RESEARCH PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Provision of healthy and high-quality school meals is an important solution to improve children’s health and well-being. Moreover, the meals provided at schools should not only meet dietary guidelines but also questions of sustainability. The aim of the study was to develop a new index to assess the quality of school meal menus, specifically their accordance with actual regulations, dietary guidelines and some sustainability goals.

Material and methods:
The School Meal Index-Lunch Evaluation (SMI-LE) is an originally created index to evaluate the quality of 5-day school menus. The general idea is to reflect the healthy and sustainability issues that should be present in school canteens according to WHO and EU recommendations. The index was tested in a real-life situation and fifty 5-day school menus available online from primary schools located in different regions of Poland, in rural and urban areas, were assessed with SMI-LE.

Results:
The median value of SMI-LE equaled 52 /140 points. Most of the analyzed menus (72%) were classified as ‘Medium’ quality according to SMI-LE. The menus classified as ‘Low’ were characterized by the lowest energy value, the lowest content of calcium, magnesium, iron, potassium, and folates, while the highest of sodium. Menus from the ’Good’ category had the highest nutritional value, as well as the lowest sodium content.

Conclusions:
A novel tool to has been provided for measuring the quality of school meals that addresses health and sustainability issues. It responds to the need for new indices that would consider changes in dietary guidelines and increasing knowledge about the impact of food systems on the environment.

REFERENCES (45)
1.
Brooks CG, Spencer JR, Sprafka JM, et al. Pediatric BMI changes during COVID-19 pandemic: An electronic health record-based retrospective cohort study. E Clin Med. 2021;16;38:101026. doi: 10.1016/j.eclinm.2021.101026.
 
2.
Kim ES, Kwon Y, Choe YH, et al. COVID-19-related school closing aggravate obesity and glucose intolerance in pediatric patients with obesity. Sci Rep. 2021;11(1):5494. doi: 10.1038/s41598-021-84766-w.
 
3.
Rezaeipour M. COVID-19-related weight gain in school-aged children. Int J Endocrinol Metab. 2020;19(1):e110634. doi: 10.5812/ijem.110634.
 
4.
World Health Organization. Fact sheets. Obesity and overweight. https://www.who.int/news-room/... (access: 2023.02.16).
 
5.
Dostępność profilaktyki i leczenia dla dzieci i młodzieży z zaburzeniami metabolicznymi wynikającymi z otyłości i chorób cywilizacyjnych, 2021. https://www.nik.gov.pl/ (access: 2023.05.22).
 
6.
Mazur A, Zachurzok A, Baran J, et al. Childhood obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity. Nutrients. 2022;14(18):3806. doi: 10.3390/nu14183806.
 
7.
Avgerinos KI, Spyrou N, Mantzoros CS, et al. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019;92:121–135. doi: 10.1016/j.metabol.2018.11.001.
 
8.
Harrist AW, Swindle TM, Hubbs-Tait L, et al. The social and emotional lives of overweight, obese, and severely obese children. Child Dev. 2016;87(5):1564–80. https://doi.org/10.1111/cdev.1....
 
9.
Suder A, Jagielski P, Piórecka B, et al. Prevalence and factors associated with thinness in rural Polish children. Int J Environ Res Public Health. 2020;17(7):2368. doi: 10.3390/ijerph17072368.
 
10.
Wolnicka K, Jarosz M, Jaczewska-Schuetz J, et al. Differences in the prevalence of overweight, obesity and underweight among children from primary schools in rural and urban areas. Ann Agric Environ Med. 2016;23(2):341–344. doi:10.5604/12321966.1203902.
 
11.
European Union. EU Action Plan on Childhood Obesity 2014–2020; European Union: Brussels, Belgium, 2014. Available online: https://publichealthwell.ie/no... (access: 2023.05.26).
 
12.
Cohen JFW, Hecht AA, McLoughlin GM, et al. Universal school meals and associations with student participation, attendance, academic performance, diet quality, food security, and body mass index: A systematic review. Nutrients. 2021;13(3):911. https://doi.org/10.3390/nu1303....
 
