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Background There is no tradition of serving school lunches in primary schools in the Netherlands. Most children tend to bring their own packed lunch, however these are often nutritionally suboptimal. While school lunch provision can aid healthy eating behavior amongst children, its introduction would constitute a profound change for children, parents and school staff. Therefore, this qualitative study aims to explore children’s, parents and school staffs’ perceptions of both the current lunch situation and the implementation of school lunch provision within primary schools in the Netherlands. Methods In this qualitative study we conducted nine interviews with school principals, 98 interviews with children, and held six focus groups with teachers and six with parents at primary schools in two Dutch cities. The data was analysed via iterative coding. Results The results showed that most children and parents are satisfied with the current lunch situation, although existing school food policies are not always put in place. Most teachers felt that children had insufficient time to consume their lunch in the current situation. The children were generally positive about the idea of a school lunch, and stressed that it was important to have the ability to choose. While both parents and school staff saw school lunch provision as an opportunity to educate families about healthy food options, they also expressed concern about who would be responsible, as well as the financial and organizational implications of its introduction. Conclusions Perceptions of children, parents and school staff about a school provided lunch are mixed. A complex intervention such as a new school lunch program is difficult to envisage for all parties involved and more research is needed regarding the effects, organization, logistics and the costs of school lunch provision in the Netherlands.

While school meals are often the healthiest option for students, lunch participation remains relatively low. Few approaches for increasing participation have leveraged teachers’ potential social influence. We determined if a teacher intervention about the benefits of school lunch could improve teachers’ perceptions of, and participation in, school lunch, and encouragement of students to eat school lunch. This repeated cross-sectional study included teacher/student survey administration in spring of 2016 and 2018 in 19 public secondary schools (9 intervention, 10 comparison) educating students of ages ≈ 11–18. Intervention teachers received monthly newsletters; lunch taste tests; and a promotional video and website. Mixed effects models with a random effect for school showed the proportion of teachers that reported eating with students increased in intervention schools relative to control schools (difference-in-change: 7.6%; 95% CI: 3.578%, 14.861%), as did student agreement that adults at their schools encouraged them to eat school lunch (difference-in-change: 0.15 on a 5-point scale; 95% CI: 0.061, 0.244). There were no between-group differences in teachers’ perceptions of school meals or teachers’ lunch participation. These findings suggest that teachers’ perceptions of school meals do not necessarily need to improve to promote the school lunch program to students. However, to see meaningful change in teacher lunch participation, the taste of school meals likely needs improving.

The Healthy, Hunger-Free Kids Act of 2010 updated the nutrition standards in the National School Lunch and School Breakfast Programs (NSLP and SBP) and expanded universal free meals’ availability in low-income schools. Past studies have shown that school meals are an important resource for children in food-insecure households. This analysis used data from the School Nutrition and Meal Cost Study to classify students as food insecure (FI), marginally secure (MS), or food secure (FS). Diet quality from school and nonschool foods that students consumed was assessed using Healthy Eating Index (HEI)-2010 scores. Chi-squared and two-tailed t-tests were conducted to compare school meal participation, students’ energy intakes, and diet quality across food security groups. FI and MS students were significantly more likely to participate in NSLP than FS students (79%, 71%, and 49%, respectively). SBP participation followed a similar pattern but was lower (38% FI, 33% MS, and 16% FS). Compared to FS students, FI and MS students more likely attended schools offering SBP, universal free meals, or afterschool snacks and suppers. School meals contributed significantly more energy to FI and MS students’ diets than to FS students (22%, 20%, and 13%, respectively). All groups’ dietary intakes from school foods were of higher quality than non-school foods. These findings highlight the role of school meals in meeting the energy and diet quality needs of FI and MS students.

