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LCQ18: Healthy eating and weight issues of children

     Following is a question by the Dr Hon Elizabeth Quat and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (December 3):


     Currently, quite a number of whole-day primary schools and secondary schools arrange lunch suppliers (suppliers) to provide lunch for students at school. As the obesity rate among students in the 2011-2012 school year was as high as 20.9 per cent, some parents are of the view that the Government should stringently monitor the quality of the lunch provided by suppliers in order to safeguard the health of students. In this connection, will the Government inform this Council:

(1) whether suppliers are required to set out, for students' reference, the nutritional content of the food items on the menus provided to the students; if so, of the content of such requirements; if not, the reasons for that;

(2) given that some suppliers call certain food combinations on the menus "nutritional meals" or "healthy meals", whether the authorities have conducted sample checks to ascertain if the nutritional content of such combinations meet the relevant standards in the Nutritional Guidelines on Lunch for Students issued by the Department of Health; if they have, of the findings; if not, the reasons for that;

(3) whether the Government will provide suppliers with suggested food combinations for "nutritional meals" and "healthy meals" for their reference; if it will, of the details; if not, the reasons for that; and

(4) of the obesity rate among students in the 2012-2013 school year; what new plans the Government has in place to encourage students to choose lunch food that meets the principle of a balanced diet, complemented by regular exercise, with a view to bringing down the obesity rate among students?



     The Government attaches great importance to healthy eating and weight issues concerning children. In 2008, a Steering Committee on Prevention and Control of Non-Communicable Diseases, chaired by the Secretary for Food and Health, was established and the "Strategic Framework for Prevention and Control of Non-communicable Diseases" was published in the same year. Under the framework, the Government established a Working Group on Diet and Physical Activity, and launched the "Action Plan to Promote Healthy Diet and Physical Activity Participation in Hong Kong" (the Action Plan) in 2010. The Action Plan outlines 30 specific actions that different government bureaux/departments and relevant parties will work together to promote healthy diet and physical activity participation in Hong Kong over the next few years. It includes actions to promote healthy diet and physical activity participation among students at different levels such as school, family and community, so as to reduce their risk of obesity.

     To tackle the problem of childhood obesity in Hong Kong, the Department of Health (DH) has been running the (ESS) Campaign since the 2006/07 school year to raise public awareness of and attention about healthy eating of children, and to create an environment conducive to healthy eating in schools and the community. Under the ESS Campaign, an ESS Steering Committee has been set up by DH to provide comprehensive guidance and advice to the ESS Campaign. Members include representatives from relevant government departments, professional bodies, the education sector and the Committee on Home-School Co-operation. Moreover, a standing working group on suppliers of healthy lunch in schools has been set up under the Steering Committee to regularly discuss and exchange views with the lunch suppliers on how to provide healthy, delicious and nutritious lunch to students.

     The whole ESS Campaign adopts multi-pronged strategies including alliance building, publicity and advocacy, education, as well as research and evaluation to improve the nutritional environment in schools. The ESS Campaign has been favourably received by schools, students and parents. In the 2013/14 school year, the major activities under the ESS Campaign attracted the participation of over 450 primary schools (including special schools), accounting for about 70 per cent of the total number of primary schools in Hong Kong.

     Against the above background, my reply to the four parts of the question is as follows:

(1) The food items on the menus provided by lunch suppliers to students are not subject to the regulation of the Food and Drugs (Composition and Labelling) Regulations (Cap. 132W) (the Regulations). Besides, the nutrition labelling requirement under the Regulations is not applicable to food items provided to students by suppliers if such food items are non-prepackaged, or if they are prepackaged but fall under the exemption under subsections 2 or 15 of Part 1 of Schedule 6 to the Regulations (i.e., prepackaged food sold at a catering establishment which is usually bought for immediate consumption; and prepackaged food sold to a catering establishment as a single item). Nevertheless, the Centre for Food Safety of the Food and Environmental Hygiene Department has all along been enhancing the knowledge of the citizens on the nutrient values of food through various means and channels, including the design and launch of an online searchable database to provide nutrient data of commonly consumed food items which are of relevance and interests to the community.

