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Background: Recommendations for the development of school menus can promote healthier, more sustainable food systems. In Spain, these recommendations depend on regional governments (Autonomous Communities—CCAAs) that develop their own guides. The objective of this study was to explore the nutritional and sustainability recommendations for the development of menus by school food services in Spain. Methods: Guides were reviewed that were available on the official web pages of the councils of health and education. Twenty-four variables were studied and organized into three categories: characteristics, nutritional recommendations and sustainability. The number of recommendations included in each guide was counted. The weekly frequency of the suggested food provision for each food group was calculated, as was the average, median, standard deviation, confidence interval and interquartile index. Results: Overall, 13 guides were reviewed from different CCAAs. All of them included at least three of the nutritional recommendations, two suggested restrictions in the provision of foods with high quantities of salt and six suggested restrictions in foods with high levels of trans and saturated fats and sugars. All except one guide recommended the weekly provision of foods by food group: protein-rich foods (n = 8), cereals and root vegetables (n = 6), vegetables (n = 5.2) and fruit (n = 4.3). Of the eight criteria for sustainability studied, nine guides included one or none. Conclusions: Guides for the provision of meals at school in Spain promote the incorporation of healthy foods; however, they rarely restrict foods with high levels of fat, salt and sugar, and the promotion of food sustainability is only just beginning. These guides should be reviewed and updated to include recommendations that promote healthy and sustainable food systems. [ABSTRACT FROM AUTHOR]

