally
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Max. 1/wk pastry, biscuits or ice cream | Only offered non-daily or only occasionally
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -

Fresh drinking water must be provided and be easily accessible
Water supply: 2.1. Depending on the number of pupils there are multiple distribution points available to ensure that students at least during breaks have the chance to drink (free) water; 2.2. There is free water available at any time of the school day for all students; 2.3. In the refectory water or low-fat milk is offered; 2.4. The students get the chance to drink water before and after exercise
Water supply: 2.1. Depending on the number of pupils there are multiple distribution points available to ensure that students at least during breaks have the chance to drink (free) water; 2.2. There is free water available at any time of the school day for all students; 2.3. In the refectory water or low-fat milk is offered; 2.4. The students get the chance to drink water before and after exercise

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Beverage offer: 3.1. Every outlet, vending machine, shop or other distribution point at school has a balanced selection of drinks consisting of water, milk and fruit juices; 3.2. Balanced drinks are promoted by offering a lower price or more access points; avoid offering alcoholic beverages | Beverage offer: 3.1. Every outlet, vending machine, shop or other distribution point at school has a balanced selection of drinks consisting of water, milk and fruit juices; 3.2. Balanced drinks are promoted by offering a lower price or more access points; avoid offering alcoholic beverages
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Consume only occasionally | -
Salt provision is restricted | - | -

Other
Meals: 4.1. Bread meals offered by the school include mainly wholemeal bread with vegetables; 4.2. Bread eaters have the opportunity to drink fresh soup with their meal; 4.3. Mayonnaise or other sauces and butter are not by default spread on rolls; 4.4. Hot meals are well balanced and consist among others of a moderate amount of meat and a large portion of vegetables; 4.5. For dessert fruit or milk dishes are offered to form a wholesome meal; 4.6. Sufficient time for meal intake (minimum 30 minutes) is provided for all pupils; 4.7. In the refectory a pleasant climate prevails: quiet, cosy, atmospheric and clean; 4.8. If breakfast is offered, this is well balanced (juice, milk product, multigrain bread, lean filling); 4.9. Healthy sandwiches and dishes are specifically promoted); 6. Opportunities for physical activity: 6.1. Each student can participate in a lunch sports activity during at least one lunch per week; 6.2. After-school sports activities are provided; 6.3. Pupils are encouraged to come to school by bike or on foot (bike pooling/walking school bus) as much as possible; 6.4. During the breaks, students are encouraged to move for example through the presence of game boxes, hopscotch, ….; 6.5. If a trip is done, the destination is preferably reachable by foot or by bike or otherwise active transport is preferred over other forms; 7. Agreements and Regulations: 7.1. There are agreements on the loan of sports equipment and the use of sports facilities by the students during breaks or after school; 7.2. There are agreements with the parents about bringing sweets (eg treats) and beverages (such as soft drinks) to school; 7.3. The school shop and other outlets offer balanced drinks and snacks; 7.4. Balanced drinks and snacks are specifically promoted (pricing, variety, quality); 7.5. The regulations for teachers and other school stakeholders (management, staff, parents, others) is similar to that of the students and they also adhere to the agreements; 8. Process / gender: 8.1. The initial situation at the school is analysed by creating an inventory of all the actions in the field of nutrition and exercise already undertaken at school; 8.2. Based on the analysis, there are priority issues within the team that have to be worked on; 8.3. For priority attention various objectives are formulated to be achieved within a certain time period; 8.4. The specific results are checked against the various objectives set; 9. Involvement / participation: 9.1. Within the school there is a panel or other consultative body with which the exercise and nutrition policy can be discussed; 9.2. Parents are clearly informed of the exercise and nutrition policy at school and the changes that are made; 9.3. Students are always clearly informed of the movement and nutrition at school and the changes that are made; 9.4. The parents via e.g. parent working group or other organ can have their say in the development of the exercise and nutrition policy at school; 9.5. There is a good interaction with the students (participation through student councils or other panels) in terms of exercise and nutrition policy at school; 9.6. The entire school has a say in setting up the exercise and nutrition policy; 10. Partners / networking: 10.1. The school uses the services of external partners for the development of an exercise and nutrition policy. There is collaboration with BLOSO/SVS, CLB, Logo, parents’ association, student council, municipal sports department, sports clubs, youth groups or other external partners
Snack policy: 5.1. Each outlet, vending machine, shop or other distribution point at school has a balanced range of snacks (fruit, high-fibre biscuits, dairy); 5.2. There is a range of fresh fruit during the break, every day or on certain days of the week; 5.3. Balanced snacks are promoted by offering lower prices or easier access; 5.4. During a trip (sports day, field trip) a healthy snack such as fruit or high-fibre cereal biscuits is offered; secondary school students are allowed a wider range of snack foods as they are considered more able to make conscious food choices

School food policy (voluntary) | “Politique de promotion des attitudes saines sur les plans alimentaire et physique pour les enfants et les adolescents” “Cahier special des charges - Objet : confection et livraison de repas dans des collectivités d’enfants de 3 à 18 ans”
Developed by | Government of the French Community; appointed committee charged with elaboration of details composed of Ministry of Health, of Obligatory Education and of Sport
Year of publication | 2006, 2013
Web link(s) | http://mangerbouger.be/IMG/pdf/planAttitudeSaine-2.pdf http://www.sante.cfwb.be/index.php?id=4299

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 210,878 | 3,582,292 | 18%
10 to 14 years | 213,088
15 to 19 years | 216,076
Total 5 to 19 years | 640,042

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Belgium

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (6 years) | 19.3% | 6.0% | 18.0% | 5.8%
Boys (7 years) | 23.4% | 9.1% | 23.1% | 9.5%
Boys (8 years) | 22.1% | 8.1% | 21.9% | 7.9%
Boys (9 years) | 27.4% | 10.9% | 27.3% | 11.2%
Girls (6 years) | 18.4% | 5.1% | 18.2% | 5.2%
Girls (7 years) | 24.3% | 8.0% | 24.1% | 8.5%
Girls (8 years) | 22.7% | 6.3% | 22.4% | 6.7%
Girls (9 years) | 27.1% | 8.9% | 26.6% | 9.0%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Better identify related or aggravating factors for health problems to strengthen the prevention thereof; develop adequate food intake acquisition rhythms and encourage regular physical activity; strengthen the discernment of children and minors from advertising or commercial displays; mobilize intellectual learning to encourage healthy attitudes and vice versa; ensure policy coherence and messages issued by different competent authorities in the different places of public attendance; strengthen networking between family and authority in field of food and sporting activity through neighbourhood associations, federations and local authorities; emotional health, i.e. self-acceptance, self-esteem, fulfilment.

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Other measures:

• Information and support to parents; environmental impact

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Other standards/guidelines:

• Food sourcing and quality; seasonality; organic produce; fair trade; taste education.

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See Annex I for more details on the food-based standards/guidelines in BE-Wallonia.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in BE-Wallonia.

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BE-Wallonia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

BE-Wallonia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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BE-Wallonia

School food guideline mentions importance of educating children and adolescents about healthy eating and lifestyle

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Walloon food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Vegetable soup 17/20, vegetables 17/20, salad 2-3/20, fresh fruit 11-12/20, mashed fruit 1/20, legumes 2/20 | -
Specified number of times (red) meat served | 2-3/20 | n/a
Specified number of times other sources of protein served | Lean and fatty fish 3-4/20, fish sticks 1/20, poultry 3-5/20, eggs 1/20, legumes 2/20, yogurt 4/20, dairy desserts 2-3/20 | n/a
Specified number of times dairy products served | Yogurt 4/20, dairy desserts 2-3/20; preference to lower-fat and -sugar varieties | n/a
Specified number of times (oily) fish should be on the school lunch menu | Lean and fatty fish 3-4/20 | n/a
Restrictions on availability of fried, deep-fried or processed products | Fish sticks 1/20, deep-fried potato dishes 2/20 | Limit foods high in fat

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
Give preference to e.g. dark chocolate, fruit chips, fruit paté, dry biscuits, jam with min 50% fruit, honey, sirop de Liège, fruit tart; tolerated are milk chocolate, jam with <50% fruit, marzipan, nut spread, éclair, meringue, popcorn (salted or sweet); only occasionally offer white chocolate, cream or butter patisserie, Berlin balls, etc.
Limit foods high in sugar

Starchy food cooked in fat or oil restricted | Fish sticks 1/20, deep-fried potato dishes 2/20 | Limit foods high in fat
Crisps and savoury snacks restricted | Offer crisps only occasionally | Limit foods high in fat and/or salt
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Give preference to water (<200 mg Na/l), tea, coffee, infusions | Give preference to water (<200 mg Na/l), tea, coffee, infusions
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Diet sodas and drinks with max 2% sugar allowed occasionally; no alcoholic or diet drinks for small children | Diet sodas and drinks with max 2% sugar allowed occasionally; no alcoholic or diet drinks for small children
Salt provision is restricted | Keep frequency of foods rich in salt in check; salt must be iodised, at max. 15 mg per kg | -

Other
Daily menus include 1 soup, 1 main dish, 1 dessert; vegetarian alternatives; choices of starchy foods; non-Belgian national dish once per month to support cultural integration; preference to low(er)-fat preparation techniques; flavour enhancers, colourants and other additives of potential allergenicity forbidden
Vaguely mentions that food offers in the school environment should be in line with dietary recommendations in order to be coherent in message

Annex II

Additional information on Walloon energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | x
Fat | x | x
Saturated fat | x | x
Total carbohydrate | x | x
Non-milk extrinsic sugars | added sugars | added sugars
Fibre | x | x
Protein | x | x
Iron | x | x
Zinc | x | x
Calcium | x | x
Vitamin A | x | x
Vitamin C | x | x
Folate | x | x
Sodium | x | x
Other | Mg, I; give preference to vegetable fat and lean protein | Mg, I

School food policy (mandatory) | “Ordinance for healthy nutrition in school, 2009 and Recipe Book for school meals, 2012”
Developed by | Ministry of Health
Year of publication | 2009, 2012
Web link(s) | http://lex.bg/en/laws/ldoc/2135752009 http://www.mh.government.bg/Articles.aspx?lang=bg-BG&pageid=391&categoryid=1564

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 327,440 | 7,282,552 | 13%
10 to 14 years | 316,089
15 to 19 years | 335,811
Total 5 to 19 years | 979,340

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Bulgaria

| Overweight (including obesity) | Obesity
2007/8 | 2007/8
Boys (7 years) | 28.2% | 12.8%
Girls (7 years) | 27.9% | 12.8%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

 25% or more

 20-24%

 15-19%

 10-14%

 Less than 10%

 No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other Objectives:

• n/a

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Other measures:

• n/a

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Other standards/guidelines:

• Food safety and quality specifications; weekly menus to be prepared with the participation of health care professionals

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See Annex I for more details on the food-based standards/guidelines in Bulgaria.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Bulgaria.

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Bulgaria

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Bulgaria

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Bulgaria

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Bulgarian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | for all-day dining, min. 400 g of fruit & vegetables provided daily; menu must include fresh and seasonal fruit and/or vegetables | for all-day dining, min. 400 g of fruit & vegetables provided daily; menu must include fresh and seasonal fruit and/or vegetables
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | daily at least one representative from the group of meat, poultry, fish, eggs, legumes; fish at least once per week; dairy daily | n/a
Specified number of times dairy products served | for all-day dining, daily menu should include at least 400 g of yoghurt or milk and at least 30 g of cheese; yoghurt may be included as component of breakfast, snacks or in dishes and desserts; milk as beverage or incorporated in desserts | n/a
Specified number of times (oily) fish should be on the school lunch menu | at least 1/wk | n/a

Restrictions on availability of fried, deep-fried or processed products
fried foods offered in school canteens maximum twice per week; when offering fried foods, use only fresh fat, without overheating of the fat, not using hydrogenated vegetable fat, replacing frying fat at the end of each and not re-using this fat in other preparations; fried potato and cereal products, fried nuts, fried pasta should not be offered in canteens, cafeterias and vending machines for snacks and drinks; generic recommendation to use lower-fat modes of preparation
fried foods offered in school canteens maximum twice per week; when offering fried foods, use only fresh fat, without overheating of the fat, not using hydrogenated vegetable fat, replacing frying fat at the end of each and not re-using this fat in other preparations; fried potato and cereal products, fried nuts, fried pasta should not be offered in canteens, cafeterias and vending machines for snacks and drinks; generic recommendation to use lower-fat modes of preparation

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | chocolate and sugar confectionery and confectionery high in fat and sugar (cakes and pastries with cream and/or butter cream, syrup sweets) should not be offered in canteens, cafeterias and vending machines for snacks and drinks | chocolate and sugar confectionery and confectionery high in fat and sugar (cakes and pastries with cream and/or butter cream, syrup sweets) should not be offered in canteens, cafeterias and vending machines for snacks and drinks
Starchy food cooked in fat or oil restricted | generic recommendation to use lower-fat modes of preparation | generic recommendation to use lower-fat modes of preparation
Crisps and savoury snacks restricted | fried and salted products not allowed | fried and salted products not allowed
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | only bottled natural mineral, spring and table waters, 100% natural fruit & vegetable juices; fruit and fruit & vegetable nectars with max. 20% mono- and disaccharides; milk and milk/yoghurt drinks with max. 2% fat; fruit and herbal tea; hot chocolate | only bottled natural mineral, spring and table waters, 100% natural fruit & vegetable juices; fruit and fruit & vegetable nectars with max. 20% mono- and disaccharides; milk and milk/yoghurt drinks with max. 2% fat; fruit and herbal tea; hot chocolate
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | x
Salt provision is restricted | limit addition of salt in food preparation; pre-soak salty products like cheese and olives in water; pickles only in winter and max 1 per week for lunch-only facilities and 2 per week for all-day dining | limit addition of salt in food preparation; pre-soak salty products like cheese and olives in water; pickles only in winter and max 1 per week for lunch-only facilities and 2 per week for all-day dining; recipe book for school meals with salt limits

Other
include wholegrain options for bread at least twice per week, for pasta and cereal-based snacks at least once per week; offer skinless poultry and veal, pork, lamb without visible fat; no sausages for main dishes; meat products and sausage with reduced fat included in snacks; lower-fat cheese and other dairy products to replace regular-fat versions in snacks; where snacks are offered, must include sandwich choice from three groups: 1) with milk component; 2) with lean meats, meat products, fish and eggs; 3) with vegetables (fresh, cooked, baked, stewed, preserved); 1 and 2 must also include fresh vegetable component); must include one wholemeal option per sandwich group; schools may only use butter, sunflower oil and olive oil in food preparation; canned fruit & vegetables may not contain preservatives, colours or sweeteners; fruit and herbal teas may not contain added colours or flavours; use only salt iodised with potassium iodate; http://www.mh.government.bg/Articles.aspx?lang=bg-BG&pageid=391&categoryid=1564
include wholegrain options for bread at least twice per week, for pasta and cereal-based snacks at least once per week; offer skinless poultry and veal, pork, lamb without visible fat; no sausages for main dishes; meat products and sausage with reduced fat included in snacks; lower-fat cheese and other dairy products to replace regular-fat versions in snacks; where snacks are offered, must include sandwich choice from three groups: 1) with milk component; 2) with lean meats, meat products, fish and eggs; 3) with vegetables (fresh, cooked, baked, stewed, preserved); 1 and 2 must also include fresh vegetable component); must include one wholemeal option per sandwich group; http://www.mh.government.bg/Download-Handler.ashx?id=8917

Annex II

Additional information on Bulgarian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | specified by age group (6-10y, 10-14y, 14-19y), based on DRV for each age group, fixed distribution across 4-5 daily meal times | specified by age group (6-10y, 10-14y, 14-19y), based on DRV for each age group, fixed distribution across 4-5 daily meal times
Fat | specified by age group (6-10y, 10-14y, 14-19y) based on DRV for each age group; limits specified for milk/dairy products, and no vegetable fats may be added to these | specified by age group (6-10y, 10-14y, 14-19y) based on DRV for each age group; limits specified for milk/dairy products, and no vegetable fats may be added to these
Saturated fat | x | x
Total carbohydrate | specified by age group (6-10y, 10-14y, 14-19y), based on DRV for each age group | specified by age group (6-10y, 10-14y, 14-19y), based on DRV for each age group
Non-milk extrinsic sugars | added sugars | added sugars
Fibre | based on DRV for each age group | based on DRV for each age group
Protein | specified by age group (6-10y, 10-14y, 14-19y), based on DRV for each age group | specified by age group (6-10y, 10-14y, 14-19y), based on national dietary guidelines
Iron | based on DRV for each age group | based on DRV for each age group
Zinc | based on DRV for each age group | based on DRV for each age group
Calcium | based on DRV for each age group | based on DRV for each age group
Vitamin A | based on DRV for each age group | based on DRV for each age group
Vitamin C | based on DRV for each age group | based on DRV for each age group
Folate | based on DRV for each age group | based on DRV for each age group
Sodium | based on DRV for each age group | based on DRV for each age group
Other | Vitamins D, E, K, thiamine, riboflavin, niacin, folate, B12; minerals K, Ca, P, Mg, I, Se, F, Cu; cholesterol, MUFA, PUFA (n-3 and n-6), TFA; http://www.fnap.government.bg/UserFiles/File/doc/NAREDBA23%202005%20fiziologic-nite_normi.doc | Vitamins D, E, K, thiamine, riboflavin, niacin, B12; minerals K, Ca, P, Mg, I, Se, F, Cu; cholesterol, MUFA, PUFA (n-3 and n-6), TFA; DRV for each age group; http://www.fnap.government.bg/UserFiles/File/doc/NAREDBA23%202005%20fiziologic-nite_normi.doc

DRV = Dietary Reference Value; MUFA = mono-unsaturated fatty acids; PUFA = poly-unsaturated fatty acids; TFA = trans fatty acids.

School food policy (voluntary) | “Swiss Nutrition Policy 2013–2016” “Schweizer Qualitätsstandards für eine gesundheitsfördernde Gemeinschaftsgastronomie”
Developed by | Federal Food Safety and Veterinary Office FSVO
Year of publication | 2012

Web link(s)
http://www.blv.admin.ch/themen/04679/05055/index.html?lang=en&download=NH-zLpZeg7t,lnp6I0NTU042l2Z6ln1ad1IZn4Z2qZpnO2Yuq2Z6gpJCFfYJ2fWym162epYbg2c_JjKbNoKSn6A--
http://www.goodpractice-gemeinschaftsgastronomie.ch/fileadmin/user_upload/downloads_de/D_QSTGGG_V2.2web_20150425.pdf
http://www.sge-ssn.ch/bildung-und-schule/essen-in-der-schule/schulverpflegung/

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 390,062 | 8,039,060 | 15%
10 to 14 years | 406,092
15 to 19 years | 442,704
Total 5 to 19 years | 1,238,858

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Switzerland

| Overweight (excluding obesity) | Obesity
2009 | 2012 | 2009 | 2012
Boys (6-12 years) | 12.5% | 11.9% | 6.2% | 8.1%
Girls (6-12 years) | 12.4% | 11.9% | 4.4% | 5.9%

Source: MOSEB 2009, 2012.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Prevent non-communicable diseases

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• Sustainability and environmental friendliness; safety at work; food hygiene

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Switzerland.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Switzerland.

