School breakfasts: how far can the school go to avoid ultra-processed foods?

“Every morning I give breakfast to the early childhood education students, from I3 to I5, and the breakfasts of the little ones are always: Oreos, potato chips, chocolate snacks, and low-quality pastries. Every morning I think that there should be a law that protects me so I don't have to poison the children. That is something I would go on an indefinite strike for; it is worse than not knowing how to add, because they will get sick,” explains Estel Marín to Criatures, a teacher at a high-complexity school in Barcelona.

Marín's perception is not anecdotal. A study from the Open University of Catalonia (UOC), in collaboration with the Public Health Agency of Catalonia, points out that nearly 44% of the children's afternoon snacks analyzed are directly unhealthy. Although the research focuses on afternoon snacks and not breakfast, the researchers point out that the pattern is similar.

“Regular consumption of these products leads to a nutritional imbalance that can have serious consequences for health in the short and long term. This pattern favors childhood overweight and obesity, factors that increase the risk of early development of cardiovascular diseases and type 2 diabetes,” warn the report's researchers Anna Bach, Nadia San Onofre, and Alícia Aguilar. According to the Aladino 2023 Study, based on a sample of 12,678 children aged 6 to 9 in Spain, 20% of schoolchildren are overweight and almost 16% suffer from obesity: altogether, nearly 36% of children have excess weight.

“The unhealthy option is currently the most economical, the most accessible, and the most promoted by marketing. The difficulty of integrating healthy recommendations into daily life is explained by the ease, immediacy, and high palatability of processed products, enriched with salt, fat, and added sugars,” explain the researchers and professors of health studies at the UOC.

The consumption of ultra-processed foods, rapidly absorbed sugars, and unhealthy fats satisfies children less and displaces more nutritious foods, such as fruit and whole grains. "It also entails adverse psychosocial consequences and affects school performance and quality of life," the researchers add. Furthermore, it represents a very high ecological footprint in relation to the low real quality of the nutrients they offer.

What can the school do, where are the limits?

However, the choice of breakfasts and afternoon snacks is up to the families. That said, in the case of breakfasts, it is a meal that takes place during the school day and, therefore, within the educational center. But to what extent can the school decide what can be eaten there?

“Public health recommendations constitute a frame of reference for educational centers, but the specific organizational decisions about what is allowed or not in school usually form part of the autonomy of each center and the agreements adopted by the educational community and the school board,” explains Gemma Salvador, a dietitian nutritionist at the Public Health Agency of Catalonia.

State regulations focus on the food supply of the center and the meals that schools and institutes provide, but there is no mandatory regulation for the breakfasts and snacks that families bring. Even so, the center can have its own operating rules: “Each school can establish common criteria, such as fruit days and offer specific recommendations on the various possibilities and options of foods for breakfasts and snacks. It can also make recommendations regarding wrappers, avoiding plastics, aluminum, juice boxes... and encouraging paper, cloth fabrics, canteens...”, adds Salvador.

Some schools are already explicitly asking families to avoid sweets, soft drinks, and certain products. This is the case at the center where Jordina Martí's daughter studies. "From the administration, they sent us an email asking us to be a little more careful when preparing breakfasts and to try to make them healthier," she explains. But Martí raises an underlying issue: "Many times we demand that families make breakfasts healthier, but perhaps we don't always give them enough tools to know what that exactly means and how they can apply it in their day-to-day lives." Following that experience, she created the children's book And what do you have for breakfast?, designed to help children and families.

For Nadia San Onofre, schools have a role that goes beyond sending out circulars. “They are fundamental educational platforms and their intervention should not be limited to sending information. Besides raising awareness, action must be taken by modifying obesogenic environments,” she states. This includes ensuring a healthy offering at the center, eliminating certain products from vending machines, and working together with the AFAs.

The classroom shock: when others' breakfast educates (or frustrates)

Teachers and children share a space where eating habits clash within the same class. This can lead to comparisons, envy, or complaints regarding classmates' snacks, both inside and outside the classroom. "My daughter would see how other classmates brought pastries to school every day and would come home asking us to pack them for her, too. We had to talk a lot with her so she would understand that we would not pack that type of snack for her," explains Joan Marqués, father of an 8-year-old girl.

The debate even reached the class WhatsApp group, where families disagreed about what could be considered healthy. In the classroom, the situation repeats itself: “In I5, there is a girl who brings cut fruit and a small sandwich. The face with which her classmates look at the girl while they open their own breakfast is brutal,” relates Estel Marín.

