Search Results (199)

Background: School meals are crucial for children’s development and can contribute to the prevention, amongst others, of obesity and type 2 diabetes mellitus. We analyzed the conformity of meal composition with the quality standard for meals in schools (QST) of the German Nutrition Society (DGE) and reference values for nutrient intake of the nutrition societies of Germany and Austria (DGE/ÖGE) in Thuringian schools. Methods: Components of the school meals (portions in primary and secondary schools) were collected at two timepoints (T1 and T2). The contents of selected nutrients (protein, carbohydrates, fat, fatty acids, dietary fiber, vitamins, minerals) were analyzed and tested for alignment with the aforementioned adapted reference values. Results: More than half of the school meals examined were ovo-lacto-vegetarian meals (T1: 64%; T2: 63%). The energy content of macronutrients and the contents of vitamins B₁ and E, folate, calcium, iron and magnesium covered the requirements of the DGE/ÖGE reference values. Good n-6/n-3 PUFA ratios between 2.6 and 4.1 were found. In contrast, vitamin C was not detectable in 88.5% (T1) and 90.6% (T2) of the tested meal components, and sodium references were exceeded by a factor of five to eight. Additionally, the total sugar content of the meals tended to be high, with 85% of all meals exceeding the lower energy limit for free sugars (≥7 to <10 years) and >70% exceeding the upper limit (≥10 to <19 years) set forth by WHO and DGE/ÖGE. Conclusions: In the process of school meal preparation, attention should be paid to the preservation of vitamin C and the economical use of salt and sugar. Full article

Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article

Background/Objectives: The purpose of this article (a comparative analysis of state laws) is to thoroughly examine enacted state-level healthy universal school meals bills to summarize bill content and determine current practices for program implementation and long-term viability, with special attention to the Community Eligibility Provision (CEP). Methods: Bills enacted at the state level, as of 31 December 2025, were located electronically on state legislature websites and subsequently reviewed with rules, regulations, and implementation guidelines. Content analyses were conducted to identify patterns, themes, and key concepts pertaining to healthy universal school meals laws and program implementation guidelines to inform comparison policy analyses. Results: Nine states (California, Colorado, Maine, Massachusetts, Michigan, Minnesota, New Mexico, New York, and Vermont) have healthy universal school meals laws that include mandatory funding provisions for programming. Michigan is the only state that has a non-permanent law. Such laws eliminate requirements to certify individual students for free, reduced-price, or full-price meals based on their household income, and instead allow entire schools and/or school districts to offer all enrolled students no-cost meals. All states are funding healthy universal school meals programming by leveraging existing or new tax revenue to bridge the gap between the cost of school meals and federal meal reimbursements. Conclusions: State laws that leverage the Community Eligibility Provision (CEP) have become a key way to sustain universal school meal programs when federal funding falls short. States that direct resources to high-poverty schools, help districts determine the most accurate Identified Student Percentage, and reduce undercounting through strong direct-certification practices are better positioned to maintain universal meals over time. These strategies strengthen both child health and academic outcomes by ensuring stable access to no-cost, nutritious meals. Full article

Background/Objective: Helping Early Adolescents Live Their Healthiest Youth (HEALTHY) is a four-session, smoothie-based nutrition education program grounded in Social Cognitive Theory (SCT) and Choice Architecture, designed to promote nutrition security among rural adolescents. This study examined students’ experiences with the program, including perceptions of likeability and perceived learning, as well as the theoretical mechanisms shaping engagement. Methods: A mixed-methods evaluation was conducted in two rural middle schools where the programming was delivered. Process indicators were assessed using brief paper-based surveys administered after each program session. Quantitative items captured likability and willingness to consume smoothies again (at home or school lunch), and qualitative open-ended responses were analyzed inductively. Post-program focus groups were conducted with a subsample of participants (N = 18) and analyzed deductively using a coding framework aligned with SCT constructs. Results: Across sessions, students (N = 360) reported high smoothie likeability, with fewer than 15% indicating dislike of any recipe. Willingness to consume smoothies again remained high, with affirmative responses ranging from 72% to 94% at home and 79% to 97% at school lunch. Inductive thematic analysis indicated that 53% of survey responses reflected session-aligned nutrition knowledge, along with themes related to acceptability and suggestions for improvement. Focus group findings reflected multiple SCT constructs, including knowledge awareness, self-efficacy, and goal-setting, as well as environmental influences regarding engagement, consistent with Choice Architecture. Conclusions: Findings indicate that the HEALTHY program was well received by rural adolescents and reflected key theoretical mechanisms underlying its design. Student feedback guides future program refinement. Full article