7 | [picture]

Switzerland

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Switzerland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Switzerland

Swiss nutrition policy and national programme “nutrition and physical activity” mention importance of nutrition education, but no information about school curriculum

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Swiss food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | 1-2 portions of vegetables or fruit served with warm main dish; for full board, 3 portions of vegetables (at least one raw) and 2 portions of fruit daily | 1-2 portions of vegetables or fruit served with warm main dish; for full board, 3 portions of vegetables (at least one raw) and 2 portions of fruit daily
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | Daily 1 portion of meat, fish, egg, cheese or other protein source such as tofu or quorn | n/a
Specified number of times dairy products served | For full board, 3 portions of milk or dairy daily | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish 1-2 times per week; alternate low-fat and oily fish (from properly managed stocks) | n/a
Restrictions on availability of fried, deep-fried or processed products | Max. 2 high-fat dishes (>10% fat) per week, not specific to mode of preparation | Max. 2 high-fat dishes (>10% fat) per week, not specific to mode of preparation
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Sweets, pastry, confectionery (together with soft drinks, energy drinks and ice tea, and savoury snacks) do not exceed 15% of total food & beverage choice | Sweets, pastry, confectionery (together with soft drinks, energy drinks and ice tea, and savoury snacks) do not exceed 15% of total food & beverage choice
Starchy food cooked in fat or oil restricted | Max. 2 high-fat dishes (>10% fat) per week, not specific to mode of preparation | Max. 2 high-fat dishes (>10% fat) per week, not specific to mode of preparation
Crisps and savoury snacks restricted | Savoury snacks (together with soft drinks, energy drinks and ice tea, and sweets, pastry, confectionery) do not exceed 15% of total food & beverage choice | Savoury snacks (together with soft drinks, energy drinks and ice tea, and sweets, pastry, confectionery) do not exceed 15% of total food & beverage choice
Fresh drinking water must be provided and be easily accessible | Free or cost-reduced tap water | Free or cost-reduced tap water
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Not strictly limited to specific types, but emphasis on water and diluted fruit juices (2 parts water, one part juice) | Not strictly limited to specific types, but emphasis on water and diluted fruit juices (2 parts water, one part juice)
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Soft drinks, energy drinks and ice tea (together with sweets, pastry, confectionery and savoury snacks) do not exceed 15% of total food & beverage choice | Soft drinks, energy drinks and ice tea (together with sweets, pastry, confectionery and savoury snacks) do not exceed 15% of total food & beverage choice
Salt provision is restricted | Use salt sparingly in dishes, should not exceed 2.5 g salt (1 g Na) per dish; salt-containing seasoning only made available to customers on request | Use salt sparingly in dishes, should not exceed 2.5 g salt (1 g Na) per dish; salt-containing seasoning only made available to customers on request

Other
Use herbs and spices for seasoning; at least 25% of foods are seasonal and/or local produce; 50% of bread offer is wholegrain; wholegrain options of other cereal-based foods to be included; emphasis on low(er)-fat food options and modes of preparation; pulses at least once per week; a carbohydrate component to be served with each main meal; for full board, ideally include one portion of nuts daily; need to balance nutrition criteria with customers’ food preferences (including cultural and religious aspects); aim is to cover average nutrient requirements of target group over a period of 4 weeks; vegetarian alternative daily
Use herbs and spices for seasoning; at least 25% of foods are seasonal and/or local produce; 50% of bread offer is wholegrain; wholegrain options of other cereal-based foods to be included; emphasis on low(er)-fat food options and modes of preparation; pulses at least once per week; a carbohydrate component to be served with each main meal; for full board, ideally include one portion of nuts daily; need to balance nutrition criteria with customers’ food preferences (including cultural and religious aspects); aim is to cover average nutrient requirements of target group over a period of 4 weeks; vegetarian alternative daily

NB: It is important to note that the standards are not specifically addressed to children; therefore some points such as salt may not be appropriate. Switzerland is adapting these standards for school meals at the moment.

Annex II

Additional information on Swiss energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | D-A-CH reference values | D-A-CH reference values
Fat | D-A-CH reference values; use oils and spreadable fats sparingly, max 10 g per meal (should not exceed 30 g per person per day) | D-A-CH reference values; use oils and spreadable fats sparingly, max 10 g per meal (should not exceed 30 g per person per day)
Saturated fat | - | -
Total carbohydrate | D-A-CH reference values | D-A-CH reference values
Non-milk extrinsic sugars | - | -
Fibre | D-A-CH reference values | D-A-CH reference values
Protein | D-A-CH reference values | D-A-CH reference values
Iron | D-A-CH reference values | D-A-CH reference values
Zinc | - | -
Calcium | D-A-CH reference values | D-A-CH reference values
Vitamin A | - | -
Vitamin C | D-A-CH reference values | D-A-CH reference values
Folate | D-A-CH reference values | D-A-CH reference values
Sodium | Max. 1 g per meal | Max. 1 g per meal
Other | Vitamins E, B1, B2; magnesium, iodine; recommendations on E% split between protein, fat and carbohydrate for full board and for lunch, by age (4-6y, 7-9y, 10-12y, 13-14y, 15-18y) | Vitamins E, B1, B2; magnesium, iodine; recommendations on E% split between protein, fat and carbohydrate for full board and for lunch, by age (4-6y, 7-9y, 10-12y, 13-14y, 15-18y)

School food policy (mandatory) | “Vyhláška č. 107/2005 Sb., 0 školním stravování” “Vyhláška č. 108/2005 Sb., 0 školských výchovných a ubytovacích zařízeních a školskýchúčelových zařízeních” “Vyhláška č. 107/2008 Sb., kterou se mění vyhláška č. 107/2005 Sb., 0 školním stravování”
Developed by | Ministry of Education, Youth and Sport
Year of publication | 2005, 2008
Web link(s) | http://www.msmt.cz/uploads/soubory/sb034_05.pdf http://www.msmt.cz/uploads/soubory/vyhlasky/Novela_stravovani_107_08.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 522,828 | 10,516,125 | 14%
10 to 14 years | 455,768
15 to 19 years | 510,265
Total 5 to 19 years | 1,488,861

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Czech Republic

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (7 years) | 21.4% | 24.4% | 9.7% | 10.7%
Girls (7 years) | 20.2% | 23.7% | 5.7% | 7.3%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• n/a

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Czech Republic.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Czech Republic.

7 | [picture]

Czech Republic

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Czech Republic

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Czech Republic

Educational framework programmes have been defined (for kindergartens, basic and high schools) which contain topic “Man and Health” – nutrition is a part of it

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Czech food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | 85-370 g vegetables per day; 65-290 g fruit per day | 85-370 g vegetables per day; 65-290 g fruit per day
Specified number of times (red) meat served | 55-163 g per day; 15-25 g egg for vegetarians | n/a
Specified number of times other sources of protein served | 10-30 g fish per day; 10-30 g beans per day | n/a
Specified number of times dairy products served | 55-450 g milk per day; 9-210 g other dairy per day | n/a
Specified number of times (oily) fish should be on the school lunch menu | 10-30 g fish per day | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | -
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | - | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | - | -
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | - | -

Other
daily quantities by age group provided for the following food groups: meat, fish, liquid milk, dairy products, “free fat”, “free sugar”, total vegetables, total fruit, potato, legumes; lacto-ovo-vegetarian nutrition can be applied if approved by all legal guardians of minors or adult boarders or operators of catering services; food consumption corresponds to the monthly average with a maximum tolerance of +/-25% with the exception of fats, where the amount of free fat is the upper limit (can be reduced)
daily quantities by age group provided for the following food groups: meat, fishes, liquid milk, dairy products, “free fat”, “free sugar”, total vegetables, total fruit, potato, legumes, eggs; lacto-ovo-vegetarian nutrition can be applied if approved by all legal guardians of minors or adult boarders or operators of catering services; catering services beyond the scope of § 4 provided to diners have to conform to the principles of healthy nutrition and product mix may not include alcoholic beverages and tobacco products; food consumption corresponds to the monthly average with a maximum tolerance of +/-25% with the exception of fats, where the amount of free fat is the upper limit (can be reduced)

Annex II

Additional information on Czech energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | 18 E% for breakfast, 15 E% for snacks, 35 E% for lunch, 10 E% afternoon snack and 22 E% for dinner | 18 E% for breakfast, 15 E% for snacks, 35 E% for lunch, 10 E% afternoon snack and 22 E% for dinner
Fat | “free fat”; ratio of consumption of vegetable and animal fats is approximately 1:1, with an emphasis on increasing proportion of fats of vegetable origin | “free fat”; ratio of consumption of vegetable and animal fats is approximately 1:1, with an emphasis on increasing proportion of fats of vegetable origin
Saturated fat | - | -
Total carbohydrate | - | -
Non-milk extrinsic sugars | “free sugar” | “free sugar”
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | x | x
Folate | - | -
Sodium | - | -
Other | in schools with a strong emphasis on physical activity, energy intake references can be increased by 30% | in schools with a strong emphasis on physical activity, energy intake references can be increased by 30%

School food policy (voluntary) | “Sund skolemad med smag smil og samvaer”
Developed by | Ministry of Food, Agriculture and Fisheries
Year of publication | 2012 (website update)
Web link(s) | http://altomkost.dk/servicemenu/publikationer/publikation/pub/hent-fil/publication/sund-skolemad-med-smag-smil-og-samvaer/

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 329,520 | 5,602,628 | 18%
10 to 14 years | 335,120
15 to 19 years | 358,224
Total 5 to 19 years | 1,022,864

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Chronic disease prevention depending on lifestyle

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Denmark.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Denmark.

7 | [picture]

Denmark

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Denmark

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Denmark

The Ministry of Food, Agriculture and Fisheries cooperates with the Ministry of Children and Education to strengthen Home Economics and supports the subject Health and Sex Education and Family Studies, e.g. in terms of materials. A new elementary school reform effective 2014/2015 sets new goals for Home Economics and makes it mandatory that all students should be physically active on average 45 minutes during a school day (total time of teaching).

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Danish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | It should be a third of a child’s lunch; children over 10 years should eat 200-300 g vegetables/fruit daily | Children over 10 years should eat 200-300 g vegetables/fruit daily
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | Milk ½ litre a day (0.7 g fat/100 g); serve cheese with maximum 17% fat | n/a
Specified number of times (oily) fish should be on the school lunch menu | One of five meals should be fish based; 200-300 g fish a week | n/a
Restrictions on availability of fried, deep-fried or processed products | x | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Should never be served | Should never be served
Starchy food cooked in fat or oil restricted | x | x
Crisps and savoury snacks restricted | Should never be served | Should never be served
Fresh drinking water must be provided and be easily accessible | Without cost | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Milk with 0.7 g fat/100 g or lower; fruit juice without sugar 2 times per 5 days | Milk with 0.7 g fat/100 g or lower; fruit juice without sugar 2 times per 5 days
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Shouldn’t be served | Shouldn’t be served
Salt provision is restricted | - | -

Other
Carbohydrates like rice, pasta and potatoes minimum in 2 out of 5 meals; whole wheat bread should be sold every day. Schools can apply for funding from EU school fruit scheme, but this is not common. Served meat should contain max. 10 g fat/100 g. EU school milk scheme has high degree of participation
Whole wheat bread should be sold every day; there are no vending machines in Danish schools. Schools can apply for funding from EU school fruit scheme, but this is not common. EU school milk program has high degree of participation

Annex II

Additional information on Danish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | There are recommendations for a small and a big meal; small meal (ages 7-10 years) should consist of 1800-2100 kJ. A big meal (ages 11-15 years) consist of 2200-2500 kJ; there are also recipes covering 185 different meals containing the right amount of energy and nutrients | x
Fat | x | -
Saturated fat | x | x
Total carbohydrate | x | -
Non-milk extrinsic sugars | - | -
Fibre | x | x
Protein | x | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | -
Other | - | -

School food policy (voluntary) | “DGE-Qualitätsstandard für die Schulverpflegung”; networking centers on school food in all 16 federal states
Developed by | Ministry of Health; Ministry of Food and Agriculture
Year of publication | 2011
Web link(s) | http://www.bmel.de/SharedDocs/Downloads/Ernaehrung/Kita-Schule/QualitaetsstandardsSchulverpflegung.pdf?_blob=publicationFile www.vernetzungsstellen-schulverpflegung.de

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 3,500,125 | 82,020,578 | 14%
10 to 14 years | 3,825,538
15 to 19 years | 4,071,631
Total 5 to 19 years | 11,397,294

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Address eating disorders; prevent diet-related diseases

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Other measures:

• Regular evaluations (studies) of school food quality at national and federal levels

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Other standards/guidelines:

• Food cultures (e.g. vegetarian); religious aspects (e.g. use of pork meat)

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See Annex I for more details on the food-based standards/guidelines in Germany.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Germany.

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Germany

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Germany

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Sponsoring by external partners is acknowledged as a means to increase school budget, but a clear distinction is made from product-specific marketing

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Germany

Actual implementation of food education measures – which are seen as important – is in the hands of the federal states

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on German food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Min. 8/20 for fruit and 20/20 for vegetable | 20/20 fruit, fresh or frozen, no added sugar; 20/20 vegetable or salad, vegetable fresh or frozen
Specified number of times (red) meat served | Max. 8/20 meat, of which max. 4/20 processed meat | n/a
Specified number of times other sources of protein served | Min. 4/20 fish, of which 1-2 fatty fish; max. 2/20 egg dishes | n/a
Specified number of times dairy products served | Min. 8/20 | n/a
Specified number of times (oily) fish should be on the school lunch menu | 1-2/20 fatty fish | n/a
Restrictions on availability of fried, deep-fried or processed products | Max. 4/20 deep-fried (potato) or bread-crumbed products | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Max. 2/20 sweet main dishes | No sweets should be offered
Starchy food cooked in fat or oil restricted | Max. 4/20 deep-fried or bread-crumbed products (not limited to starchy foods) | x
Crisps and savoury snacks restricted | In principle we work with a positive listing, i.e. what is allowed, but in effect this results in a restriction of such food | Only nuts and seeds without added salt or sugar
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | x | x
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | x | Water mentioned as optimal choice, but no clear statements against soft drinks
Salt provision is restricted | Use salt sparingly; must be iodised salt | Only mention of salt in relation to savoury snacks

Other
Menu cycle of minimum 4 weeks (20 days); one ovo-lacto-vegetarian choice daily; seasonal produce; regional and cultural food habits considered; meat-providing species varied regularly; efforts to include students with food allergies and intolerances; students ideas/wish lists considered in food offer; alternative meat offer in case of pork dishes; http://www.bmel.de/SharedDocs/Downloads/Ernaehrung/Kita-Schule/Quali-taetsstandardsSchulverpflegung.pdf?__blob=publicationFileDocumento1
http://www.bmel.de/SharedDocs/Downloads/Ernaehrung/Kita-Schule/QualitaetsstandardsSchulverpflegung.pdf?blob=publicationFile

Annex II

Additional information on German energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | -
Fat | x | -
Saturated fat | x | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | x | -
Fibre | x | -
Protein | x | -
Iron | x | -
Zinc | x | -
Calcium | x | -
Vitamin A | x | -
Vitamin C | x | -
Folate | x | -
Sodium | x | -
Other | Vitamins E and B1; magnesium; D-A-CH recommendations (which list more than those nutrients explicitly stated in the policy document); http://www.dge.de/modules.php?name=Content&pa=showpage&pid=3 | -

School food policy (mandatory) | “Tervisekaitsenõuded toitlustamisele koolieelses lasteasutuses ja koolis”
Developed by | Ministry of Education
Year of publication | 2008
Web link(s) | https://www.riigiteataja.ee/akt/12912436

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 70,313 | 1,320,174 | 15%
10 to 14 years | 60,377
15 to 19 years | 64,021
Total 5 to 19 years | 194,711

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• n/a

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Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Estonia.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Estonia.

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Estonia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Estonia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Advertising Act prohibits commercial advertising overall in educational facilities from kindergarten to high school and vocational schools, but it does not refer to way of advertising (print advertising, branding, sponsorships, events, etc.)

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Estonia

Nutrition education is part of national curriculum in primary and secondary schools since 2002 (subject syllabus “Health education”), and of national preschool education curriculum in kindergartens (since 1999); new curriculum and subject syllabus currently under development

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Estonian food-based and foods other than lunch standards for lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Vegetables are served every day, fruits are served at least three times a week | -
Specified number of times (red) meat served | Meat or poultry at least twice a week; frankfurters, cooked sausages, sardelki and sauces made from them should not be served more than once a month | -
Specified number of times other sources of protein served | - | -
Specified number of times dairy products served | - | -
Specified number of times (oily) fish should be on the school lunch menu | Meals from fresh fish or fish products are served at least once a week | -
Restrictions on availability of fried, deep-fried or processed products | Meals fried in a lot of fat are prohibited | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Sweets such as chewing gum, fruit and muesli bars, and candies are not served as dessert | -
Starchy food cooked in fat or oil restricted | Meals fried in a lot of fat are prohibited | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | - | -
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Water-based flavoured drinks, including energy and sports drinks which contain food colorants E 102, E 110, E 122, E 123, E 124, E 129, E 151, E 154, E 155, E 180 are not served as drinks | -
Salt provision is restricted | - | -

Other
Mayonnaise and mayonnaise-based sauces may be used in small portions and not more often than three times a months; products containing hydrogenated vegetable fats should be avoided; fat in food preparations should be vegetable oil; School fruit scheme has been introduced since 2009; bread must be available on a daily basis; milk has to be pasteurised; canned or preserved food based dishes are not allowed; pasta shouldn’t be served more than twice a week; liver not more than twice a month; supplements on prescription from health care professionals
-

Annex II

Additional information on Estonian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | Lunch covers 30-35 % of the daily energy). Daily energy need based on age groups (kcal): 7-9 y: 1880+/-190; 10-12 y: 2120+/-210; 13-15 y: 2410+/-240; 16-19 y: 2610+/-260 | Daily energy need based on age groups (kcal): 7-9 y: 1880+/-190; 10-12 y: 2120+/-210; 13-15 y: 2410 +/-240; 16-19 y: 2610+/-260
Fat | 30 +/-2.5 E% | 30 +/-2.5 E%
Saturated fat | max 10 E% | max 10 E%
Total carbohydrate | 57.5 +/-2.5 E% | 57.5 +/-2.5 E%
Non-milk extrinsic sugars | max 10 E% | max 10 E%
Fibre | 14-22 g | 14-22 g
Protein | 12.5 +/-2.5 E% | 12.5 +/-2.5 E%
Iron | 9-12.5 mg | 9-12.5 mg
Zinc | 7-9 mg | 7-9 mg
Calcium | 700-900 mg | 700-900 mg
Vitamin A | 400-800 mcg | 400-800 mcg
Vitamin C | 45-75 mg | 45-75 mg
Folate | 130-325 mcg | 130-325 mcg
Sodium | max 1.56-2.20 g | max 1.56-2.20 g
Other | https://www.riigiteataja.ee/aktilisa/1200/4201/2008/Lisa3.pdf | ttps://www.riigiteataja.ee/aktilisa/1200/4201/2008/Lisa3.pdf

School food policy (voluntary) | “Food & Nutrition Guidelines for Primary Schools”
Developed by | Ministry of Health
Year of publication | 2003
Web link(s) | http://www.fooddudes.ie/Primary_Schools_Food_Nutrition.pdf

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 326,660 | 4,591,087 | 20%
10 to 14 years | 307,996
15 to 19 years | 274,872
Total 5 to 19 years | 909,528

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Ireland

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (7 years) | 27.6% | 25.7% | 8.7% | 8.6%
Girls (7 years) | 31.1% | 30.0% | 9.7% | 6.9%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Health promotion, improve children’s self-esteem and well being

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Other measures:

• Is there enough time for children to enjoy lunch and have some physical activity at lunch time?

• Are children encouraged to sit while eating?

• Is lunchtime supervised?

• Is there a designated area for eating?

• Do/Could older children help younger children with lunch?

• Are there handwashing facilities?

• Is there a storage area for lunches?

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Other standards/guidelines:

• n/a

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See Annex I for more details on the food-based standards/guidelines in Ireland.

