LCQ20: School lunch boxes - Government World Magazine

Following is a question by the Hon Nixie Lam and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (November 20):

Question:

There are views that at present, school lunch boxes (lunch boxes) in Hong Kong are plagued with problems such as poor taste, insufficient nutrition, limited menu choices and excessive sodium, which may affect the development of school children during their critical growth stages. In this connection, will the Government inform this Council:

(1) given that according to the Department of Health's Student Health Service Annual Health Report for 2022/23 School Year, the prevalence of overweight (including obesity) among primary and secondary school students in the 2022-2023 school year were 19.5% and 20.5% respectively, and there are views that this has reflected the increasingly serious problem of childhood obesity, whether the authorities will formulate guidelines on the nutrition standards of lunch boxes with a view to reducing their oil and sodium content, and focus on improving the taste and quality of lunch boxes, so as to ensure that school children will be able to take in the necessary nutrition;

(2) whether it will step up the regulation of lunch box suppliers and conduct more stringent tests in light of the relevant hygiene standards, so as to ensure that lunch boxes are fresh and hygienic; and

(3) whether it will require schools to establish effective communication channels and feedback mechanisms with parents, so as to notify parents of the problems concerning the quality of lunch boxes in a timely manner, and enable parents to know about the quality of lunch boxes and give their comments at once?

Reply:

President,

The Government attaches great importance to healthy eating and weight issues among children. Healthy eating promotes healthy growth of school children and reduces their risks of chronic diseases such as heart disease, diabetes and certain types of cancers. The Department of Health (DH) and the Education Bureau (EDB), with the support of the education sector, the medical sector and relevant professional bodies, have launched the EatSmart@school.hk Campaign (ESS) since the 2006/07 school year to raise public awareness of and attention to healthy eating of children, and to create an environment conducive to healthy eating in schools and the community. Over the years, the ESS has been enhanced based on the necessity. At present, the ESS mainly comprises the EatSmart School Accreditation Scheme which aims at providing guidance to schools for developing a healthier eating environment on campus through accreditation; the Salt Reduction Scheme for School Lunches which aims to enhance the collaboration with lunch suppliers to reduce the sodium content in school lunches; and the Joyful Fruit Month which aims to cultivate the daily habit of fruit consumption among school children.

The fundamental cause of obesity problem is an energy imbalance between the calories consumed from food as well as beverages and the calories expended in by normal body functions along with daily activities. Lack of physical activity is one of the main risk factors for obesity. Children should also regularly engage in sufficient amount of physical activities to reduce fat accumulation in order to make the weight control effect more lasting.

Meanwhile, education and health are closely intertwined, and are of paramount importance to personal growth. Schools play a key role in student development by providing effective and extensive health promotion. At the same time, good communication and collaboration between home and school can set a common goal for healthy living and education for children.

In consultation with the EDB, the Environment and Ecology Bureau (EEB) and the DH, the reply to the question raised by the Hon Nixie Lam is as follows:

(1) The DH's Student Health Service Centres (SHSCs) provide annual health assessment service to all daytime primary and secondary school students to identify health problems at an early stage for timely advice and intervention. Among the primary and secondary school students attending the SHSCs in the 2022/23 school year, the prevalence of overweight (including obesity) was 19.5 per cent and 20.5 per cent respectively. The preliminary figures for the 2023/24 school year (as at the end of August 2024) show a slight improvement in the overweight (including obesity) situation among primary school students, with a prevalence of 16.3 per cent, while the prevalence for secondary school students is 20.0 per cent.

The DH has published and updated the Nutritional Guidelines on Lunch for Students (Guidelines) since 2006 to ensure that primary and secondary school students can have nutritionally balanced school lunches that meet the needs of their growth and development, and serve as a reference for the quantity and quality of food as stipulated in the contracts signed between schools and lunch suppliers. The Guidelines encompass the sodium level of lunches when preparing the recipes and during the cooking process, providing at least one serving of vegetables in lunches, keeping the volume ratio of grains, vegetables and meat in lunches at a ratio of three: two: one and increasing the ratio of whole grains, etc. In addition, the DH recommends the use of ingredients low in oil, salt, and sugar, and use more natural ingredients, herbs, and spices to enhance the flavour of dishes, making lunches more appetising. The DH regularly discusses with lunch suppliers, advising them to prepare food with reference to the Guidelines to ensure the lunches meet the recommended nutritional requirements.

The EDB issues circulars and guidelines to call on schools to refer to the Guidelines published by the DH, as well as the guidelines issued by other relevant government departments, to formulate and implement a policy on healthy eating; and to pay attention to the nutritional quality of lunches and make appropriate arrangement when selecting lunch suppliers. Besides, the DH encourages schools to monitor school lunches regularly in accordance with its School Lunch Monitoring Manual and to reflect their opinions to lunch suppliers to ensure the nutritional quality of school lunches.

In addition, the DH launched the Health Promoting School Programme as a pilot project in 30 schools from the 2019/20 to 2022/23 school years. Since 2023/24 school year, the DH has regularised the programme and named it Whole School Health Programme (WSHP), to further promulgate the Health Promoting School framework advocated by the World Health Organization (WHO) and assist participating schools to become a health-promoting school for living, learning and working, including enhancing physical activities and diet arrangements.