Background/Objectives: School meals play an important role in ensuring reliable, healthy access to food, but there are many barriers to participation, especially for rural students. This study examined the perceived impact of UFSM policies and the perceptions of school meals among students in rural areas of Maine. Methods: This mixed-methods study included surveys with n = 61 middle and high school students and interviews with n = 11 middle and high school students between 2023 and 2024. The surveys and interviews focused on potential impacts of UFSM policies as well as general barriers and facilitators to participation in school meals. Quantitative surveys were analyzed using logistic regression, adjusting for demographic characteristics. Interviews were analyzed using principles of content analysis. Results: Students reported that UFSM had multiple benefits, and many students perceived that providing free school meals for all helped reduce the stigma associated with school meals, in part through increased participation. Students liked the variety of foods offered, but many did not perceive school meals, especially breakfast, to be “fresh” or “healthy”. Additionally, many students perceived there to be long lunch lines and insufficient time to eat their meals. Conclusions: While students perceived multiple benefits to UFSM, opportunities to further improve the quality of school meals, as well as policies to ensure sufficient lunch period lengths, may be important complements to increase participation and consumption of school meals among rural students. Full article

Background/Objective: Nutrition security, defined as consistent access to and consumption of nutritious foods that support health, remains a persistent challenge in rural populations. The HEALTHY (Helping Early Adolescents Live Their Healthiest Youth) program aimed to improve rural adolescents’ nutrition security through school-based strategies. This study evaluated its effectiveness by examining changes in fruit consumption, fruit waste, and skin carotenoid levels. Methods: A quasi-experimental, pre–post program was assessed in five rural middle schools (two experimental sites, three comparison sites). The programming paired four biweekly smoothie taste tests with nutrition education grounded in Social Cognitive Theory and Choice Architecture. Students in grades 3–8 (N = 149) participated. Digital tray photographs quantified selection and waste. The Veggie Meter^® assessed skin carotenoids on a scale from 0 to 800. Surveys captured perceptions and self-reported intakes. Analyses included χ², McNemar’s, GLMM, paired t-tests, and ANCOVA. Significance was set at p < 0.005. Results: At post-program, 98.3% of experimental trays contained the standard fruit option and/or a smoothie, compared with 41.0% of comparison trays (χ² = 41.66, p < 0.001). Fruit selection odds were 16.22 times higher in experimental schools (95% CI: 6.30–41.77, p < 0.001). Among trays with both (n = 39), smoothie waste was lower than the standard fruit option waste (t(38) = −7.10, p < 0.001, d = 1.14), resulting in greater estimated consumption (~0.43 vs. ~0.15 cups). Skin carotenoids increased in both groups, with greater improvement among experimental students in the lowest baseline quartile, F (1,19) = 9.20, p = 0.007, partial η² = 0.326. Conclusions: The HEALTHY program, which paired frozen-fruit smoothies with nutrition education, may offer a feasible and scalable approach to improving nutrition security among rural adolescents. Full article

Background/Objectives: In 2023, the United States Congress amended Section 13 of the National School Lunch Act to allow non-congregate meal service as an option within the Summer Food Service Program in rural areas, creating “SUN Meals To-Go.” The purpose of this qualitative study was to explore caregivers’ perceptions of USDA rural non-congregate summer meal programs in California during the summer of 2024. Methods: This was a cross-sectional, qualitative study using an electronic 20-item survey instrument that was available in English and Spanish. Five school foodservice directors in California shared and/or posted at meal pick-up sites a flyer with a QR code leading caregivers to the survey instrument. A conventional content analysis was conducted with the open-ended responses and descriptive statistics were calculated for close-ended items. Results: Caregivers (n = 827) were primarily married (70.5%) and Hispanic/Latino (54.3%) women (85.5%). They (55%) reported using the 2024 summer meal program “most times” or “every time” it was available. Three themes were constructed through qualitative content analysis: (1) Family support and resource relief, (2) Navigating program accessibility and logistics, and (3) Nourishment and practicality: Reflections on food quality, nutrition, and sustainability. Conclusions: Caregivers highlighted that the program supported their families and provided resource relief. They indicated that accessibility and logistics were effective, provided ideas for fine-tuning the delivery of the program, described this program as supporting their children’s nutrition. Full article