6 | [picture]

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Ireland

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Ireland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Dept of Health recommends that schools should be protected zones and free from marketing (EU Strategy); there have been a number of initiatives by government, regulators, private sector and consumer groups in relation to practice of advertising of foods and beverages to children; codes, rules and practices have been developed; work was on-going according to Report of Inter-sectoral Group on Implementation of Recommendation of National Task Force on Obesity of April 2009, including measures in Broadcasting Bill 2009 to prohibit TV and radio advertising of high fat, sugar and salt products subject to public concern in respect to general public health interests of children.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Ireland

It is a part of the guidelines to teach about food and nutrition, but the guidelines are voluntary

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Irish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
One or more servings: vegetable – cooked or raw; salad vegetable, e.g. lettuce, tomato, cucumber, sweetcorn, peppers, celery, carrot – included in sandwiches; vegetable sticks e.g. cucumber, carrots, celery, pepper (red, yellow, green); all fresh fruit, e.g. apples, mandarines, satsumas, tangerines, peaches, pears, plums, bananas (try to buy in season and wash before school); oranges – slice into 6-8 segments and wrap in cling film; kiwis – slice in half and wrap in cling film, or eat with teaspoon; dried fruit – raisins, sultanas, apricots, figs; unsweetened pure fruit juice (one serving is: 1 large piece of fruit, i.e. 1 apple, 1 orange, 1 banana; 2 small pieces of fruit, i.e. 2 satsumas, 2 kiwis; 100 ml of unsweetened pure fruit juice (1 small carton = 200 ml); ½ tin of fruit, in own juice; 2 tbsp/3 tsp vegetable, i.e. carrots chopped or grated; 1 small salad, i.e. lettuce, tomato, cucumber, celery sticks (Dept of Agriculture and Food launched fruit & vegetable programme in 120 primary schools; Dept of Agriculture Food Dudes programme also incorporates EU School Fruit Scheme)
Unsweetened fruit juice, banana, apple, orange, peach, satsumas, plum, grapes, kiwi, pear, melon, pineapple, raw carrot sticks, dried fruit (Dept of Agriculture and Food launched fruit & vegetable programme in 120 primary schools; also EU School Fruit Scheme)

Specified number of times (red) meat served | - | n/a

Specified number of times other sources of protein served
Sources of protein including fish and meat: one serving; meat – lean beef, lamb, pork or ham; chicken or turkey – sliced or chopped; eggs; fish – tinned, fresh; nuts – whole nuts are not suitable for children under 5 years; peanut butter; cheese (not only listed on the dairy shelf but is also a source of protein); textured vegetable protein (TVP), tofu, beans. One serving is: 56 g meat, i.e. 2 slices cooked meat; 56 g chicken, i.e. 2 slices chicken/turkey breast; 84 g fish, e.g. tuna, salmon, mackerel, sardines; 2 eggs – hard boiled, sliced or mashed; 56 g cheddar cheese, i.e. slices or cubes
n/a

Specified number of times dairy products served | One serving; milk – all types include the same amount of calcium; cheese – all types – including cubes, sticks, slices, triangles, spreads; yoghurt – all types (one serving is: 1 glass/mini carton of milk; 1 yoghurt (125 ml); 28 g cheddar type cheese; 2 processed cheese slices) | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
Foods from this shelf can be high in fat/sugar and should be used sparingly; chocolate, fizzy drinks, sweets, cakes biscuits should only be eaten occasionally and should not replace important foods from other shelves of the pyramid; these foods may fill children quickly and reduce their appetite for more nutritious healthy food
x

Starchy food cooked in fat or oil restricted | - | -

Crisps and savoury snacks restricted
Crisps and savoury snacks are on the top shelf of the Food Pyramid and are not recommended – but may be eaten occasionally; foods from this shelf can be high in fat/sugar and should be used sparingly; savoury snacks, i.e. crisps should only be eaten occasionally and should not replace important foods from other shelves of the pyramid; these foods may fill children quickly and reduce their appetite for more nutritious healthy food
x

Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Milk, water and unsweetened fruit juice; School Milk Scheme entitles school-going children to a quarter litre of milk on each school day; pre-schools, primary and second-level schools are eligible for the Scheme | Milk, water and unsweetened fruit juice; School Milk Scheme entitles school-going children to a quarter litre of milk on each school day; pre-schools, primary and second-level schools are eligible for the Scheme
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Soft drinks are on top shelf of Food Pyramid and are not recommended | x
Salt provision is restricted | - | -

Other
Bread, cereals and potatoes: 2 or more servings a day; include high fibre choices frequently; bread (all types, plain or toasted) – sliced breads (brown, whole-meal, wholegrain, white), homemade breads (brown, wholemeal, white or brown soda), currant breads, french bread/stick, soda farls; rolls of all sizes – brown, white, wholemeal, petit pains, burger buns; scones – wholemeal, brown, currant, white Pitta breads, tortilla wraps, bagels; crackers (preferably wholegrain/whole wheat); pasta, spaghetti and rice – may be included in salad boxes; combination foods i.e. pizzas, quiche (one serving is: 1 slice of bread; 1 medium roll; 2 crackers; 1 small scone; 2 tablespoons/3 dessertspoons cooked rice/pasta; small serving of popcorn; guidelines also contain suggestions for vegetarian diets and other special diets
Examples from food pyramid: glass of milk, milk on cereal, unsweetened milk shake, yoghurt, cheese slice, cubes or spread; slice of cooked meat, small chicken sandwich, small egg sandwich, baked beans; break-fast cereal, bread, toast, rolls, crackers, crispbreads, bagels, scones, plain biscuits, plain popcorn

School food policy¹⁵ (mandatory) | “ΚΥΛΙΚΕΙΑ - ΕΡΜΗΝΕΙΑ ΥΓΕΙΟΝΟΜΙΚΗΣ ΔΙΑΤΑΞΗΣ ΠΕΡΙ ΔΙΑΘΕΣΙΜΩΝ ΠΡΟΪΟΝΤΩΝ (Υ1/Γ.Π./οικ.109167/2006)”
Developed by | Ministry of Health
Year of publication | 2013
Web link(s) | http://edu.klimaka.gr/nomothesia/symvulia-epitropes/1259-ermhneia-diataxhs-proion-ta-se-scholika-kyklikeia.html

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 537,497 | 11,062,508 | 15%
10 to 14 years | 535,487
15 to 19 years | 546,389
Total 5 to 19 years | 1,619,373

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Greece

| Overweight (including obesity) | Obesity
2009/10 | 2009/10
Boys (7 years) | 48.9% | 23.9%
Boys (9 years) | 57.2% | 30.5%
Girls (7 years) | 44.8% | 18.6%
Girls (9 years) | 50.0% | 20.8%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Hygiene and food safety

• Prevent diet-related chronic diseases

• Prevention of obesity and improvement of dietary habits will indirectly lead to improvement of body image and self confidence

3 | [picture]

Other measures:

• Across all areas of school premises, both public and private, controls are carried out on a regular or occasional basis by authorities in charge, namely the Regional Public Health Services of the Hellenic Food Authority (EFET)

4 | [picture]

Other standards/guidelines:

• Regarding food-based standards for lunch, the Mediterranean diet pyramid based on dietary guidelines for Greece (Ministry of Health, 1999) is in place and applies only to schools with dining halls, which offer school lunches to students; no other recommendations included; school lunches are offered only by specific private schools in Greece, for which the Mediterranean diet menu applies

• Regarding food-based standards for non-lunch, the implementation of specifications mentioned in the list is mandatory as this falls under the healthcare order; school premises with dining halls (restaurants) should follow a weekly menu based on the Mediterranean diet pyramid; food items included in list of current healthcare order should be consumed by children only during breaks and are not related to school lunches

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Greece.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Greece.

7 | [picture]

Greece

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Greece

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Greece

Health education programmes, conducted on an annual basis in Greek schools, may include basic nutrition knowledge according to Law 2817/2000 of the Ministry of Education. The Ministry of Education has created educational material for students in primary and secondary education regarding Nutrition, Eating Habits and Consumer’s Education. Programs on nutrition and eating habits are implemented by trained teachers from relevant university departments such as Harokopion University of Athens & Medical Schools

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Greek food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
-
Sweets authorised for sale are: cream and rice pudding in individual servings of 150 g (lipids content up to 4%); halva in individual servings up to 50 g; pasteli (sesame with honey) in individual servings up to 50 g; honey in individual servings; bitter and milk chocolate in individual servings up to 30 g; furthermore, in category “Pastries” are included: plain biscuits, without filling, in individual package (up to 60 g) with following specifications: 1. trans fatty acids content should not exceed 2% of total lipids; 2. per 100 g of product: (a) sugar should not exceed 10 g, (b) lipids should not exceed 10 g, (c) saturated fatty acids should not exceed 5 g, (d) sodium should not exceed 0.5 g

Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | - | -

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
-
Authorised for sale items include: natural fruit juice and/or vegetable juice prepared in the canteen; packed natural fruit juice and similar products, without preservatives and added sugar, in individual packaging up to 330 ml; standardised and pasteurised milk, full fat and semi-skimmed (1.5-1.8% lipids), in individual packaging up to 500 ml; Semi-skimmed chocolate milk (max 1,8%) in packaging up to 250 ml; beverages based on a combination of fresh milk and fresh fruit prepared in canteen; added sugar is not allowed; sale of similar commercial beverages as well as usage of powder for their preparation is prohibited; bottled water; in canteens of secondary and high schools the following beverages are allowed: chamomile, sage, mountain tea, without added sugar or artificial sweeteners; coffee only for staff

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | x
Salt provision is restricted | - | Following sodium content restrictions apply: max 0.5% for sesame buns, bread-sticks, toast, crackers, cereal bars, biscuits; boiled turkey: up to 1%

Other
-
In the case of cereals and their products it is suggested to choose mainly wholegrain; use of pre-packed sandwiches was decided in order to ensure that food hygiene standards are being followed; moreover, these products via food labelling provide information on their nutritional content; in this way the quality of food provided at school canteens (including content of trans fatty acids) will be more easily controlled; in the case of food products that are not, at least currently, available in prepacked forms (e.g. spinach and/or cheese pies), limits were set with regard to the trans fatty acid content of their dough, which should not be more than 2% of the total lipid content of the product; traditional Greek snacks are included in catalogue for highschool/lyceum/evening-school canteens; these include pasteli (sesame seed bar), chalva (semolina and/or sesame paste based dessert) and Greek honey; rationale for this decision was to familiarise students with traditional Greek sweets of high nutritional value (olive oil as the basic added lipid, honey as main sweetener and sesame seeds as a good source of calcium and other micronutrients); however, only small portion sizes are allowed and emphasis is given to appropriate nutritional training of students so that negative side effects from over-consumption are avoided

Annex II

Additional information on Greek energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | - | -
Fat | - | Full fat and semi-skimmed milk (1.5-1.8% fat); chocolate milk with max 1.8% fat; yogurt with max 5% fat; cream and rice pudding with max 4% fat; biscuits with max 10% fat; cheese pie with max 30% fat
Saturated fat | - | Sesame bun, breadsticks, melba toasts, crackers, cereal bar with max 3% saturated fatty acids; boiled turkey with max 1% saturated fatty acids; biscuits with max 5% saturated fatty acids
Total carbohydrate | - | -
Non-milk extrinsic sugars | - | Biscuits with max 10% sugar; added sugars forbidden in the following: dried fruits, fruit salad, natural and packed fruit juices, yogurt, fresh milk and fruit beverages (smoothies)
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | Sesame bun, breadsticks, melba toasts, crackers, cereal bar with max 0.5% sodium; boiled turkey with max 1% sodium; biscuits with max 0.5% sodium
Other | - | Sesame bun, breadsticks, melba toasts, crackers, cereal bar with max 0.1% trans fatty acids; biscuits with max 2% trans fatty acids; cheese pie with max 0.1% trans fatty acids

School food policy (voluntary) | “CONSENSUS DOCUMENT ON FOOD IN EDUCATIONAL CENTRES”
Developed by | Ministry of Education, Culture and Sport and Ministry of Health, Social Services and Equality. The application is responsibility of regional administrations (education and health).
Year of publication | 2010

Web link(s)
http://www.naos.aesan.msssi.gob.es/naos/ficheros/escolar/Standards.pdf
Annex 1 of the above includes a list of school food policies in Spanish regional Administrations (Comunidades Autonomas); these Comunidades Autonomas have developed their own regional laws or guidance on school food policy in accordance with national legislation

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 2,440,531 | 46,727,890 | 15%
10 to 14 years | 2,226,702
15 to 19 years | 2,165,610
Total 5 to 19 years | 6,832,843

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Spain

| Overweight (including obesity) | Obesity
2009/10¹⁶ | 2012 | 2009/10¹⁷ | 2012
Boys (6 years) | 42.4% | 42.4% | 16.4% | 16.4%
Boys (7 years) | 48.0% | 44.0% | 22.1% | 19.9%
Boys (8 years) | 48.0% | 47.5% | 21.5% | 23.1%
Boys (9 years) | 51.1% | 51.1% | 23.2% | 23.2%
Girls (6 years) | 36.4% | 36.4% | 13.6% | 13.6%
Girls (7 years) | 41.6% | 39.5% | 16.0% | 15.4%
Girls (8 years) | 42.9% | 41.4% | 16.3% | 15.6%
Girls (9 years) | 43.6% | 43.6% | 16.2% | 16.2%

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Dining hall should strive to teach pupils principles of 1) Health, hygiene and diet: aimed towards developing and reinforcing healthy eating habits, rules for good behaviour and the correct usage and care of dining hall equipment; 2) Responsibility: involving the pupils in tasks, events and projects that take place in the dining halls in accordance with their age and educational level; 3) Free time: planning free-time and hobby-type activities which contribute to the development of personalities and which encourage social and cultural habits; 4) Coexistence: encouraging feelings of companionship and respect, education and tolerance amongst the members of the school community, in a suitably stable and social environment

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Other measures:

• Several regional administrations (Comunidades Autonomas) perform a nutritional assessment of school meals (food consumption frequency and variety), information provided on the school menu, cooking methods and offer in vending machines, canteens and kiosks in educational centres. In addition, aspects of the management and organization of the school dining halls and related health education, healthy eating and hygiene habits are also verified activities

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Other standards/guidelines:

• Special dietary requirements; meal plan information for families to complement dietary provision and inspection and follow-up; many of the regional guides include sanitary hygienic conditions for food handling

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See Annex I for more details on the food-based standards/guidelines in Spain.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Spain.

7 | [picture]

Spain

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Spain

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

New PAOS Code 2013: self-regulation of advertising to children under 12 years old (TV media) and under 15 years old (Internet) according to the Law 17/2011 (art. 45º and 46º). It includes: Recommendations and prohibitions in order to reduce the marketing pressure existing on children, as well on television and internet; Copy advice technical monitoring by AUTOCONTROL before the broadcasting of the ads; Evaluation by the Monitoring Commission (AECOSAN, Ministry of Agriculture, Secretary of State of Telecommunications and Information Society, organizations of consumers, advertisers, manufacturers, distribution and catering)

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Spain

Law 17/2011, of 5 July 2011, about food safety and nutrition (article 40) reflects the inclusion of content aimed at prevention and awareness of the benefits of balanced nutrition in teacher training plans; see http://www.observatorio.naos.aesan.msssi.gob.es/docs/docs/documentos/ley_seguridad_alimentaria.pdf

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Spanish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
Starters: vegetables (incl. potatoes) 1-2/wk; side dishes: mixed salads 3-4/wk, other side dishes (potatoes, vegetables, pulses, etc.) 1-2/wk; dessert: fruit 4-5/wk
Fresh fruit - whole or minimally processed, which do not contain added sugars; Fruit Juices - natural juices and those made from concentrate that do not have added sugars. Fruit nectars or fruit and milk drinks with added sugar or artificial sweeteners are not included in this category; Vegetable-based drinks that contain at least 50% vegetables and do not have any added sugars or artificial sweeteners

Specified number of times (red) meat served | Meats 1-3/wk; non-specified red meat | n/a
Specified number of times other sources of protein served | Fish 1-3/wk; eggs 1-2/wk; pulses 1-2/wk | n/a
Specified number of times dairy products served | Dairy dessert (preferably yoghurt) 0-1/wk; cheese and other dairy can be incorporated in starters and main dishes, but no numbers specified | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish 1-3/wk, alternating between oily fish (fatty) and white fish (lean) | n/a

Restrictions on availability of fried, deep-fried or processed products
Fried foods offered max 2/wk; pre-cooked products (i.e. cannelloni, croquettes, pasties, pizzas, battered foods, breadcrumbed foods, etc) should be limited to max 3/mo; fried side dishes should be avoided as accompaniments; same cooking method should not be used for both starters and main dishes, or as a component of main dishes and its accompanying side dishes
-

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Should be removed from educational centres | Should be removed from educational centres
Starchy food cooked in fat or oil restricted | x | -
Crisps and savoury snacks restricted | Should be removed from educational centres | Should be removed from educational centres
Fresh drinking water must be provided and be easily accessible | x | Bottled water varieties acknowledged by legislation. Water-based drinks that are classed as soft-drinks and which contain flavourings and/or sweeteners, are not classed as water in this case. However, it is recommended that there should be free access to water fountains or water dispensers
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Water should be the only drink to accompany meals | Water should be the only drink to accompany meals
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Should be removed from educational centres | Should be removed from educational centres
Salt provision is restricted | x | x

Other
Cereals should form basis of diet, using wholegrain as much as possible; bread daily; vary cooking methods for different courses; olive or sunflower oil high in oleic acid should be used for fried dishes; extra virgin olive oil should be used for dressings; concentrated meat stocks or any product that contains enhanced flavours such as monosodium glutamate often have too much salt so their use should be limited, and when they are used, extra salt should not be added; introducing ecologically produced foods in school meals could have advantages regarding sustainability and environmental protection; in cases where pupils cannot have a certain type of food for cultural or religious reasons, an alternative shall be available which suitably covers their nutritional needs – as long as the organisational conditions and facilities allow for it, and it is economically viable; latex gloves should not be used to stop latex proteins being transferred from gloves to foods, as they can cause anaphylactic reactions in some people
Recommends that vending machines sell healthy products: Milk -in any of its forms (whole milk, skimmed, semi-skimmed) or preservation method; dairy products (fermented milk, yoghurts, milk shakes, etc) made from whole, skimmed or semi-skimmed milk with max 12.3 g sugar/100 ml (4.8 g lactose + 7.5 g added sugars) or 24.6 g sugar (9.6 g lactose + 15 g added sugars) per 200 ml carton/packet; low fat cheeses that do not exceed established salt levels; breakfast cereals and cereal bars as long as they comply with established criteria for fats, sugars and salt; biscuits and cakes - as long as they comply with established criteria for sugar and fat content (especially saturated fat); nuts which do not contain added sugars or fats (and are not fried or toasted in oil) and whose salt content does not exceed established limit. Serving size should not exceed maximum energy value; ice cream - preferably made from milk, as long as they comply with criteria established for fat and sugar content; sandwiches as long as they comply with criteria established for fat, salt and sugar content; rolls - preferably made with brown bread. Most should be made at point of sale and therefore do not have a label, but as they are mainly made of bread, they generally do not contain high levels of fat, sugar or salt; bread products (breadsticks, toasted bread, etc.) as long as they comply with criteria established for fat, salt and sugar content

Annex II

Additional information on Spanish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | 35% of energy needs, grouped by age and gender | Portion limits for foods from kiosks, vending machines and cafeterias: max energy value of 200 kcal
Fat | - | Max. 35% of these kilocalories should come from fats; for a serving with less than 200 kcal, this is equivalent to a maximum content of 7.8 grams of fat
Saturated fat | - | Max. 10% of kcal should come from saturated fats; for a serving with less than 200 kcal, this is equivalent to max content of 2.2 g of saturated fats
Total carbohydrate | - | -
Non-milk extrinsic sugars | - | Max. 30% of kcal should come from total sugars; for a 200 kcal serving, this is equivalent to max 15 g sugar
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | Max. 0.5 g of salt (0.2 g of sodium)
Other | - | Absence of trans fatty acids, except for those naturally found in meat and dairy products; foods should be free of artificial sweeteners; should be free from caffeine or other stimulants, except those naturally present in cocoa

School food policy¹⁸ (mandatory) | “Arrêté du 30 septembre 2011 relatif à la qualité nutritionnelle des repas servis dans le cadre de la restauration scolaire”

Developed by
Several ministries including Ministry of Defence and Veteran Affairs; Ministry of Home Affairs; Ministry of Economy, Finances and Industry; Ministry of Work, Employment and Health; Ministry of National Education, Youth and Community Life; Ministry of Agriculture, Nutrition, Fisheries and Land Management.

Year of publication | 2011
Web link(s) | http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000024614763

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Demographic data

School-age population | Total Population | School-aged children as % of total population
5 to 9 years | 3,907,887 | 63,659,608 | 18%
10 to 14 years | 3,927,401
15 to 19 years | 3,815,313
Total 5 to 19 years | 11,650,601

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Understand food production

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Other measures:

• Composition of meals

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in France.

6 | [picture]

7 | [picture]

France

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No Vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

France

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

Recommendations are made by education, health and agriculture authorities in http://eduscol.education.fr/cid47778/nutrition-a-l-ecole-alimentation-et-activite-physique.html

9 | [picture]

France

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on French food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Min. 10/20 meals with fresh/raw fruit & vegetables as starter or side dish; min. 8/20 meals with fresh fruit as dessert; 10/20 meals with cooked vegetables as side dish | Min. 10/20 meals with fresh/raw fruit & vegetables as starter or side dish; min. 8/20 meals with fresh fruit as dessert; 10/20 meals with cooked vegetables as side dish
Specified number of times (red) meat served | Min. 4/20 meals with non-minced meat (beef, veal, lamb, offal | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | Min. 8/20 meals with cheese of min. 150 mg Ca per portion; min. 4/20 meals with cheese of 100-150 mg Ca; min. 6/20 meals with dairy food or milk-based dessert of more than 100 mg Ca and less than 5 g fat per portion | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | Max. 4/20 meals with main dishes or sides fried/deep-fried | Max. 4/20 meals with main dishes or sides to be fried/deep-fried
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Max. 4/20 desserts from sweetened foods of less than 15% fat | Max. 4/20 desserts from sweetened foods of less than 15% fat
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Water the only recommended beverage | -
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | Salt and sauces not freely available at the table and only served in function of the meal | Salt and sauces not freely available and only served in function of the meal
Other | Menu cycle of 20 dishes; lunches and dinners need to be composed of main dish, side dish, dairy product, and a choice of starter and/or dessert; portion sizes must be age-appropriate; free access to bread | Menu cycle of 20 dishes; lunches and dinners need to be composed of main dish, side dish, dairy product, and a choice of starter and/or dessert; portion sizes must be age-appropriate; free access to bread

School food policy (mandatory) | “NACIONALNE SMJERNICE ZA PREHRANU UČENIKA U OSNOVNIM ŠKOLAMA”
Developed by | Ministry of Health
Year of publication | 2013
Web link(s) | http://www.zdravlje.hr/content/download/11609/84157/file/Nacionalne_smjernice_za_prehranu_ucenika_u_osnovnim_skolama.pdf

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Demographic data

School-age population | Total Population | School-aged children as % of total population
5 to 9 years | 205,124 | 4,262,140 | 16%
10 to 14 years | 218,179
15 to 19 years | 246,638
Total 5 to 19 years | 669,941

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Learn table manners and hygienic habits, socialisation, improving relationships, reducing the risk of eating disorders

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Other measures:

• Kitchens equipped according to standards; sufficient number of qualified staff; sufficiently large and adequately furnished dining facilities; safe water provision; enough time for eating; verified suppliers; include representatives of individual grades in meal planning; publish menu at least two weeks in advance; affordable meals accessible to all participants; HACCP system for self-control of production process; control of ready meals in order to check energy and nutritional value of meals.

http://www.zdravlje.hr/content/download/11609/84157/file/Nacionalne_smjernice_za_prehranu_ucenika_u_osnovnim_skolama.pdf (Chapter 8)

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Other standards/guidelines:

• At what hour you should eat your meals and how much time you’ll need.

