Busey Emily A, Chamberlin Grace, Mardin Kayla, Perry Michelle, Taillie Lindsey Smith, Dillman Carpentier Francesca R, Popkin Barry M
Global Food Research Program, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Curr Dev Nutr. 2024 Sep 19;8(10):104456. doi: 10.1016/j.cdnut.2024.104456. eCollection 2024 Oct.
The school food environment is a key intervention point for influencing children's and adolescents' diets. As more countries establish school meal programs to provide critical nourishment to students, establishing standards for the foods served can increase the consumption of key nutrients and limit the consumption of foods that do not build health. This global scoping review explores the prevalence and basic characteristics of national policies that regulate food served through school meals across 193 countries, particularly by restricting the provision of categories, nutrients, or ingredients of nutritional concern. We gathered evidence from policy databases, grey literature, peer-reviewed literature, and primary policy documents. We included nationally mandated policies that included restrictions on categories, nutrients, or ingredients of concern served in school meals. Policies that were sub-national, voluntary, and/or did not include restrictive language were excluded from this review. Data was collected in research electronic data capture then extracted into Microsoft Excel and analyzed for policy frequency, prevalence by world region or country income group, and prevalence of certain policy characteristics. Globally, only 15% of countries were found to have a national-level policy restricting foods served through school meals in some capacity, including either nutritional or categorical restrictions. The majority of these policies were found in high-income countries, and no low-income countries had a policy meeting inclusion criteria. Policies in Latin-American and Caribbean countries limited the content of more nutrients of concern than in other regions. Although many policies included explicit guidelines to monitor implementation, few outlined mechanisms for policy enforcement. Future research should evaluate the impact of various school meal regulatory approaches, including implementation of similar policies at sub-national levels, and other elements that affect the impact of school meal programs, such as procurement, infrastructure, costs to school and to students and their families, and acceptability and consumption of foods provided.
学校食品环境是影响儿童和青少年饮食的关键干预点。随着越来越多的国家设立学校供餐计划以向学生提供关键营养，制定所供应食品的标准可以增加关键营养素的摄入量，并限制不利于健康的食品的消费。这项全球范围综述探讨了193个国家针对学校供餐所供应食品进行监管的国家政策的普遍性和基本特征，特别是通过限制提供令人关注的食品类别、营养素或成分。我们从政策数据库、灰色文献、同行评审文献和主要政策文件中收集证据。我们纳入了国家强制实施的政策，这些政策包括对学校供餐中令人关注的食品类别、营养素或成分的限制。本次综述排除了地方层面的、自愿性的和/或不包含限制性语言的政策。数据通过研究电子数据采集进行收集，然后提取到微软Excel中，并分析政策频率、按世界区域或国家收入组划分的普遍性以及某些政策特征的普遍性。在全球范围内，仅15%的国家被发现有某种程度上限制学校供餐所供应食品的国家级政策，包括营养或类别限制。这些政策大多出现在高收入国家，没有低收入国家有符合纳入标准的政策。拉丁美洲和加勒比国家的政策限制的令人关注的营养素含量比其他地区更多。尽管许多政策包括了监督实施的明确指导方针，但很少有政策概述了政策执行机制。未来的研究应评估各种学校供餐监管方法的影响，包括在地方层面实施类似政策，以及其他影响学校供餐计划效果的因素，如采购、基础设施、学校和学生及其家庭的成本，以及所提供食品的可接受性和消费量。
