Emma Patterson1, Liselotte Schäfer Elinder2. 1. 1 Center for Epidemiology and Social Medicine, Stockholm County Council, Sweden 2 Deparment of Public Health Sciences, Karolinska Institutet, Sweden emma.patterson@ki.se. 2. 1 Center for Epidemiology and Social Medicine, Stockholm County Council, Sweden 2 Deparment of Public Health Sciences, Karolinska Institutet, Sweden.
Abstract
BACKGROUND: Sweden provides a free school lunch to every child in the compulsory (9-year) school system. It consists of a hot meal, a salad buffet, bread and a beverage. The Education Act states it must be free of charge (since 1997) and 'nutritious' (since 2011). No standards/limits are specified but voluntary guidelines for serving of the school meal exist. We describe how school meal quality has changed since 2011. METHODS: A random sample of schools were contacted in spring 2011 and invited to use a novel web-based instrument to evaluate school meal quality. In spring 2013, the participating schools (N = 191) were encouraged to use it again and 97 did. The outcomes were measures of quality including food provision/choice, adherence to serving guidelines and, using validated food-based criteria, nutritional quality. RESULTS: No change was seen in the proportion offering alternative options daily, but a vegetarian option was significantly more widely available in 2013. Adherence to all but one of the studied serving guidelines improved, although this reached significance for only a small number. Adherence to two of the four nutrient criteria improved significantly. CONCLUSION: Two years after the introduction of new legislation, school meal quality in Sweden has improved modestly. The effect of the law itself is difficult to separate from other influences, including the effect of monitoring. Extended follow-up of schools will allow us to evaluate the longer-term changes and effects on health, learning and equality in health.
BACKGROUND: Sweden provides a free school lunch to every child in the compulsory (9-year) school system. It consists of a hot meal, a salad buffet, bread and a beverage. The Education Act states it must be free of charge (since 1997) and 'nutritious' (since 2011). No standards/limits are specified but voluntary guidelines for serving of the school meal exist. We describe how school meal quality has changed since 2011. METHODS: A random sample of schools were contacted in spring 2011 and invited to use a novel web-based instrument to evaluate school meal quality. In spring 2013, the participating schools (N = 191) were encouraged to use it again and 97 did. The outcomes were measures of quality including food provision/choice, adherence to serving guidelines and, using validated food-based criteria, nutritional quality. RESULTS: No change was seen in the proportion offering alternative options daily, but a vegetarian option was significantly more widely available in 2013. Adherence to all but one of the studied serving guidelines improved, although this reached significance for only a small number. Adherence to two of the four nutrient criteria improved significantly. CONCLUSION: Two years after the introduction of new legislation, school meal quality in Sweden has improved modestly. The effect of the law itself is difficult to separate from other influences, including the effect of monitoring. Extended follow-up of schools will allow us to evaluate the longer-term changes and effects on health, learning and equality in health.
Authors: Patricia Jane Lucas; Emma Patterson; Gary Sacks; Natassja Billich; Charlotte Elizabeth Louise Evans Journal: Nutrients Date: 2017-07-11 Impact factor: 5.717
Authors: Patricia Eustachio Colombo; Emma Patterson; Liselotte S Elinder; Anna Karin Lindroos Journal: Public Health Nutr Date: 2020-04-21 Impact factor: 4.022
Authors: Patricia Eustachio Colombo; Emma Patterson; Liselotte Schäfer Elinder; Anna Karin Lindroos; Ulf Sonesson; Nicole Darmon; Alexandr Parlesak Journal: Int J Environ Res Public Health Date: 2019-08-21 Impact factor: 3.390
Authors: Lily Grigsby-Duffy; Ruby Brooks; Tara Boelsen-Robinson; Miranda R Blake; Kathryn Backholer; Claire Palermo; Anna Peeters Journal: Health Promot Int Date: 2022-10-01 Impact factor: 3.734