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Croatia.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Croatia.

7 | [picture]

Croatia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No Vendingmachine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Croatia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Croatia

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Croatian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | every day | every day
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | meat, poultry, eggs, legumes, nuts and seeds in the ground form; every day, of which meat up to 5 times a week | n/a
Specified number of times dairy products served | every day | n/a
Specified number of times (oily) fish should be on the school lunch menu | fish at least 1-2 times a week; recommended to increase intake of omega-3 fatty acids in relation to intake of omega-6 fatty acids; food of animal origin rich in omega-3 fatty acids is oily fish (sardines, tuna, mackerel, etc.) and salmon | n/a
Restrictions on availability of fried, deep-fried or processed products | Potatoes | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | avoid sweets and other confectionery and general products with added sugar | avoid sweets and other confectionery and general products with added sugar
Starchy food cooked in fat or oil restricted | x | x
Crisps and savoury snacks restricted | x | x
Fresh drinking water must be provided and be easily accessible | 4-14 y: 1.2-1.8 l/water; 14-17 y: 2.6 l/water | 4-14 y: 1.2-1.8 l/water; 14-17 y: 2.6 l/water
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | milk, water, juice; prefer freshly squeezed juices and herbal or fruit teas without added sugar or moderately sweetened with honey | milk, water, juice; prefer freshly squeezed juices and herbal or fruit teas without added sugar or moderately sweetened with honey
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | avoid carbonated beverages and/or non-carbonated sweetened drinks | avoid carbonated beverages and/or non-carbonated sweetened drinks
Salt provision is restricted | x | x

Other
cereals, cereal products and potatoes every day; foods with high fat, sugar and salt twice a month; food to be eaten rarely or avoid: Bakery and confectionery products, industrial desserts; as a rule, contain a large proportion of fat and sugar, which is why it is recommended that in the case of their inclusion in the menu using only those products that contain less sugar and fats and which are made on the basis of milk (yogurt), from the whole grain, with added fruit, seeds, nuts, etc., which significantly increased their nutritional density; Carbonated or non-carbonated sweet drinks; manufactured with artificial colours and fruit flavours, and added sugar or artificial sweeteners; we recommend completely avoiding caffeinated drinks; Meat, cream/chocolate spreads, hard margarines; contain a high proportion of fat and / or undesirable trans fatty acids, which is why we do not recommend their use; adequate for the moderate use of dairy spreads, spreads based on legumes, dairy margarine or sour cream; Foods with high fat content and foods containing predominantly saturated and trans fatty acids; preparing meals with the use of fat increases the fat content of the diet all day, which is why we recommend the use of a moderate fat; animal fats largely replaced by high-quality vegetable oils; with classic fried food, if placed on the menu, pay attention to use fresh oil for frying food and oil temperature during preparation; meat products with a homogeneous structure for milling (pate, sausages, cold meats, etc.); instant soups and soup concentrates and similar concentrated products; high content of salt and additives
cereals, cereal products and potatoes every day; foods with high fat, sugar and salt twice a month; food to be eaten rarely or avoid: Bakery and confectionery products, industrial desserts; as a rule, contain a large proportion of fat and sugar, which is why it is recommended that in the case of their inclusion in the menu using only those products that contain less sugar and fats and which are made on the basis of milk (yogurt), from the whole grain, with added fruit, seeds, nuts, etc., which significantly increased their nutritional density; Carbonated or non-carbonated sweet drinks; manufactured with artificial colours and fruit flavours, and added sugar or artificial sweeteners; we recommend completely avoiding caffeinated drinks; Meat, cream/chocolate spreads, hard margarines; contain a high proportion of fat and / or undesirable trans fatty acids, which is why we do not recommend their use; adequate for the moderate use of dairy spreads, spreads based on legumes, dairy margarine or sour cream; Foods with high fat content and foods containing predominantly saturated and trans fatty acids; preparing meals with the use of fat increases the fat content of the diet all day, which is why we recommend the use of a moderate fat; animal fats largely replaced by high-quality vegetable oils; with classic fried food, if placed on the menu, pay attention to use fresh oil for frying food and oil temperature during preparation; meat products with a homogeneous structure for milling (pate, sausages, cold meats, etc.); instant soups and soup concentrates and similar concentrated products; high content of salt and additives

Annex II

Additional information on Croatian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | kcal/day intake with moderate physical activity, depending on gender and age: Boys 7-9:1970; 10-13: 2220; 14-18: 2755. Girls 7-9: 1740; 10-13: 1845; 14-18: 2110 | kcal/day intake with moderate physical activity, depending on gender and age: Boys 7-9:1970; 10-13: 2220; 14-18: 2755. Girls 7-9: 1740; 10-13: 1845; 14-18: 2110
Fat | depending on age: 7-9y: 30-35 E%; 10-13y: 30-35 E%; 14-18y: 25-30 E% | depending on age: 7-9: 30-35 E%; 10-13: 30-35 E%; 14-18: 25-30 E%
Saturated fat | ≤ 10 E% | ≤ 10 E%
Total carbohydrate | > 50 E% | > 50 E%
Non-milk extrinsic sugars | simple sugars: <10 E% | simple sugars: <10 E%
Fibre | > 10 g/1000 kcal | > 10 g/1000 kcal
Protein | 10-15 E% | 10-15 E%
Iron | 10; 13.5; 13.5 mg | 10; 13.5; 13.5 mg
Zinc | 7.0; 8.0; 8.38 mg | 7.0; 8.0; 8.38 mg
Calcium | 900; 1100; 1200 mg | 900; 1100; 1200 mg
Vitamin A | 0.8; 0.9; 1.03 mg | 0.8; 0.9; 1.03 mg
Vitamin C | 80; 90; 100 mg | 80; 90; 100 mg
Folate | 300; 400; 400 mcg | 300; 400; 400 mcg
Sodium | 1380; 1380; 1600 mg | 1380; 1380; 1600 mg
Other | http://www.zdravlje.hr/content/download/11609/84157/file/Nacionalne_smjernice_za_prehranu_ucenika_u_osnovnim_skolama.pdf (Table 4.5), Table 4.4 shows the best sources for each micronutrient | http://www.zdravlje.hr/content/download/11609/84157/file/Nacionalne_smjernice_za_prehranu_ucenika_u_osnovnim_skolama.pdf (Table 4.5), Table 4.4 shows the best sources for each micronutrient

ITALY

School food policy¹⁹ (mandatory) | “LINEE DI INDIRIZZO NAZIONALE PER LA RISTORAZIONE SCOLASTICA”
Developed by | Ministry of Health
Year of publication | 2010
Web link(s) | http://www.salute.gov.it/imgs/c_17_pubblicazioni_1248_allegato.pdf

1 | [picture]

Demographic data

School-age population | Total Population | School-aged children as % of total population
5 to 9 years | 2,810,939 | 59,685,227 | 16%
10 to 14 years | 2,800,258
15 to 19 years | 2,824,461
Total 5 to 19 years | 8,435,658

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Italy

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (8 years) | 49.0% | 44.8% | 26.6% | 22.8%
Boys (9 years) | 47.1% | 43.8% | 25.7% | 21.9%
Girls (8 years) | 42.5% | 40.4% | 17.3% | 16.0%
Girls (9 years) | 40.1% | 37.4% | 15.8% | 13.0%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Health promotion and disease prevention

• Learn about food traditions

3 | [picture]

Other measures:

• To control portion sizes

• To control organization of service

• Continuing education of employees in canteen

• That contract/laws are followed; quality/price evaluation

• That menu and particularly diets like coeliac diet, are followed

4 | [picture]

Other standards/guidelines:

• Enough time to eat

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Italy.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Italy.

7 | [picture]

Italy

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Italy

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Italy

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Italian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Both fruit and vegetables should be a part of the lunch every day | Snack in the morning/afternoon should be fruit & vegetable-based
Specified number of times (red) meat served | Meat (all kinds of) 1-2/week | n/a
Specified number of times other sources of protein served | Fish 1-2/week; 1 egg/week; “salumi” 2/month; legumes 1-2/week | n/a
Specified number of times dairy products served | Cheese 1/week | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish (all kind of) 1-2/week | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | -
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | - | -
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | Iodised, and moderate use | -
Other | Cereals every day; bread every day; potatoes max. 1/week; meals like lasagne/pizza 1/week; Change the menu spring-summer and autumn-winter to use food of the different seasons; use the same menu in 4-5 weeks intervals. Offer alternatives based on religion, culture or other ethical reasons. | -

Annex II

Additional information on Italian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | Lunch should provide 35% of daily energy (440-640 kcal/pre-school; 520-810 kcal/primary school; 700-830 kcal/secondary school); difference at same school level depends on recommendations concerning sex, age and level of physical activity | Snack in the morning/afternoon should each consist of 8-10% of the total daily kcal intake
Fat | 30% of the lunch | -
Saturated fat | Max. 30% of total fat | -
Total carbohydrate | 55% of the lunch | -
Non-milk extrinsic sugars | - | -
Fibre | 5/6/7.5 g depending on school level | -
Protein | 15% of the lunch; animal:vegetable protein ratio 2:3 | -
Iron | 5/6/9 mg depending on school level | -
Zinc | - | -
Calcium | 280/350/420 mg depending on school level | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | -
Other | http://www.salute.gov.it/imgs/c_17_pubblicazioni_1248_allegato.pdf | -

School food policy (mandatory) | There is no generic school food policy, but legally binding lists of foods and beverages approved for sale in school kiosks exist; if kiosks are found to deviate, they are fined. “Timokatalogos dimotiki ekpaidefsi” “Timokatalogos mesi ekpaidefsi”
Developed by | Ministry of Education and Culture
Year of publication | 2012
Web link(s) | n/a

1 | [picture]

Demographic data

School-age population | Total Population | School-aged children as % of total population
5 to 9 years | 45,486 | 865,878 | 17%
10 to 14 years | 46,558
15 to 19 years | 58,570
Total 5 to 19 years | 150,614

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• n/a

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Cyprus.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Cyprus.

7 | [picture]

Cyprus

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Cyprus

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Second National Nutrition Plan was adopted in 2007, where specific actions regarding marketing pressure to children were planned; However, no specific details have been reported; Cyprus is also involved in the European Member States Action Network on reducing marketing pressure to children

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Cyprus

Inclusion of physical and nutrition education in primary and secondary school curriculum is mandatory at national level

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Cyprus food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | predefined list of allowed sweet treats; less choice in primary schools
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | x
Fresh drinking water must be provided and be easily accessible | - | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | - | focus on water and fruit juices (100% fruit); tea; ice tea only allowed in secondary schools
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | - | nuts and dried fruits on sale must not have added salt
Other | subsidised milk is offered to school children and EU funded programme for fruit distribution in schools has started in Sep 2009; no vending machines exist in schools | subsidised milk is offered to school children and EU funded programme for fruit distribution in schools has started in Sep 2009; no vending machines exist in schools

Annex II

Additional information on Cyprus energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | - | -
Fat | - | -
Saturated fat | - | -
Total carbohydrate | - | -
Non-milk extrinsic sugars | - | certain foods must not contain added sugar
Fibre | - | yoghurt with fibre in the list of allowed foods
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | -
Other | - | yoghurt without lactose in the list of allowed foods

School food policy (mandatory) | “Ministru kabineta noteikumi Nr.172 Rīgā 2012.gada 13.martā (prot. Nr.14 17.§) Noteikumi par uztura normām izglītības iestāžu izglītojamiem, sociālās aprūpes un sociālās rehabilitācijas institāciju klientiem un ārstniecābas iestāžu pacientiem”
Developed by | Cabinet of Ministers is responsible for normative regulation and legislation adoption regarding to school food and meals policy. But the health, education and agriculture sectors are responsible for school food and meal policy development
Year of publication | 2012 (amendments in 2013)
Web link(s) | http://likumi.lv/doc.php?id=245300

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 101,240 | 2,023,825 | 14%
10 to 14 years | 89,805
15 to 19 years | 99,633
Total 5 to 19 years | 290,678

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Latvia

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (7 years) | 24.0% | 24.5% | 8.6% | 10.8%
Girls (7 years) | 18.9% | 22.2% | 4.6% | 7.5%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• n/a

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Latvia.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Latvia.

7 | [picture]

Latvia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Latvia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

In 2006 regulations were adopted to restrict marketing of unhealthy food and beverages in pre-schools and schools

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Latvia

Food and nutrition is a part of different curricula at schools (Social sciences, Health education, Domestic sciences, Biology, etc.).

Teacher training in the promotion of healthy nutrition is provided.

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Latvian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | At least 500 g of fruit and vegetables per week) (also fruit consumption encouraged by EU School Fruit Scheme since 2010 and free fruits and vegetables are offered to children in grades 1-9 | -
Specified number of times (red) meat served | At least 200 g of lean meat or fish (fillet) per week | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | At least 50 g of products rich in milk proteins (cottage cheese, cheese) per week. At least 250 g of milk, kefir, yoghurt or other cultured product per week | n/a
Specified number of times (oily) fish should be on the school lunch menu | At least 200 g of lean meat or fish (fillet) per week | n/a
Restrictions on availability of fried, deep-fried or processed products | Fried potatoes (fries), potato croquettes and other food products boiled in oil and analogous food products are excluded | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Confectionery containing partially hydrogenated vegetable fats is excluded | Sugar confectionery (candies, caramels) with added food additives - colours and sweeteners - are excluded
Starchy food cooked in fat or oil restricted | Fried potatoes (fries), potato croquettes and other food products boiled in oil and analogous food products are excluded | -
Crisps and savoury snacks restricted | - | Crisps and savoury snacks which contain 1.25 g or more salt per 100 g or 0.5 g or more sodium per 100 g are excluded
Fresh drinking water must be provided and be easily accessible | - | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Milk consumption encouraged by EU School Milk Scheme since 2004, and free milk is offered to children in grades 1-9 | Milk consumption encouraged by EU School Milk Scheme since 2004, and free milk is offered to children in grades 1-9
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | Soft drinks with added food additives (colours, sweeteners, preservatives), caffeine are excluded
Salt provision is restricted | Amount of added salt in a prepared dish shall not exceed 0.4 g per 100 g of product | x
Other | Rich in complex carbohydrates | Unhealthy foods and beverages are not allowed in vending machines; EU school fruit scheme provides free fruit to school children in grades 1-9

Annex II

Additional information on Latvian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | -
Fat | x | -
Saturated fat | - | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | x | -
Fibre | - | -
Protein | x | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | x | -
Other | - | -

School food policy (mandatory) | “MAITINIMO ORGANIZAVIMO IKIMOKYKLINIO UGDYMO, BENDROJO UGDYMO MOKYKLOSE IR VAIKŲ SOCIALINĖS GLOBOS ĮSTAIGOSE TVARKOS APRAŠO PATVIRTINIMO 2011 m. lapkričio 11 d. Nr. V-964”
Developed by | Ministry of Health
Year of publication | 2011
Web link(s) | http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=411986&p_query=&p_tr2=2

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 134,535 | 2,971,905 | 16%
10 to 14 years | 151,020
15 to 19 years | 187,705
Total 5 to 19 years | 473,260

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Lithuania

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (7 years) | 24.8% | 24.4% | 9.4% | 9.5%
Girls (7 years) | 21.0% | 21.0% | 7.2% | 7.1%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Enable health

3 | [picture]

Other measures:

• Local public health authority evaluates menus within 15 days of receipt

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Lithuania.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Lithuania.

7 | [picture]

Lithuania

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Lithuania

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Advertising not allowed at schools concerning the “prohibited food” listed in paragraph 17 of the policy

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Lithuania

Topic of healthy nutrition is mandatory, but is incorporated in several subjects, especially biology and natural science; guidelines for the promotion of healthy nutrition and physical activity in schools are provided to school teachers; these topics are also included in the undergraduate/postgraduate education of teachers.

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Lithuanian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Fruit & vegetables (recommended fresh) are obligatory at lunchtime; schools are encouraged to participate in EU-funded School Fruit Scheme | Schools are encouraged to participate in EU-funded School Fruit Scheme
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | Hot lunch should be rich in protein, and lunch has to be served every day | n/a
Specified number of times dairy products served | Schools are encouraged to participate in EU-funded School Milk Scheme | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | “Oil-boiled” foodstuffs prohibited | “Oil-boiled” foodstuffs prohibited
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Sweets, chocolate, products with chocolate or cream prohibited | Sweets, chocolate, products with chocolate or cream prohibited
Starchy food cooked in fat or oil restricted | Potato and corn prohibited | Potato and corn prohibited
Crisps and savoury snacks restricted | Savoury pastry prohibited | Savoury pastry prohibited
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Juice, milk and water are mentioned | Water, juice and milk are mentioned
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Soft drinks and energy drinks prohibited | Soft drinks and energy drinks prohibited
Salt provision is restricted | x | x

Other

Amendment of Hygiene Norm was approved in 2010, restricting unhealthy food in school catering, especially in vending machines;

PROHIBITED FOODS: Children’s school meals are prohibited to supply the food groups: potato, corn or other chips and other fried, roasted or puffed products, candies, chocolate and its products, confectionery glaze, chocolate, cream, savoury pastry (with more sodium than 0.4 g per 100 g) of food products and chewing gum with food additives (in the Procedure, Appendix 3), soft drinks, energy drinks, beverages and food products made from (or containing) coffee tree, coffee bean or extract, chicory, deep or grain beverages (coffee substitutes) Kisiel, bouillon concentrates, smoked fish, canned meat and fish products (which are allowed in the general education institutions organized summer camps or at the conclusion of the food packets to the home), non-industrial production of canned products; steaks; mechanically separated meat and meat products, offal (kidneys, brain, lungs), dietary supplements, food produced from genetically modified organisms (hereinafter - GMOs), or the food, which is composed of GMOs [5.2, 5.13, 5.25, 5.29]

RECOMMENDED FOODS: vegetables, potatoes, fruits, and berries dishes, juices (especially fresh), grain (bread products, cereals products) and legume products, milk and milk products, lean meat and meat products, fish and products, oil (to be used less animal fat, fatty meat and meat products must be replaced lean meat, poultry, fish or vegetables, legumes, animal fats and margarine, where possible, changes in oil), eggs, drinking water and natural mineral and the source of water (non-carbonated)

Amendment of Hygiene Norm was approved in 2010, restricting unhealthy food in school catering, especially in vending machines;

PROHIBITED FOODS: Children’s school meals are prohibited to supply the food groups: potato, corn or other chips and other fried, roasted or puffed products, candies, chocolate and its products, confectionery glaze, chocolate, cream, savoury pastry (with more sodium than 0.4 g per 100 g) of food products and chewing gum with food additives (in the Procedure, Appendix 3), soft drinks, energy drinks, beverages and food products made from (or containing) coffee tree, coffee bean or extract, chicory, deep or grain beverages (coffee substitutes) Kisiel, bouillon concentrates, smoked fish, canned meat and fish products (which are allowed in the general education institutions organized summer camps or at the conclusion of the food packets to the home), non-industrial production of canned products; steaks; mechanically separated meat and meat products, offal (kidneys, brain, lungs), dietary supplements, food produced from genetically modified organisms (hereinafter - GMOs), or the food, which is composed of GMOs [5.2, 5.13, 5.25, 5.29]

RECOMMENDED FOODS: vegetables, potatoes, fruits, and berries dishes, juices (especially fresh), grain (bread products, cereals products) and legume products, milk and milk products, lean meat and meat products, fish and products, oil (to be used less animal fat, fatty meat and meat products must be replaced lean meat, poultry, fish or vegetables, legumes, animal fats and margarine, where possible, changes in oil), eggs, drinking water and natural mineral and the source of water (non-carbonated)

Annex II

Additional information on Lithuanian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | Breakfast 20-25%, lunch 30-40%, afternoon snack 10-15%, dinner 20-25%). RDI 2030-2890 kcal a day (level depends on three age groups: 7-10, 11-14, 15-18, and sex | Breakfast 20-25%, lunch 30-40%, afternoon snack 10-15%, dinner 20-25%). RDI 2030-2890 kcal a day (level depends on three age groups: 7-10, 11-14, 15-18, and sex
Fat | RDI 66-93 g (level depends on three age groups: 7-10, 11-14, 15-18, and sex) | RDI 66-93 g (level depends on three age groups: 7-10, 11-14, 15-18, and sex)
Saturated fat | - | -
Total carbohydrate | RDI 294-396 g | RDI 294-396 g
Non-milk extrinsic sugars | - | -
Fibre | - | -
Protein | RDI 65-95 g | RDI 65-95 g
Iron | RDI 10-18 mg | RDI 10-18 mg
Zinc | RDI 7-15 mg | RDI 7-15 mg
Calcium | RDI 700-800 mg | RDI 700-800 mg
Vitamin A | RDI 700-1000 mcg | RDI 700-1000 mcg
Vitamin C | RDI 45-60 mg | RDI 45-60 mg
Folate | RDI 80-200 mcg | RDI 80-200 mcg
Sodium | - | -
Other | P RDI 800-1200 mg, Mg RDI 250-400 mg, I RDI 120-150 mcg, E RDI 7-10 mg, D RDI 5 mcg, B1 RDI 1.1-1.4 mg; B2 RDI 1.3-1.7 mg; B6 RDI 1.5-2.0 mg; niacin RDI 13-18 mg; B12 RDI 3.0 mcg | P RDI 800-1200 mg, Mg RDI 250-400 mg, I RDI 120-150 mcg, E RDI 7-10 mg, D RDI 5 mcg, B1 RDI 1.1-1.4 mg; B2 RDI 1.3-1.7 mg; B6 RDI 1.5-2.0 mg; niacin RDI 13-18 mg; B12 RDI 3.0 mcg RDI = Reference Daily Intake.