School food services can potentially promote changes in the food system to make it healthier and more sustainable. They can dictate which foods to buy and how to acquire, produce, and distribute them, favoring the production of meals based on sustainable nutrition. The study aimed to obtain an instrument to identify sustainability practices in school food services, covering the five dimensions of sustainable nutrition. The preliminary instrument's version underwent content validation and semantic evaluation. Reliability was assessed by evaluating 23 school food services for interobserver reproducibility and 148 for internal consistency in the Federal District and the State of Mato Grosso (Brazil). The instrument was composed of 76 items divided into 3 sections (1. Water, energy, and gas supply; 2. Menu and food waste; 3. Reduction of waste, construction materials, chemicals, employees and social sustainability). The instrument showed excellent results in content validation, semantic evaluation, and interobserver reproducibility (ICC = 0.949) and reasonable results for internal consistency (KR-20 = 0.660). Evaluating public and private school food services, they showed low sustainability scores in the general instrument (26.93 ± 4.87) and in all 3 sections (1 = 9.97 ± 1.67; 2 = 9.16 ± 2.54; 3 = 7.80 ± 2.39). Section 3 was the one in which school food services performed the worst. Some practices seem consolidated, such as employee attitudes towards reducing water and energy use, recycling cooking oil, offering vegetables and fruits regularly and encouraging diners to reduce waste. Public and private school food services in the Federal District had better results than those in the State of Mato Grosso (31.86 ± 4.63 versus 25.35 ± 3.76). The instrument has strengths, considering its excellent results for content validation, semantic evaluation, and interobserver reproducibility. For internal consistency, the result is believed to reflect the recent topic within school food services. The low performance of school food services points to the need for specific legislation on sustainability, greater planning and investments at the management level, and the execution and recording of activities at the operational level. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since 2016, the School Food Program in the Buenos Aires Province, Argentina, implemented a nutritional regulatory framework (NRF) and varying administration systems (AS). Here, we examined the association between the interventions (only NRF and NRF + AS) and breakfast nutritional and food indicators between 2016 and 2019. METHODS: Data collected from the Survey of the School Food Program, 2016‐2019, were analyzed. The dependent variables were the energy, macro‐and micronutrients, milk/yogurt, and fruit quantities in school breakfasts. The independent variables were the school's status: (a) control group, (b) Intervention 1 (only NRF), and (c) Intervention 2 (NRF + AS). We preformed crude and adjusted linear regressions with robust variances. RESULTS: We evaluated 4,060 schools (control group: 24%; Intervention 1: 39%; Intervention 2: 37%). Only vitamin A levels increased after Intervention 1, and almost all indicators (80%) showed better values when applying Intervention 2. SCHOOL HEALTH POLICY IMPLICATIONS: Nutritional and food indicator improvements were associated with the implementation of the NRF and AS, emphasizing the significance of design and management of school food public policies, along with the amount of investment/territorial coverage. CONCLUSIONS: Our findings highlight the importance of school food and nutrition policies with a potential impact on improving the nutritional status of children. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to identify factors that interfere with the adoption of good hygiene practices in public school food services (SFS) in Bahia, Brazil. The search was conducted in public schools in Bahia/Brazil. Data collection included (i) evaluation of the adoption of Good Practices in school food services through visual observation and registration in the checklist in Good Hygienic Practices in School Food Services; (ii) Identification of schools' foodservice physical areas and environmental comfort measures; (iii) identification of sociodemographic and occupational characteristics and assessment of attitudes and level of knowledge in food hygiene. The minimum sample of 158 schools (confidence level of 95% and an error of 5%) was stratified considering the total number of districts (areas) and the schools' number per area. The data were analyzed using the Statistical Package for Science—SPSS® in version 26.0. The categorical variables were described as frequencies and percentages, and the quantitative variables as mean and standard deviation. Chi-square, Kruskal-Wallis with Tukey's post-hoc tests were used to examine qualitative variables. Independent Student t-test and ANOVA with Tukey's post-hoc tests were used to examine quantitative variables. Categorical variables were evaluated by Pearson Chi-squared tests. The Pearson test was used to analyze the correlation between Attitude and knowledge. The classification of the sanitary status was of moderate risk in 74.8% (n = 119) of the SFS (51-75% of compliance) and 25.2% (n = 40) at high risk (26-50% compliance). The average percentage of compliance for the 159 SFS in the municipality was 50.23%, obtaining a high-risk classification (26–50% compliance). In the SFS, the absence of dry goods' storage, meat preparation area, and storage of residues in more than 98% of schools was observed. Accessing attitudes, 1.4% (n = 2) of the food handlers were classified as unsatisfactory (0 to 49% of correct answers), 8.5% (n = 12) as satisfactory with restriction (50–69% of correct answers) and 90.1% (n = 128) as satisfactory. There was no correlation between Attitude and Knowledge level (p = 0.394). Considering the knowledge level, the item with the highest and lowest number of hits were: “To avoid food contamination, I wash and disinfect my hands before preparing food” and “Contaminated food will always have some change in color, smell, or taste”. There was a significant difference in the level of knowledge considering mean wage (p = 0.000), time working in school food service (p = 0.001), weekly workday (p = 0.000), and participation in food hygiene training (p = 0.000). Therefore, factors that interfered in adopting good practices in the SFS were: inadequate physical structure, absence of areas in the SFS, and absence/low number of equipment to control the production process in the cold and hot chain. Food handlers showed satisfactory attitudes and level of knowledge. However, the physical structure of the SFS compromises the adoption of good practices. It risks the safety of the food served to students at the evaluated public schools.

Food service work is hazardous due to the intense rhythm of food production, and the working conditions can cause discomfort, fatigue, and occupational accidents and illnesses. For the perception of exposure to occupational hazards, workers must participate in continuing education programs. This study aimed to verify the perception and exposure to occupational risks at school food services (SFS) in Bahia, Brazil. This cross-sectional study was conducted in SFS from public schools in Bahia/Brazil. Researchers identified sociodemographic variables, occupational characteristics, and the Perception of Exposure to Occupational Risks by SFS food handlers. Also, anthropometric assessment (weight, height, and waist circumference), the presence of comorbidities, and the identification of exposure to occupational risks and measures of environmental comfort were evaluated. Most workers were female (98.6%; n = 140), mean age of 46.85 y/o, working as SFS food handlers between 1 and 5 years (50.7%; n = 72) but with no training on occupational risks (52.8%; n = 75). This lack of training is not associated with demographic or other occupational variables. The majority of the food handlers present a fair or good perception of exposure to occupational risk. These food handlers are also mostly overweight, and higher BMI was associated with hypertension and edema. The SFS were classified as of high occupational risk (mean of 31.24% of adequacy) environments. Ergonomic Risks had the lowest percentage of adequacy (7.69%, very high risk) regarding occupational risks, followed by chemical risks (31.5% of adequacy, high risk), accident risk (32.19%, high risk), and physical risk (36.89%, high risk). The excess of activities associated with precarious physical structure, insufficient number of equipment and utensils (in inadequate conservation) favors the exposure to occupational risk in SFS.

