A comparison of British school meals and packed lunches from 1990 to 2007: meta-analysis by lunch type.

Primary school children in the UK have the choice of a school meal provided by the school or a packed lunch provided from home. Currently, more than half of primary school children have a packed lunch. New food-based standards for school meals were introduced in English primary schools in 2006, followed by nutrient-based standards in 2008. No formal comparisons of primary school lunches by lunch type have been undertaken to date. The present review identified seven studies from 1990 to 2007 measuring lunchtime nutrient intake in children aged 5-11 years having a school meal and children having a packed lunch. Pooled estimates for each nutrient were as follows: energy intake was 543 (95 % CI 233, 854) kJ higher in packed lunches; total sugar intake was 14.0 (95 % CI 10.3, 17.7) g higher in packed lunches; non-milk extrinsic sugar intake was 11.7 (95 % CI 7.3, 16.2) g higher in packed lunches; saturated fat intake was 4.7 (95 % CI 2.4, 7.1) g higher in packed lunches and Na intake was 357 (95 % CI 174, 539) mg higher in packed lunches. Differences between school meals and packed lunches were larger for all nutrients after the introduction of food-based standards compared with the period of no standards. However, differences between before and after standards did not reach statistical significance. The nutritional quality of packed lunches is poor compared with school meals. The introduction of food-based standards for school meals in 2006 has moderately improved the nutrient content of school meals, slightly widening the nutritional gap between school meals and packed lunches.