Aims: To evaluate the quality of lunch menus for workers in commercial food services across social, health and environmental sustainability dimensions. Methods: Mixed methods were applied to five restaurants. Data collection included a sociodemographic questionnaire, the Brazilian Food Insecurity Scale (EBIA), workers’ nutritional status, nutritional composition of 111 lunch menus, and environmental footprints. Data triangulation integrated caloric–nutritional adequacy, food insecurity, obesity, protein supply, and environmental footprints. Results: We assessed 261 participants (71.6% male; average age 32.3; 53.5% with a high school education). Food insecurity affected 53.3% and was associated with income, education, household composition, and municipality (p < 0.05). Nutritional status (n = 438) showed 68.3% were overweight/obese; obesity affected 42.7% of women and 30.5% of men. Menu analyses (n = 111) showed adequate energy and protein, but excessive lipids and sodium and reduced carbohydrates. Environmental analyses indicated beef had the highest impact; protein type was more influential than quantity, indicating no simple linear nutrition–impact relationship. Conclusion: Widespread food insecurity and obesity co-occurred with menus characterized by excessive lipids, sodium, and beef-driven impacts. The findings highlight that health and sustainability outcomes depend on both menu quality and social context, necessitating integrated, multidimensional policies. Full article

School meals are a cornerstone of the United States’ nutrition safety net for children from low-income families, providing nearly 30 million lunches daily. However, recent U.S. policy actions may limit access to school meals for children who need them most. The One Big Beautiful Bill Act changed eligibility requirements to limit participation in the Supplemental Nutrition Assistance Program (SNAP) and Medicaid. School-age children enrolled in SNAP and Medicaid are automatically enrolled in school meal programs. Limiting participation in SNAP and Medicaid has the potential to significantly impact children’s ability to receive nutritious school meals at low or no cost, will make it harder for schools to participate in community eligibility provision, and will increase the administrative burden on school staff and parents. Full article

In advanced economies, most food waste occurs at the downstream stages of the supply chain; within the EU, it has been estimated that 64.57% of food waste occurs at the consumption stage, with about 5.4 million tons (9.45% of the total) being generated in food service. This study aims to contribute to this stream of research by providing evidence about the quantity of food waste produced in Italian primary schools and discussing the results against the evidence available in other EU countries. This research is based on a large-scale study involving 78 primary schools and over 11,000 students for a total number of almost 110,000 monitored meals. The results show that the amount of food not consumed at lunch is 21.7% of the food prepared every day. Plate waste accounts for almost 90 g/day per capita and the total amount of wasted food, including unserved food, accounts for 117 g/day per capita. To our knowledge, this study represents the largest sample size monitored in Italy under the framework of the EC Delegated Decision (EU) 2019/1597 on food waste measurement. Given its scale and adherence to the EU’s standardized methodology, this dataset should serve as the reference data for Italy reported to Eurostat, as it is based on direct measurements rather than estimates or secondary data sources. This underscores the importance of systematic, comparable data collection for tracking progress on food waste reduction at both national and European levels. Full article

Background: School lunch programs play a crucial role in shaping the nutritional status and academic performance of children, making them a cornerstone of public health initiatives worldwide. Objective: To elucidate emerging trends and propose a comprehensive framework for free school lunch as a nutrition policy through a combined bibliometric approach and critical review. Methods: A bibliometric analysis was performed to identify key thematic areas, influential research, and knowledge gaps from global literature databases, followed by a critical review synthesizing insights on nutritional adequacy, socio-cultural considerations, policy effectiveness, and innovative practices in free school meal programs. Results: The analysis revealed an increasing focus on sustainability, food waste management, and integration of nutrition education within school curricula, alongside notable disparities in implementation and accessibility, particularly in low-income regions. Conclusions: We propose a future-oriented framework emphasizing stakeholder collaboration, culturally adaptive meal designs, and utilization of technology for personalized nutrition strategies, contributing to the optimization of school lunch programs and advancement of sustainable development goals, particularly Zero Hunger and Quality Education. Full article