Background Schools in the United States play a crucial role in promoting healthy eating habits. Despite numerous public health efforts, children’s consumption of fruits and vegetables (FVs) still fall short of recommended amounts. Advocates have promoted school lunch salad bars as an effective strategy to increase primary students’ FV consumption, but rigorous research has lagged behind their efforts. This study evaluated the effectiveness of introducing school lunch salad bars, FV marketing, and the combination of both on elementary students’ objectively measured fresh FV selection and consumption. Methods A cluster-randomized factorial trial was conducted among 13 elementary schools from 12 public school districts participating in the U.S. National School Lunch Program with more than 50% of students eligible for free or reduced lunch. Schools were assigned randomly to one of four conditions: Salad Bar with FV Marketing ( n  = 4), Salad Bar-only ( n  = 3), FV Marketing-only ( n  = 3), and wait-listed control ( n  = 3). The conditions were assessed at three measurement waves. Students’ ( N  = 3,080) aggregated fresh FV selection and consumption were measured via digital scales (grams) using objective plate waste methodology. Zero-inflated negative binomial models were used to examine differences in consumption (accounting for excess zeros and overdispersion) by condition and wave. Results No significant differences were observed for students selecting FVs across any condition. In contrast, after ten weeks of exposure, stand-alone school lunch salad bars significantly increased students’ consumption of FV (IRR = 1.84, 95% CI 1.12, 3.04) compared to the wait-listed control. Findings for FV marketing alone suggested increased consumption (IRR = 1.60, 95% CI 0.97, 2.64) relative to control, but were non-significant and inconclusive. Salad bars in combination with FV marketing showed the strongest effect on FV consumption relative to the wait-list control, with a significant increase observed at ten weeks (IRR = 2.07, 95% CI 1.29, 3.31). Conclusions Stand-alone salad bars are effective at increasing elementary students’ FV consumption after a minimum of ten weeks. The combined intervention of salad bars and FV marketing demonstrated the greatest improvement in FV consumption. These findings support the promotion of salad bars in schools as a strategy to increase FV consumption among students. Trial registration ClinicalTrials.gov Identifier: NCT03283033 (preregistered on: 9/14/2017).

School meals play a major role in supporting children’s diets and food security, and policies for universal school meals (USM) have the potential to contribute to positive child health outcomes. During the COVID-19 pandemic, schools provided free school meals to all students in the United States, but this national USM policy ended in school year (SY) 2022–2023; however, a few states have adopted policies to continue USM statewide for SY 2022–2023. Research examining the challenges and strategies for successful continuation of USM is essential, along with studying pandemic-related challenges that are likely to persist in schools. Therefore, we conducted a study in Maine (with a USM policy) to evaluate the impact of COVID-19 and the concurrent implementation of USM, as well as examine differences in implementation by school characteristics, throughout the state. A total of n = 43 school food authorities (SFAs) throughout Maine completed surveys. SFAs reported multiple benefits of USM including increased school meal participation; reductions in the perceived stigma for students from lower-income households and their families; and no longer experiencing unpaid meal charges and debt. SFAs also experienced challenges due to the COVID-19 pandemic, particularly regarding costs. When considering future challenges, most respondents were concerned with obtaining income information from families, product and ingredient availability, and the costs/financial sustainability of the school meal programs. Overall, USM may have multiple important benefits for students and schools, and other states should consider implementation of a USM policy.