13.
Regulation of the Minister of Health of 26 August 2015 on foods intended for sale to children and youth in the units of education system and the requirements to be met by foods served in meals for children and youth in these units. DzU 2015, poz. 1256.
 
14.
Regulation of the Minister of Health of 26 July 2016 on foods intended for sale to children and youth in the units of education system and the requirements to be met by foods served in meals for children and youth in these units. DzU 2016, poz. 1154.
 
15.
Lang T, Mason P. Sustainable diet policy development: implications of multi-criteria and other approaches, 2008–2017. Proc Nutr Soc. 2018;77(3):331–346. doi: 10.1017/S0029665117004074.
 
16.
Martinez S, Alvarez S, Martinez Marin R, et al. Feeding children with environmentally based dietary guidelines: The Nitrogen Footprint of school lunch menus adhering to the Spanish dietary guidelines. Sci Total Environ. 2022;848:157796. doi: 10.1016/j.scitotenv.2022.157796.
 
17.
Healthy and sustainable diets. Report of an expert meeting on healthy and sustainable diets. A workshop to share challenges, identify knowledge gaps and receive feedback, 24–25 March 2021. Copenhagen: WHO Regional Office for Europe; 2021. https://www.who.int/europe/pub... (access: 2023.05.21).
 
18.
Devos Y, Arena M, Ashe S, et al. Addressing the need for safe, nutritious and sustainable food: Outcomes of the “ONE – Health, Environment & Society – Conference 2022”. Trends Food Sci. 2022;129:164–178. https://doi.org/10.1016/j.tifs....
 
19.
Dahmani J, Nicklaus S, Grenier J-M, et al. Nutritional quality and greenhouse gas emissions of vegetarian and non-vegetarian primary school meals: A case study in Dijon, France. Front Nutr. 2022;9:997144. doi: 10.3389/fnut.2022.997144.
 
20.
Elinder LS, Eustachio Colombo P, Patterson E, et al. Successful implementation of climate-friendly, nutritious, and acceptable school meals in practice: The OPTIMAT™ Intervention Study. Sustainability. 2020;12(20):8475. https://doi.org/10.3390/su1220....
 
21.
Milan’s Food Policy. www.foodpolicymilano.org/ (access: 2023.05.26).
 
22.
Position of the Committee on Human Nutrition of the Polish Academy of Sciences on new standards for school meals. https://knozc.pan.pl/images/st... (access: 2022.02.08).
 
23.
Gronowska-Senger A, Senger M. Ocena żywienia. In: Gawęcki J, editor. Żywienie człowieka. Podstawy nauki o żywieniu. Warszawa: PWN; 2022. p. 644–674.
 
24.
National Center for Nutrition Education, Pyramid of Healthy Eating and Lifestyle for Children and Youth. https://ncez.pzh.gov.pl/dzieci... (access: 2023.02.20).
 
25.
National Center for Nutrition Education, Recommendations for Healthy Eating. https://ncez.pzh.gov.pl/abc-zy... (accessed: 2023.02.20).
 
26.
Kasper N, Mandell C, Ball S, et al. The Healthy Meal Index: A tool for measuring the healthfulness of meals served to children. Appetite. 2016;103:54–63. doi: 10.1016/j.appet.2016.02.160.
 
27.
Oostindjer M, Aschemann-Witzel J, Wang Q, et al. Are school meals a viable and sustainable tool to improve the healthiness and sustainability of children´s diet and food consumption? A cross-national comparative perspective. Crit Rev Food Sci Nutr. 2017;57(18):3942–3958. doi: 10.1080/10408398.2016.1197180.
 
28.
Wallace TC, Bailey RL, Blumberg JB, et al. Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake. Crit Rev Food Sci Nutr. 2020;60(13):2174–2211. doi: 10.1080/10408398.2019.1632258.
 
29.
McEvoy CT, Guyer H, Langa KM, et al. Neuroprotective diets are associated with better cognitive function: The Health and Retirement Study. J Am Geriatr Soc. 2017;65(8):1857–1862. doi: 10.1111/jgs.14922.
 
