Healthy School Lunches and Lunchboxes

School lunch is often the one meal a parent does not see being eaten. Packing it well is less about rules and more about a simple pattern you can repeat all week with whatever is in the kitchen.

What should a school lunch contain?

The NHS advises building a lunchbox around starchy foods such as bread, rice, pasta and potatoes, choosing wholegrain where you can. Then add the other parts:

• A protein food. The NHS suggests lean meats such as chicken or turkey, or fish such as tuna or salmon. Eggs and pulses such as chickpeas or lentils work the same way.
• Vegetables. The NHS names cherry tomatoes and sticks of carrot, cucumber, celery and peppers, and says these count towards a child's 5 A Day.
• Fruit. Chopped apple, peeled orange segments, strawberries, halved grapes or slices of melon are all suggested by the NHS.
• A dairy food. The NHS suggests lower-fat, lower-sugar yoghurt.

The United States Centers for Disease Control and Prevention (CDC) describes the same healthy pattern for children aged two and over: a variety of fruits and vegetables, whole grains, low-fat dairy, a variety of protein foods and oils, while limiting solid fats, added sugars and sodium.

How much fruit and vegetables does a child need?

WHO advises at least 400 grams of fruit and vegetables a day for everyone over 10 years old, and 250 to 350 grams for younger children depending on age. A lunchbox is a good place to fit in two of those portions.

What swaps make the biggest difference?

The NHS suggests a few changes that are easy to keep up:

• Include crisps less often, and swap them for plain homemade popcorn or plain rice cakes.
• Swap cakes, chocolate, cereal bars and biscuits for fruit, fruit bread or fruited teacakes.
• Choose lower-fat spread and reduced-fat cheese, and use less of the high-fat, high-salt cheeses.
• Go easy on mayonnaise in sandwiches.

WHO advises limiting free sugars to less than 10% of daily energy, and says cutting to 5% or less may bring extra benefits. WHO also advises adults to keep salt under 5 grams a day, so salty packet snacks are worth rationing for the whole family.

What should children drink at school?

Water is the everyday choice. The CDC notes that most young people do not drink the recommended amount of water, and that drinking enough water may improve thinking in children and teenagers, which matters for learning. Plain milk is a useful option too. Fizzy drinks and juice drinks add sugar without adding much else.

Does lunch really affect schoolwork?

Food and learning are connected. The CDC reports that eating a healthy breakfast is linked with better thinking skills, especially memory, fewer days absent from school, and better mood. Do not skip breakfast to make lunch "count" more.

What does a week of lunches look like?

Rotate a handful of combinations rather than inventing something new daily. For example: roti roll with shredded chicken and cucumber; rice with lentils and a boiled egg; a wholemeal sandwich with cheese and tomato; chana chaat with carrot sticks. Add a piece of seasonal fruit such as banana, guava or orange, a small pot of yoghurt, and a bottle of water.

When to see a doctor

Talk to a health worker if your child:

• Is not gaining weight, is losing weight, or has fallen behind other children in height.
• Keeps refusing food, or brings the lunchbox home untouched most days.
• Is often tired, pale, or unable to concentrate in class.
• Complains of tooth pain, or has visible tooth decay.
• Has stomach pain, diarrhoea or vomiting after eating certain foods.

If a child has swelling of the face or lips, a spreading rash, or trouble breathing after eating, call Rescue 1122 where available, or go to the nearest hospital emergency department.