Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T10:32:57.016Z Has data issue: false hasContentIssue false
  • English
  • Français

Free school meals and children's social and nutritional status in Trinidad and Tobago

Published online by Cambridge University Press:  22 December 2006

MC Gulliford ,
D Mahabir ,
B Rocke ,
S Chinn  and
RJ Rona
MC Gulliford*
Affiliation:
Department of Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK
D Mahabir
Affiliation:
Nutrition and Metabolism Division, Ministry of Health, Trinidad and Tobago
B Rocke
Affiliation:
Nutrition and Metabolism Division, Ministry of Health, Trinidad and Tobago
S Chinn
Affiliation:
Department of Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK
RJ Rona
Affiliation:
Department of Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK
*
*Corresponding author: Email martin.gulliford@kcl.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To evaluate the provision of free school meals in Trinidad and Tobago in relation to children's social and nutritional status.

Design and methods: Cross-sectional survey of a nationally representative sample of 66 government schools, including children in the admissions classes (aged 4 to 7 years) and classes for ‘rising nines’ (aged 7–10 years). Data included questionnaire details of free school meals and children's social background, and measurements of children's heights, weights and skinfold thicknesses.

Results:

Of 6731 eligible children, data were analysed for 5688 (85%). There were 2386 (42%) children receiving free meals provided at school. At different schools the proportion of all children receiving free meals ranged from 20% to 100%, P < 0.001. Receipt of free meals was associated with larger family size (one child, 32% received free meals; ≥6 children, 63%), lower paternal educational attainment (primary, 52% free; university, 30%), father's employment (employed, 39% free meals; unemployed <12 months, 59%) as well as maternal education and employment and household amenities. After adjusting for age, sex and ethnic group, children who received free meals were shorter (mean difference in height standard deviation score (SDS) –0.12, 95% confidence interval (CI) –0.17 to –0.06), lighter (body mass index SDS –0.21, –0.28 to –0.14) and thinner (subscapular skinfold SDS –0.13, –0.18 to –0.09).

Conclusions:

Free school meals were widely available, with some targeting of provision to children with less favourable social and nutritional status. Greater universality would reduce inequity, but more stringent targeting and reduction of school-level variation would increase efficiency.

Keywords

ChildrenNutritional statusSchool mealsUnemploymentEducationTrinidad and TobagoWest Indies
Type
Research Article
Information
Public Health Nutrition , Volume 5 , Issue 5 , December 2002 , pp. 625 - 630
Copyright
Copyright © CABI Publishing 2002

