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Song S, Tabares E, Ishdorj A, Crews M, Dave J. The Quality of Lunches Brought from Home to School: A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100255. [PMID: 38876395 DOI: 10.1016/j.advnut.2024.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 06/16/2024] Open
Abstract
This systematic review and meta-analysis, spanning studies published between 1995 and 2021, investigates various aspects of lunches brought from home (LBFH) to school by children. These meals, in contrast to those provided by the National School Lunch Program (NSLP), lack strict nutritional standards. Despite the availability of NSLP lunches, ∼40% of US children opt for LBFH. This review aims to assess the food content and nutritional quality of LBFH, their adherence to NSLP standards in terms of nutrition and cost, effectiveness of intervention programs designed to enhance their nutritional quality and parental and student perceptions of LBFH. The comprehensive literature search yielded 28 eligible papers, with 16 included in meta-analysis. LBFH commonly include fruits (50%), yet vegetables (17%) and dairy (25%) are less prevalent. They frequently contain snacks (50%), sweets (48%), and sugar-sweetened beverages (31%). Compared with school lunches, LBFH exhibit lower levels of calcium, protein, iron, fiber, and vitamin A, and higher levels of carbohydrates and saturated fat. Intervention programs had no effect on quality of LBFH. On average, LBFH ($1.81) cost slightly less than lunches served at school ($1.98), without accounting for free/reduced-price meals in the calculation. The cost of school lunch for pre-k and kindergarten children became $11.32, nearly 4 times higher than that of LBFH ($2.92), after replicating the meal at home and accounting for meal preparation time. Parents preferred LBFH over school lunches because of concerns related to the quality of school meals served. This study concludes that LBFH are generally less nutritious compared with lunches provided by NSLP. Future research needs to further explore ways to improve parent perception of NSLP. Especially with many states making free meals available to all children, identifying effective ways in promoting and increasing NSLP participation can ensure more children have access to nutritionally balanced and affordable lunches.
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Affiliation(s)
- Siwan Song
- Department of Agricultural and Applied Economics, University of Wisconsin-Madison, Madison, WI, United States
| | - Elizabeth Tabares
- Norman Borlaug Institute for International Agriculture and Development, Texas A&M University, College Station, TX, United States
| | - Ariun Ishdorj
- Norman Borlaug Institute for International Agriculture and Development, Texas A&M University, College Station, TX, United States; Department of Agricultural Economics, Texas A&M University, College Station, TX, United States.
| | - Molly Crews
- School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jayna Dave
- USDA/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
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Olsson C, Hörnell A, Waling M. High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake. Food Nutr Res 2023; 67:9405. [PMID: 37533447 PMCID: PMC10392862 DOI: 10.29219/fnr.v67.9405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 08/04/2023] Open
Abstract
Background An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases. Objective The purpose of this study was to investigate what types of VF 4th grade pupils (10-11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender. Design A cross-sectional study design was used where pupils' VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated. Results The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123). Discussion This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden. Conclusions The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.
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Affiliation(s)
| | | | - Maria Waling
- Maria Waling Department of Food, Nutrition and Culinary Science, SE-901 87 Umeå, Sweden.
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Packed School Lunch Food Consumption: A Childhood Plate Waste Nutrient Analysis. Nutrients 2023; 15:nu15051116. [PMID: 36904116 PMCID: PMC10004809 DOI: 10.3390/nu15051116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Packed school lunch consumption remains a sparsely studied aspect of childhood nutrition. Most American research focuses on in-school meals provided through the National School Lunch Program (NSLP). The wide variety of available in-home packed lunches are usually nutritionally inferior compared to the highly regulated in-school meals. The purpose of this study was to examine the consumption of home-packed lunches in a sample of elementary-grade children. Through weighing packed school lunches in a 3rd grade class, mean caloric intake was recorded at 67.3% (32.7% plate waste) of solid foods, while sugar-sweetened beverage intake reported a 94.6% intake. This study reported no significant consumption change in the macronutrient ratio. Intake showed significantly reduced levels of calories, sodium, cholesterol, and fiber from the home-packed lunches (p < 0.05). The packed school lunch consumption rates for this class were similar to those reported for the regulated in-school (hot) lunches. Calories, sodium, and cholesterol intake are within childhood meal recommendations. What is encouraging is that the children were not "filling up" on more processed foods at the expense of nutrient dense foods. Of concern is that these meals still fall short on several parameters, especially low fruit/vegetable intake and high simple sugar consumption. Overall, intake moved in a healthier direction compared to the meals packed from home.
