Sugar Free Soft in Secondary Schools Evidence Report and Proposals Aberdeen City Council - Sugar Free Soft Drinks in Secondary Schools

Introduction Following the introduction of new nutritional regulations in schools on the 12 April 2021, there have been a number of adaptations to the school catering provision in schools. Secondary head teachers and parents have raised concerns regarding the introduction of sugar free soft drinks.

Main areas of concern raised by parents and head teachers -

1. Lack of consultation and collaboration with schools, parents and young people 2. Young people purchasing caffeinated drinks multiple times throughout the school day 3. Young people with ADHD purchasing caffeinated drinks leading to hyperactivity 4. Larger 330ml cans being put into rubbish bins without being finished 5. Removal of alternative drinks 6. Cook in charge worried about providing sugar free soft drinks

It was agreed that the three newly introduced sugar free soft drinks would be temporarily taken off of the school catering provision from the 5 May 2021 for the remainder of the school term. This will allow time to consult with head teachers, parents and young people and identify a mutually agreed way forward.

This paper will discuss the evidence base surrounding the provision of sugar free soft drinks in schools and propose next steps. Changes to School Food and Regulations NHS Health Scotland, Food Standards Scotland and Education Scotland reviewed the existing School Food and Drink Regulations and provided evidence based recommendations. The primary focus was the health and wellbeing of children and young people.

Permitted drinks – sugar free drinks (excluding high - 150mg per litre)

Statement from the Technical Working Group (TWG) Paper -

The TWG consulted with catering and education colleagues who felt that the range of drinks currently provided in schools were not attractive to young people and that this was a contributory factor to young people leaving school at lunchtime to purchase their lunch out of school.

This evidence, along with the need to reduce sugar intake considerably, led to the TWG recommending that sugar free drinks be included within the permitted list in schools. The drinks standard is a permitted list, meaning that the choice of drinks provided from the list is at the discretion of schools, Local Authorities and other providers.

However, it should be noted that in accordance with ‘The Schools (Health Promotion and Nutrition (Scotland)) Act 2007’ children and young people should have access to free drinking water across the school day.

The TWG also recognise that there will need to be careful consideration given to educating young people, parents and educators about the reasons for this change in approach to drinks.’

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Changes to School Catering Provision Aberdeen School Catering Service introduced three sugar free soft drinks on the 12 April 2021 – Diet Pepsi, Sugar Free Orange Tango and No Sugar Sprite.

Ingredients of newly introduced sugar free soft drinks:

Diet Pepsi Sugar Free Orange Tango No Sugar Sprite Carbonated Water, Carbonated Water, Orange Carbonated Water, Citric Colour (Caramel E150d), Fruit from Concentrate (5%), Acid - E330, Natural Lemon Acids (Phosphoric Acid - Acids (Citric Acid - E330, and Lime Flavourings, E338, Citric Acid - E330), Malic Acid - E296), Natural Sweeteners (Aspartame - Flavourings (including Orange Flavouring with E951, Acesulfame K - E950), Caffeine), Sweeteners other Natural Flavourings, Acidity Regulator (Sodium (Aspartame - E951, Acidity Regulator Citrate - E331) Acesulfame K - E950), (Sodium Citrate - E331), Acidity Regulator (Sodium Sweeteners (Acesulfame Citrate - E331), Preservative K - E950, Sucralose - E955), (Potassium Sorbate - E202) Preservative (Potassium Sorbate - E202), Natural Colour (Carotenes - E160a), Antioxidant (Ascorbic Acid - E300), Stabiliser (Xanthan Gum - E415)

Diet Pepsi is the only caffeinated drink introduced. Many other food additives (such as Citric Acid and Aspartame) are already available in other drinks within the school lunch provision.

Some secondary schools in the city already provide other caffeinated drinks - and .

There is anecdotal evidence in some schools that since the introduction of sugar free soft drinks there has been increased uptake of school lunches and new customers. Nutritional Evidence Base Below is a summary of the nutritional evidence base around food additives and caffeine contained within sugar free soft drinks.

3 Aberdeen City Council - Sugar Free Soft Drinks in Secondary Schools

Food Additives –

Food additives are substances added to food or drinks to perform certain functions (e.g. to colour, to sweeten or to help preserve foods). In the European Union (EU) all food additives are identified by an E number. Post Brexit, the UK continues to uphold existing EU food standards.

All food additives in the EU undergo a rigorous safety assessment by the European Food Safety Authority (EFSA). The EFSA sets an acceptable daily intake, which is the maximum amount can considered safe to consume each day over the course of our lifetime. Eating habits are factored in when specifying where food additives can be used.

Research into sweeteners shows they are perfectly safe to eat and drink daily as part of a healthy diet. There is little evidence from longer term studies that sweeteners cause weight gain due to appetite stimulation (NHS, 2019). Advice from NHS Grampian, Community Child Health, is that there is no universal advice to eliminate sweeteners in the diet of children with ADHD, although it may help some children.

Sugar free soft drinks contain acids that can erode the outer surface of the tooth. By limiting consumption to mealtimes, increases saliva flow which helps to clean the mouth but also decreases the amount of time teeth are under acid attack (NHS, 2018).

The Food Standards Agency funded research into possible links between food colours and hyperactivity in children. It found that consuming certain artificial food colours could cause increased hyperactivity in some children; sunset yellow FCF (E110), quinoline yellow (E104), carmoisine (E122), allura red (E129), tartrazine (E102), ponceau 4R (E124). None of these 6 artificial food colours are found in any drinks provided by the school catering service.

Caffeine -

The UK currently has no clear recommendations for daily caffeine limits for children or adults. The American Academy of Paediatrics recommend young people aged 12-18 years consume no more than 100mg of caffeine per day. Which is the equivalent of 2 cans of .

Advice from NHS Grampian, Community Child Health, is that caffeine is not necessarily a problem and there is no blanket recommendation for children to avoid if they have ADHD.

Based on current scientific opinions on the safety of caffeine, the Foods Standards Agency advise that children, or other people sensitive to caffeine, should only consume caffeine in moderation. Conclusion The provision of sugar free soft drinks in schools must be based on scientific evidence with a focus on offering young people choice. It is recognised that sugar free soft drinks are not a healthy option but there is not enough evidence to say that they should not be provided.

In consultation with schools, parents and young people, it must be agreed the variety, type and frequency of sugar free soft drinks available within schools.

It is essential that children and young people can make informed choices about food and drinks they consume. Whether eating out, in school or at home, school communities need to support children and young people to make healthier food and drink choices and have a balanced diet. 4 Aberdeen City Council - Sugar Free Soft Drinks in Secondary Schools

Proposals 1. Share evidence within this report and consult with young people, schools and parents regarding sugar free soft drink provision in schools. 2. Limit sugar free soft drink provision to lunchtimes to reduce the impact of acid on tooth decay and reduce multiple purchases throughout the school day. 3. Further discussion required regarding the provision of caffeinated, sugar free soft drinks. 4. School communities consider how they can support children to make healthy and informed food and drink choices. 5. School communities consider looking beyond the school gate when it comes to supporting access to healthy food and drink choices for young people during the school day.

SFDR/BR/15/06/2021 5