The case for water only in primary schools

In England, a third of children aged two- to 15-years-old are categorised as overweight or obese. In Southwark, odds are stacked against some of our children based on economic circumstances and social preferences for sugary drinks for refreshment or hydration. In these circumstances, sugary drinks have all but replaced water. Parents and carers may be blinded by branding. Assuming soft drinks, energy drinks and sweetened juices are on par with water is contributing to serious risks related to obesity, oral health and complex conditions like diabetes.

Southwark’s data, indicates that BAME (black and minority ethnic) children run the greatest risk of obesity ahead of children of other ethnic backgrounds. To motivate behavioural change and perception, Southwark primary schools will offer plain water only. Children in nursery will have reduced fat milk in classes. The milk offered will include lactose free, soya and other alternatives. Skimmed or semi skimmed milk will also be available for nursery classes.

Healthcare providers, educators, parents and carers acknowledge an urgent requirement to reduce the incidence of obesity in people of all ages. NHS studies point to clear links between obesity and complex health conditions like diabetes, heart disease, non-alcoholic fatty liver disease and infertility as overweight and obese children mature to adulthood.

Previously, paediatric patients who were being treated for diabetes had been diagnosed with Type 1 diabetes. However with a trend towards obesity in under-16’s, diagnosis of Type 2 diabetes in paediatric patients is on the increase.

Sugar consumption is the primary cause of excessive weight gain and food addictions. Any of us can become habituated to simple sugars by consuming sweetened drinks. Sugary drinks and food with high sugar content trigger dopamine responses in the brain. Dopamine creates ‘a feel-good factor’ and creates a link between sugar and rewards. The more sugar we consume, the more we want to consume, however sugar can lay the foundation for complex health issues including poor oral health. The combination of acid and plaque erode tooth enamel over time and cause tooth decay. If left untreated, invasive dental procedures may be required to resolve issues.

Organisations like the British Dental Association (BDA) are outspoken about the state of children’s oral health and have offered insight into the urgent need to stem tooth decay. In 2018, the BDA cited 170 children and teenagers in England were admitted to hospital for tooth extractions. Two years on, this number has increased to 180 surgical procedures. The cost to the NHS runs into millions of pounds. Right now, we’re seeing one in six five-year-olds developing tooth decay in Southwark which may require extractions if there is no intervention.

Recognising the trauma of undergoing surgery at such a young age, the BDA is supportive of Southwark Council’s move to put the water only policy in place. Shared concerns about oral health are the pain of tooth decay, sleepless nights, impacts on children’s ability to learn and poor development of social skills. The BDA assess low sugar and no sugar drinks as being more acidic than vinegar.

In February, all Southwark schools were sent details of the new water-only policy to allow ample time for teachers and school staff to work with pupils to transition from fizzy drinks to water. This policy will be mandatory for all primary schools in Southwark (and nursery classes) from the start of summer term in April 2020. Promoting drinking water and banning fizzy drinks should kick start making healthier choices and improving children’s health from nursery onwards.

Evelyn Akoto is a councillor on Southwark Council