Background: Recommendations for the development of school menus can promote healthier, more sustainable food systems. In Spain, these recommendations depend on regional governments (Autonomous Communities—CCAAs) that develop their own guides. The objective of this study was to explore the nutritional and sustainability recommendations for the development of menus by school food services in Spain. Methods: Guides were reviewed that were available on the official web pages of the councils of health and education. Twenty-four variables were studied and organized into three categories: characteristics, nutritional recommendations and sustainability. The number of recommendations included in each guide was counted. The weekly frequency of the suggested food provision for each food group was calculated, as was the average, median, standard deviation, confidence interval and interquartile index. Results: Overall, 13 guides were reviewed from different CCAAs. All of them included at least three of the nutritional recommendations, two suggested restrictions in the provision of foods with high quantities of salt and six suggested restrictions in foods with high levels of trans and saturated fats and sugars. All except one guide recommended the weekly provision of foods by food group: protein-rich foods (n = 8), cereals and root vegetables (n = 6), vegetables (n = 5.2) and fruit (n = 4.3). Of the eight criteria for sustainability studied, nine guides included one or none. Conclusions: Guides for the provision of meals at school in Spain promote the incorporation of healthy foods; however, they rarely restrict foods with high levels of fat, salt and sugar, and the promotion of food sustainability is only just beginning. These guides should be reviewed and updated to include recommendations that promote healthy and sustainable food systems.

Objective: School-based interventions are common approaches to address childhood obesity; however, there is little understanding of strategies that can foster their implementation into schools. In this study, we aimed to identify goals and the specific strategies selected by school nutrition directors (SNDs) in Virginia to execute school-based interventions. Methods: Between 2018 and 2019, SNDs in Virginia participated in Team Nutrition workshops through which they created action plans. We carried out a content analysis of 132 action plans collected from 100 school divisions. We developed codes deductively and inductively. The codes captured plan completion, goals, and strategies. Each plan was independently coded by 2 coders. Results: Action plans included 1.2 goals (SD = 0.54) and 3.9 strategies per goal (SD = 2.1). Goals were most commonly related to improving menus or increasing participation in the school meal programs. The strategies varied based on the goals. However, obtaining buy-in from school personnel and students was the most commonly included goal (64.4%) across plans. The level of action plan completion decreased with each subsequent section of the worksheet. Conclusions: Emerging patterns identified in this study suggest SNDs' strategy selection is based on goals and that trainings should be tailored to promote the development of skills required to execute optimal strategies. [ABSTRACT FROM AUTHOR]

Objective: Social support is one of the predictors of nutrition behaviors. Therefore, measuring and improving the level of support is necessary to improve students' nutritional status. The purpose of this study was to design instruments and evaluate their psychometric properties for the evaluation of social support for breakfast and snack consumption. Methods: This methodological study was carried out from 2016 to 2018. The qualitative phase was performed in 3 Iranian cities: Isfahan, Khorramabad and Tehran. The quantitative phase was completed in Isfahan only. Initially, 2 questionnaires were developed using the results of the qualitative research. Subsequently, we assessed the face, content, and construct validity of both instruments. Results: The maternal support questionnaire consisted of 3 dimensions, including mother-sponsored support, family life pattern, and school-based collaboration, which explained 55.35% of the instrument's variance. The school support questionnaire comprised 2 dimensions including informational support and instrumental support, which explained 54.52% of the variance in the results. Conclusions: These instruments can be used to measure and improve social support by designing, implementing, and evaluating community-based campaigns and interventions to improve breakfast consumption and snacking behaviors among children and youth at home and in school. [ABSTRACT FROM AUTHOR]