30.
Brookie KL, Best GI, Conner TS. Intake of raw fruits and vegetables is associated with better mental health than intake of processed fruits and vegetables. Front Psychol. 2018;9:487. doi: 10.3389/fpsyg.2018.00487.
 
31.
Górnicka M, Jeruszka-Bielak M, Chłopecka J. Proposes of one-course school meals. https://um.warszawa.pl/waw/wie... (access: 2023.03.14).
 
32.
Damsgaard CT, Biltot-Jensen A, Tetens I, et al. Whole-grain intake, reflected by dietary records and biomarkers, is inversely associated with circulating insulin and other cardiometabolic markers in 8- to 11-year-old children. J Nutr. 2017;147(5):816–824. doi: 10.3945/jn.116.244624.
 
33.
McRae MP. Health benefits of dietary whole grains: An umbrella review of meta-analyses. J Chiropr Med. 2017;16(1):10–18. https://doi.org/10.1016/j.jcm.....
 
34.
Seal CJ, Courtin CM, Venema K, et al. Health benefits of whole grain: effects on dietary carbohydrate quality, the gut microbiome, and consequences of processing. Compr Rev Food Sci Food Saf. 2021;20(3):2742–2768. https://doi.org/10.1111/1541-4....
 
35.
González N, Marques M, Nadal M, et al. Meat consumption: Which are the current global risks? A review of recent (2010–2020) evidences. Food Res Int. 2020;137:109341. doi: 10.1016/j.foodres.2020.109341.
 
36.
Skorek P, Glibowski P, Banach K. Nutrition of vegetarians in Poland – a review of research. Rocz Panstw Zakl Hig. 2019;70(3):217–223. doi: 10.32394/rpzh.2019.0072.
 
37.
Poole MK, Musicus AA, Kenney EL. Alignment of US school lunches with the EAT-Lancet healthy reference diet’s standards for planetary health. Health Aff (Millwood). 2020;39(12):2144–2152. doi: 10.1377/hlthaff.2020.01102.
 
38.
Dziechciarz P, Horvath A, Socha P, Gajewska D, Rachtan-Janicka J, Mazur A, Kułaga Z. Sugar in nutrition of infants, children and adolescents – a position statement Recommendations of the Polish Society for Pediatric Gastroenterology, Hepatology and Nutrition. Standardy Medyczne/Pediatria. 2019;16:561–570.
 
39.
Korzycka M, Jodkowska M, Oblacińska A, et al. Nutrition and physical activity environments in primary schools in Poland – COSI study. Ann Agric Environ Med. 2020;27(4): 605–612. doi: 10.26444/aaem/114223.
 
40.
Sygit KM, Sygit M, Wojtyła-Buciora P, et al. Environmental variations of nutritional mistakes among Polish school-age adolescents from urban and rural areas. Ann Agric Environ Med. 2019;26(3):483–488. doi: 10.26444/aaem/105262.
 
41.
Tocher DR, Betancor MB, Sprague M, et al. Omega-3 long-chain polyunsaturated fatty acids, EPA and DHA: Bridging the gap between supply and demand. Nutrients. 2019;11(1):89. https://doi.org/10.3390/nu1101....
 
42.
Lachowicz K, Stachoń M. Determinants of dietary vitamin D intake in population-based cohort sample of Polish female adolescents. Int J Environ Res Public Health. 2022;19(19):12184. https://doi.org/10.3390/ijerph....
 
43.
Education in the 2020/2021 school year. Statistics Poland. Statistical Office in Gdansk. Warsaw, Gdansk 2021.
 
44.
The Global Survey of School Meal Programs. Program Report: Poland. GCNF GLOBAL SURVEY 2021. https://gcnf.org/wp-content/up... (access: 2023.05.30).
 
45.
The Lancet Regional Health-Americas. Unhealthy school meals: A solution to hunger or a problem for health? Lancet Reg Health Am. 2022;16:100413. doi: 10.1016/j.lana.2022.100413.
 
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ISSN:1232-1966
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