School food policy (voluntary) | “Plan d’action pour la promotion de l’alimentation saine et de l’activité physique”
Developed by | Ministry of National Education and Vocational Training, Ministry of Health, Ministry of Family and Integration, Ministry of Sports
Year of publication | 2006
Web link(s) | http://www.sante.public.lu/publications/rester-bonne-sante/activite-physique/plan-action-promotion-alimentation-saine-activite-physique/plan-action-promotion-alimentation-saine-activite-physique.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 29,930 | 537,039 | 17%
10 to 14 years | 31,038
15 to 19 years | 32,133
Total 5 to 19 years | 93,101

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Healthy attitudes

3 | [picture]

Other measures:

• Evaluation plan should be developed and implemented, but is not specified further

4 School food policy standards and guidelines

Other standards/guidelines:

• Government-endorsed national website for school catering services: http://portal.education.lu/restopolis/Accueil.aspx

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Luxembourg.

6 | [picture]

7 | [picture]

Luxembourg

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Luxembourg

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Luxembourg

National educational curriculum includes optional hours of health education

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Luxembourg’s food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | Stop isolated sale of certain products such as pommes frites | Stop isolated sale of certain products such as French fries
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | -
Starchy food cooked in fat or oil restricted | Stop isolated sale of certain products such as French fries | Stop isolated sale of certain products such as pommes frites
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | - | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Make water cheaper than sugared drinks; phase out all sugary drinks distributors | Make water cheaper than sugared drinks; phase out all sugary drinks distributors
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Make water cheaper than sugared drinks; phase out all sugary drinks distributors | Make water cheaper than sugared drinks; phase out all sugary drinks distributors
Salt provision is restricted | - | -

Other
All canteens are required to provide balanced meals; gradual replacement of cooked meals with fresh foods; implementation of distributors of fresh produce (fruit, etc.); involve students in the preparation of school meals: pilot projects in selected schools and primary schools and developing transferable prospects nationally
-

School food policy (mandatory) | “37/2014. (IV. 30.) EMMI rendelet a közétkeztetésre vonatkozó táplálkozás-egészségügyi előírásokról” “20/2012. (VIII. 31.) EMMI rendelet a nevelési-oktatási intézmények működéséről és a köznevelési intézmények névhasználatáról”
Developed by | Ministry of Human Resources
Year of publication | 2012, 2014
Web link(s) | http://njt.hu/cgi_bin/njt_doc.cgi?docid=169011.268148 http://njt.hu/cgi_bin/njt_doc.cgi?docid=154155.272424

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 485,119 | 9,908,798 | 15%
10 to 14 years | 482,459
15 to 19 years | 567,039
Total 5 to 19 years | 1,534,617

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Hungary

| Overweight (including obesity) | Obesity
2009/10 | 2009/10
Boys (7 years) | 25.1% | 14.2%
Girls (7 years) | 28.2% | 10.3%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Special diet needs (lactose intolerance, etc.)

3 | [picture]

Other measures:

• Assessment of which points of the regulation are being followed, at predefined intervals

4 | [picture]

Other standards/guidelines:

• Seasonality; variety (10-day cycle); special dietary needs

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Hungary.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Hungary.

7 | [picture]

Hungary

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Hungary

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

General government regulation (2008/XLVIII) prohibits all advertising to children in kindergartens, elementary and middle schools and their dormitories with certain exceptions.

Hungarian Media Law (Act82/210) prohibits advertisements capable of harming the development of children in general.

“20/2012. (VIII. 31.) EMMI rendelet a nevelési-oktatási intézmények méködésérűl és a köznevelési intézmények névhasználatáról” prohibits marketing of foods and drinks subject to Public Health Product Tax.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Hungary

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Hungarian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
For full day catering: 4 servings/day of vegetable – excluding potatoes – or fruit, at least one portion in raw form; for nursery catering: 3 servings of vegetable – excluding potatoes – or fruit, at least one portion in raw form; for 3 meals: 2 portions of vegetable – excluding potatoes – or fruit at least one portion in raw form; 1 meal: 1 portion fruit or vegetable, at least 3/10 raw
For full day catering: 4 servings/day of vegetable – excluding potatoes – or fruit, at least one portion in raw form; for nursery catering: 3 servings of vegetable – excluding potatoes – or fruit, at least one portion in raw form; for 3 meals: 2 portions of vegetable – excluding potatoes – or fruit at least one portion in raw form; 1 meal: 1 portion fruit or vegetable, at least 3/10 raw

Specified number of times (red) meat served | Depending on age and number of meals provided in a day: meat 6-10, no restriction on red meat per se, but fat content <30% | n/a
Specified number of times other sources of protein served | Depending on age and number of meals per day; eggs max 8/10; number of times legumes served depends on the type of catering and on the month | n/a

Specified number of times dairy products served
5 l of milk or an equivalent amount of dairy products containing calcium per 10 days for whole day catering; 4 l of milk or an equivalent amount of dairy products containing calcium per 10 days for nursery catering; In case of 3 meals per day 3 l of milk or an equivalent amount of dairy products containing calcium per 10 days
n/a

Specified number of times (oily) fish should be on the school lunch menu | At least 1/10 | n/a
Restrictions on availability of fried, deep-fried or processed products | Deep-fried max. 1/10 (forbidden in nursery catering) | Max. 1/10
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Confectionery and sweet treats should not be given as lunch | Restricted with some exceptions
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | To ensure the required fluid consumption, water and/or mineral water must be provided between meals
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Depending on age: (full fat) milk, tea with sugar not exceeding age-specific amounts, overall sugary drinks limited; fruit juice only with 100% fruit, frequency limited per 10 days | Depending on age: (full fat) milk, tea with sugar not exceeding age-specific amounts, overall sugary drinks limited; fruit juice only with 100% fruit, frequency limited per 10 days
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Forbidden; fruit juice only with 100% fruit; no artificial sweetener/colorants below age 6; alcohol, coffee, energy drinks forbidden | Forbidden; no artificial sweetener/colorants below age 6; alcohol, coffee, energy drinks forbidden; fruit juice only with 100% fruit
Salt provision is restricted | Age-specific limits, also depending on whether only single meal or full board; gradual reduction with transition periods for children above age 7, until salt provision meets age-specific WHO recommendations | Age-specific limits, also depending on whether only single meal or full board; gradual reduction with transition periods for children above age 7, until salt provision meets age-specific WHO recommendations
Other | - | -

Annex II

Additional information on Hungarian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | x
Fat | x | x
Saturated fat | - | -
Total carbohydrate | - | -
Non-milk extrinsic sugars | Sugar | Sugar
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | x | x
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | x | x
Other | - | -

School food policy (voluntary) | “Healthy Eating Lifestyle Plan (HELP)”
Developed by | Ministries for Education and Employment and Ministry for Health
Year of publication | 2007, revised in 2014
Web link(s) | http://education.gov.mt/en/resources/Documents/Policy%20Documents/healty%20eating%20lifestyle%20plan.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 19,425 | 421,364 | 16%
10 to 14 years | 21,279
15 to 19 years | 25,488
Total 5 to 19 years | 66,192

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Malta

| Overweight (including obesity) | Obesity
2007/8 | 2007/8
Boys (6 years) | 34.4% | 14.7%
Girls (6 years) | 29.5% | 11.9%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Chronic disease prevention; provide a holistic education

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• Food preparation guidelines

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Malta.

6 | [picture]

7 | [picture]

Malta

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Malta

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Companies producing/selling products high in salt, sugar or fat are not permitted to sponsor school activities

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Malta

Mandatory only in public schools; voluntary in private schools

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Maltese food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | -
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | x | x
Fresh drinking water must be provided and be easily accessible | x | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Furthermore, milk and low fat milk 2-3 servings day for children up to 11 years, 3-4 servings for children > 11 years (CINDI) | -
Soft-drinks (e.g. sugarsweetened or artificiallysweetened soft drinks, squash) restricted | x | -
Salt provision is restricted | x | -
Other | No school lunches are provided. Children bring their own food; food brought to school is regulated by HELP | Vending machines are not allowed in public schools and most private schools; an organised food service is the EU School Fruit Scheme which started in October 2010; this provides free/subsidised portion of fruit/vegetables to all primary school children once a week

School food policy (voluntary) | “Landelijke nota gezondheidsbeleid ‘Gezondheid dichtbij’”
Developed by | Ministry of Education, Science and Culture and Ministry of Health, Welfare and Sport

Year of publication
2011 (this is the most recent national policy document on healthy lifestyle and prevention made by the government, where healthy school canteens are a part. In 2015 changes in policy on this topic will be communicated to Parliament. Specific policy documents for schools are of a much more recent date (2014) and can be found at Rijksoverheid.nl and the website of the National Nutrition Centre (Voedingscentrum) mentioned below)

Web link(s) | http://www.rijksoverheid.nl/documenten-en-publicaties/notas/2011/05/25/landelijke-no-ta-gezondheidsbeleid.html http://gezondeschoolkantine.voedingscentrum.nl

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 949,986 | 16,779,575 | 18%
10 to 14 years | 1,015,734
15 to 19 years | 992,851
Total 5 to 19 years | 2,958,571

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• To influence sustainability of environment (eating more fruit, vegetables and wholegrain cereals and less animal products)

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• “Healthy school canteen” mentions importance of attractive dining spaces, food arrangements and so on, but there are no standards for this

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in the Netherlands.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in the Netherlands.

7 | [picture]

Netherlands

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Netherlands

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Since 1st January 2015 new self-regulation is in effect. The age of children 0-13 years is included, and new food-criteria are in place. See: https://www.reclamecode.nl/bijlagen/SRC_NRC_Engels_apr14.pdf

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Netherlands

Schools are encouraged to include lifestyle issues including diet in the educational curriculum

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Dutch food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | Classified as “exceptional” | Classified as “exceptional”
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | -
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | x | x
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | - | -

Other
Charter signed by various stakeholders from public health and industry sectors provides food-based recommendations for healthier school meals. No specified numbers or amount of food-based standards are given, and it doesn’t say what isn’t allowed, however in the canteen offer should be based on 75% food essentials, and maximum 25% of non-basic food. The recommendations also include if food should be “preferred, intermediate or exceptional” (available at: http://www.voed-ingscentrum.nl/Assets/Uploads/Documents/Handvest%20Gezonder%20voedingsaan-bod%20op%20scholen.pdf (p. 7)). It is specified at what level soft drinks (>30 kcal/100 ml), sauces (>5 g), soups (>100 kcal/100 g) and sandwiches (>15 g of “broodbeleg”) are NOT to be considered as food essentials.
Charter signed by various stakeholders from public health and industry sectors provides food-based recommendations for healthier school meals. No specified numbers or amount of food-based standards are given, and it doesn’t say what isn’t allowed, however the canteen offer should be based on 75% food essentials, and maximum 25% of non-basic food. The recommendations also include if food should be “preferred, intermediate or exceptional” (available at: http://www.voed-ingscentrum.nl/Assets/Uploads/Documents/Handvest%20Gezonder%20voedingsaan-bod%20op%20scholen.pdf (p. 7)). It is specified at what level soft drinks (>30 kcal/100 ml), sauces (>5 g), soups (>100 kcal/100 g) and sandwiches (>15 g of “broodbeleg”) are NOT to be considered as food essentials.

Annex II

Additional information on Dutch energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | There are recommendations for the amount of energy from NON basic food (maximum 25% of the canteen offer) which include lunch and other meals: preferred level <75 kcal/portion, intermediate level < or = 110 kcal, exceptional level >110 kcal/portion | -
Fat | - | -
Saturated fat | - | -
Total carbohydrate | - | -
Non-milk extrinsic sugars | - | -
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | -
Other | - | -

School food policy (voluntary) | “Retningslinjer for skolemåltidet i grunnskole og videregående skole”
Developed by | Directorate of Health, an executive agency subordinate to the Norwegian Ministry of Health and Care Services
Year of publication | 2003
Web link(s) | https://helsedirektoratet.no/Lists/Publikasjoner/Attachments/492/Retningslinjer-for-skolem%C3%A5ltidet-IS-0048.pdf

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 305,702 | 5,051,275 | 19%
10 to 14 years | 308,467
15 to 19 years | 326,069
Total 5 to 19 years | 940,238

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Norway

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2009/10 | 2007/8
Boys (8 years) | 23.0% | 29.2% | 7.5% | 11.6%
Girls (8 years) | 23.1% | 26.2% | 6.0% | 6.2%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Prevent illness

3 | [picture]

Other measures:

• Norwegian Directorate of Health in 2013 mapped the organisation and provision of school lunches at national level; results are being used to revise current guidelines. New guidelines will be launched autumn 2015.

4 | [picture]

Other standards/guidelines:

• Enough time to eat (20 min) at lunch, and to supervise the students eating at least from grade 1-4; to serve meals with not more than 3-4 hours between them; recommended to have a canteen in secondary schools

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Norway.

6 | [picture]

7 | [picture]

Norway

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Norway

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Act relating to Primary and Secondary Education, § 9-6 on advertising in schools states that the school shall ensure that pupils are not exposed to advertisements that cause commercial pressure or that to a large extent influence attitudes, behaviour and values, including on school premises, in text-books and other utilised teaching material; school as an arena free of marketing of unhealthy foods is underlined in the food industries self-regulatory guidelines.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Norway

“Food and Health” is a mandatory class in primary school (total of 114h in the course of grades 1 - 7) and lower secondary school (total of 85h in the course of grades 8 - 10)

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Norwegian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Should be served/offered at some point during the school day | -
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Shouldn’t be offered | Shouldn’t be offered
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | Shouldn’t be offered | Shouldn’t be offered
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Water, fruit juice and low fat milk; schools can choose to take part in partly subsidised school food programs as regards milk; majority of schools offer a milk subscription program, paid by the parents | Water
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Soft drinks and other sugar-sweetened drinks shouldn’t be offered | Soft drinks and other sugar-sweetened drinks shouldn’t be offered
Salt provision is restricted | - | -

Other
Whole wheat bread, light butter (margarine) should be offered; guidelines recommend that lower and upper secondary schools have a school canteen and include food-based guidelines for what to offer; for primary schools, food should be offered free of charge to children who do not have a packed lunch with them
-

School food policy (voluntary) | “Leitlinie Schulbuffet – Empfehlungen für ein gesundheitsförderliches Speisen-und Getränkeangebot an österreichischen Schulbuffets”

Developed by
Leading ministry for developing nutritional standards is the Health Ministry; implementing standards is the responsibility of school authorities - in terms of primary and normal secondary schools (Hauptschule, kooperative Mittelschule) the provinces (“Länder”) or cities (“Statutarstädte”) are responsible whereas for grammar schools (Gymnasium) and most institutions of higher education (höhere Bundeslehranstalten) the Ministry of Education is responsible.

Year of publication | 2011
Web link(s) | http://bmg.gv.at/cms/home/attachments/6/4/0/CH1047/CMS1313558884746/leitlinie_schulbuffet_final_201108121.pdf

1 | [picture]

Demographic data

School-age population |  | School-aged children as % of total population
5 to 9 years | 403 639 | [picture] | 15%
10 to 14 years | 418 845
15 to 19 years | 480 555
Total 5 to 19 years | 1 303 039

Source: EUROSTAT, year 2013.

Total population: 8 451 860

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Better offers for all - changing environments

• Includes recommendation to use local produce if available and economically reasonable

• Economic stability for cafeteria owners

• Quality assurance

3 | [picture]

Other measures:

• We do not evaluate outcome but we evaluate functioning of processes, numbers and satisfaction of participants, economic realities (feasibility of standards in practice)

• Improvements in food and drinks offers in school cafeterias

4 | [picture]

Other standards/guidelines:

• Recommendations laid down in the Austrian guideline for school cafeterias in terms of liquids include the variation of drinks offered via vending machines in schools

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Austria.

6 | [picture]

7 | [picture]

Austria

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Austria

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Restrictions on marketing of food or drink are not in the competence of the federal ministry of health; handbook to implement the school cafeteria guidelines includes some marketing recommendations (no advertising of products high in fat, sugar and salt by the cafeteria itself) and suggestions for prominently placing healthy products (or hiding others that should be consumed rarely or in moderation according to the Austrian food pyramid)

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Austria

Food literacy and healthy nutrition are part of two main education principles (health education and consumer education principle)

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Austrian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Minimum of 10 pieces of fruit (at least 3 different types) on display in every break | x
Specified number of times (red) meat served | Maximum 50% of total offer of baked goods contains sausage, salami or other meat products | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | At least three types of ideal dairy products (e.g. milk, natural yoghurt, butter milk) offered daily | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | Generic recommendation to switch from deep-frying to lower-fat modes of preparation | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Offer as few conventional products as possible (ideally none); pack size max. 30 g; minimum visibility; long-term goal not to offer any conventional confectionery; pastry to be offered as little as possible, no more than 10 items per break, and at minimum visibility | x
Starchy food cooked in fat or oil restricted | Generic recommendation to switch from deep-frying to lower-fat modes of preparation | x
Crisps and savoury snacks restricted | Maximum one high-fat savoury snack on offer (ideally none); long-term goal not to offer any | x
Fresh drinking water must be provided and be easily accessible | - | -

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
At least 8 out of 10 beverages offered are “ideal thirst quenchers” (mineral water, highly-diluted fruit juices) or products with moderate sugar levels and no artificial sweeteners; 80% of display area dedicated to these options; non-flavoured water always part of the offer; no alcoholic or energy drinks; no caffeinated beverages for children under the age of 10; beverages with azo dyes which carry the label “may impair activity and attention in children” not offered; except for water, no drink sizes above 0.75l; give maximum visibility to “ideal” beverages
x

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Max. 2 out of 10 beverages offered are products with moderate sugar levels, but no artificial sweeteners; no energy drinks; no caffeinated beverages for children under the age of 10; beverages with azo dyes which carry the label “may impair activity and attention in children” not offered | -
Salt provision is restricted | Addition of salt is limited to a minimum; long-term goal not to offer any snacks or dishes high in salt | x

Other
Reduce high-fat and meat-centred warm snacks and dishes (don’t offer daily); give preference to vegetarian dishes; improve warm snacks/dishes by adding vegetables where possible; use rapeseed oil for preparing warm snacks/dishes (alternating with sunflower oil; for salads olive oil is recommended); offer warm snacks/dishes only after 3rd lesson of the day; vary offer on daily or weekly basis); reference is made to Austrian food pyramid:
http://bmg.gv.at/home/Schwerpunkte/Ernaehrung/Empfehlungen/Die_Ernährung-spyramide_im_Detail_-_7_Stufen_zur_Gesundheit;
Besides the national guideline for school cafeteria also some regional standards for school food exist. Links
(http://www.aks.or.at/versteckter-ordner-fuer-randspalte/dokumente-fuer-rand-spalte/informationen-fuer-fachleute/schule/2011_leitlinie-gemeinschaftsverpfle-gung_version-2_stoeckler.pdf http://www.styriavitalis.at/cms/download/mindeststandards_gemeinschaftsverpfle-gung.pdf http://www.gutessen.at/uploads/downloads/Leitfaden_SchulbuffetDruckfrei.pdf http://www.gesundegemeinde.ooe.gv.at/xchg/SID-AF1D5CA1-BDD8FFD8/hs.xsl/5056_DEU_HTML.htm http://www.gesundeschule.at/wp-content/uploads/Qualit%C3%A4tsstandards-Gesun-de-Schule.pdf http://www.gutessen.at/uploads/downloads/Leitfaden_SchulbuffetDruckfrei.pdf http://www.gesundegemeinde.ooe.gv.at/xchg/SID-AF1D5CA1-BDD8FFD8/hs.xsl/5056_DEU_HTML.htm http://www.gesundeschule.at/wp-content/uploads/Qualit%C3%A4tsstandards-Gesun-de-Schule.pdf
There is no clear distinction of meal times; only mentioned that warm snacks/dishes should only be served from after the third lesson

School food policy (voluntary) | “OBIADY SZKOLNE z uwzględnienie zasad Dobrej Praktyki Higienicznej oraz systemu HACCP dla posiłków szkolnych”
Developed by | Ministry of Health
Year of publication | 2008
Web link(s) | http://www.mz.gov.pl/__data/assets/pdf_file/0016/6307/obiady_szkolne_16012012.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 1,867,591 | 38,533,299 | 15%
10 to 14 years | 1,872,768
15 to 19 years | 2,218,662
Total 5 to 19 years | 5,959,021

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note. HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

 10-14%

  Less than 10%

  No data

Note. HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• n/a

3 | [picture]

Other measures:

• Children should be monitored at school for body weight and height; children with impaired nutritional status must be suspended and provided with specialist medical care

4 | [picture]

Other standards/guidelines:

• Enough time to eat; ensure dietary variety

• On 1 September 2015, new regulation about food provision in food shops at school and at vending machines as well as food-based standards for lunch will enter into force

5 | [picture]

6 | [picture]

See Annex I for more details on the energy-/nutrient-based standards/guidelines in Poland.

