School food policy at primary and secondary schools in Belgium-Flanders: does it influence young people's food habits?

Objective: To describe the availability of food items at primary and secondary schools in Belgium-Flanders and to examine the influence of school food policy (availability of food items, school food rules, nutrition education programmes) and aggregated school socioeconomical status (AGG SES) on the consumption of fruit, soft drinks, crisps and sweets, using multilevel modelling. Design, setting and subjects: In spring 2002, 360 schools were invited to participate in the Health Behaviour in School-aged Children survey. In January 2003, the same schools were asked to complete a short school policy questionnaire. Pupils of 197 schools participated in the pupil survey (n = 16560); 247 school principals completed the school questionnaire; for 157 schools data were available for both (n = 12360). Results: Mineral water, fruit juice, chocolate milk, and soup were available in most schools. Whole fat milk was available in most primary schools; soft drinks, diet soft drinks and biscuits were available in most secondary schools. Fruit was available in 14% of primary and 26% of secondary schools. Assessment of the variation in the outcome variables revealed no significant between-school variation in primary schools, but considerable variation between secondary schools in the consumption of soft drinks, sweets and crisps (but not fruit). School characteristics explaining some of this school variance independent of pupil level characteristics were: for soft drinks: availability at the school, rules regarding the consumption of sweets and AGG SES; for sweets: AGG SES; and for crisps: rules regarding the consumption of savoury snacks and AGG SES. Conclusion: The results indicate that school food policy can have an impact on adolescents' food habits.