In 2012, the US government overhauled school nutrition standards, but few studies have evaluated the effects of these standards at the national level. The current study examines the impact of the updated school nutrition standards on dietary and health outcomes of schoolchildren in a nationally representative data set.

Difference-in-differences. We compared weekday fruit and vegetable intake between students with daily school lunch participation and students without school lunch participation before and after implementation of updated school nutrition standards using a multivariable linear regression model. Secondary outcomes included weekday solid fat and added sugar (SoFAS) intake and overweight and obesity prevalence. We adjusted analyses for demographic and family socio-economic factors.

USA.

K-12 students, aged 6–20 years (n 9172), from the National Health and Nutrition Examination Survey, 2005–2016.

Implementation of updated school nutrition standards was not associated with a change in weekday fruit and vegetable intake (β = 0·02 cups, 95 % CI −0·23, 0·26) for students with daily school lunch participation. However, implementation of the policy was associated with a 1·5 percentage point (95 % CI −3·0, −0·1) decline in weekday SoFAS intake and a 6·1 percentage point (95 % CI −12·1, −0·1) decline in overweight and obesity prevalence.

Changes to US school nutrition standards were associated with reductions in the consumption of SoFAS as well as a decrease in overweight and obesity in children who eat school lunch. However, we did not detect a change in weekday intake of fruits and vegetables associated with the policy change.

School-based interventions and policies encourage youths to include and consume fruits and vegetables at lunchtime via school lunches, but limited research has examined how these behaviours compare when youths have home-packed lunches. The objective of the present study was to compare fruit and vegetable contents and consumption among students having school or home-packed lunches over the school week.

Participants were observed over five consecutive days at school lunchtime. Trained analysts estimated students’ lunchtime fruit and vegetable contents and consumption using digital imaging. Mixed models examined associations between fruit and vegetable dietary behaviours and lunch source (school v. home-packed), controlling for student gender, grade and school.

Three elementary schools in northern California, USA.

Fourth-, fifth- and sixth-grade students (nchildren 315; nobservations 1421).

Students were significantly less likely to have and to consume fruits and vegetables (all P<0·05) when having home-packed lunches, compared with when having school lunches. Among those who did have or did consume these foods, having a home-packed lunch was associated with consuming significantly less fruit (P<0·05) but no differences for other dietary outcomes.

The study adds to a growing body of literature indicating shortfalls in fruit and vegetable contents and consumption associated with having a home-packed lunch, relative to having a school lunch. Findings suggest that school-based interventions, particularly when targeting home-packed lunches, should focus on whether or not these foods are included and consumed, with less emphasis on quantities.

To describe the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES) in China and to share the experiences of developing and implementing nationwide school meal programmes with other countries.

The article is based on a literature review of technical documents and reports of NIPRCES and relevant national legislation, technical reports and studies on school nutrition, minutes of meetings and national conferences, and official documents of the National Office of Student Nutrition and the Chinese Center for Disease Control and Prevention.

People’s Republic of China.

Published papers, national policies, legislation and unpublished official documents.

A total of 23 million rural compulsory education students were covered by NIPRCES. In the development and implementation process of NIPRCES, fifteen ministries and national committees were involved and an efficient collaborative mechanism was established. All NIPRCES-covered schools were required to serve meals on a daily basis. By the end of June 2012, the proportions of students choosing ‘school feeding’, ‘food package’ and ‘family feeding’ modes were respectively 64·0 %, 32·0 % and 4·0 %. The central government subsidized school meals annually by more than $US 2·5 billion and invested $US 4·8 billion on school kitchens to support this programme.

The NIPRCES is a significant movement of governmental nutritional intervention in China. Food safety, financial security, decentralization and other potential concerns should be considered and lessons can be learned from other countries. Further relevant research and a nationwide monitoring and evaluation programme are needed.

The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level.

Regression models examined cross-sectional, state- and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts’ racial/ethnic composition and state poverty rates.

Adult-age cohorts (18–34, 35–49, 50–64 and 18–64 years) by US state over a 25-year period (1984–2008).

The cohorts’ prevalence of overweight and obesity was compared with the cohorts’ estimated NSLP participation during schooling (1925–2007; the NSLP began in 1946).

Among adults aged 18–64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0·29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results.

The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences.

The present paper analyses the advances and challenges of the school feeding programme in Brazil (PNAE), as part of the Brazilian experience building up an integrated food and nutrition security national system. It explores the role of policy and regulatory frameworks in constructing quality service delivery and intersectoral integration.

Review of PNAE and federal government technical documents and studies, legislation, minutes of meetings and official documents of the National Council of Food and Nutrition Security from 2003 to 2011.