Background: Adjustments in teaching resources and school meal programs are urgently needed during the COVID‐19 pandemic. This study examined teaching resources that would have been helpful when schools closed, and how school meal programs should be changed in the 2020‐2021 school year. Methods: In October 2020, a 27‐item, cross‐sectional, online survey was administered to 99 teachers and staff members in an urban, Midwestern school district. Data were analyzed using frequencies and proportions, and open‐ended responses were analyzed using content analysis. Results: Online teaching was difficult for teachers and students, and training for online teaching, improved Internet access, and more time for grading or office hours would have been helpful when schools closed. Meal programs were offered by 86% of schools after closing, and many participants supported continuing meal programs for 2020‐2021. Resources needed to continue meal programs included funding for meal reimbursement, transportation to the meal sites, and more staff. Suggested changes to meal programs included offering more variety or more food, and solving transportation issues. Conclusion: Addressing these concerns can improve school and community health. Findings will inform efforts to enhance online teaching and improve and continue school meal programs as the world continues to be affected by COVID‐19. [ABSTRACT FROM AUTHOR]

BACKGROUND Improving children's fruit and vegetable (FV) preferences may be important as preferences can predict FV consumption. The purpose of this study was to evaluate FV preferences over time, with repeated experience, as part of the Fresh Fruit and Vegetable Program (FFVP). METHODS: Fruits (F; N = 28) and vegetables (V; N = 29) were distributed twice a week, over 35 weeks, at a participating FFVP school (N = 236 students, 12 teachers, K‐2nd grade). Preference ratings using 3‐point Likert scale were analyzed over 35 weeks. RESULTS: For 57 FVs rated for preference, ratings revealed that F had higher frequency of children choosing "I like it" than for V (78% F; 38.2% V; p <.05) and liking distribution was different between F and V (p <.001). Significant relations were found between liking and: (1) grade (r = −0.02, p =.02), and (2) time (r = −0.09, p <.001). Models indicated that V served (β = −0.40), timepoint (β = −0.07), and grade level (β = −0.02) accounted for significant variance for preference ratings (R2 = 0.17, p <.001), indicating that preference ratings declined over time. CONCLUSIONS: Fruits were preferred over vegetables. Overall preference ratings were negatively impacted by time, grade level, and vegetables served. Being exposed one time to a variety of FVs did not improve ratings for vegetables. [ABSTRACT FROM AUTHOR]

BACKGROUND The study objective was to determine impact of a Farm‐to‐School intervention on low‐income, diverse elementary school students' nutrition‐related attitudes, self‐efficacy, behaviors, and locally grown vegetable choices. METHODS: Six elementary schools within 1 US school district were equally assigned to 1 of 3 conditions: Local Message, Nutrition Message, or Control. Locally grown vegetables (kale, green beans, zucchini, butternut squash, and beets) were served twice during lunch over 16 weeks. "Local" and "Nutrition" groups also received biweekly nutrition education and a messaging campaign in the cafeteria. Knowledge, attitudes, self‐efficacy, and related behaviors were assessed using a validated questionnaire. Vegetable selection was assessed using the food service daily production records. General linear model analysis, analysis of covariance, and t tests were performed. RESULTS: Students in the "Local" group (N = 81) had significantly improved nutrition‐related attitudes (p =.0001), preferences (p =.001), and overall vegetable behavior score (p =.002), compared to control (N = 79). There was no difference in overall locally grown vegetable choices, but local beet choices were higher in the "Local" (p =.005) and "Nutrition" (p =.02) groups compared to control. CONCLUSIONS: Messages about local foods in school cafeterias may improve students' attitudes, preferences, and selection of certain locally grown vegetables. [ABSTRACT FROM AUTHOR]

When school buildings across the U.S. closed in March 2020 due to the COVID-19 pandemic, many school districts mobilized to establish emer­gency school meal programs to operate outside the setting of school cafeterias. The aim of this conver­gent mixed-methods study is to (a) examine the structure and rates of participation in the spring 2020 meal programs in Connecticut, and (b) obtain insight about the challenges, strategies used, and lessons learned during this time by food service leaders. We obtained quantitative data from the Connecticut State Department of Education and district websites, and qualitative data from nine one-hour interviews with school food service lead­ers. Although the National School Lunch Program provides meals at standard price, reduced-price, or no cost based on student household income, all emergency meals during spring 2020 were provided at no cost following the school closures resulting from the COVID-19 public health emergency dec­lara­tion. The average number of meals distrib­uted from March to May 2020 was significantly lower than the overall participation rates (i.e., paid, free, and reduced-price meals combined) prior to COVID-19. However, participation rates in April and May 2020 approached those of free and reduced-price meal participation a year earlier. Four key action themes emerged from the interviews: (1) tailor the program to community needs and resources; (2) identify strategies to facilitate partici­pation; (3) develop partnerships to coordinate school, municipal, and community efforts; and (4) establish programs that encourage resiliency. The interviewees also saw this event as an oppor­tunity to improve the perception of school meals. Inno­vations developed during the spring 2020 school building closures provide a road map for best prac­tices for the 2020–2021 school year and beyond.

