Objective: This article aims to review the history of the school lunch program in Japan and to clarify matters that are important for other countries trying to start and develop a sustainable school lunch program.
Method: Literature and reports on the school lunch program were searched, selected and analyzed.
Results: The sustainable school lunch program in Japan was developed after the School Lunch Act was enacted in 1954, in which the school lunch was positioned as an educational activity, and government financial subsidies were legislated. In addition, in order to provide meals that are safe and suitable for the growth of school children, professionals with a dietitian license were appointed for the operational management of school lunches, and the diet and nutrition teacher system was established in 2004. The nutritional standards for school lunches have repeatedly been revised to ensure the maintenance and improvement of the nutritional status of growing children. In 2008, the objectives and targets of the School Lunch Act were revised.
Conclusion: The sustainable school lunch program in Japan developed owing to the School Lunch Act that clarified its objectives, established a financial foundation, and positioned professionals to manage it. Legislative preparations, including the revision of the necessary standards in response to social backgrounds and issues, are essential for the continuous advancement of the school lunch program.
Objective: This study aimed to outline the operation of the Japanese school lunch system with reference to the cooking delivery system, operation organization, finances, and management resources, in addition to discussing the development of a sustainable school lunch system.
Method: Laws and public notices, and general statistical surveys of the relevant government bodies and municipalities published on the Internet have been cited to enable foreign countries to utilize the discussed contents in the implementation of such programs in their country.
Results: Japanese school lunches are systematized and operated under the guidance of the Board of Education of the Prefecture or designated city and the Board of Education of the municipality based on the laws established by the Ministry of Education, Culture, Sports, Science and Technology. The operation system has been developed to ensure continuous safety management to avoid health hazards owing to school lunch consumption.
Conclusions: The School Lunch Act and many other laws and regulations related to the school lunch enabled the establishment of a sustainable system for the provision of school lunch in Japan. Japan employs a cooking delivery system in which designated personnel decide and establish an organized system according to specific guidelines. These factors helped construct this sustainable system.
Objective: This study aimed to ascertain the philosophy and utilization of the current dietary reference intakes of school lunch programs in terms of nutritional management and indicate the role thereof by examining the changes in nutritional management implemented on the basis of the School Lunch Act enacted in 1954.
Methods: We summarized the role of nutritional management of school lunches by carefully examining the information required for nutritional management through an examination of the history, laws, results of surveys serving as indicators of nutritional management reforms, revisions in nutritional management of school lunches and the circumstances surrounding those revisions, survey reference materials on current nutritional management of school lunches, and a search of the literature, including previous researches regarding changes in nutritional management of school lunches in Japan from World War II to the present.
Results: The School Lunch Act was enacted following the World War II for the purpose of indicating basic nutritional standards and standard dietary composition tables relating to nutritional management, and nutrition and meal plans have since been implemented on the basis thereof. The menu contents of school lunches have been periodically revised based on survey results accompanied by changes in Japanese eating habits, and menu plans have been devised in consideration of incorporating a diverse range of foods and regional characteristics, with school lunches incorporating more than one-third of those nutrients unlikely to be consumed in the home each day.
Conclusion: The nutritional management of school lunches in Japan following the World War II has been revised in response to the changing times based on the School Lunch Act. The dietary pattern of school lunches in Japan established as full meal consisting of staple food, milk and an accompanying dish. Nutritional Standards were set to higher standard values than one-third of the daily energy requirement and one-third or more of the daily nutrient intake based on the actual circumstances surrounding the schoolchildren. Menu controls were developed by suitably combining a diverse range of foods while considering such factors as regional characteristics based on the Nutritional Standard values and contribute to the daily dietary intake status of schoolchildren.
Objective: School lunch programs maintain and enhance the nutritional status of schoolchildren and assist in the healthy development of the children. The aims of this study were to observe and assess how quality control and nutrition and meal management systems are operated in a Japanese elementary school lunch program and to reveal current practices.
Methods: A key informant interview with the diet and nutrition teacher in charge of the school lunch program was conducted to assess the food service management system at A Elementary School, a public school in Saitama Prefecture. Details of current practices in preparing and serving school lunches, data on intake status, and information on the physical conditions of the schoolchildren were collected from three types of records (a scheduled school lunch menu, a stockpot quantity chart, and a plate waste log) for the months of April and September 2015 and January 2016. The energy targets, energy intake, and 33% of the estimated energy requirements (EERs) were then compared.