Schools in the United States play a crucial role in promoting healthy eating habits. Despite numerous public health efforts, children's consumption of fruits and vegetables (FVs) still fall short of recommended amounts. Advocates have promoted school lunch salad bars as an effective strategy to increase primary students' FV consumption, but rigorous research has lagged behind their efforts. This study evaluated the effectiveness of introducing school lunch salad bars, FV marketing, and the combination of both on elementary students' objectively measured fresh FV selection and consumption. A cluster-randomized factorial trial was conducted among 13 elementary schools from 12 public school districts participating in the U.S. National School Lunch Program with more than 50% of students eligible for free or reduced lunch. Schools were assigned randomly to one of four conditions: Salad Bar with FV Marketing (n = 4), Salad Bar-only (n = 3), FV Marketing-only (n = 3), and wait-listed control (n = 3). The conditions were assessed at three measurement waves. Students' (N = 3,080) aggregated fresh FV selection and consumption were measured via digital scales (grams) using objective plate waste methodology. Zero-inflated negative binomial models were used to examine differences in consumption (accounting for excess zeros and overdispersion) by condition and wave. No significant differences were observed for students selecting FVs across any condition. In contrast, after ten weeks of exposure, stand-alone school lunch salad bars significantly increased students' consumption of FV (IRR = 1.84, 95% CI 1.12, 3.04) compared to the wait-listed control. Findings for FV marketing alone suggested increased consumption (IRR = 1.60, 95% CI 0.97, 2.64) relative to control, but were non-significant and inconclusive. Salad bars in combination with FV marketing showed the strongest effect on FV consumption relative to the wait-list control, with a significant increase observed at ten weeks (IRR = 2.07, 95% CI 1.29, 3.31). Stand-alone salad bars are effective at increasing elementary students' FV consumption after a minimum of ten weeks. The combined intervention of salad bars and FV marketing demonstrated the greatest improvement in FV consumption. These findings support the promotion of salad bars in schools as a strategy to increase FV consumption among students.

Schools in the United States play a crucial role in promoting healthy eating habits. Despite numerous public health efforts, children's consumption of fruits and vegetables (FVs) still fall short of recommended amounts. Advocates have promoted school lunch salad bars as an effective strategy to increase primary students' FV consumption, but rigorous research has lagged behind their efforts. This study evaluated the effectiveness of introducing school lunch salad bars, FV marketing, and the combination of both on elementary students' objectively measured fresh FV selection and consumption. A cluster-randomized factorial trial was conducted among 13 elementary schools from 12 public school districts participating in the U.S. National School Lunch Program with more than 50% of students eligible for free or reduced lunch. Schools were assigned randomly to one of four conditions: Salad Bar with FV Marketing (n = 4), Salad Bar-only (n = 3), FV Marketing-only (n = 3), and wait-listed control (n = 3). The conditions were assessed at three measurement waves. Students' (N = 3,080) aggregated fresh FV selection and consumption were measured via digital scales (grams) using objective plate waste methodology. Zero-inflated negative binomial models were used to examine differences in consumption (accounting for excess zeros and overdispersion) by condition and wave. No significant differences were observed for students selecting FVs across any condition. In contrast, after ten weeks of exposure, stand-alone school lunch salad bars significantly increased students' consumption of FV (IRR = 1.84, 95% CI 1.12, 3.04) compared to the wait-listed control. Findings for FV marketing alone suggested increased consumption (IRR = 1.60, 95% CI 0.97, 2.64) relative to control, but were non-significant and inconclusive. Salad bars in combination with FV marketing showed the strongest effect on FV consumption relative to the wait-list control, with a significant increase observed at ten weeks (IRR = 2.07, 95% CI 1.29, 3.31). Stand-alone salad bars are effective at increasing elementary students' FV consumption after a minimum of ten weeks. The combined intervention of salad bars and FV marketing demonstrated the greatest improvement in FV consumption. These findings support the promotion of salad bars in schools as a strategy to increase FV consumption among students.

Schools in the United States play a crucial role in promoting healthy eating habits. Despite numerous public health efforts, children's consumption of fruits and vegetables (FVs) still fall short of recommended amounts. Advocates have promoted school lunch salad bars as an effective strategy to increase primary students' FV consumption, but rigorous research has lagged behind their efforts. This study evaluated the effectiveness of introducing school lunch salad bars, FV marketing, and the combination of both on elementary students' objectively measured fresh FV selection and consumption. A cluster-randomized factorial trial was conducted among 13 elementary schools from 12 public school districts participating in the U.S. National School Lunch Program with more than 50% of students eligible for free or reduced lunch. Schools were assigned randomly to one of four conditions: Salad Bar with FV Marketing (n = 4), Salad Bar-only (n = 3), FV Marketing-only (n = 3), and wait-listed control (n = 3). The conditions were assessed at three measurement waves. Students' (N = 3,080) aggregated fresh FV selection and consumption were measured via digital scales (grams) using objective plate waste methodology. Zero-inflated negative binomial models were used to examine differences in consumption (accounting for excess zeros and overdispersion) by condition and wave. No significant differences were observed for students selecting FVs across any condition. In contrast, after ten weeks of exposure, stand-alone school lunch salad bars significantly increased students' consumption of FV (IRR = 1.84, 95% CI 1.12, 3.04) compared to the wait-listed control. Findings for FV marketing alone suggested increased consumption (IRR = 1.60, 95% CI 0.97, 2.64) relative to control, but were non-significant and inconclusive. Salad bars in combination with FV marketing showed the strongest effect on FV consumption relative to the wait-list control, with a significant increase observed at ten weeks (IRR = 2.07, 95% CI 1.29, 3.31). Stand-alone salad bars are effective at increasing elementary students' FV consumption after a minimum of ten weeks. The combined intervention of salad bars and FV marketing demonstrated the greatest improvement in FV consumption. These findings support the promotion of salad bars in schools as a strategy to increase FV consumption among students.