(2) and (3) On top of the ESS Campaign, the EatSmart School Accreditation Scheme (ESAS), a project to improve and strengthen the nutritional environment in schools, was jointly launched by DH and the Education Bureau (EDB) since the 2009/10 school year. To attain accreditation status, the schools need to formulate healthy eating policies and measures, as well as foster full co-operation amongst schools, parents and food suppliers with a view to effectively implementing the nutritional requirements laid down by DH regarding the quality of lunches and snacks to be supplied in the schools. This serves to ensure that a "nutrition friendly" learning and nurturing environment is in place for school children. In addition, schools are also required under ESAS to establish an effective mechanism of monitoring nutritional quality of food and following up on related matters. For example, they are advised to conduct checks at least four times in a school year, each covering five consecutive school days, to find out if the lunch boxes comply with "Nutritional Guidelines on Lunch for Students" (the Guidelines). They should keep record of such checking and inform lunch suppliers of their observations for improvement. Participating schools will also receive professional support from DH. Upon fulfilment of the specified objective criteria, these schools will attain an accreditation status for a validity period of three years. Within the accreditation period, the schools are required to confirm with DH annually of their continuous commitment to implement relevant measures relating to the prevailing accreditation criteria. If necessary, the schools should also accept visits made by DH officers and produce to DH updated documents (e.g. relevant parts of the contracts signed with lunch suppliers, lunch menus from the past three months, records of lunch checks, documents of feedback issued to lunch suppliers, etc.) in order to maintain validity of the accreditation status. As at October 2014, over 220 primary schools (about one third of all primary schools in Hong Kong) have signed up with ESAS, and 103 of them have successfully attained accreditation status.

     In the promotion of healthy school lunch, DH has also provided many resources and assistance, as follows:

The Guidelines

     DH requires that the schools should regard the contents of the Guidelines as the benchmark of balanced nutrition to be provided to primary and secondary students by lunch suppliers, a core component specifying the quality and quantity of food in the contracts signed between schools and lunch suppliers, as well as an important basis for schools to monitor the performance of lunch suppliers within the contract period. The Guidelines have been incorporated into notices and other guidelines issued by EDB to require the primary and secondary schools in Hong Kong to provide healthy lunch to students accordingly. Overall speaking, the Guidelines aim to ensure that students are served with a nutritionally balanced school lunch that promotes normal growth and development. In line with the recommendations made by the World Health Organization, the objectives of the Guidelines are:

* to achieve energy balance and a healthy weight
* to increase consumption of fruits and vegetables
* to limit intake of total fats
* to limit intake of sugar
* to limit intake of salt (sodium)

     The recommendations in the Guidelines are divided into two parts, which should be implemented simultaneously. Part one specifies the quantity of major food items to be included in a school lunch so as to provide ideal and balanced lunch meeting the daily nutritional needs of a student. Part two specifies the quality of a lunch box and the extra food items attached to it, with the primary aim to prevent students from consuming too much fat, sugar and salt (sodium).

Handbook of Selection of Lunch Suppliers

     The "Handbook of Selection of Lunch Suppliers" (the Handbook) provides concrete assistance for schools and parents in choosing their lunch suppliers at the start of a new school year. Amongst others, it recommends that thorough consideration should be made when choosing lunch suppliers, and that such consideration should cover: the nutritional value of the lunch, the effort of suppliers to promote healthy diet among students, the eagerness of suppliers to take environmental protection measures, their scale of operation and track record, food hygiene, impressions after plant visits, etc. It is not advisable to overly emphasise on the performance of tasting sessions and pricing of meals.

Database of School Lunch Suppliers

     DH has invited lunch suppliers to provide information on whether they are able and willing to provide lunch in compliance with the Guidelines, and such information has been compiled into the "Database of School Lunch Suppliers". Up until now, over 30 lunch suppliers have had their information uploaded to the thematic website of the ESS Campaign. This initiative can increase transparency, and assist schools and parents in their search for suitable lunch suppliers.


     DH organises various types of nutrition workshops such that principals, teachers and lunch suppliers will be more confident and capable when implementing healthy diet policies on campus, understand the nutritional needs of students, have better command of the standards as listed out in the Guidelines, and use the educational resources in a more effective manner. Besides, workshops are organised by DH at the beginning of every school year to give principals and teachers a better understanding of the application of the Handbook.

(4) According to the record of the Student Health Service (SHS) of the DH, the detection rate of overweight (including obesity) for primary school students in the 2011/12 school year was 20.9 per cent, and 20.8 per cent for the 2012/13 school year. There has not been an upward trend for four consecutive years.

     The SHS Centres of DH provide health assessments, individual counselling and health education including information on healthy lifestyle, balanced diet and physical activities for secondary and primary school students. The health assessments include annual body height and body weight measurements and detection of overweight or obesity problems for each participating student. Students found to be overweight or obese would receive individual counselling by dietitians under SHS. Subject to individual conditions and needs, the student may be referred to the paediatric specialists of the Hospital Authority for follow-up. Since 2009, SHS has been notifying schools the total number of their students who were assessed by the SHS as overweight and obese in the last school year on an anonymous basis together with relevant information on healthy diet for children and weight problems. This aims to support the development of a healthy school environment, so as to encourage the schools to facilitate their students to nurture healthy lifestyles by adopting healthy dietary habits and regular physical activities. Moreover, the Adolescent Health Programme of SHS provides outreach services to participating secondary schools, which include basic life skills training and topical programmes on balanced diet, etc.

Ends/Wednesday, December 3, 2014
Issued at HKT 15:43


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