Results: The energy targets for school lunches was calculated by using the values for grades 3 and 4 as a reference and was revised three times per year (April 2015, September 2015, and January 2016) to account for the growth of the children. These target values for the service standard of energy, which were determined 2 months before the commencement of the school lunch program, exceeded the representative value; in other words, 33% of the EER at the time of serving the meals. The food service management system used the energy targets for grades 3 and 4 as the reference for planning menus and used conversion factors (80% for grades 1 and 2, 100% for grades 3 and 4, and 120% for grades 5 and 6) to determine adequate serving portions. Regarding school lunch consumption levels, although some plate waste was observed among children in grades 1 and 2, none was seen in grades 3 to 6. The energy intake of school lunches exceeded 33% of EER, and the values increased as the grades got higher. The observed values also increased over the 3 recorded months.
Conclusion: In the food service management system of A Elementary School, the energy targets for school lunches was set higher than 33% of EER. Although some food waste was seen in grades 1 and 2, none was seen in grades 3 to 6. Proper quality control was practiced in the school lunch program, which indicated that proper nutrition and meal management of schoolchildren was being conducted.
Purpose: A systematic review was undertaken for the purpose of determining trends in food and nutrition education utilizing school lunches following the enactment of the Shokuiku Basic Act in 2005.
Method: A search for academic papers published over the 12-year period from 2005 to 2016 was conducted using the database of the Japan Medical Abstracts Society as well as a manual search. The criteria for selection were as follows: Firstly, papers had to be published in reviewed academic journals. Secondly, papers had to be original articles. Thirdly, the subjects of the papers had to be Japanese elementary school or junior high school students. Fourthly, the contents had to relate to the school lunch program. Fifthly, the papers had to contain statistical analyses.
Results: A total of 165 papers were selected from the database search and 86 papers from the manual search. Eleven papers were ultimately chosen. The contents of these papers comprised food and nutrition education taught in the classroom (eight papers) and food and nutrition education that utilized school lunch times (three papers). The reports were published following the enactment of the Shokuiku Basic Act in 2005 and the School Lunch Act in 2008. Three papers were published in the period 2005 to 2010 and eight in the period 2011 to 2016.
Conclusion: In recent years there has been an increase in the number of reports relating to food and nutrition education using school lunches with the recommendation that this method of education becomes part of the curriculum.
Objective: This study aimed to examine a historical verification of hygiene management and food allergy management of school lunches in Japan.
Methods: We investigated the trend of past food poisoning from school lunches. We also examined each of the Standards of Hygiene Control of School Lunches. Furthermore, we investigated the historical backgrounds of standards related to hygiene management of school lunches, and showed changes in such standards up to the present. Regarding food allergies, we compiled data on current efforts by the Ministry of Education, Culture, Sports, Science and Technology (MEXT).
Results: Prompted by the first food poisoning fatalities caused by school lunches, the then Ministry of Education (currently MEXT) issued the Standards of Hygiene Control of School Lunches ("Old Standards") as a notice in 1997. Subsequently, the "School Lunch Act" was largely revised and came into force on April 1, 2009, to work out an appropriate implementation of hygiene management. Under this revision, Article 9 of the School Lunch Act set the Standards of Hygiene Control of School Lunches according to a standard stipulated by MEXT ("New Standards"). Currently, each board of education in each territory is preparing and improving the manuals under the food allergy guidelines at school lunches.
Conclusions: For measures against both food poisoning and food allergies, it is important to decrease human errors as well as to educate people.
Objective: To compile rules concerning monitoring and evaluation systems related to implementation of the school lunch program in Japan based on the Plan-Do-Check-Act (PDCA) cycle.
Methods: Using surveys conducted by MEXT and related organizations, we compiled data on monitoring and evaluation and then extracted and organized monitoring/evaluation items, document titles, subjects, implementation time, and frequency.
Results: Monitoring and evaluation systems were divided into two categories: "Healthy development of children" and "Operation of school lunch programs." Both should be conducted in conjunction with each other. For "healthy development of children," it is necessary to evaluate school children's dietary habits, attitudes, QOL, and health status. Concerning "operation of school lunch programs," an understanding is required of nutrition/dietary controls, menu controls, receiving, storage and inventory control of foodstuffs, financial management, food safety and hygiene management, and quality control. "Nutritional Standards" corresponding to nutrition and dietary control, and the implementation status of school lunch programs are reported annually. As a result, an increase in children's height and body weight has been observed in line with improvements in school lunches and the overall quality of meals.
Conclusion: School lunch programs in Japan play an important educational role. To be successful, it requires coordinated monitoring and evaluation of school children's status and the operation of the program.
Objectives: In Indonesia, many schools do not have school feeding programs, and children usually buy snacks from school canteens or vendors. The history of the country's school feeding programs is not well documented. This study examined Indonesia's nutritional problems and previous school feeding programs. It also investigated the implementation and related challenges in a current pilot national school feeding program known as PROGAS.
Methods: We conducted situational analysis by reviewing secondary data and the existing literature. We also measured the impact of PROGAS on students' nutritional status.