(1) To explore the feasibility of such programmes in Australia, this study examined parents' views on free school lunch provision. (2) To examine the associations between parents' demographic and personal characteristics and their support for free universal school lunches. An online cross-sectional survey of parents. Australia, April 2021. Seven hundred and eighty-seven parents took the survey. They had a mean age of 40. The respondents were predominantly female (95 %) and had a university degree (72 %). Fifty-three percentage of the respondents agreed that all students should have access to healthy and well-balanced, free school lunches. Parents were concerned about healthiness, catering, allergies and cost of school-provided school lunches. Ethnic background, universalism values and education levels were significantly associated with support for free school lunch provision. Non-native English-speaking parents were almost three times more likely to support free universal lunches in primary schools than their native English-speaking counterparts. Parents with higher universalism-concern values were more likely to endorse free lunches in primary school. However, the level of education was negatively associated with parents' support for free school lunches. The survey results highlight the complexity of parental views on free school lunch provision. Parents' concerns regarding lunches should be considered in developing school lunch programmes that meet the needs and preferences of diverse communities. These findings can be used to guide future primary school lunch provision initiatives.

Background School meals hold considerable potential to shape children’s diets and reduce food-related greenhouse gas emissions (GHGE)—in the short and long term. This study applied linear optimization to develop a GHGE-reduced, nutritionally adequate, and affordable school lunch menu. The effects on food waste, consumption and pupils’ satisfaction with the meals were evaluated. Methods A pre-post design was employed to assess the effects of implementing an optimized lunch menu on daily food waste, consumption, and pupils’ school meal satisfaction in three schools (grades 0–9) from one Swedish municipality. A food list containing amounts, prices, nutrient content, and GHGE-values of all foods used for a previously served (baseline) four-week lunch menu was created. Using linear programming, this food list was optimized for minimum deviation and constrained to ensure nutritional adequacy and a reduced climate impact. The optimized food list was developed into a new (intervention) four-week lunch menu by a professional meal planner, following the baseline menu as closely as possible. The baseline and intervention menus were served for four weeks, respectively, with a two week break in between. Prepared, wasted and leftover food were weighed daily by the school kitchen staff during both periods. Interrupted time series analysis assessed mean and slope differences in daily food waste and consumption between the two periods. School lunch satisfaction was assessed with an online questionnaire at baseline and during the intervention. Results Optimization resulted in a food list that was 40% lower in GHGE, met all nutrient recommendations for school meals, and cost 11% less compared to baseline. The intervention menu was served as planned, with only minor changes required (for practical reasons). Plate waste, serving waste, consumption and school lunch satisfaction did not differ significantly from baseline, in any of the schools. Conclusions The findings demonstrate that school meals can successfully be improved regarding health and environmental sustainability using linear optimization, without negative effects on food waste, consumption or cost. This approach offers the necessary flexibility to tailor menus towards different priorities and could therefore be transferred to other types of meal services. Trial registration The trial is registered at clinicaltrials.gov ( NCT04168632 Fostering Healthy and Sustainable Diets Through School Meals (OPTIMAT).