References

1Sinha, DP. Children of the Caribbean. Kingston, Jamaica: Caribbean Food and Nutrition Institute, PAHO/CFNI, 1988;185.Google Scholar
2Gulliford, MC. Health and health care in the English-speaking Caribbean: a British public health physician's view of the Caribbean. J. Public Health Med. 1994;16:263–9.Google ScholarPubMed
3Gulliford, MC, Mahabir, D, Rocke, B, Chinn, S, Rona, RJ. Overweight, obesity and skinfold thicknesses of children of African or Indian descent in Trinidad and Tobago. Int. J. Epidemiol. 2001;30:989–98.CrossRefGoogle ScholarPubMed
4Cameron, N. The methods of auxological anthropometry. In: Falkner, F, Tanner, JM, eds. Human Growth. A Comprehensive Treatise. Vol. 3. Methodology, Ecological, Genetic and Nutritional Effects on Growth. New York: Plenum Press, 1986;3–46.CrossRefGoogle Scholar
5Tanner, JM, Whitehouse, RH. Revised standards for triceps and subscapular skinfolds in British children. Arch. Dis. Child. 1975;50:142–5.CrossRefGoogle ScholarPubMed
6Republic of Trinidad and Tobago, Central Statistical Office. 1990 Population and Housing Census. Vol.2. Age Structure, Religion, Ethnic Group, Education. Port of Spain: Office of the Prime Minister, Central Statistical Office, 1994.Google Scholar
7Freeman, JV, Cole, TJ, Chinn, S, Jones, PR, White, EM, Preece, MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch. Dis. Child. 1995;73:17–24.CrossRefGoogle ScholarPubMed
8Cole, TJ, Freeman, JV, Preece, MA. Body mass index reference curves for the UK, 1990. Arch. Dis. Child. 1995;73:25–9.CrossRefGoogle ScholarPubMed
9Cole, TJ. Fitting smoothed centile curves to reference data (with discussion). J. Roy. Statist. Soc. A 1988;151:385–418.CrossRefGoogle Scholar
10Stata Corporation. Stata Reference Manual. Release 7. Vol. 4 Su-Z. College Station, TX: Stata Corporation, 2001.Google Scholar
11Grantham-McGregor, SM, Chang, S, Walker, SP. Evaluation of school feeding programs: some Jamaican examples. Am. J. Clin. Nutr. 1998;67:785S–9S.CrossRefGoogle ScholarPubMed
12Gordon, AR, Devaney, BL, Burghardt, JA. Dietary effects of the National School Lunch Program and the School Breakfast Program. Am. J. Clin. Nutr. 1995;61:221S–31S.CrossRefGoogle ScholarPubMed
13Baker, IA, Elwood, PC, Hughes, J, Jones, M, Moore, F, Sweetnam, PM. A randomised controlled trial of the effect of the provision of free school milk on the growth of children. J. Epidemiol. Community Health 1980;34:31–4.CrossRefGoogle ScholarPubMed
14Rona, RJ, Chinn, S. School meals, school milk and height of primary school children in England and Scotland in the eighties. J. Epidemiol. Community Health 1989;43:66–71.CrossRefGoogle ScholarPubMed
15Powell, CA, Walker, SP, Chang, SM, Grantham-McGregor, SM. Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children. Am. J. Clin. Nutr. 1998;68:873–9.CrossRefGoogle ScholarPubMed
16Chandler, AM, Walker, SP, Connolly, K, Grantham-McGregor, SM. School breakfast improves verbal fluency in undernourished Jamaican children. J. Nutr. 1995;125:894–900.Google ScholarPubMed
17Maurer, KM. The National Evaluation of School Nutrition Programs: program impact on family food expenditures. Am. J. Clin. Nutr. 1984;40:448–53.CrossRefGoogle ScholarPubMed
18Gelbach, JB, Lant, HP. More for the Poor is Less for the Poor: Politics of Targeting. Working Paper 1799. New York: World Bank, 2001.Google Scholar
19Rona, RJ, Chinn, S. Parents' attitudes towards school meals for primary school children in 1981. Hum. Nutr. Appl. Nutr. 1984;38:187–98.Google ScholarPubMed
20Glovinsky-Fahsholtz, D. The effect of free or reduced-price lunches on the self-esteem of middle school students. Adolescence 1992;27:633–8.Google ScholarPubMed
21Jacoby, HG. Self-selection and the redistributive impact of inkind transfers – an econometric analysis. J. Hum. Resource. 1997;32:233–49.CrossRefGoogle Scholar
22Walker, SP, Powell, CA, Hutchinson, SE, Chang, SM, Grantham-McGregor, SM. School children's diets and participation in school feeding programmes in Jamaica. Public Health Nutr. 1998;1:43–9.CrossRefGoogle ScholarPubMed
23Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. Br. Med. J. 2000;320:1–6.CrossRefGoogle ScholarPubMed
24Wechsler, H, Devereaux, RS, Davis, M, Collins, J. Using the school environment to promote physical activity and healthy eating. Prev. Med. 2000;31:S121–37.CrossRefGoogle Scholar
25Pannell, DV. Why school meals are high in fat and some suggested solutions. Am. J. Clin. Nutr. 1995;61:245S–6S.CrossRefGoogle ScholarPubMed
26Rose, R, Falconer, P. Individual taste or collective decision – public policy on school meals. J. Social Policy 1992;21:349–73.CrossRefGoogle Scholar