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Lalchandani NK, Poirier B, Crabb S, Miller C, Hume C. School lunchboxes as an opportunity for health and environmental considerations: a scoping review. Health Promot Int 2023; 38:daac201. [PMID: 36715703 PMCID: PMC9885980 DOI: 10.1093/heapro/daac201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Very little research has focussed on children's school lunchboxes from both a health and environment standpoint. This scoping review explores studies that considered children's lunchbox food consumption trends at school and the environmental impacts of lunchbox contents. We conducted a scoping review of peer-reviewed literature with a focus on lunchboxes of children in preschool or primary school settings that contained food packed from home, through the lens of food and nutrition in combination with environmental outcomes-particularly food and/or packaging waste. The review included 10 studies, with articles from Australia, USA, Spain, New Zealand and the UK. Half of them were intervention studies aiming to shift knowledge levels and attitudes of teachers, parents and children with regard to reducing packaged food choices and food waste, and improving dietary habits. Acknowledging the complexity of lunchbox packing and consumption practices, this review recommends the consideration of socio-ecological influences on children's health and sustainability behaviour, and mobilizing their pro-environmental agency.
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Affiliation(s)
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia
| | - Shona Crabb
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
| | - Caroline Miller
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide 5000, Australia
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
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Weigel MM, Armijos RX. The Ecuadorian School Food Environment: Association With Healthy and Unhealthy Food and Beverage Consumption and BMI. Food Nutr Bull 2022; 43:439-464. [PMID: 35993259 DOI: 10.1177/03795721221116447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition. OBJECTIVES 2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617). METHODS Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods. RESULTS The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001). CONCLUSION The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.
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Affiliation(s)
- M Margaret Weigel
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN, USA.,Center for Latin American and Caribbean Studies, Indiana University, Bloomington, IN, USA.,Indiana University Center for Global Health, Bloomington, IN, USA
| | - Rodrigo X Armijos
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN, USA.,Center for Latin American and Caribbean Studies, Indiana University, Bloomington, IN, USA.,Indiana University Center for Global Health, Bloomington, IN, USA
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Song S, Ishdorj A, Dave JM. Gender Differences in Nutritional Quality and Consumption of Lunches Brought from Home to School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413168. [PMID: 34948778 PMCID: PMC8700912 DOI: 10.3390/ijerph182413168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
Gender difference in the lunches brought from home to school and the amount consumed by elementary and intermediate school students were examined using data collected from 12 schools in Texas. The amount and nutritional quality of food items brought and consumed was evaluated, by comparing the results to the 2012 school meal standards, and Dietary Reference Intakes (DRIs). Almost all lunches brought from home contained grain and meat/meat alternatives, and the amount brought and consumed exceeded the NSLP standards. The majority of students did not bring fruits, vegetables, and whole grain foods, but those who brought consumed most of what they brought. Among elementary school students, only 9% of boys and 14% of girls brought vegetables and the amount brought and consumed did not meet the standards. Although carbohydrate and protein consumption were adequate for boys and girls, the intakes of micronutrients and fiber did not meet the requirements across both genders at both school levels. Overall, lunches brought from home were not well balanced and did not meet NSLP standards and DRIs. It is imperative to identify strategies to improve the nutritional quality of lunches brought from home considering gender difference in food choice and educating parents and children on what is a healthy well-balanced lunch.
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Affiliation(s)
- Siwan Song
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
| | - Ariun Ishdorj
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX 77843, USA;
- Correspondence:
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA;
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Nutritional Characteristics, Sites of Origin, and Cost of Foods Consumed during School Hours and Their Relationship to Nutritional Status of Schoolchildren in Mexico City. Life (Basel) 2021; 11:life11050439. [PMID: 34068865 PMCID: PMC8153579 DOI: 10.3390/life11050439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/17/2022] Open
Abstract
Access, nutritional characteristics, preferences, and cost can affect food intake at school. A cross-sectional study was performed to determine the nutritional characteristics, sites of origin, and cost of foods consumed during school hours. Three hundred and sixty-nine children from five public elementary schools in Mexico City participated. The children gave information about the foods that they consumed five days out of the week during school hours, including the place of acquisition, cost of the food, and portion size. Anthropometric measurements of height and weight of the children were taken. Caloric consumption and percentage of recommended daily energy intake from food during school hours was determined. Children were 10.9 ± 0.9 years old; 55.6% were girls, 26% were overweight, 23% were obese, and 3.3% were of low height for age. The average calorie intake was 515 kilocalories (kcal) (boys, 535 kcal; girls, 476 kcal, p = 0.051); calorie intake was higher when school meal intakes included foods from home, school, and outside of school. No significant differences were found in calorie intake by children’s nutritional status. The cost in Mexican pesos per 100 kcal consumed showed differences according to the nutritional status of the children; it was 4.0 Mexican pesos for children with normal weight and 4.2 and 3.8 pesos in children who were overweight or obese, respectively. The information obtained in this study should be used to provide nutritional guidance. The food portion size intake during school hours should be reduced, and the food should come from one or at most two sites, because each extra food represents an increase in the total kilocalorie intake.
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