Food insecurity has decreased significantly in Brazil in the last decade, indicating that appropriate choices were made in terms of public policies and institutional arrangements, which other countries can learn from.

Brazil food and nutrition security system; school feeding; school food.

Brazil's integrated food and nutrition security policy approach promoted intersectorality in the food system, articulating actions to guarantee access to healthy food and to strengthen family farming. The quality of school meals has progressively improved; in particular, the availability of fruits and vegetables increased. However, national standards regarding menu composition have not yet been met. Regulations were an important factor, along with the policy approach linking food production, nutrition, health and education. Challenges are related to conflict of interests and to farmers’ insufficient capacity to meet supply requirements and comply with technical procedures.

Local food production, school meals and nutrition education can be linked through integrated programmes and policies, improving access to healthier foods. Government leadership, strong legislation, civil society participation and intersectoral decision making are determinant.

To provide an overview of school food and nutrition monitoring from 1980 to the Healthy Hunger-Free Kids Act of 2010 and data on school food availability in the USA.

A review of the history of school food and nutrition policy, monitoring and evaluation efforts in the USA over the past three decades.

USA.

School food service, school districts and schools nationwide.

The school food environment in the USA is governed by a patchwork of federal, state and local laws and policies. The federal government has primary authority over the school meal programmes and has recently issued updated regulations governing the food and nutrient requirements for meals sold or served through the National School Lunch and School Breakfast Programs. Competitive foods (i.e. foods and beverages sold/served outside the meal programmes) are governed primarily by state and district laws and policies, although new federal regulations are expected to set minimum standards in this area. The USA has a long history of data monitoring and evaluation funded by government and private foundations which has enabled decision makers to monitor progress and opportunities to improve the foods and beverages made available to students in school.

School food-related monitoring and evaluation research has been highly influential in influencing legislation and policy, leading to improvements in the foods and beverages available to children at school as part of planned meals and individual items sold outside the meal programmes. The lessons learned from the US experience provide insights that may be valuable for implementation, monitoring and evaluation of school food programmes in other countries.

To assess the nutritional quality of lunchtime food consumption among elementary-school children on Prince Edward Island according to the source of food consumed (home v. school).

Students completed a lunchtime food record during an in-class survey. Dietary adequacy was assessed by comparing median micronutrient intakes with one-third of the Estimated Average Requirement; median macronutrient intakes were compared with the Acceptable Macronutrient Distribution Ranges. The Wilcoxon signed rank test was used to assess differences in nutrient intakes according to source of food consumed.

Elementary schools in Prince Edward Island, Canada.

Grade 5 and 6 students (n 1980).

Foods purchased at school were higher in nutrient density for ten micronutrients (Ca, Mg, K, Zn, vitamin A, vitamin D, riboflavin, niacin, vitamin B6 and vitamin B12) compared with packed lunch foods from home, which were higher in three micronutrients (Fe, vitamin C and folate). School lunches provided sufficient protein but were higher in sugar and fat than home lunches. Foods brought from home were higher in carbohydrates, fibre and Na than foods purchased at school.

The overall nutritional quality of lunches was poor, regardless of source. A significant proportion of foods consumed by the students came from home sources; these were lower nutritional quality and were higher in Na than foods offered at school. Findings suggest that improving the dietary habits of school-aged children will require a collaborative effort from multiple stakeholders, including parents.

To compare the school lunch consumption of Texas middle-school students with the 2009 Institute of Medicine's (IOM) school meal report recommendations. These new lunch menu patterns increase fruit to one serving and vegetables to two servings, with 50 % wholegrain food.

Lunch food records were collected from middle-school students from four schools in south-east Texas in the spring of 2008, and entered into the Nutrition Data System for Research software. Average intake was calculated for those consuming meals according to the National School Lunch Program (NSLP; n 5414) and for those consuming lunch from other sources (n 239). The percentage of students selecting each food group was calculated.

Middle schools in south-east Texas.

Middle-school students in south-east Texas.

Students consuming NSLP meals reported consuming almost serving of fruit, serving of vegetables, 8 oz of milk and serving of whole grains at lunch. Non-NSLP consumers reported almost no intake of fruit, vegetables or milk, and consumed serving of whole grains at lunch. Among NSLP consumers, about 40 % selected and consumed a fruit serving. About two-thirds of students selected a vegetable, consuming about 67 %. Less than 4 % selected a dark green or orange vegetable.

Students’ lunch intake did not meet the new IOM recommendations. Few students selected dark green or orange vegetables, and only 40 % selected fruit. Whole grains consumption was low. Interventions with all stakeholders will be necessary to improve students’ food and beverage selections overall when school meal patterns are revised.