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André Picard

Why is Canada one of the only countries in the Western world that doesn't routinely feed children at school?

If we are, as it is often said, building a 'knowledge economy,' shouldn't we start with the most elemental step of all: Nourishing young brains?

The evidence of benefit is compelling: Healthier growth of children, less disruptive behaviour in class, better test scores, lower absenteeism, fewer dropouts, lower rates of obesity, and so one. School nutrition programs are also good for the beleaguered agricultural sector, especially if fresh foods are purchased locally.

The cost is minimal: A couple of bucks a day per child for a nutritious lunch and a few cents more for healthy snacks. And "cost" might not even be the right word because it's a good bet that the dollars invested will be recouped in savings from reduced health and social assistance spending down the road.

Consider that, during a typical school career, kindergarten through high school, children will eat more than 2,500 lunches at school.

That's a lot of brown-bagging and, increasingly, a lot of junk food purchased down the street from school because parents are too busy to prepare a nutritious lunch. It's a lot of opportunity to feed children properly and instill good food habits.

Earlier this week, at a conference hosted for the Centre for Science in the Public Interest in Gatineau, Que., delegates learned about the gold standard for school-based nutrition: SkolmatSverige.

Emma Patterson, the project manager for School Food Sweden, said the country has been feeding kids in school since the late 1800s but, during the Second World War, it became routine. In 1997, the principle of free meals for all was enshrined in the Education Act and, in 2011, the law was amended to say meals must also be nutritious.

That means all Swedish school children get lunch at school, which includes a hot main course (vegetarian or not), and a salad bar with at least five items, but no soft drinks, juice or desserts.

All the children, teachers and other staff get the same food choices and they eat together. In other words, lunch is an integral part of the school curriculum, not an every-kid-for-themselves hour. The food is cooked on-site (no pre-packaged foods are allowed) and served on plates with cutlery for environmental reasons.

While the system is highly decentralized, there are national nutritional standards that must be met, and schools compete to see who can offer the best food.

The meals cost about 10 krona (roughly $1.50), though they are provided free of charge. Schools also have the option of providing breakfast and snacks, which many do.

There are only two other countries that, like Sweden, have universal, free meals at school – Finland and Estonia. Others rely on approaches like subsidizing so meals are cheap, offering vouchers for low-income children, or providing free food only for those who meet a means test.

But Canada is the only country where hot lunches (and school cafeterias) are the exception, not the norm, in elementary schools. In high schools, cafeterias tend to be businesses, where hot dogs and fries are staples.

For the most part, this country's 5.6 million elementary school children and 2.2 million high schoolers are on their own when it comes to eating, even though they spend the bulk of their waking lives in school.

Diana Bronson, executive director of Food Secure Canada, said what Canada needs is a national school food program.

What it has now, however, is a patchwork of hundreds, maybe even thousands, of programs, most of which focus on providing breakfast to low-income kids.

It is estimated that about one in seven Canadian kids go to school hungry. One study found that one in three primary school kids and two in three second school kids don't eat a healthy breakfast. That explains why breakfast gets a lot of attention. There are also numerous programs that provide school snacks of fruit, milk and yogurt, often designed to bolster the agricultural sector.

But if kids don't get breakfast, what are the chances that they are coming to school with lunch? Beyond that, what is in those brown bags? How many kids are routinely eating processed meat sandwiches and pizza pockets for lunch?

"We have to move from simply feeding hungry kids to a healthy food agenda," Ms. Bronson said.

This position is not a radical one, even the conservative Conference Board of Canada has called for systemic school feeding programs.

No one is suggesting a huge bureaucracy but rather, like Sweden, a set of standards that should be met to ensure all kids are fed, and fed well.

There is an increasing recognition – in the business community, in government and in the social sphere – that the social-determinants of health (income, education, housing, food security, healthy environment) matter to both the health of the population and the economy, and that they have more impact that providing medical care.

It's not enough to talk about these issues; we have to commit to addressing the health of Canadians, not just their medical needs, and we have to implement policies to give life to this philosophy.

What better place to start than in the school lunch room?

André Picard is The Globe's public health columnist.