The children may not be the problem: evidence of acceptance and enjoyment of higher fibre breads from choice architecture studies in school breakfast clubs

Low fibre consumption is endemic in the United Kingdom (UK). Replacing refined staples with wholegrain starchy staples could increase fibre consumption. School food contributes to children's nutrition and establishes eating norms, presenting both a public health opportunity and challenge. It could be a policy lever to effect generational dietary change and influence health outcomes, and goal-strategic public sector procurement. However, this policy lever is under-exploited. Despite efforts by non-governmental organizations and individual schools, school food has not been conferred high value or status in national food policy and often does not provide children with a diet rich in healthy, high-fibre foods. In the H3 project, we trialled interventions to increase the fibre content of school breakfast, with particular focus on replacing white bread-a UK breakfast staple-with higher fibre breads. Here we review this work, providing insights from the food industry and children's perspectives. A key outcome was that child preferences were not a major barrier. When provided with higher fibre foods, children ate and enjoyed them. This suggests that simple food policy levers could significantly reduce the approximately 6 g average 'fibre gap' in UK school children's intake, for example by mandating that all bread served in schools be at least a 'source of fibre'. Larger scale trials should be conducted, ideally as part of universal school breakfast pilots.This article is part of the theme issue 'Transforming terrestrial food systems for human and planetary health'.