Recent research has indicated high economic and environmental costs of human paper usage. Technologies have been developed to reduce consumers' paper use behavior, including mechanical dispensers that institute a delay between opportunities to obtain each consecutive unit. However, there is no empirical evidence that these dispensers or delays reduce paper use. In Experiment 1, implementing a delay between paper-unit deliveries using mechanical dispensers in a university cafe resulted in a significant decrease in units per person, material per person, and cost per person, compared to free-access dispensers. In Experiment 2, a relatively long delay was more effective than a short delay in reducing paper consumption in a laboratory experiment using mechanical dispensers. These results indicate that delays could be used to decrease paper use in many contexts on a larger scale. More research is necessary to determine the underlying behavioral mechanisms responsible for the observed reduction and the cost-benefit relationship under different circumstances. Keywords Reinforcement delays * Paper dispensers * Sustainability * Climate change * Behavioral nudges, Sustainability is rooted in human behavior, which is controlled by variables that can be manipulated (Baum, 2005; Skinner, 1953; Ylek & Steg, 2007). Verbal strategies (e.g., requests, education, information) to [...]

When school buildings across the U.S. closed in March 2020 due to the COVID-19 pandemic, many school districts mobilized to establish emergency school meal programs to operate outside the setting of school cafeterias. The aim of this convergent mixed-methods study is to (a) examine the structure and rates of participation in the spring 2020 meal programs in Connecticut, and (b) obtain insight about the challenges, strategies used, and lessons learned during this time by food service leaders. We obtained quantitative data from the Connecticut State Department of Education and district websites, and qualitative data from nine one-hour interviews with school food service leaders. Although the National School Lunch Program provides meals at standard price, reduced-price, or no cost based on student household income, all emergency meals during spring 2020 were provided at no cost following the school closures resulting from the COVID-19 public health emergency declaration. The average number of meals distributed from March to May 2020 was significantly lower than the overall participation rates (i.e., paid, free, and reduced-price meals combined) prior to COVID-19. However, participation rates in April and May 2020 approached those of free and reduced-price meal participation a year earlier. Four key action themes emerged from the interviews: (1) tailor the program to community needs and resources; (2) identify strategies to facilitate participation; (3) develop partnerships to coordinate school, municipal, and community efforts; and (4) establish programs that encourage resiliency. The interviewees also saw this event as an opportunity to improve the perception of school meals. Innovations developed during the spring 2020 school building closures provide a road map for best practices for the 2020-2021 school year and beyond. [ABSTRACT FROM AUTHOR]

BACKGROUND: Few studies examine why rural public schools have weaker policies and practices related to school nutrition environments compared to their urban counterparts. It is important to understand this disparity because federal school meal standards aim for children to access health‐promoting nutrition environments. In this study, we identify challenges and opportunities for the implementation of school meal standards in rural high schools. METHODS: We interviewed 38 rural school professionals from 22 high schools across 7 states. School professionals included food service directors, principals, school nurses, and teachers. Team coding in Atlas.ti Qualitative Data Analysis software v8 and principles of comparative analysis were employed to generate themes related to challenges and opportunities. RESULTS: Overall, school professionals described improvements with implementation experiences and student acceptance over time. Key challenges included the negative influences of home and community food environments and limited staff size and capacity. Key opportunities involved joining co‐ops to enhance purchasing power, leveraging state technical assistance, and forming external partnerships. CONCLUSIONS: This study offers insights from a broad range of rural school professionals' implementation experiences. The findings can inform governments and technical assistance agencies working with rural schools and school districts to facilitate implementation and sustainability of initiatives. [ABSTRACT FROM AUTHOR]