7 | [picture]

Poland

  Vending machines don’t exist exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Poland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

 Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

School can be a place for advertising food products; however, school cannot be a place for the sale of food products of unsatisfactory quality, not recommended in children’s diets; assortment of foods and beverages sold in schools should comply with principles of sound nutrition

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Poland

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Polish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x (properly balanced and planned meal, served in the school cafeteria should provide 30-35% of total daily energy needs) | x (Breakfast 25-30 E%; Second breakfast 5-10 E%; Tea 5-10 E%; Dinner 15-20 E%)
Fat | x (not more than 30-35 E%) | x (limit the intake of fat (especially animal fat))
Saturated fat | x (not more than 10 E%) | -
Total carbohydrate | x (50-65 E%) | -
Non-milk extrinsic sugars | x (not more than 10-12 E%) | x (consumption of sugar and sweets allowed in limited quantities)
Fibre | x (content of dietary fibre in daily diet should be 20-40g, dinner should not be less than 6g) | -
Protein | x (at least 10-14 E%, wherein share of animal protein should be at least half of total meal protein pool) | -
Iron | x (at least 30% of age-specific recommendation) | -
Zinc | x (at least 30% of age-specific recommendation) | -
Calcium | x (at least 30% of age-specific recommendation) | -
Vitamin A | x (at least 30% of age-specific recommendation) | -
Vitamin C | x (at least 30% of age-specific recommendation) | -
Folate | x (at least 30% of age-specific recommendation) | -
Sodium | x (content of salt in daily ration should not exceed 5g) | -
Other | x (vitamins and minerals: at least 30% of recommendations for that decade; content of cholesterol in daily food ration should not exceed 300mg; polyunsaturated fat 6-10 E%) | x (content of cholesterol in daily food ration should not exceed 300mg)

School food policy (voluntary) | “Orientações sobre ementas e refeitórios escolares – 2013/2014”
Developed by | Ministry of Education
Year of publication | 2013
Web link(s) | http://www.dge.mec.pt/data/educacaosaude/alimentacao/orientacoes_ementas_e_refeitorios_escolares_circular_1_agosto_2_1_2_.pdf http://www.dgidc.min-edu.pt/educacaosaude/data/educacaosaude/accaosocialescolar/desdbufetes.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 513,870 | 10,487,289 | 15%
10 to 14 years | 555,366
15 to 19 years | 551,206
Total 5 to 19 years | 1,620,442

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Portugal

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (7 years) | 40.5% | 31.5% | 16.7% | 14.2%
Girls (7 years) | 35.5% | 36.2% | 12.6% | 12.2%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Make school meal an educational experience; inform about seasonality of plant foods; provide safe food to all students; reduce salt intake

3 | [picture]

Other measures:

• Hygiene of establishment; performance of staff

4 | [picture]

Other standards/guidelines:

• Guidelines for school coffee shops

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Portugal.

6 | [picture]

7 | [picture]

Portugal

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Portugal

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Portugal

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Portuguese food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
Raw vegetables (salads) and/or cooked vegetables likely to be seasoned and served separately (e.g., green bean salad, courgettes, etc.) must be served daily, preferably in a separate dish, with at least three varieties and according to portion specification provided; cooked vegetables should wherever possible be part of side dishes (e.g. grilled salmon with baked potato and broccoli; Russian salad with tuna, etc.); for seasoning, should be available onion rings, lemon, coriander, parsley and oregano in proper spice packaging; dessert constituted of various fruit daily, preferably of the season, at least three varieties, according to specified amounts; simultaneously with raw fruit can be served boiled or roasted fruit with-out added sugar, no more than once a week; simultaneously with raw fruit, but on a different day than cooked/roasted fruit, fresh/vegetable gelatin/ice milk/yoghurt may also be served once a week
-

Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | Menus including fried foods min 1/fortnight | x
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | x
Starchy food cooked in fat or oil restricted | - | x
Crisps and savoury snacks restricted | - | x
Fresh drinking water must be provided and be easily accessible | x | -
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Only water | x
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Not allowed | x
Salt provision is restricted | Use iodised salt | -

Other
Cream soup max 2/wk; vegetable-based soup min 1/wk; chicken soup max 1/mo; fish soup max 1/m; dish incl. pulses min 1/wk; poultry dishes appropriate 1/wk; dishes with eggs max 2/mo; dishes with steak/chop/schnitzel/steamed or roasted sliced meat max 1/wk; dishes with meat or fish chopped, sliced or chipped (a) in small servings min 2/wk; fish dishes max 1/wk; meat and fish dishes on alternating days; starchy sides: rice, pasta or potato on alternating days and prepared in different ways; different type of bread daily; details of food options in different groups specified; orientation document for school buffets gives further detail
Where schools have food vending machines: food selection must obey exclusively the characteristics of genres to promote in particular dairy products, bread and sandwiches, water, drinks as specified; regarding fruit, recommended to use minimally processed fruit by washing, cutting and cleaning, and preserved by cold through own packaging; foods “to limit” or “not to be made available” cannot be part of the portfolio of vending machines (e.g. HFSS foods, low-fibre foods, foods containing significant amounts of sweeteners, preservatives or colourants); where equipment permits, the operation of this should be complementary with the opening hours of the buffet; thus, students should not have access during lunchtime

HFSS = High Fat/Sugar/Salt.

School food policy (mandatory)
“ORDIN comitet nutritie 27 martie 2008 pentru înfiinţarea Comitetului Naţional pentru Alimentaţie şi Nutriţie”
“ORDIN Nr 1563 din 2008 pentru aprobarea Listei alimentelor nerecomandate preşcolarilor şi şcolarilor şi a principiilor care stau la baza unei alimentaţii sănătoase pentru copii şi adolescent”
“LEGE Nr 123 din 2008 pentru o alimentaţie sănătoasă în unităţile de învăţământ preuniversitar”

Developed by | Ministry of Health
Year of publication | 2008
Web link(s) | http://www.ms.ro/?pag=186

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 1,059,569 | 20,020,074 | 16%
10 to 14 years | 1,079,138
15 to 19 years | 1,091,355
Total 5 to 19 years | 3,230,062

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• n/a

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Other measures:

• n/a

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Other standards/guidelines:

• n/a

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See Annex I for more details on the food-based standards/guidelines in Romania.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Romania.

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Romania

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Romania

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Romania

National educational curriculum includes optional hours of health education

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Romanian food-based standards for lu and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | - | 1 apple/day, 85 days during the school year (School Fruit Scheme)
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | - | n/a
Restrictions on availability of fried, deep-fried or processed products | - | High-salt foods (>1.5 g salt (0.6 g Na) per 100 g food) not allowed - examples include crisps; high-fat foods (>20 g total fat per 100 g, >5 g saturated fat per 100 g or >1 g trans fat per 100 g) not allowed - examples include French fries
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | High-sugar foods (>15 g sugar per 100 g) not allowed
Starchy food cooked in fat or oil restricted | - | High-salt foods (>1.5 g salt (0.6 g Na) per 100 g food) not allowed - examples include crisps; high-fat foods (>20 g total fat per 100 g, >5 g saturated fat per 100 g or >1 g trans fat per 100 g) not allowed - examples include French fries
Crisps and savoury snacks restricted | - | High-salt foods (>1.5 g salt (0.6 g Na) per 100 g food) not allowed; examples include crisps, crackers, salted pretzels and similar savoury snacks
Fresh drinking water must be provided and be easily accessible | Fresh drinking water is easily accessible | Fresh drinking water is easily accessible
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Only drinking water or bottled mineral water | Only drinking water or bottled mineral water
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Not allowed | Not allowed
Salt provision is restricted | High-salt foods (>1.5 g salt (0.6 g Na) per 100 g food) not allowed | High-salt foods (>1.5 g salt (0.6 g Na) per 100 g food) not allowed

Other
Ensure proportionality between food groups based on food pyramid; aim for higher intake of fruits, vegetables, whole grains, milk and dairy products relative to foods high in (sat) fat and added sugar; quantities matched to age, gender, level of activity
Ensure proportionality between food groups based on food pyramid; aim for higher intake of fruits, vegetables, whole grains, milk and dairy products relative to foods high in (sat) fat and added sugar; quantities matched to age, gender, level of activity; avoid dinner dishes requiring strong digestive stimulant effect (e.g. baked beans)

Annex II

Additional information on Romanian energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | - | Total energy / portion < 300 kcal
Fat | - | x
Saturated fat | - | x
Total carbohydrate | - | x
Non-milk extrinsic sugars | - | -
Fibre | - | -
Protein | - | -
Iron | - | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | - | -
Folate | - | -
Sodium | - | x
Other | - | -

School food policy (mandatory) | “Razglašam Zakon o šolski prehrani (ZŠolPre-1), ki ga je sprejel Državni zbor Republike Slovenije na seji dne 28. decembra 2012.”
Developed by | Primarily responsible for developing school food policy is Ministry of Education, Science and Sport, in collaboration with Ministry of Health and other sectors
Year of publication | 2011
Web link(s) | http://www.uradni-list.si/1/content?id=111596

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 94,955 | 2,058,821 | 14%
10 to 14 years | 91,798
15 to 19 years | 98,467
Total 5 to 19 years | 285,220

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Slovenia

| Overweight (including obesity) | Obesity
2007/8 | 2009/10 | 2007/8 | 2009/10
Boys (6 years) | 28.0% | 23.5% | 11.7% | 10.0%
Boys (7 years) | 32.5% | 29.6% | 15.6% | 13.5%
Boys (8 years) | 35.9% | 36.1% | 16.4% | 17.6%
Girls (6 years) | 23.6% | 21.7% | 8.4% | 6.8%
Girls (7 years) | 28.0% | 24.8% | 9.8% | 9.4%
Girls (8 years) | 31.7% | 32.0% | 10.9% | 11.9%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Teach food and personal hygiene; teach social skills; raise awareness on sustainable consumption, availability of high-quality school meals, optimal growth and cognitive development, responsible attitude to health and environment

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Other measures:

• Implementation of Guidelines for healthy nutrition in kindergartens and schools is also measured (e.g. organisation of school meals, methods of school meal planning, pupils’ satisfaction with school meals, food waste, organisation of school nutrition action groups

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Other standards/guidelines:

• Practical planning of menus, processes for preparing meals, recommendations for food choices; frequency of food inclusions; recommendations for the purchase of food, organisation of school nutrition action group

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See Annex I for more details on the food-based standards/guidelines in Slovenia.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Slovenia.

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Slovenia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Slovenia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Ban on installation of vending machines in school areas is defined by School Meals Act; headmasters are responsible for restricting all kinds of marketing in school environments (textbooks, all kind of placement, …) and regular response to every reported case of violation is provided by Ministry of Education, Science and Sport.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Slovenia

In addition, school has to define in annual work plan educational activities related to healthy eating promotion, and activities that encourage healthy eating and increase food culture.

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Slovenian food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Fruit and/or vegetables are recommended in every meal; recommendation for mid-morning snack + lunch is 1-1.5 units of fruits and 1-2.5 units of vegetable, depending on child or adolescent age | Provide fruit and/or vegetables with every meal)
Specified number of times (red) meat served | Protein foods such as meat and poultry, milk and products, eggs, legumes and nuts are recommended 7 days per week; meat and poultry as such are recommended max 5 times per week, which means 3-4 times per week at working days | n/a
Specified number of times other sources of protein served | Protein foods such as milk and products, eggs, legumes and nuts are recommended 7 days per week | n/a
Specified number of times dairy products served | Milk and dairy products should be included in school meals on daily basis, regardless in which meal | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish should be included in school meals once up to max twice per week, regardless in which meal | n/a
Restrictions on availability of fried, deep-fried or processed products | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities
Starchy food cooked in fat or oil restricted | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities
Crisps and savoury snacks restricted | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities | Guidelines recommendation according to the list of non-recommended foods: rare inclusion in the menu (e.g. 2 times per month) and in small quantities
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Water, other unsweetened or lightly sweetened beverages; fruit and vegetable juices; calories contained in juices must be considered in total menu energy content | Guidelines recommended types are: tap water, mineral water, unsweetened or lightly sweetened tea; fruit and vegetable juices
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Guidelines recommendation according to list of non-recommended foods: rare inclusion in the menu (e.g. 2/mo) and in small quantities | -
Salt provision is restricted | Moderate use of salt in the daily diet; mandatory use of iodised salt in accordance with the legislation on food preparation | Moderate use of salt in the daily diet; mandatory use of iodised salt in accordance with the legislation on food preparation

Other
Enough time and an appropriate environment for meals must be offered and in a manner which conveys a positive attitude towards eating;
http://www.mz.gov.si/fileadmin/mz.gov.si/pageuploads/javno_zdravje_09/Smernice_zdravega_prehranjevanja.pdf; http://www.mz.gov.si/fileadmin/mz.gov.si/pageuploads/javno_zdravje_09/prehrana/ZRSS_uvod_low_res_pop.pdf; http://www.mz.gov.si/si/medijsko_sredisce/novica/browse/2/article/698/5805/27ffce8a04/?tx_ttnews[year]=2008
Enough time and an appropriate environment for meals must be offered and in a manner which conveys a positive attitude towards eating; advise against installing vending machines with sugary, fatty, salty snacks and sweet-flavoured drinks

School food policy (mandatory) | “VYHLÁŠKA Ministerstva školstva Slovenskej republiky zo 14. augusta 2009 o zariadení školského stravovania”
Developed by | A combination of ministries
Year of publication | 2009

Web link(s)
http://www.minedu.sk/skolske-zariadenia/
http://www.minedu.sk/data/att/653.pdf
http://www.minedu.sk/8009-sk/skolske-stravovanie/
http://www.minedu.sk/vyhlasenie-vysledkov-vyzvy-na-podavanie-ziadosti-o-poskytnutie-financnych-prostriedkov-na-rozvojovy-projekt-zdravie-na-tanieri-2014/

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 268,671 | 5,410,836 | 16%
10 to 14 years | 270,137
15 to 19 years | 316,992
Total 5 to 19 years | 855,800

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Prevent addiction; ensure personality development (mental and physical health); prevent non-communicable diseases

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Other measures:

• n/a

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Other standards/guidelines:

• Food handling, storage and hygiene (staff and food)

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See Annex I for more details on the food-based standards/guidelines in Slovakia.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Slovakia.

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Slovakia

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Slovakia

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Marketing restrictions on drinks high in caffeine

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Slovakia

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Slovak food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Seasonal fresh vegetables daily; one main dish per week based on vegetables; fruit included in daily menu as budget allows; dessert including fruit at least 2/wk | -
Specified number of times (red) meat served | Reference to meat and meat products in general, not red meat specifically; 2 main dishes per week with meat/poultry/fish, one with reduced meat content | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | - | n/a
Specified number of times (oily) fish should be on the school lunch menu | One main dish per week with fish, not specified if oily or lean | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | - | Vending machines for sweets banned in both primary and secondary schools
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | - | -
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Drinking water, mineral water, milk, unsweetened fruit and dark tea | Drinking water, mineral water, milk, unsweetened fruit and dark tea
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | - | -
Salt provision is restricted | - | -
Other | Wholemeal bread or dark breads are served as part of supplementary food; defined list of foods not recommended from food safety perspective | -

Annex II

Additional information on Slovak energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | x
Fat | x | x
Saturated fat | - | -
Total carbohydrate | - | -
Non-milk extrinsic sugars | Sugar | Sugar
Fibre | x | -
Protein | x | x
Iron | x | -
Zinc | x | -
Calcium | x | -
Vitamin A | x | -
Vitamin C | x | x
Folate | x | -
Sodium | x | -
Other | Vitamins and minerals referred to generically | Vitamins and minerals referred to generically

School food policy (mandatory) | “Kouluruokailusuositus”
Developed by | Ministry of Education is responsible for legislation, curriculum and paedagogical aspects, Ministry of Health and Ministry of Agriculture work with nutritional guidelines etc.
Year of publication | 2008
Web link(s) | http://www.ravitsemusneuvottelukunta.fi/attachments/vrn/kouluruokailu_2008_kevyt_nettiin.pdf

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 296,980 | 5,426,674 | 17%
10 to 14 years | 290,329
15 to 19 years | 320,713
Total 5 to 19 years | 908,022

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

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Other objectives:

• Disease prevention, long term cost savings (healthcare), teach good table manners and social interaction skills

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Other measures:

• Nutrient-based energy evaluation, nutrient quality evaluation, saturated fat, salt control of school meals; is a “healthy meal” (plate model) being displayed in the canteen? other evaluation considering health-based objectives, social interaction and canteen service etc. can be decided upon and evaluated; pupils should be encouraged to give feedback

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Other standards/guidelines:

• n/a

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See Annex I for more details on the food-based standards/guidelines in Finland.

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See Annex II for more details on the energy-/nutrient-based standards/guidelines in Finland.

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Finland

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

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Finland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

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Finland

School food provision is considered a part of the education

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Finnish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Fresh and cooked vegetables covering half of the plate, berries or fruits for dessert | Every snack should contain vegetables, fruit or berries
Specified number of times (red) meat served | - | n/a
Specified number of times other sources of protein served | - | n/a
Specified number of times dairy products served | Skimmed or semi-skimmed milk, fermented milk; products should have max 1% fat | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish, at least once, preferably twice a week (not oily) | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Not recommended | Not recommended
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | Not recommended | Not recommended
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Water and skimmed/semi-skimmed milk are mentioned as parts of a balanced meal; products should have max 1% fat | Max 1 % fat
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Not recommended | Not recommended
Salt provision is restricted | x | x
Other | Bread with wholemeal; vegetable margarine; potato/rice/pasta every meal. Meat/charcuterie should be low-fat | Cheese max 17 g fat/100 g; vegetable margarine for sandwiches; wholemeal for porridge; low fat charcuterie; cakes with max 10 g fat/100 g and max 20 g sugar/100 g and max 0.7% salt

Annex II

Additional information on Finnish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | A third of child’s daily energy intake, amount of kcal depend on age: 6-8: 550 kcal; 9-12: 650 kcal; 13-15: 740 kcal; 16-19: 860 kcal | -
Fat | 30% of kcal | We have a list of recommended snacks (such as yogurts with max 1% fat and max 12 g/100 g carbohydrate)
Saturated fat | 10% of kcal | -
Total carbohydrate | 55% of kcal | We have a list of recommended snacks (such as yogurts with max 1% fat and max 12 g/100 g carbohydrate)
Non-milk extrinsic sugars | - | -
Fibre | 12.6 g/1000 kcal | -
Protein | 15% of kcal | -
Iron | 6.7 mg/1000 kcal | -
Zinc | - | -
Calcium | 420 mg/1000 kcal | -
Vitamin A | - | -
Vitamin C | 34 mg/1000 kcal | -
Folate | - | -
Sodium | NaCl max 2.1 g/1000 kcal | -
Other | Thiamine 0.5 mg/1000 kcal | -

School food policy (mandatory) | Cost-free and nutritious school meals for all students aged 7-16 are required by Education Act, 2010:800. Voluntary guidelines: “GOOD SCHOOL MEALS - Guidelines for primary schools, secondary schools and youth recreation centres”
Developed by | The Ministry of Education and Research gave orders to the National Food Agency (under the Ministry for Rural Affairs) to develop guidelines for healthy food in schools together with the Swedish National Agency for Education
Year of publication | 2013
Web link(s) | http://www.livsmedelsverket.se/globalassets/english/food-habits-health-environment/public-meals/good_school_meals.pdf

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Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 543,993 | 9,555,893 | 17%
10 to 14 years | 494,283
15 to 19 years | 564,627
Total 5 to 19 years | 1,602,903

Source: EUROSTAT, year 2013.

