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School food and nutrition education (FNE) is fundamental to promote healthy eating and hygiene habits, necessary for the realization of the right to adequate food (FAO, 2020). In this context, the Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security call for measures that promote healthy consumption habits (FAO, 2004). Likewise, the Framework Law on School Feeding of the Latin American and Caribbean Parliament emphasizes the importance of incorporating FNE into the school curriculum, by requiring States to include FNE in primary, basic, and adult education programs.

Several countries in the Latin American and the Caribbean Region have passed legislation echoing the Model Law. For example, the School Feeding Law of Guatemala includes FNE as one of its principles (Article 6), highlighting it as a key factor in achieving the objectives of the school feeding program (Article 10).

The inclusion of FNE in schools to promote healthy diets is key in combating malnutrition in all its forms (FAO & WHO, 2019). However, the question has been asked as to whether all factors that impact food and nutrition at school age are being considered.

According to the World Health Organization (WHO), in 2019 about 14 million people suffered from eating disorders (ED), including approximately 3 million children and adolescents (WHO, 2022). EDs are disorders that manifest themselves in harmful behaviours and preoccupations around food and eating and are generally accompanied by an obsession with body image and weight (WHO, 2024). These include binge eating disorder, bulimia and anorexia nervosa, the latter being one of the mental disorders with the highest mortality rate (WHO, 2021). EDs can lead to malnutrition both by overnutrition and undernutrition. Additionally, they present a high rate of comorbidity, mainly coupled with anxiety, depression, and substance abuse (WHO, 2021).

The Committee on the Rights of the Child (CRC) and the Committee on the Elimination of Discrimination against Women (CEDAW) have expressed concern about what they describe as an “epidemic” of EDs (CRC & CEDAW, 2014) that occurs in the context of increasingly weakened adolescent mental health (CRC, 2013). Although EDs are mostly diagnosed in adults, these diseases tend to start in childhood and adolescence upon exposure to unhealthy food environments (WHO, 2018). Incidence among women is prevalent, owing to gender-associated patterns (CRC & CEDAW, 2014).

EDs, in addition to affecting health, pose a threat to food and nutritional security, especially for women, children, and adolescents. They also prevent the full enjoyment of the right to adequate food, no just due to lack of physical or economic access to healthy food, but rather as a result of behaviours associated with a mental condition that prevents people from exercising agency tools to nourish themselves properly. In this regard, both the CRC and the WHO have highlighted the importance of prevention, especially among minors, encompassing educational environments and proper or controlled use of digital media such as social media and advertising (CRC, 2021; WHO, 2021).

Countries such as Argentina, El Salvador, Mexico, Guatemala, Colombia, Panama, Paraguay, Brazil, Ireland, Lesotho, Nigeria, Kenya, Lebanon, Pakistan and the Marshall Islands have identified EDs as a specific challenge and have decided to address this either in their national nutrition plans and programs or through legislation. The common factor in these initiatives is the preventive approach, through awareness and capacity-building campaigns using FNE in schools. Thus, the aim is to avoid the normalization of these behaviours through information and empowerment of minors and the school community. Some countries regulate ED prevention and obesity. For example, the third chapter of the Law on Nutrition and the Fight against Obesity in the State of Yucatan in Mexico establishes measures for the prevention and treatment of obesity, undernutrition and ED, reflecting the understanding that EDs are not exclusively linked to undernutrition, but may also be connected to obesity.

This type of action is aligned with the CRC's calls to adopt legislative and administrative measures to protect the mental health of children and adolescents. The CRC has stated that in these matters a multisectoral preventive approach is required, especially in school food environments (CRC, 2013; CRC, 2016; CRC, 2021).

Therefore, FNE from childhood and adolescence not only presents an opportunity to improve healthy diets and avoid overweight, but also to prevent EDs, to inform about its consequences, strengthen capacities as well as to provide an early warning and diagnosis system that protects children and adolescents from this silent threat.

Abril Venegas (Former FAO Consultant) 

References:

CRC. 2013. General comment No. 15 on the right of the child to the enjoyment of the highest attainable standard of health. Available at: https://www.refworld.org/legal/general/crc/2013/en/96127.

CRC. 2016. General comment No. 20 on the implementation of the rights of the child during adolescence. Available at: https://docs.un.org/en/CRC/C/GC/20.

CRC. 2021. General comment No. 25 on children’s rights in relation to the digital environment. Available at: https://www.unicef.org/bulgaria/en/media/10596/file.

CRC & CEDAW. 2014. Joint general recommendation No. 31 of the Committee on the Elimination of Discrimination against Women/general comment No. 18 of the Committee on the Rights of the Child on harmful practices. Available at: https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/TBSearch.aspx?SymbolNo=CEDAW/C/GC/31/CRC/C/GC/18.

FAO. 2004. Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security. Rome. Available at: https://openknowledge.fao.org/server/api/core/bitstreams/1898ca74-1041-4741-a53a-295af3c09a17/content.

FAO & WHO. 2019. Sustainable healthy diets – guiding principles. Rome. Available at: https://openknowledge.fao.org/server/api/core/bitstreams/03bf9cde-6189-4d84-8371-eb939311283f/content.

FAO. 2020. Legislating for adequate food and nutrition in schools. Available at: https://openknowledge.fao.org/server/api/core/bitstreams/0b3fb7e7-9999-47c6-8faa-44394d57213a/content.

WHO. 2018. Implementing effective actions for improving adolescent nutrition. Geneva. Available at: https://www.who.int/publications/i/item/9789241513708.

WHO. 2021. Mental health of adolescents. Available at: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.

WHO. 2022. Mental disorders. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-disorders.

WHO. 2024. Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. Geneva. Available at: https://www.who.int/publications/i/item/9789240077263.

PARLATINO. 2012. Framework Law on School Feeding. Panama City. Available at: https://parlatino.org/wp-content/uploads/2017/09/ley-alimentacion-escolar-ing.pdf.