School breaktimes: Opportunities for promoting health enhancing diet and physical activity

1. School breaktimes: Opportunities for promoting health enhancing diet and physical activity Flo Harrison University of East Anglia, School of Environmental Sciences UKCRC Centre for Diet and Physical Activity, Institute for Public Health, Cambridge 24th January 2012

2. Why schools? • Schools are important settings for health promotion • Children are there a lot • Schools are already designed to shape knowledge and behaviour through education • The provide space and facilities for food and drink consumption and physical activity.

3. Why breaktimes? • Key opportunity for free play within school hours • The main time during which children interact with the school food environment

4. Analysis 1 • Food and drink consumption at school lunchtime: the impact of lunch type and contribution to overall intake in British 9–10-year-old children • Flo Harrison*1, Amy Jennings2, Andy Jones*1, Ailsa Welch2, Esther van Sluijs*3, • Simon Griffin*3 and Aedín Cassidy2 • UKCRC Centre for Diet and Physical Activity, Institute for Public Health, Cambridge • 1 School of Environmental Sciences, University of East Anglia, Norwich NR4 7JT, UK • 2 Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK • 3 Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK • In Press Public Health Nutrition (2012) doi:10.1017/S1368980011002321

5. Food and drink consumption at school lunchtime • Research questions • How does lunchtime consumption differ between those eating packed lunches and those having school meals? • Is there evidence of a school influence on lunchtime intake? • How do any differences in school lunchtime intake impact overall intake?

6. Adjusted mean intake at lunchtime on school days Fruit & vegetables 71.9 69.6 Fruit * 51.0 20.3 Vegetables * 20.9 47.6 Fruit juice 46.9 46.5 Fizzy drinks 1.9 3.0 Squash * 82.7 20.3 Savoury snacks * 10.4 2.5 Confectionary * 11.0 2.8 Chips * 6.1 23.0 100 75 50 25 0 25 50 75 100 mean intake (g) Packed lunches School meals

7. Adjusted mean intake over whole day Food and drink consumption at school lunchtimeExplanatory line if required. Fruit & Vegetables 196.9 202.3 Fruit * 100.2 90.3 Vegetables * 96.7 112.0 • Results II • Secondary text • Bullet • Bullet Fruit Juice 134.1 139.9 Fizzy Drink 81.1 83.8 Squash * 191.0 150.1 Savoury snacks * 14.0 10.2 Confectionary * 21.5 17.7 Chips * 30.3 37.7 - 250 - 200 - 150 - 100 - 50 0 50 100 150 200 250 mean intake (g) < - Packed lunches School meals - >

8. Mean intake at lunchtime on school days as % of intake over whole day Food and drink consumption at school lunchtimeExplanatory line if required. Fruit & Vegetables 36.5% 34.4% Fruit * 50.9% 22.5% Vegetables * 21.6% 42.5% • Results II • Secondary text • Bullet • Bullet Fruit Juice 35.0% 33.2% Fizzy Drink 2.3% 3.6% Squash * 43.3% 13.5% Savoury snacks * 74.4% 24.4% Confectionary * 51.0% 15.8% Chips * 20.2% 61.1% - 250 - 200 - 150 - 100 - 50 0 50 100 150 200 250 mean intake (g) < - Packed lunches School meals - >

9. Food and drink consumption at school lunchtime • Conclusions and policy implications • Difference in intake between school meal and packed lunch eaters • School meal intake is in line with standards • For specific food groups school lunch consumption is important

10. Analysis 2 • The impact of rainfall and school break time policies on physical activity in 9-10 year old British children: a repeated measures study • Flo Harrison*1, Andrew P Jones1, Graham Bentham1, Esther MF van Sluijs2, Aedín Cassidy3 and Simon J Griffin2 • * UKCRC Centre for Diet and Physical Activity, Institute for Public Health, Cambridge • 1 School of Environmental Sciences, University of East Anglia, Norwich, NR4 7JT, UK. • 2 Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK • 3 School of Medicine, University of East Anglia, Norwich, NR4 7JT, UK • International Journal of Behavioral Nutrition and Physical Activity 2011, 8:47

11. The impact of rainfall and school policies on physical activity • Research Questions • What is the relationship between physical activity and rainfall? • Can school policies moderate the relationship between physical activity and rainfall?

12. The impact of rainfall and school policies on physical activityResults Results I Minutes MVPA over whole day Minutes MVPA over school lunchbreak Minutes MVPA 0 0.1-0.3 0.4-3.3 0 3.4+ 0.1-0.3 0.4-3.3 3.4+ Total daily rainfall (7am-9pm)

13. The impact of rainfall and school policies on physical activity

14. Minutes MVPA 3.4+ 0 0.1-0.3 0.4-3.3 Total daily rainfall (7am-9pm)

15. Minutes MVPA 3.4+ 0 0.1-0.3 0.4-3.3 Total daily rainfall (7am-9pm)

16. The impact of rainfall and school policies on physical activity • Conclusions • The relationship between rainfall and physical activity is moderated by school policy • Children allowed to play outdoors in wet weather are less active than those who can be active indoors • By allowing children to be physically active indoors in wet weather, schools may help children maintain activity levels.

17. ACKNOWLEDGEMENT This work was undertaken by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.