Childhood overweight/obesity prevalence in Sweden

| Overweight (including obesity) | Obesity
2007/8 | 2007/8
Boys (7 years) | 23.5% | 6.8%
Boys (8 years) | 26.3% | 9.7%
Girls (7 years) | 22.0% | 5.1%
Girls (8 years) | 23.5% | 6.8%

From: Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Reduce impact on environment; reduce food waste; improve child health and prevent diseases as part of public health work

3 | [picture]

Other measures:

• Recommended quality measures to use in the schools systematic quality improving work: tasty, integrated, pleasant, nutritious, sustainable, and secure. To measure quality of school meals there is a webbased tool (the nutritional assessment is validated) (www.skolmatsverige.se) which is used by 26% of schools in Sweden (Nov 2013) and evaluate aspects as service, organisation, environment, nutritional quality. The tool enhances a systematic work at local, regional and national level of the school meal quality.

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in Sweden.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in Sweden.

7 | [picture]

Sweden

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

Sweden

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Swedish food and retail sector has also enacted codes of conduct with a self-regulatory framework limiting marketing to children in general, and an additional regulatory framework for marketing of food and non-alcoholic beverages

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

Sweden

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Swedish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | At least 100 g of fruit and vegetables per lunch. At least 5 different varieties of vegetables, legumes, vegetable combinations or fruit. | Fruit & vegetables should be included at breakfast and available in cafeteria
Specified number of times (red) meat served | Sausage should be limited to no more than 1-3 times per month depending on fat and salt content | n/a
Specified number of times other sources of protein served | Black pudding or liver once a month; beans, peas and lentils should replace meat in vegetarian dishes | n/a
Specified number of times dairy products served | Milk (and water) should be available with meals on a daily basis for students to choose from | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish at least once a week, oily fish at least two times per 4 weeks | n/a
Restrictions on availability of fried, deep-fried or processed products | - | -
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | Shouldn’t be served | Shouldn’t be served
Starchy food cooked in fat or oil restricted | - | -
Crisps and savoury snacks restricted | Shouldn’t be served | x
Fresh drinking water must be provided and be easily accessible | x | x
Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these) | Milk and water | Milk should be included at breakfast and available in the cafeteria
Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | Shouldn’t be served | Shouldn’t be served
Salt provision is restricted | Restricted use of salt in cooking and no salt available in canteen | -
Other | Recommendations for vegetarians and people with intolerance/allergies; food-based guidelines to choose cooking fat and sandwich spreads with good fat quality (high proportion of polyunsaturated and limited content of saturated fats), low-fat dairy products and whole-meal bread and pasta | Bread and cereals should be included at breakfast and available in the cafeteria

Annex II

Additional information on Swedish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | x
Fat | x | -
Saturated fat | x | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | - | -
Fibre | x | -
Protein | x | -
Iron | x | -
Zinc | - | -
Calcium | - | -
Vitamin A | - | -
Vitamin C | x | -
Folate | x | -
Sodium | x | -
Other | Vitamin D and polyunsaturated fat | -

School food policy (mandatory) | “The Requirements for School Food Regulations 2014, No. 1603” “School Food Standards - A practical guide for schools, their cooks and caterers”
Developed by | Ministry of Education
Year of publication | 2007, as amended 2008, 2011, and 2014

Web link(s)
http://www.legislation.gov.uk/uksi/2007/2359/pdfs/uksi_20072359_en.pdf
http://www.legislation.gov.uk/uksi/2014/1603/pdfs/uksi_20141603_en.pdf
http://www.education.gov.uk/aboutdfe/advice/f00197541/school-food
The School Food Plan: https://www.gov.uk/government/publications/the-school-food-plan
Free School Meals: http://www.education.gov.uk/schools/pupilsupport/pastoralcare/a00202841/fsmcriteria
http://www.schoolfoodplan.com/wp-content/uploads/2014/09/School-Food-Standards-Guidance-FINAL-140911-V2C.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 3,135,795 | 53,680,526 | 18%
10 to 14 years | 2,992,167
15 to 19 years | 3,270,579
Total 5 to 19 years | 9,398,541

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Improve economic viability of school food services

3 | [picture]

Other measures:

• Applies to lunch only

4 | [picture]

Other standards/guidelines:

• n/a

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in UK-England.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in UK-England.

7 | [picture]

UK-England

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

UK-England

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

UK-England

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on English food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Not less than 2 portions per day per pupil must be provided; at least one should be vegetables or salad and at least one should be fruit; includes all fresh, frozen and canned varieties; fruit-based dessert (≥50% fruit by weight of raw ingredients) at least twice per week in primary schools | Fruit & vegetables must be available in any place on the school premises where food is provided
Specified number of times (red) meat served | Red meat must be provided at least twice each week in primary schools, and at least three times each week in secondary schools; except that a day when a food from meat products group (burger, sausage, meat pie, etc.) which contains red meat is provided may count towards this total | n/a
Specified number of times other sources of protein served | Meat, fish or other non-dairy protein source once daily except a day when a food from meat products group (see above) is provided as permitted | n/a
Specified number of times dairy products served | One portion daily; in primary schools a dairy source of protein may be provided in place of meat, fish, or other non-dairy protein source | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish must be provided at least once each week in primary schools and at least twice each week in secondary schools. Oily fish at least once every three weeks | n/a

Restrictions on availability of fried, deep-fried or processed products
No more than two portions each week of deep-fried food; starchy foods cooked in fat or oil not provided on more than 3 days per week; processed meats provided not more often than once every two weeks
A portion from starchy food group which is cooked in fat or oil may only be provided if a portion permitted under paragraph 5(2) of Schedule 2 or paragraph 4 of Schedule 3 of these standards is not provided; a portion of food which has been deep-fried in the cooking or manufacturing process may only be provided if a portion permitted under paragraph 8 of Schedule 2 or paragraph 7 of Schedule 3 is not provided

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
No confectionery or snacks may be provided except snacks which consist of (a) nuts, seeds, fruit or vegetables with no added salt, sugar, honey or fat (except that dried fruit may contain no more than 0.5% vegetable oil as a glazing agent); or (b) savoury crackers or bread sticks which are served with food from fruit & vegetable group or dairy group; cakes or biscuits must not contain any confectionery
No confectionery or snacks shall be provided except snacks which consist of nuts, seeds, fruit or vegetables with no added salt, sugar, honey or fat (except that dried fruit may contain no more than 0.5% vegetable oil as a glazing agent

Starchy food cooked in fat or oil restricted | Starchy foods cooked in fat or oil not provided on more than 3 days per week; on each day when a starchy food cooked in fat or oil is provided, a food from that group (other than bread) not so cooked must also be provided | A portion from starchy food group which is cooked in fat or oil may only be provided if a portion permitted under paragraph 5(2) of Schedule 2 or paragraph 4 of Schedule 3 of these standards is not provided

Crisps and savoury snacks restricted
No confectionery or snacks may be provided except snacks which consist of (a) nuts, seeds, fruit or vegetables with no added salt, sugar, honey or fat (except that dried fruit may contain no more than 0.5% vegetable oil as a glazing agent); or (b) savoury crackers or bread sticks which are served with food from fruit & vegetable group or dairy group)
No confectionery or snacks shall be provided except snacks which consist of nuts, seeds, fruit or vegetables with no added salt, sugar, honey or fat (except that dried fruit may contain no more than 0.5% vegetable oil as a glazing agent)

Fresh drinking water must be provided and be easily accessible | Supply of drinking water required by regulation 22(1) of the Education (School Premises) Regulations 1999(a) must be provided free of charge at all times to registered pupils on the school premises | Supply of drinking water required by regulation 22(1) of the Education (School Premises) Regulations 1999(a) must be provided free of charge at all times to registered pupils on the school premises

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
No drinks other than those included in group F (F1 - plain drinks: plain water (still or carbonated); milk (skimmed, semi-skimmed or lactose-reduced); fruit juice or vegetable juice; plain soya, rice or oat drinks enriched with calcium; plain fermented milk drinks; F2 - Combination drinks: Combinations of fruit juice or vegetable juice with—(a) plain water, in which case the fruit juice or vegetable juice must be at least 50% by volume and may contain vitamins and minerals; (b) milk (skimmed, semi-skimmed or lactose-reduced) or plain fermented milk drinks (in each case with or without plain water) in which case the milk or fermented milk drink must be at least 50% by volume and may contain vitamins, minerals and less than 5% added sugars or honey; (c) plain soya, rice or oat drink (in each case with or without plain water) in which case the soya, rice or oat drink must be at least 50% by volume and may contain vitamins, minerals and less than 5% added sugars or honey; combinations of milk (skimmed, semi-skimmed or lactose-reduced), plain fermented milk drinks or plain soya, rice or oat drinks (in each case with or without plain water) with cocoa, in which case the milk, fermented milk drink, soya, rice or oat drink must be at least 50% by volume and may contain vitamins, minerals and less than 5% added sugars or honey; flavoured milk (skimmed, semi-skimmed or lactose-reduced) containing not less than 90% milk by volume and which may contain vitamins, minerals and less than 5% added sugars or honey; Tea, coffee; Hot chocolate containing no more than 20 kcal per 100 ml; whole milk may be provided for pupils up to the end of the school year in which they attain the age of five
No drinks other than those included in group F may be provided, except that whole milk may be provided for pupils up to the end of the school year in which they attain the age of five

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | See above | See above
Salt provision is restricted | No salt shall be available to add to food after the cooking process is complete; other condiments may be available to pupils only in individual sachets or in individual portions of no more than 10 grams or one teaspoonful | No salt shall be available to add to food after the cooking process is complete; other condiments may be available to pupils only in individual sachets or in individual portions of no more than 10 grams or one teaspoonful

Other
No food additives in drinks other than those in accordance with Directive 89/107/EEC; fruit juice must not contain added honey or added vitamins or minerals; no economy burgers as defined in Meat Products Regulation shall be provided; any shaped product comprising a mixture of meat and other ingredients which is not included in the reserved descriptions specified in Schedule 2 to the Meat Products Regulations may only be provided if it complies with the meat content requirements for “Burger” in that Schedule; no meat product shall be provided if it contains any carcase part listed in regulation 6(2) of the Meat Products Regulations, subject to the exception in regulation 6(3) of those Regulations; a type of bread with no added fat or oil and another starchy food must be provided daily
-

Annex II

Additional information on English energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | -
Fat | x | -
Saturated fat | x | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | x | -
Fibre | x | -
Protein | x | -
Iron | x | -
Zinc | x | -
Calcium | x | -
Vitamin A | x | -
Vitamin C | x | -
Folate | x | -
Sodium | x | -
Other | - | -

School food policy (mandatory) | “Healthy Food for Healthy Outcomes - Food in Schools Policy”
Developed by | Joint venture of Dept. Education and Dept. Health, Social Services and Public Safety
Year of publication | 2013
Web link(s) | http://www.deni.gov.uk/healthy_food_for_healthy_outcomes_-_food_in_schools_policy_-_english_version.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 116,280 | 1,826,656 | 19%
10 to 14 years | 114,460
15 to 19 years | 123,563
Total 5 to 19 years | 354,303

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Prevention of cardiovascular diseases and cancer; dental health; increase uptake of school meals

3 | [picture]

Other measures:

• Only take up explicitly mentioned in general policy, but reference to further guidance made

4 | [picture]

Other standards/guidelines:

• Healthier cooking practice; catering for special circumstances e.g. children with special dietary requirements, religious and cultural requirements etc.

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in UK-Northern Ireland.

6 | [picture]

7 | [picture]

UK-Northern Ireland

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Addressed in Nutritional Standards for Other Food and Drinks in Schools which are a mandatory element of the policy. However due to a gap in existing legislation Nutritional Standards for Other Food and Drinks in Schools are not mandatory at present in the controlled and maintained sectors where food is provided by the school (rather than an Education and Library Board) through tuck shops, vending machines etc. http://www.deni.gov.uk/de1_09_125647_nutritional_standards_for_other_food_and_drinks_in_schools_a_guide_for_implementation-2.pdf

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

UK-Northern Ireland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Schools have discretion to make their own decisions in matters of advertising and sponsorship; reference made to OFCOM Standards on the Television Advertising of Food and Drink Products to Children.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

UK-Northern Ireland

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Northern Ireland food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
Not less than two portions of fruit & vegetable should be available per child through-out the lunch service; of this, at least one portion should be vegetable or salad and at least one portion should be fruit (fresh, tinned in juice, fruit salad, fruit juice or dried fruit); pies, crumbles and other composite fruit dishes must contain at least one portion of fruit per serving; pies, cas-seroles, stews and other composite main course dishes must contain a minimum of half a portion of vegetable per serving, in addition to a separate serving of vegetable or salad; in nursery and primary schools a fruit based dessert such as, fruit tinned in natural juice, fruit salads, fruit crumble, or fruit pie must be offered at least 3x/wk; baked beans must not be served as a vegetable more than once a week in a primary school; baked beans must not be the only vegetable option on any day in a post-primary school; if beans or pulses form the protein part of a main course, another vegetable must be available
Variety of fruit and vegetables should be available in all school food outlets; this could include fresh, frozen, tinned, dried and juiced products

Specified number of times (red) meat served | Meals containing red meat must be served: a minimum of twice a week and a maximum of three times a week in nursery and primary schools; and a minimum of three times a week and a maximum of four times a week in post-primary schools | n/a
Specified number of times other sources of protein served | Every lunch service must contain a portion or portions of food from meat/fish/eggs/beans and other non-dairy group | n/a
Specified number of times dairy products served | Every lunch service must contain a portion or portions of dairy; in addition drinking milk must be available as an option every day; cheese must not be served as the only vegetarian option more than twice a week; cheese may be used as a topping more frequently | n/a
Specified number of times (oily )fish should be on the school lunch menu | Every lunch service must contain a portion or portions of food from meat/fish/eggs/beans and other non-dairy group. Oily fish at least once per 4 weeks | n/a

Restrictions on availability of fried, deep-fried or processed products
Deep-fried foods or other high fat products, such as chips, roast potatoes, other fried potatoes, garlic bread, or meal choices containing pastry, eg quiche, apple pie, vol-au-vent may be served a maximum of twice a week; whole muscle or fillet of fish coated in breadcrumbs can be served once a week; meat or chicken products (such as burgers, sausages, chicken nuggets etc.) may be served max once a week in primary schools and max twice a week in post primary schools; to allow choice for pupils on days when meat or chicken products are available, schools should aim for 50% healthy meal options and they should be presented and marketed in a competitive way to other meal options; this standard does not apply to single choice menus; there should be at least 2 days each week without any meat or chicken products, fried foods, foods cooked in batter, breadcrumbs or foods containing pastry, for example fish in breadcrumbs, chips, sausages, vol-au-vents, quiche, apple pie etc.; this is to encourage children to try a greater range of foods in their diets and explore new taste experiences; when a high fat starchy food is served, e.g. chips or garlic bread, an alternative without added fat must be available; lower fat desserts must be available on days when deep-fried foods and other high fat foods are offered
Foods high in fat or deep fried foods are restricted across the whole school day and should not be offered in total more than twice a week; there should be at least 2 days each week without any fried foods or foods high in fat

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
Confectionery, chocolate and chocolate-coated products should not be available throughout the lunchtime; cakes and biscuits can only be provided at lunchtime and as part of a meal; cakes, biscuits and puddings made with cocoa powder should only be available a maximum of 2 days per week; high fat and or high sugar toppings used for decoration for example cream, butter cream, icing sugar should be kept to a minimum and only used if essential e.g. to set fruit on top of a sponge; if used, an undecorated or healthier dessert should also be available
No confectionery should be sold in schools; cakes and biscuits must not be provided (except at lunchtime and as part of a meal

Starchy food cooked in fat or oil restricted | High fat products, such as chips, roast potatoes, other fried potatoes, garlic bread, or meal choices containing pastry, e.g. quiche, apple pie, vol-au-vent may be served a maximum of twice a week | Includes: chips, roast potatoes, other fried potatoes, oven chips, potato waffles and potato shapes; garlic bread
Crisps and savoury snacks restricted | The only savoury snacks available should be nuts and seeds with no added salt or sugar; savoury crackers or breadsticks may be offered provided they are served with fruit or vegetables or a dairy food | No savoury snacks other than nuts* and seeds (without added salt or sugar) should be sold;* be aware of nut allergies; It will be for individual schools to decide on whether or not to provide nuts
Fresh drinking water must be provided and be easily accessible | Drinking water, i.e. tap water, must be provided free every day | Children and young people must have easy access at all times to free, fresh, preferably chilled water and should not depend on going to the lavatory to get water

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
Only drinks available should be: plain water (still or sparkling); milk; unsweetened fruit or vegetable juices; yoghurt or milk drinks (with less than 5% added sugar); drinks made from combinations of the above (e.g. smoothies); low calorie hot chocolate, tea, coffee (these drinks are not suitable for the nursery sector); combination drinks must contain at least 50% of the milk, yoghurt or fruit juice as appropriate; artificial sweeteners are only permitted in combination drinks; low calorie hot chocolate is defined as 20 kcal/100 ml
Only drinks available should be: plain water (still or sparkling); milk; unsweetened fruit or vegetable juices; yoghurt or milk drinks (with less than 5% added sugar); drinks made from combinations of the above (e.g. smoothies); low calorie hot chocolate, tea, coffee (these drinks are not suitable for the nursery sector); combination drinks must contain at least 50% of the milk, yoghurt or fruit juice as appropriate; artificial sweeteners are only permitted in combination drinks; low calorie hot chocolate is defined as 20 kcal/100 ml

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted | See above restrictions | See above restrictions

Salt provision is restricted
Table salt should not be available within nursery or primary schools; it should not be on view in the post-primary school dining room but may be made available on request from the service counter; condiments (tomato ketchup, brown sauce, salad cream, relishes, etc.) should only be provided from the service counter and should be controlled by the kitchen staff
x

Other
Every lunch service must contain a portion or portions from starchy food group; rice and pasta must be offered at least once a week; in a single choice menu, rice or pasta must be served at least once a week; bread should be available on a daily basis in all schools; additional requirements on fried foods; standards for special schools; catering for diabetics, children with allergies, religious beliefs; standards are based on eatwell plate
Meat or chicken products are restricted across the whole school day and should only be offered a maximum of once a week in primary schools and a maximum of twice a week in post primary schools; food choices or meals containing red meat must be served a minimum of twice a week and a maximum of three times a week in nursery and primary schools and a minimum of three times a week and a maximum of four times a week in post primary schools; this standard applies across the whole school week

School food policy (mandatory) | The Schools (health promotion and nutrition) (Scotland) Act 2007 and the associated Nutritional requirements for food and drink in schools (Scotland) regulations 2008

Developed by
Responsibility for school food policy rests with the Scottish Government’s Learning Directorate – i.e. Education; however, policy is developed closely with Health and Environment colleagues, the former having lead responsibility for the obesity route map and beyond the school gates and the latter having responsibility for Scotland’s Food and Drink policy

Year of publication | The Act, 2007 and Regulations, 2008 (links to other existing policy documents published since 2003, including Better Eating, Better Learning can be found in the link below)
Web link(s) | http://www.scotland.gov.uk/Topics/Education/Schools/HLivi/schoolmeals

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 279,043 | 5,320,115 | 16%
10 to 14 years | 278,323
15 to 19 years | 317,658
Total 5 to 19 years | 875,024

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• Physical activity; targets for tooth brushing schemes in primary schools; substance misuse; sexual health; promote consistent messages about healthy eating; via food and health experiences and outcomes in Curriculum for Excellence help understand relationship between food, health and wellbeing; raise awareness of food issues such as sourcing, production and cultural differences; set out building blocks for cooking and food safety; provide guidelines on commercial activities in schools

3 | [picture]

Other measures:

• Care, welfare and development; progress with the delivery and impact of aspects of provision in health and wellbeing; see indicators in the link below which is currently being reviewed and updated. It is useful in terms of evaluating the work of a school against many different quality indicators in relation to food and health education but it does not represent the framework under which schools are inspected by our Health and Nutrition Inspectors as part of a formal school inspection. http://www.educationscotland.gov.uk/Images/HowgoodisourschoolJtEpart3_tcm4-684258.pdf

4 | [picture]

Other standards/guidelines:

• The 2007 Act places duties on Scottish education authorities that must be met, beyond that all partners are asked to engage with the planning and delivery including children, parents, wider community, etc.