Background: The Healthy, Hunger-Free Kids Act requires access to free drinking water in public school cafeterias during meal times. Previous studies suggest that increasing access to water in schools can increase its consumption among students, potentially reducing their intake of sugar-sweetened beverages. The current study provides a descriptive assessment of water availability, delivery methods, and quality in 96 public schools across four New Jersey school districts. Methods: As part of the New Jersey Child Health Study, we administered an online and paper survey to school nurses at 96 schools to evaluate the availability, delivery, and quality of water in the school cafeteria during lunchtime. Univariate and bivariate statistics were used to analyze the data. Results: In school year 2019–20, 83 (86.5%) schools reported providing free drinking water in the cafeteria during lunch. The most common source of water was water fountains, available in 64 schools (66.7%). Issues related to water quality, specifically cleanliness, temperature, pressure, and taste, were present in 20–30% of schools. Conclusions: While most schools surveyed provide access to clean, free drinking water, students in some schools still lack free access to drinking water during school meals, which may affect overall water consumption among students. Full article

Background/Objectives: The majority of Canadian children bring a home-packed lunch to school, and previous research suggests lunches are of poor nutritional quality. This pilot study aimed to test the feasibility, acceptability, and preliminary impact of an eHealth family-based intervention designed to improve the nutritional quality of home-packed lunches. Methods: In this 12-week intervention, families (n = 20 parents with children aged 4–8 years) received a toolkit which included a cookbook on tips for preparing healthy lunches and 15 tested lunch box-friendly recipes, a lunch box, text messages, and an online cooking class. Feasibility was assessed via documentation of intervention delivery and participant retention rates. Acceptability was assessed via post-intervention surveys and semi-structured interviews in a sub-sample of parents (n = 9). Preliminary impact was assessed using 3-day lunch food records. Descriptive statistics were used to assess feasibility and acceptability, and Wilcoxon signed-rank tests were used to evaluate changes in the nutritional content of packed lunches. Results: Findings indicated a high retention rate (85%), and the majority (94%) of participants reported that the intervention was helpful and that they would recommend it to another parent. Qualitative interviews suggest parents found the recipes practical and diverse, the lunch box and the cooking class helpful, and some reported increased confidence and greater awareness of the foods being packed. No changes in the nutritional content of packed lunches were observed (n = 10 children). Conclusions: In summary, a home-packed lunchbox intervention is feasible and well accepted by families, but further refinements are needed to optimize its impact before a full-scale trial. Full article

Background/Objectives: Vegetable leftovers constitute more than half of Vietnamese school lunch waste, partly due to limited ingredient variety, which may reduce meal acceptance. Methods: This cross-over study assessed the impact of diversifying vegetable options on intake and satisfaction among 40 students at a suburban Vietnamese primary school. Five new menus were developed by redistributing a 100 g vegetable portion into smaller servings of multiple vegetable types, combining them creatively with protein-rich foods or rice while maintaining nutritional value and cost. Students alternated between current and new menus over four weeks. Sensory evaluations using a 5-point hedonic scale and food weighing were conducted daily. Results: Most students increased vegetable intake during the new menu period. Mean intake was significantly higher with new menus (81.5 g; 95%CI: 77.1–85.9) compared to current menus (71.1 g; 95%CI: 65.2–75.1) (p < 0.001). Conclusions: These findings demonstrate that enhancing vegetable variety in combination can significantly improve intake and sensory characteristics without additional costs. This scalable strategy offers a practical solution for schools to foster healthier eating habits among students. Full article

A fundamental step to foster a sustainable future is enhancing students’ awareness of responsible food consumption. The present research study assessed students’ awareness of food waste (FW) issues, attitudes towards school catering and lunch management, and the reasons for plate waste (PW) in Rezekne city schools, Latvia. A survey was conducted in April 2024 involving 944 students in grades 2 to 7 across four selected schools (S1, S2, S3, and S4), provided with state and municipality-funded free lunches. Statistical analysis methods (Mean ± SD, Kruskal–Wallis H test, Mann–Whitney U post hoc test, and Spearman’s correlation analysis) were used to analyze the results. The findings revealed limited awareness and knowledge of students about FW issues, and generally indifferent attitude towards FW and school meals. In addition, significant dissatisfaction with the sensory qualities of meals was observed, yet sensory satisfaction did not correlate with FW levels, pointing to broader issues within the catering model. The restrictive pre-served portion system was found ineffective in reducing FW and fostering responsible consumption. A sustainable catering model should empower students to independently choose the type and quantity of food, combining their abilities and motivation with practical actions. These findings provide a basis for strategies aimed at reducing FW and promoting responsible and sustainable food consumption in Latvian schools. Full article