Objective: The objective of this research was to determine the school and community characteristics associated with milk and milk alternative (MMA) consumption by Canadian youth. Methods: We analyzed self-reported data from 50,058 Canadian students participating in the 2017-2018 wave of the COMPASS survey. We used logistic and linear regression analyses to identify school- and community-level factors associated with students meeting the MMA guidelines, and factors associated with daily number of MMA servings consumed, respectively. Results: Student-level factors were more strongly associated with MMA consumption than school- and community-level factors. Students who attended schools that provided staff with nutrition training consumed fewer daily servings of MMAs and were less likely to meet MMA guidelines. Students attending schools that received healthy eating grants were more likely to meet MMA guidelines, whereas students attending schools that sold flavored milk in their vending machines were less likely to meet MMA guidelines. Conclusion: Our findings suggest that student-level factors have a stronger association with MMA consumption than school or community factors. Additional research is needed to understand how factors associated with MMA consumption may influence behaviours over time, and how changes to Canada's food guide may impact youth eating habits. [ABSTRACT FROM AUTHOR]

BACKGROUND: In Spartanburg County, SC, nearly 33.7% of children are overweight or obese. The purpose of this study was to investigate differences in eating behavior of youth by race/ethnicity and socioeconomic status. METHODS: Students (N = 997) in 4th to 5th grades completed the School Nutrition and Physical Activity Survey. School databases categorized students as either White or racial/ethnic minority and free/reduced or full paid lunch status. Dietary behaviors included 13 composite measures: unhealthy proteins, healthy proteins, dairy, refined grains, whole grains, vegetables, fruit, fried snacks, sugar‐sweetened beverages, sweets, and consumption of a breakfast, evening, and/or restaurant meal. Logistic regression, controlling for sex, was used to analyze differences in consumption for each nutrition variable. RESULTS: Minority youth were less likely to consume healthy proteins (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.55‐0.92) and more likely to eat at a restaurant (OR = 1.32, 95% CI = 1.02‐1.70) compared to white youth. Lower socioeconomic status youth were less likely to eat an evening meal compared to higher socioeconomic status youth (OR = 0.59, 95% CI = 0.39‐0.89). CONCLUSIONS: Differences in dietary behaviors may result from food accessibility and insecurity in minority and/or low‐income neighborhoods. Future research should explore policy strategies that can help ensure all youth maintain healthy eating habits and weight status. [ABSTRACT FROM AUTHOR]

Objective: Creating healthy food environments in schools is a national strategy to reduce childhood obesity. In this study, we explore the impact of major changes to school cafeterias on students. Method: We conducted a natural experiment of redesigns in 3 cafeterias within New York City (NYC) public high schools. All received an intervention, STARCafé, that changed the cafeteria serving line, dining area, aesthetics, and signage and menu. Student outcomes were school lunch consumption, participation, and attitudes measured at pre-redesign, 3-month, and oneyear post-redesign. Additional outcomes were fidelity to the Healthy Eating Design Guidelines and ripple effect on health-related programming. Results: STARCafé had a statistically significant and positive change on 4 of the 5 students' attitude scales (serving line, dining/seating space, aesthetics, and general) from pre-redesign to one-year post-redesign (all ps < .05), and a positive impact on school lunch participation (p = .04). There were no positive changes in school lunch consumption or on a ripple effect on additional health-related programming. Conclusions: Our results show that school cafeteria redesigns may promote long-term increases in participation and students' attitudes toward school lunch. Future studies are needed to understand how various redesigns and menu changes influence healthy eating behaviors such as increasing fruit and vegetable consumption. [ABSTRACT FROM AUTHOR]