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in UK-Scotland.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in UK-Scotland.

7 | [picture]

UK-Scotland

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

All products provided from vending machines are subject to the same food and drink standards set out in the Nutritional requirements for food and drink in schools (Scotland) regulations 2008

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

UK-Scotland

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Food standards in schools are strict and therefore there is no additional requirement to place restrictions on marketing.

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

UK-Scotland

Every child and young person in Scotland is entitled to a broad general education which includes food and nutrition. However, as our national ‘Curriculum for Excellence’ is not set out in statute, it cannot accurately be described as ‘mandatory’. A better description would be ‘food and nutrition is an integral part of our national educational curriculum and it is expected that all schools will deliver on this subject in line with the experiences and outcomes detailed in Curriculum for Excellence’.

 Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Scottish food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch
Specified amounts of fruit and vegetables must be provided for each child | Choice of at least two types of vegetables and two types of fruit (not including fruit juice) must be provided every day as part of the school lunch | Variety of fruit and/or vegetables must be available in all school food outlets
Specified number of times (red) meat served | ’Red meat (e.g. beef, pork and lamb) based meals should be served about twice a week in order to assist in meeting mandatory nutrient standards for school lunches | n/a
Specified number of times other sources of protein served | Every school lunch should contain a serving of food from the meat, fish and alternatives (e.g. eggs, beans and pulses) group | n/a
Specified number of times dairy products served | Most school lunches should contain a serving or servings of food from the milk and milk products group | n/a
Specified number of times (oily) fish should be on the school lunch menu | Fish should be on the menu at least once a week; should be in addition to canned tuna (oily fish must be provided at least once every three weeks) | n/a
Restrictions on availability of fried, deep-fried or processed products | Menus must not contain more than three deep-fried items in a single week (including chips); this includes products which are deep-fried in the manufacturing process; chips, if served, must be served as part of a meal | Only pre-packaged savoury snacks can be provided outwith school lunch; pre-packaged savoury snack must meet standards around fat, saturates, sodium and sugar content and are of a pack size of no more than 25 g
Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted | No confectionery can be provided at any time of the day; at lunchtime, desserts (e.g. puddings, cakes, biscuits, pastries and icecream) should only be served as part of a meal and should be made nutritionally beneficial by modifying home-baking recipes | ’Sweet treats’ served outwith lunchtime should support the principles of a whole school approach to healthy eating
Starchy food cooked in fat or oil restricted | Menus must not contain more than three deep-fried items in a single week (including chips); this includes products which are deep-fried in the manufacturing process | No fried foods can be available outwith the school lunch, with the exception of savoury snacks that meet specified criteria

Crisps and savoury snacks restricted
No savoury snacks can be provided as part of the school lunch except savoury crackers, oatcakes or breadsticks; only pre-packaged savoury snacks can be provided outwith the school lunch; pre-packaged savoury snack must meet standards around fat, saturates, sodium and sugar content and are of a pack size of no more than 25 g
Savoury snacks can be provided outwith the school lunch; pre-packaged savoury snack must meet standards around fat, saturates, sodium and sugar content and are of a portion size less than 25 g

Fresh drinking water must be provided and be easily accessible | A specified duty under the Health Promotion Act | A specified duty under the Health Promotion Act

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
Only drinks permitted in schools are: plain water (still or carbonated); skimmed, semi-skimmed milk and other lower fat milks; milk drinks and drinking yoghurts; soya, rice or oat drinks enriched with calcium; tea and coffee; fruit juices and vegetable juices; blend containing any of the following ingredients, either singly or in combination: fruit, vegetable, fruit juice, vegetable juice; water and fruit and/or vegetable juice combination drinks. Many of these drinks are subject to specific criteria, for example around portion size and fat and sugar content
Only drinks permitted in schools are: plain water (still or carbonated); skimmed, semi-skimmed milk and other lower fat milks; milk drinks and drinking yoghurts; soya, rice or oat drinks enriched with calcium; tea and coffee; fruit juices and vegetable juices; blend containing any of the following ingredients, either singly or in combination: fruit, vegetable, fruit juice, vegetable juice; water and fruit and/or vegetable juice combination drinks. Many of these drinks are subject to specific criteria, for example around portion size and fat and sugar content

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted
Not allowed are: soft drinks, still or carbonated, including flavoured waters (only exception is combination drinks that meet criteria set out in ‘SELECT WITH CARE’ column); sugar-free soft drinks (still or carbonated) including flavoured waters; sweetened fruit juice; sweetened or salted vegetable juice; squashes/cordials, including lower sugar and ‘no added sugar’ versions; whole milk; sport drinks
Not allowed are: soft drinks, still or carbonated, including flavoured waters (only exception is combination drinks that meet criteria set out in ‘SELECT WITH CARE’ column); sugar-free soft drinks (still or carbonated) including flavoured waters; sweetened fruit juice; sweetened or salted vegetable juice; squashes/cordials, including lower sugar and ‘no added sugar’ versions; whole milk; sport drinks

Salt provision is restricted | Additional salt must not be provided in schools; condiments (if provided) must be dispensed in no more than 10 ml portions | No additional salt can be provided; condiments (if provided) must be dispensed in no more than 10 ml portions
Other | Healthy Eating in Schools - A guide to implementing the nutritional requirements for food and drink in schools (Scotland) regulations 2008 http://www.scotland.gov.uk/Publications/2008/09/12090355/0 | Healthy Eating in Schools - A guide to implementing the nutritional requirements for food and drink in schools (Scotland) regulations 2008 http://www.scotland.gov.uk/Publications/2008/09/12090355/0

Annex II

Additional information on Scottish energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | -
Fat | x | -
Saturated fat | x | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | x | -
Fibre | x | -
Protein | x | -
Iron | x | -
Zinc | x | -
Calcium | x | -
Vitamin A | x | -
Vitamin C | x | -
Folate | x | -
Sodium | x | -
Other | - | Separate standards apply to all food and drink provided during the school day outwith lunch. This includes breakfast clubs, tuck shops and vending machines.

School food policy (mandatory) | “The Healthy Eating in Schools (Nutritional Standards and Requirements) (Wales) Regulations 2013, No. 1984”
Developed by | Welsh Government, under lead of Minister for Education & Skills
Year of publication | 2013
Web link(s) | http://www.legislation.gov.uk/wsi/2013/1984/pdfs/wsi_20131984_mi.pdf

1 | [picture]

Demographic data

School-age population | Total population | School-aged children as % of total population
5 to 9 years | 170,058 | 3,078,000 | 17%
10 to 14 years | 169,295
15 to 19 years | 194,123
Total 5 to 19 years | 533,476

Source: EUROSTAT, year 2013.

Adolescent overweight/obesity prevalence in Europe

15-year-old girls who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

15-year-old boys who report that they are overweight or obese according to BMI

  25% or more

  20-24%

  15-19%

  10-14%

  Less than 10%

  No data

Note: HBSC teams provided disaggregated data for Belgium and the United Kingdom; these data appear in the map above.

From: Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

2 | [picture]

Other objectives:

• n/a

3 | [picture]

Other measures:

• n/a

4 | [picture]

Other standards/guidelines:

• Special dietary needs such as religious concerns, vegetarianism, food allergies/intolerances; don’t use food and drinks as treat or rewards; be mindful of routines and preferences as well as selective eaters

5 | [picture]

See Annex I for more details on the food-based standards/guidelines in UK-Wales.

6 | [picture]

See Annex II for more details on the energy-/nutrient-based standards/guidelines in UK-Wales.

7 | [picture]

UK-Wales

  Vending machines don’t exist on or are banned from school premises

  (Certain) unhealthful foods/drinks not allowed in vending machines

  Vending machine offer in line with healthy eating guidance/standards

  (More) healthful options recommended, promoted

  No vending machine restrictions specified

Vending machine restrictions on school premises across EU28 + Norway and Switzerland

8 | [picture]

UK-Wales

  Specific marketing limits for drinks high in sugar, foods high in sugar, and savoury snacks high in fat or salt (HFSS foods/drinks), combined with restrictions of a more generic kind or focussing on other types of foods/drinks as well

  Marketing restrictions only on HFSS foods/drinks

  Food marketing restricted in some other way without making reference to HFSS foods/drinks

  Food marketing restricted in some other way with-out making reference to HFSS foods/drinks, and including a positive role of marketing/sponsoring

  No food marketing restrictions specified

Reference to guidance document on healthy food and drink vending

Food and drink marketing restrictions on school premises across EU28 + Norway and Switzerland

9 | [picture]

UK-Wales

Not mandatory, but clearly recommended

  Mandatory food/nutrition education

  Voluntary food/nutrition education

Annex I

Additional information on Welsh food-based standards for lunch and foods other than lunch

n/a = not applicable

| Lunch | Other than lunch

Specified amounts of fruit and vegetables must be provided for each child
At least one portion of vegetables or salad must be provided each day in primary schools; at least two portions of vegetables or salad must be provided each day in secondary schools; for the purposes of sub-paragraphs (1) and (2), “vegetables” excludes potatoes; fruit: at least one portion of fruit, fruit salad or fruit juice must be provided each day; a fruit-based dessert must be provided at least twice each week; a portion of a fruit based dessert must contain (a) in primary schools, at least 40 grams measured by weight of raw ingredients; (b) in secondary schools, at least 60 grams measured by weight of raw ingredients
In addition to portion of fruit and portion of vegetables at lunchtime, fruit & vegetables should be made available in any outlet on the school premises where food is made available throughout the school day

Specified number of times (red) meat served | Daily provision of meat: meat in all forms whether fresh, frozen, canned or dried, including meat products | n/a
Specified number of times other sources of protein served | Daily provision of non-dairy sources of protein: eggs; nuts; pulses and beans, other than green beans | n/a
Specified number of times dairy products served | Daily provision of food from dairy category: milk, yoghurt (including frozen yoghurt and drinking yoghurt), fromage frais, custard and cheese, but excluding butter and cream | n/a
Specified number of times (oily) fish should be on the school lunch menu | Daily provision of fish: fish in all forms whether fresh, frozen, canned or dried, including fish products. A portion of oily fish must be provided at least twice during any four week period | n/a
Restrictions on availability of fried, deep-fried or processed products | A portion of food, including prepared, coated, battered and breaded food products, deep-fried or flash-fried on school premises or during the manufacturing process must not be provided more than twice each week; does not include potato and potato products | Product may only be provided if it is treated as being a product that is permitted under paragraph 6 of Schedule 3 (see regulation)

Sweet treats (chocolate, confectionery, cakes, biscuits, etc.) restricted
No confectionery may be provided; cakes and biscuits only allowed to be served as part of lunch provision and must not contain any confectionery
Confectionery not to be made available throughout whole school day; sweets or chocolate, including products containing, coated or flavoured by chocolate should not be made available; cakes and biscuits can only be sold outside lunchtimes in secondary schools e.g. morning break, if they are sold as part of the lunch provision and have therefore been included within nutritional analysis for that days menu; NB: cakes and biscuits cannot be served outside of the school lunch in primary schools

Starchy food cooked in fat or oil restricted | A portion of potato or potato product which is cooked in fat or oil must not be provided more than twice each week; in secondary schools, alternative starchy food not cooked in fat or oil must be provided in parallel | Product may only be provided if it is treated as being a product that is permitted under paragraph 5(1) of Schedule 3 (see regulation)
Crisps and savoury snacks restricted | No savoury snacks may be provided | No savoury snacks to be provided through-out whole school day except for nuts and seeds without added salt, sugar or fat; savoury crackers/breadsticks only allowed as part of lunch time provision when served with accompaniments
Fresh drinking water must be provided and be easily accessible | x | x

Drinks limited to specific types (e.g. milk, fruit juice, water, combination of these)
PRIMARY SCHOOLS: plain water – still or carbonated; plain milk – semi skimmed or skimmed fruit juice – still or carbonated; fruit juice from concentrate – still or carbonated; vegetable juice – still or carbonated; fruit juice combined with water; vegetable juice combined with water; fruit and/or vegetable blends/purees (e.g. fruit/vegetable smoothies); SECONDARY SCHOOL: Plain water – still or carbonated; milk – semi skimmed or skimmed; milk alternatives – plain soya, rice or oat drink; yoghurt drinks – plain; fruit juice – still or carbonated; fruit juice from concentrate – still or carbonated; fruit juice combined with water – still or carbonated; vegetable juice – still or carbonated; vegetable juice combined with water – still or carbonated; fruit and blends/purees (e.g. fruit/vegetable smoothies); fruit and/or vegetable juice combined with milk/yoghurt/milk alternatives (e.g. dairy smoothies); flavoured milk; tea and coffee; hot chocolate)
PRIMARY SCHOOLS: plain water – still or carbonated; plain milk – semi skimmed or skimmed; fruit juice – still or carbonated; fruit juice from concentrate – still or carbonated; vegetable juice – still or carbonated; fruit juice combined with water; vegetable juice combined with water; fruit and/or vegetable blends/purees (e.g. fruit/vegetable smoothies); SECONDARY SCHOOLS: Plain water – still or carbonated; milk – semi skimmed or skimmed; milk alternatives – plain soya, rice or oat drink; yoghurt drinks – plain; fruit juice – still or carbonated; fruit juice from concentrate – still or carbonated; fruit juice combined with water – still or carbonated; vegetable juice – still or carbonated; vegetable juice combined with water – still or carbonated; fruit and/or vegetable blends/purees (e.g. fruit/vegetable smoothies); fruit and/or vegetable juice combined with milk/yoghurt/milk alternatives (e.g. dairy smoothies); flavoured milk; tea and coffee; hot chocolate)

Soft-drinks (e.g. sugar-sweetened or artificially-sweetened soft drinks, squash) restricted
PRIMARY SCHOOLS: squash of any kind, including sugar free squash; flavoured waters including sugar free flavoured water; flavoured milk; sports or energy drinks; fizzy soft drinks including diet or sugar free fizzy drinks e.g. cola, lemonade; fruit and/or vegetable juice combined with milk/yoghurt/milk alternatives (e.g. dairy smoothies); SECONDARY SCHOOLS: Squash of any kind, including sugar free squash; flavoured waters including sugar free flavoured water; sports or energy drinks; fizzy soft drinks including diet or sugar free fizzy drinks e.g. cola, lemonade
PRIMARY SCHOOLS: squash of any kind, including sugar free squash; flavoured waters including sugar free flavoured water; flavoured milk; sports or energy drinks; fizzy soft drinks including diet or sugar free fizzy drinks e.g. cola, lemonade; fruit and/or vegetable juice combined with milk/yoghurt/milk alternatives (e.g. dairy smoothies); SECONDARY SCHOOLS: Squash of any kind, including sugar free squash; flavoured waters including sugar free flavoured water; sports or energy drinks; fizzy soft drinks including diet or sugar free fizzy drinks e.g. cola, lemonade

Salt provision is restricted | No salt must be available to pupils to add to food after cooking process is complete; portion of any condiment made available to pupils must not exceed 10 ml | Not permitted

Other
No more than two meat products are to be provided each week. (2) A meat product provided under paragraph (1) must not be served more than twice each week. (3) For the purposes of paragraphs (1) and (2), meat product does not include luncheon meat. (4) Meat products including luncheon meat must meet the minimum meat content levels set out in Schedule 2 to the Meat Product Regulations. (5) No meat product must be provided if it contains any carcase part listed in regulation 6(2) of the Meat Products Regulations, subject to the exception in regulation 6(3) of those Regulations. (6) No economy burgers as defined in Schedule 2 to the Meat Products Regulations must be provided. (7) Any shaped meat product consisting of a mixture of meat and other ingredients which is not included in the reserved descriptions specified in Schedule 2 to the Meat Product Regulations may only be provided if it complies with the meat content requirements for “Burger” in that Schedule; bread should be available every day, must include brown and wholemeal bread; oils and spreads must meet certain SFA/MUFA/PUFA specifications)
Food suggestions to offer outside lunch: bread-based products, e.g. wholemeal toast, English muffins, crumpets, flavoured breads and bagels; toast with various toppings e.g. baked beans, cheese, tomatoes, mushrooms, eggs (not fried); small sand-wiches/wraps/baguettes with a variety of non-mayonnaise based fillings including salad; yoghurts; fruit and dried fruit (without added fat and sugar); vegetable crudities; salads; breakfast cereals with semi-skimmed milk (not sugar coated or containing chocolate, chocolate flavour or cocoa powder) – see PSFBI guidance for suitable breakfast cereals; NB: foods covered under meat & meat products standard, potatoes cooked in fats/oils standard and deep fried products standard served outside lunch time provision may only be served as part of two per week limit, as specified in lunchtime food standards; reference to guidance on healthy food and drink vending

MUFA = mono-unsaturated fatty acids; PUFA = poly-unsaturated fatty acids; SFA = saturated fatty acids.

Annex II

Additional information on Welsh energy-/nutrient-based standards for lunch and foods other than lunch
| Lunch | Other than lunch
Energy | x | -
Fat | x | -
Saturated fat | x | -
Total carbohydrate | x | -
Non-milk extrinsic sugars | x | -
Fibre | x | -
Protein | x | -
Iron | x | -
Zinc | x | -
Calcium | x | -
Vitamin A | x | -
Vitamin C | x | -
Folate | x | -
Sodium | x | -
Other | - | -

Notes

1. Belgium has separate policies for Flanders and Wallonia, and the UK has separate policies for England, Wales, Scotland and Northern Ireland; hence the total of 34 policies.

2. EU28: Belgium, Bulgaria, Czech Republic, Denmark, Germany, Estonia, Ireland, Greece, Spain, France, Croatia, Italy, Cyprus, Latvia, Lithuania, Luxembourg, Hungary, Malta, Netherlands, Austria, Poland, Portugal, Romania, Slovenia, Slovakia, Finland, Sweden, United Kingdom.

3. http://dx.doi.org/10.2788/8214.

4. Wijnhoven T, van Raaij J, Breda J. WHO European Childhood Obesity Surveillance Initiative. Implementation of round 1 (2007/2008) and round 2 (2009/2010). Copenhagen, WHO Regional Office for Europe, 2014.

5. http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/estudio_ALADINO_2011.pdf and http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/Estudio_ALADINO_2013.pdf.

6. Currie C et al. eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6).

7. http://data.euro.who.int/nopa/.

8. http://www.ncbi.nlm.nih.gov/pubmed.

9. http://scholar.google.com.

10. http://ec.europa.eu/health/nutrition_physical_activity/docs/implementation_report_en.pdf.

11. http://webarchive.nationalarchives.gov.uk/20091012185423/http://schoolfoodtrust.org.uk/UploadDocs/Library/Documents/school_food_in18countries.pdf.

12. www.thematicnetworkdietetics.eu.

13. School Nutrition Index of Programme Effectiveness.

14. http://dx.doi.org/10.2788/8214.

15. Greece also has a policy for pre-schools, dating from 1988; Ministerial decision Γ2α/οικ.4108 (ΦΕΚ 546/τα.Β/2-8-1988) which includes the dietary regimen for nursery schools and kindergartens, and Ministerial decision 16065/22-4-2002 (ΦΕΚ 497/τα.Β/2002)

16. Estudio ALADINO: Estudio de Vigilancia del Crecimiento, Alimentación, Actividad Física, Desarrollo Infantil y Obesidad en España 2011. Agencia Española de Seguridad Alimentaria y Nutrición. Ministerio de Sanidad, Servicios Sociales e Igualdad. Madrid, 2013. http://www.observatorio.naos.aesan.msssi.gob.es/docs/docs/documentos/estudio_ALADINO.pdf.

17. Estudio ALADINO 2013: Estudio de Vigilancia del Crecimiento, Alimentación, Actividad Física, Desarrollo Infantil y Obesidad en España 2013. Agencia Española de Seguridad Alimentaria y Nutrición. Ministerio de Sanidad, Servicios Sociales e Igualdad. Madrid, 2014. http://www.observatorio.naos.aesan.msssi.gob.es/docs/docs/documentos/Estudio_ALADINO_2013.pdf.

18 France also has a policy for pre-schools, dating from 2013; http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000025242002&dateTexte=&categorieLien=id

19 Italy also has a policy for pre-schools, dating from 2010 and available at http://www.salute.gov.it/imgs/C_17_pubblicazioni_605_allegato.pdf