Colorectal Cancer Risk Factors in Adults in Nigeria.

Nineteen per cent of households with children in the UK experienced food insecurity in 2024, defined as an inability to access consistently available safe and nutritious food in quantities needed for normal human growth and a healthy life. Among households receiving Universal Credit, 38·7 % reported experiencing food insecurity. Food insecurity is associated with adverse health, social and economic outcomes, including increased risk of non-communicable diseases such as obesity and diabetes, poor dietary and nutritional outcomes due to reduction in healthy food purchases and reduced educational attainment. Food-insecure households are more likely to reduce purchases of healthy foods, such as fruits, vegetables, fish, dairy products and eggs, due to their higher cost, and numerous studies have linked food insecurity to poor diets and nutritional status. In response to concerns about the high level of food insecurity and its health consequences among children, there have been increasing calls for policy options to expand access to free or affordable school meals (FSM) to address malnutrition and reduce health and social inequalities in England. Access to a FSM has been shown to reduce school absence and improve educational attainment leading to longer-term productivity gains. However, universal access to FSM is not the current policy in England. In England, all Key Stage 1 (ages 4–7 years) pupils receive FSM. In Key Stage 2 (ages 7–11 years), FSM are means-tested, with eligibility based on households receiving income-replacement benefits; in 2024, 24·9 of KS2 pupils qualified. Although secondary pupils are also assessed through a means-tested system, this study focused on primary school provision. In Greater London, universal provision of FSM for primary school pupils has been provided since 2023, an initiative launched by the Mayor of London and funded by business rate income. For primary school pupils in the rest of England, households have the option to pay for a school meal, with the average cost in England at £2·70 per meal, or bring in a packed lunch from home. While some progress has been made towards improving access to FSM, advocacy groups, politicians, parents and the media are increasing pressure to expand FSM provision owing to increasing levels of food insecurity. Several policy options for increasing access to school meals have been suggested such as making FSM universally available to all primary and secondary school pupils, ensuring automatic enrolment for children eligible for FSM to remove the need for families to opt in, expanding provision to all pupils in schools in areas of high deprivation or expanding eligibility to include all pupils from families in receipt of Universal Credit, regardless of income levels. Yet despite significant lobbying on this issue, there are few examples of either local or national policymakers implementing these types of policies. However, since completing data collection for this study, the UK government announced that from September 2026, access to FSM in England will be extended to all children from households receiving Universal Credit, alongside a review of the school food standards. While this is a positive step, substantial work remains to ensure that every child can fully benefit from a nutritious school lunch, including consideration of more universal provision.