“The peer group is the main agent of cultural normalization in childhood, as it not only validates taste preferences, but also establishes which models of consumption and which habits of waste generation are perceived as socially desirable,” explains Anna Bach, researcher of the NUTRALiSS group.

Some families explain that they feel trapped between school recommendations and their children's demands, who may reject fruit or other healthy options by saying that "others bring tastier things". Researchers advise against, however, turning certain foods into a taboo. "The solution does not involve strict prohibition; evidence shows us that banning a product usually only increases the desire for it. A positive practice consists of not being excessively restrictive but rather guiding food choices".

Involving children in meal preparation can help increase their acceptance. You can also play with the presentation: reusable wraps, lunchboxes with compartments, or bottles chosen by the children themselves can make healthy options more attractive.

Consolidating these habits from a young age is especially important, because as children grow, the peer group and social environment gain weight in their food decisions. "When they approach pre-adolescence, they acquire more freedom to choose and buy their own food, they socialize more often outside of parental control, and they tend to move away from direct family influence," the researchers explain.

When breakfast reflects inequality

“Every morning I think that if I could record it...”, explains Estel Marín, surprised by the amount of sugary and ultra-processed products she sees in children's breakfasts, even in a high-complexity center. “I tried to get the school to ban sugar, but the coordinator replied to me that "sugar is life"”, she laments.

Talking about school breakfasts also means talking about inequality. Food decisions do not depend only on nutritional knowledge or the will of each family. “Children's meals are a faithful reflection of socioeconomic level: families with limited resources rely more on ultra-processed foods because they are more economically affordable, have longer expiration dates, are often on sale, and require less preparation time,” they explain.

Children from lower-income families suffer from more than double the obesity rate (23.6%) than those from high-income families (10.9%), a figure that has remained practically stagnant and without improvement since 2011, according to Aladino data. Price is only one part of the equation. In a fast-paced day-to-day life, prepared products often prevail for convenience over alternatives that require buying fresh food, preparing it, and storing it, and which often have shorter expiration dates.

To this is added an emotional dimension, when sugar is used as a reward: “In some households with limitations, providing children with the sweet they ask for ends up being used as an emotional prize when they cannot be offered other material goods. To avoid penalizing them, dietary recommendations must be linked to public structural policies, such as ensuring aid and support programs for access to fresh food”, explains Alícia Aguilar, researcher of the FoodLab group.

To prohibit without stigmatizing: the great challenge

In some schools, if the breakfast does not meet the established rules, the child cannot eat it. Herein lies one of the main risks. “The school can make recommendations, but one must be very careful. Each family has different needs and possibilities. Children are not responsible for the breakfast they bring to school, and we understand that families do what they consider best for their children,” explains Aina Estrades, a teacher who has shared her experience with Criatures.

Both Salvador and the UOC researchers agree that pointing out what a child brings for breakfast can generate stigma and end up blaming the family as well.

“It is important to avoid blaming messages, judgments about what children bring, or coercive strategies. The guidelines recommend acting with respect and understanding for the different family, cultural, and social realities; offering practical information on simple and affordable alternatives that facilitate habit changes, and accepting that changes and learning require time and support,” says Salvador.

For this reason, rather than monitoring every lunchbox, Public Health is committed to sharing clear guidelines, providing concrete examples of healthy breakfasts, and promoting food education activities. The researchers also recommend introducing changes gradually and involving children in the decisions. You can agree with them on breakfast from various healthy options previously defined by adults and prioritize fresh fruit, whole-grain bread, or fillings such as hummus, tomato, fresh cheese, egg, or tuna. And, above all, lead by example: family habits remain one of the main benchmarks during childhood.

A collective responsibility

“Placing all the pressure solely on caregivers and families is ineffective. Children's habits are strongly shaped by overexposure to screens and the aggressiveness of food marketing,” warn the UOC researchers. School also educates on how to eat, and not just on what is eaten. “We teachers must try to offer and promote a healthy environment around food: a routine, a welcoming space, enough time to have the meal in tranquility… As well as promoting adequate hygiene and eating habits: washing hands before lunch, having snacks while seated, chewing well, and sharing this moment with other children and adults,” comments Aina Estrades, teacher.

But neither the school nor the families can assume this responsibility alone. “The habit acquisition ecosystem depends on a structural collaboration in which government institutions, schools, public health agencies, and the community itself work together to facilitate healthy choices,” the researchers conclude.