The DH has been encouraging members of the public to do more physical activities through different channels. For example, it has launched the "I'm So Smart" Community Health Promotion Programme since 2012, which aims to enhance community collaboration and promote healthy living model with healthy eating and regular physical activities; launched the "10 000 Steps a Day" campaign since 2022 with a series of publicity activities in the community in phases to promote walking, including organising walking challenges, producing promotional videos and thematic website. The DH will continue to encourage the public (including children) to do more physical activities and establish an active lifestyle through various channels.

In the future, the Government will continue to collaborate with schools and parents to improve healthy eating and weight issues among children. In the 2024 Policy Address, the Government has put forward measures to create a better environment for the healthy growth of children. The relevant measures include:

(i) To formulate a life-course approach health promotion strategy having regard to Hong Kong's demographic structure and the health needs of different social groups (including school children) and draw up health management plans according to different age groups and health statuses so as to enhance public health comprehensively and systematically; and

(ii) To strengthen and extend the WSHP to cover all primary and secondary schools in Hong Kong and provide guidelines to each school to improve school health policies and establish healthy school environment to implement the WHO's recommendations of engaging in an average of at least 60 minutes of moderate-to-vigorous-intensity physical activity every day and developing healthy eating habits. Health reports will also be compiled for each participating school to recommend school-based measures to improve the arrangement of students' physical activities and meals, etc., with a view to further improving students' physical and psychological well-being. The WSHP covers four health themes, including physical activity, healthy eating, mental health, and social well-being. The DH will provide health promotional activities, workshops, and information to assist schools in carrying out school-based health promotion. The WSHP has set up a dedicated website to provide schools with recommendations and resources related to physical activities and healthy eating.

Meanwhile, the Primary Healthcare Commission is also actively implementing various measures to help citizens manage their own health in accordance with the Primary Healthcare Blueprint, including promoting the Life Course Preventive Care Plan through District Health Centres (DHCs), which aims to provide services to citizens including guidance on healthy lifestyle practices, in order to address their health needs at different life stages. For children and adolescents, guidance on balanced diet and regular physical activity is provided under the Life Course Preventive Care Plan to promote healthy growth and overall well-being. The DHCs also offer different types of support to the general public (including children and adolescents), such as providing recommendation on weight management, organising healthy diet talks, and collaborating with schools to provide health education, health risk factors assessment, low salt and sugar diet education and promotion activities, etc.

(2) According to the information provided by the EEB, the Food and Environmental Hygiene Department (FEHD) has all along strived to ensure that the food factories supplying school lunches comply with the licensing conditions and the relevant statutory requirements on food safety and environmental hygiene through its licensing regime, inspections, and enforcement actions in accordance with the Public Health and Municipal Services Ordinance (Cap. 132) and the Food Business Regulation (Cap. 132X). The FEHD conducts regular and blitz inspections on a risk-based basis. If irregularities were detected, FEHD staff would issue warnings or instigate prosecution to regulate the food factories and safeguard food safety.

The Centre for Food Safety (CFS) of the FEHD has been collecting food samples (including from school lunch boxes) on a risk-based approach, for chemical and microbiological tests through its regular Food Surveillance Programme to ensure food sold in Hong Kong complies with relevant requirements and is fit for human consumption.

To cater for the new school year, between July and October 2024, the FEHD has inspected all the 46 licensed food factories supplying school lunch boxes while the CFS has collected over 130 lunch box samples from these licensed food factories supplying school lunch boxes. Test results of all samples were satisfactory.

To safeguard food safety on campuses, lunch box caterers should handle students' lunch boxes properly, adhering to basic principles of food hygiene and safety, including the storage and temperature requirements during food delivery. Hot meals should be kept at temperatures preventing bacterial growth until they are delivered to schools. Besides, the CFS has published the guideline "Developing a School Food Safety Plan Based on HACCP system (for School Lunch Box Caterers)" for lunch box caterers' reference to remind them to take appropriate measures to enhance the safety of lunch box production and prevent food contamination hazards. The CFS has also arranged seminars for lunch box caterers and schools to provide information on the Hazard Analysis and Critical Control Point system, safety of lunch boxes, high-risk foods and how to implement the Five Keys to Food Safety, etc.

(3) Home and school are the main environment where children learn and develop healthy eating habits. Home-school co-operation is the key to help children develop good eating habits.

According to the information provided by the EDB, in the process of selecting lunch supplier, schools will discuss with and seek approval from the management authority such as the Incorporated Management Committee, which comprises parent representatives to reflect parents' views. In addition to the above-mentioned channel, the EDB encourages schools to invite parents to participate in the discussion of lunch arrangements, for example, engaging them in the lunch supplier selection team to develop lunch requirements, selection criteria, marking scheme and major terms of the tender/contract. Schools should also communicate with parents on the nutritional value of the lunch provided and invite their feedback in order to monitor the quality of school lunch jointly on an ongoing basis.