The importance of school lunches to the overall dietary intake of children in Sweden: a nationally representative study

Colombo, Patricia Eustachio; Patterson, Emma; Elinder, Liselotte Schäfer; Lindroos, Anna Karin

doi:10.1017/s1368980020000099

Cited by 28 publications

(28 citation statements)

References 42 publications

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“…Free school meals have, as mentioned previously, also been found to improve the quality of young people's diets especially those of low SES young people (5,21). An explanation for this may be that low-income families might be more reluctant to purchase unfamiliar foods and risk waste.…”

Section: Discussionmentioning

confidence: 85%

Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway

Illøkken

Johannessen

Barker

et al. 2021

Food & Nutrition Research

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Background: There are no national arrangements for free school meals provision in Norway despite this being an important opportunity to improve children’s and adolescents’ nutritional status and ultimately their physical and cognitive development. During a one academic year (2014–2015), a group of Norwegian sixth graders were served a free healthy school meal in a project called ‘The School Meal Project’. Objective: To explore students’ and teachers’ experiences of receiving free school meals after the free school meal in 2015 and 5 years later. Design: In-depth, semi-structured interviews with separate groups in 2015 and in 2020 were conducted face to face or via telephone or digital platforms. The findings are based on 13 students (aged 12–16) and 5 teacher interviews. Findings: Thematic analysis identified four main themes that describe the perceived benefits of receiving free school meals: 1) the meal as a social event where students made new friends and learned new skills; 2) as an aid to forming healthy eating habits; and as an opportunity to 3) improve school functioning and 4) increase social equality among students. Discussion: Our analysis suggests that the free school meal may influence healthy behaviors not only at the individual level but also at the social-, physical-, and macro-levels. Methodological limitations, including self-selection bias, should be considered when interpreting our findings. Conclusion: This study provides unique insights into the social benefits for students of receiving free school meals. Our findings illustrate the potential of free school meals: eating healthy foods, sharing a meal together, and interaction between students and teachers at mealtime, to promote health, learning, and equality. In order to maximize these benefits through national implementation of free school meals, more understanding is needed of possible facilitators and barriers related to the provision and uptake of free school meals.

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Section: Discussionmentioning

confidence: 85%

Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway

Illøkken

Johannessen

Barker

et al. 2021

Food & Nutrition Research

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“…Our results, combined with previous studies in the area of eating rate [ 17 , 24 , 25 , 26 ], support the idea to include self-reported questionnaires to estimate eating rate in population-level investigations of dietary intake among students. For example, the national food agency in Sweden conducts population-level surveys about self-reported dietary intake during school lunches [ 53 ], and could include an additional question about self-reported eating rate. Such population-level information would give a more detailed understanding of the association between eating rate and BMI z-scores among the total Swedish student population, as well as enable investigations of potential regional differences in eating rates among high-schools.…”

Section: Discussionmentioning

confidence: 99%

Fast Eating Is Associated with Increased BMI among High-School Students

et al. 2021

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Fast self-reported eating rate (SRER) has been associated with increased adiposity in children and adults. No studies have been conducted among high-school students, and SRER has not been validated vs. objective eating rate (OBER) in such populations. The objectives were to investigate (among high-school student populations) the association between OBER and BMI z-scores (BMIz), the validity of SRER vs. OBER, and potential differences in BMIz between SRER categories. Three studies were conducted. Study 1 included 116 Swedish students (mean ± SD age: 16.5 ± 0.8, 59% females) who were eating school lunch. Food intake and meal duration were objectively recorded, and OBER was calculated. Additionally, students provided SRER. Study 2 included students (n = 50, mean ± SD age: 16.7 ± 0.6, 58% females) from Study 1 who ate another objectively recorded school lunch. Study 3 included 1832 high-school students (mean ± SD age: 15.8 ± 0.9, 51% females) from Sweden (n = 748) and Greece (n = 1084) who provided SRER. In Study 1, students with BMIz ≥ 0 had faster OBER vs. students with BMIz < 0 (mean difference: +7.7 g/min or +27%, p = 0.012), while students with fast SRER had higher OBER vs. students with slow SRER (mean difference: +13.7 g/min or +56%, p = 0.001). However, there was “minimal” agreement between SRER and OBER categories (κ = 0.31, p < 0.001). In Study 2, OBER during lunch 1 had a “large” correlation with OBER during lunch 2 (r = 0.75, p < 0.001). In Study 3, fast SRER students had higher BMIz vs. slow SRER students (mean difference: 0.37, p < 0.001). Similar observations were found among both Swedish and Greek students. For the first time in high-school students, we confirm the association between fast eating and increased adiposity. Our validation analysis suggests that SRER could be used as a proxy for OBER in studies with large sample sizes on a group level. With smaller samples, OBER should be used instead. To assess eating rate on an individual level, OBER can be used while SRER should be avoided.

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“…Schools by law are required to serve free and nutritious school lunches to all pupils up to grade 9, and in fact pupils may not choose to bring a lunch with them from home. Fried food and desserts are not a feature of the Swedish school lunch, and lunches are often healthier than meals consumed outside of school [ 40 ]. Despite this, almost a third of the energy at school came from discretionary foods and beverages, highlighting that both school lunches and the entire school environment have to be targeted in order to improve the dietary intake of school children.…”

Section: Discussionmentioning

confidence: 99%

The Contribution of Foods and Beverages of Low Nutritional Value to the Diets of Swedish Adolescents, by Food Group, Time and Place. A Nationally Representative Study

et al. 2021

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Adolescence is a time in life when lifestyle behaviours are acquired. One indicator of poor diet quality is the intake of foods and beverages with a relatively low nutritional value. Using the Australian classification of such foods, termed “discretionary”, we classified the intakes of Swedish adolescents who participated in the Riksmaten Adolescent 2016–17 national dietary survey. From selected schools, 3099 adolescents in age groups 11–12, 14–15 and 17–18 years provided two 24-h recalls. Intakes and healthy dietary scores were calculated. Plasma ferritin, folate and 25(OH)D were available for a third. Almost 40% of total energy came from discretionary foods/beverages. Adolescents with higher intakes were more likely to be female, older, from a low socioeconomic position-household and born in Sweden. Most discretionary foods/beverages were consumed on weekend days and during in-between meals, outside of the home and at school. Percent energy from discretionary intake was associated with healthy dietary scores but not nutritional status. A substantial amount of energy was obtained from discretionary foods/beverages, and we found that consumption is pervasive across sociodemographic factors, time and place. Addressing this pattern will require a comprehensive approach to food environments and behaviours to reach all adolescents in an equitable manner.

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The importance of school lunches to the overall dietary intake of children in Sweden: a nationally representative study

Cited by 28 publications

References 42 publications

Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway

Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway

Fast Eating Is Associated with Increased BMI among High-School Students

The Contribution of Foods and Beverages of Low Nutritional Value to the Diets of Swedish Adolescents, by Food Group, Time and Place. A Nationally Representative Study

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