BACKGROUND: We gathered baseline data about student need of healthy, free school food, and if current school meal programming serves students in need of healthy free school food, in anticipation of the completion of a district‐wide kitchen infrastructure and educational farm project in a high‐poverty urban school district. METHODS: We used mixed methods to assess student hunger, whether the school meal program met student needs, and to determine associations between presence of a cooking kitchen and perceptions of healthy food. Participants included 72 staff, 143 parents, and 6437 K‐5 students in the qualitative component, and 9078 parents and 1693 staff in the quantitative component. RESULTS: Staff participants stated packaging and reheating food influenced student consumption. During observations, students at seven of nine high poverty sites with packaged reheated food did not eat school meals, but this was not true at four out of four high‐poverty sites with unpackaged fresh food. Parents (OR = 1.17, 95% CI 1.00‐1.39) and staff (OR = 1.58, 95% CI 1.15‐2.17) from schools with a cooking kitchen were more likely to perceive school lunch as healthy in adjusted models. CONCLUSIONS: Food preparation and presentation appears to influence student consumption of school food and adult perception of school meal quality. [ABSTRACT FROM AUTHOR]

Objective: In this paper, we describe the implementation of a novel nutrition education intervention "¡Buen Provecho! - Eat Well" that aims to improve nutrition education, reduce food insecurity, increase healthy eating, and foster school engagement for families of pre-kindergarten through first grade students in 5 public schools in a low-income New York City neighborhood over 3 years. Methods: The intervention included free, weekly parent breakfasts with nutrition discussions, complemented by a common core-integrated classroom nutrition curriculum. A process evaluation assessed program uptake and feasibility of implementation, characterized participants, and identified lessons learned. Data sources included parent breakfast attendance records, parent surveys, and teacher interviews. Results: In the program's first year, 24% (169/717) of eligible children's parents attended at least one of the 130 breakfasts held. Parents redeemed 46% of the produce vouchers. We had 173 parents complete surveys. According to survey results, one-third of parents and children ate fruit daily, and 33% of children and 27% of parents ate vegetables daily. Nine of 36 teachers who had received the classroom curriculum were interviewed, and taught an average of 19% of the lessons from the curriculum. Conclusion: ¡Buen Provecho! - Eat Well has promising uptake and implementation. [ABSTRACT FROM AUTHOR]

BACKGROUND: A nutritious diet can prevent obesity and chronic disease and improve academic performance, yet many children have energy‐dense, nutrient‐poor diets. The objective of this study was to assess nutrition policies, practices, and environments in Georgia Supplemental Nutrition Assistance Program Education (SNAP‐Ed) elementary schools and compare them across school‐level demographic characteristics. METHODS: We distributed a cross‐sectional online survey to administrators, grade level chairs, and nutrition managers from 113 Georgia SNAP‐Ed elementary schools during 2015–2017. Logistic regression, one‐way ANOVA, and Tukey's tests were performed to assess differences by free and reduced‐price lunch eligibility and percentage black. Fisher's exact and Rao‐Scott chi‐square tests were performed to assess differences by school size and geography. RESULTS: The majority of schools established wellness policies and committees, provided nutrition education, and offered fresh fruits and/or vegetables daily. Fewer schools had policies limiting sugar‐sweetened foods within classrooms or had established a school garden. There were minimal significant differences in survey responses across school‐level demographics. CONCLUSIONS: Georgia SNAP‐Ed elementary schools are providing healthy nutrition settings for their students in a number of areas, and can further improve by establishing more comprehensive wellness policies, a committee to enforce them, and engaging children in hands‐on nutrition education activities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Childhood malnutrition is commonplace among poor rural communities in China. In 2012, China launched its first nationwide school‐feeding program (SFP) to address this problem. This study examines the prevalence of malnutrition before and after the SFP and identifies possible reasons for the trends observed. METHODS: Ordinary least squares regression and propensity score matching were used to analyze data from 2 cross‐sectional surveys of 100 rural primary schools in northwestern China. Participants were fourth‐and fifth‐grade students. Outcome measures include anemia rates, hemoglobin levels, body mass index, and height for age Z scores. RESULTS: Three years after implementation of the SFP, malnutrition rates among sample students had not fallen. The SFP had no statistically significant effect on either anemia rates or BMI, but was linked to an increase in the proportion of students with below normal height for age Z scores. Meals provided to students fell far short of national recommendations that the SPF should provide 40% of the recommended daily allowance of micronutrients. CONCLUSIONS: Despite significant budgetary outlays between 2012 and 2015, China's SFP has not reduced the prevalence of malnutrition among sample students. To make the SFP more effective, funding and human resources both need to be increased. [ABSTRACT FROM AUTHOR]