Schools offer an important setting for prevention of noncommunicable diseases through its potential to support the development of healthy habits in children. The aims of this study were to examine headmaster awareness of national or regional policies and the association of this with school food policies and practices, and to assess whether having a school food policy or healthful food practices were associated with fruit and vegetable intake and overweight in children.
The Pro Children cross-sectional survey of school headmasters (n = 352) from nationally representative samples in nine European countries was conducted in 2003. School level data were matched with data on 11-year old children from child and parent surveys undertaken in the same schools. Descriptive statistics were used to examine awareness, existence and content of school polices and practices and logistic regression was used to study possible associations between school policies and practices and indicators of children's health.
Forty percent of headmasters were aware of either a national or regional policy related to food in school and 61% of all the schools had their own food policy. Teaching the importance of healthy eating was the most frequently reported policy component and restricting vending machines was the most frequent practice. Headmaster awareness of a national or regional policy increased the likelihood of schools having their own policy (OR = 3.53). Neither policy nor practices were associated with the health outcomes in children. Having a high proportion of children from low-income families was associated with a high proportion of overweight children at school (OR = 3.33).
Headmaster awareness of national or regional policies related to food in schools increases the likelihood that the school has its own policy and that certain healthful practices are followed. Whereas this study did not find any significant associations between school level policy or practices and health outcomes in children, further research on possible links is warranted, preferably applying longitudinal design with assessment of effectiveness and cost-effectiveness of implemented policy changes.