Obesity Abstracts

Background: Evidence suggests that the diet quality of children consuming school meals tends to be better than that of children consuming packed lunches or food brought from outside school. This study aims to investigate the association between the types of lunch consumed in a school day and diet quality of UK adolescents.

Methods: 2118 British adolescents were included from the National Diet and Nutrition Survey (Years 1–8). All participants were aged 11–18 years with valid 3 or 4-day diary records and attended school. The Diet Quality Index for Adolescents (DQI-A) tool was used to assess the adherence of British adolescents to dietary recommendations. The DQI-A consists of three main components; dietary quality (DQc), dietary diversity (DDc) and dietary equilibrium (DEc) which are presented in percentages. The DDc and DEc percentage ranges are 0 –100%, whereas the DQc percentage range is –100 to 100%. The overall DQI-A score ranges from –33 to 100% and a higher DQI-A% score reflects a better quality of diet.

Results: The overall mean DQI-A score for all adolescents was low at 21.0%. Cooked school lunch meals and packed lunches were the most popular lunch type. Adolescents who reported buying lunches from cafés and shops had the lowest DQI-A% score of 14.8%. Adolescents having cooked school meals (reference group) had a higher overall DQI-A% of 21.8%. Diet quality scores of adolescents having packed lunches and takeaway lunches were 1.6% higher (CI =0.1, 3.2; P=0.04) and 8.2% lower (CI=6.2, 10.2; P< 0.01) than the reference group respectively, after adjusting for confounders including age, sex and household income. In addition, significant differences were observed between cooked school meal consumers and packed lunches and takeaway consumers for most of the DQI-A components and subcomponents, after adjusting for confounders.

Conclusions: UK adolescents have a low-quality diet and lunch type has an impact on diet quality. Adolescents consuming takeaway lunches from outside the school gates have the lowest DQI-A score. These results confirm the importance of implementing and evaluating regulation policies regarding food outlets around secondary schools as well as improving food choices within school premises.