Is school lunch participation associated with higher adherence to the Mediterranean Diet and healthier body weight? a cross-sectional analysis of baseline data from the R23 project

Abstract

<jats:p>Introduction: School lunches are essential in promoting a sustainable, healthy diet for children. However, students adherence in developed countries is modest. Objectives: A cross-sectional study with the objective of evaluating school lunch participation and exploring the factors influencing participation and its associations with sociodemographic characteristics, socioeconomic status, body weight, and adherence to the Mediterranean Dietary Pattern. Methodology: Baseline results from the R23 project, collected during the first five weeks of the 2022/23 school year, were used. In total, 806 students, aged 1016 years, from the 2nd and 3rd cycles of basic education in Portugal, Benavente, participated in this study. Using a face-to-face structured questionnaire, students sociodemographic data, socioeconomic status, adherence to the Mediterranean Dietary Pattern, and school lunch participation were assessed. Daily school lunch participation was obtained via the school lunch booking service. Anthropometric measurements (weight, height and waist circumference) were performed on all students with signed consent forms. Results: The school lunch participation rate was 25.3%. Overall, 39.1% of students reported never attending the school canteen. Only 27% of the students eligible for Free or Reduced-Price Meals had an effective adherence to school lunch, and the non-participation rate in this group was 31%. Key barriers included living near to school and dissatisfaction with meal quality. Students' school lunch participation was significantly associated with age, grade, eligibility for Free or Reduced-Price Meals, and adherence to Mediterranean Dietary Pattern. Younger students and students eligible for Free or Reduced-Price Meals went to the canteen more often. While school lunch participation was positively and significantly associated with higher adherence to Mediterranean Dietary Pattern, no significant relationship was observed with body mass index or waist-to-height ratio. Students with greater adherence to Mediterranean Dietary Pattern displayed healthier body mass index and waist-to-height ratio. Conclusions: School lunch participation among adolescents was low, but increased participation was associated with higher adherence to the Mediterranean Dietary Pattern. These findings highlight the importance of school lunches in promoting healthier eating habits.</jats:p>