Results: The review revealed that Indonesia has considerable experience in establishing school feeding programs starting from 1991. The government has established a system from the school to central government level for the quality control, monitoring, and assessment of the pilot program. That program is characterized by its wide scope including improvement in students' dietary intake, promotion of local food, improvement in local agriculture, and community empowerment. However, due to the limited resources allocated to human development, diversity in the country, and difficulty in governance, the low coverage of the program (0.05% in 2013 and 0.14% in 2016) is still a major challenge. Among the students who joined PROGAS project, nutritional intake significantly increased during the project, while there were no changes in the control group.
Conclusions: Low coverage of the school feeding program is still a major challenge in Indonesia. In the future, government regulations to increase the program's coverage and nutrition education on all forms of malnutrition targeting school-aged children is necessary.
Objective: The School-based Feeding Program (SBFP) was implemented in the Philippines in 1997. We clarified the current aims and situation of the SBFP and assessed this program.
Methods: One of the authors, who has worked in this country, received related documents and information. She also visited elementary schools to observe the SBFP and interviewed teachers and nurses to grasp the real situation.
Results: The SBFP aims to improve school attendance and the nutritional status of target beneficiaries, to conduct group hand washing and tooth brushing activities, and to encourage backyard vegetable gardening to support the feeding program. The target beneficiaries are all either wasted or severely wasted kindergarten to Grade 6 children in public educational institutions who were evaluated by nutritional assessment. With respect to improved school presence, growth of vegetables, and observed positive health habits and behaviors, the SBFP might be evaluated as a "well managed program". Meanwhile, no nutritionists or dietitians are allocated in the schools, and no recommended nutritional intake values seem to have been established in the SBFP. Besides, the status of undernourished children remains unchanged and overweight or obese children have gradually increased. Concerning nutrition education, it is integrated in a specific subject, but sufficient textbooks and materials are not prepared.
Conclusion: The SBFP seems to produce good yearly achievements in terms of some original aims. However, nutritional problems of the students and the shortage of human resources remain. To promote positive health conditions in the children, improvement in these issues in the SBFP and further education are required.
Objective: To describe the Indian school meal program (Mid-Day Meal: MDM) with the aim of improving the nutritional status of children.
Method: This study investigated the Indian central government's reports and articles about the school meal program.
Results: In India, the MDM has been institutionalized, along with compulsory education. In 2015~2016, MDM coverage was 81%, with a high proportion of MDM working days. However, the school attendance rate was low, with many absent children. Despite established nutritional standards for school meals and hygiene management guidelines, there were no data on school compliance rates. To evaluate processes, each school reported to the central government, as part of a national system of monitoring system operational situations (e.g., coverage). The expected improvement in children's nutritional status after the introduction of the MDM has never been confirmed because no national health survey has been carried out to evaluate outcomes. By introducing the MDM and promoting compulsory education, the central government has triggered a rise in school enrollment rates. A plan-do-check-act (PDCA) system is in place, with a Steering-cum-Monitoring Committee assuming a key role in this system.
Conclusions: When the MDM was institutionalized in India, along with compulsory education, it represented the world's largest school meal program. The Japanese experience of introducing a children's national health surveillance system could be useful in evaluating the success of the MDM program in improving children's nutrition.
Objective: This review was conducted to clarify the current status and challenges regarding school meal program in Brazil, with a particular focus on improving children's nutritional status through an evaluation system that addresses coverage and nutritional quality.
Methods: Relevant articles were searched in Portuguese and English through government databases, as well as PubMed, Scientific Electronic Library Online, and Science Direct.
Results: Brazil's national school meal program has existed since 1955. The National School Feeding Program (Programa Nacional de Alimentação Escolar; PNAE) is a public policy initiative, which aims to contribute to healthy biopsychosocial development, learning, school performance, and healthy eating habits through food and nutritional education activities. This is also accomplished by offering meals that meet defined nutritional needs during the school year. This program is designed for students enrolled in educational institutions within public networks at the federal, state, and municipal levels, including schools in areas populated by indigenous and Quilombo remnants. All public schools must offer school meals and meet at least between 20% and 70% of a child's daily nutritional needs. Menus must be planned by nutritionists, respecting local habits and food traditions. However, the PNAE continues to experience issues, mainly related to infrastructure problems at the school level, compliance with legislative standards at the implementation level, and national monitoring and evaluation system shortcomings.
Conclusion: School meal program in Brazil is very important for meeting children's nutritional needs, as well as for providing nutritional education in order to promote healthy child development.
Objective: The National School Lunch Program (NSLP) is a federally assisted meal program in the United States (US) that provides nutritionally balanced and free or low-cost lunches each school day to 30.4 million students, including more than 22 million low-income students. Since its inception in 1946, the program has undergone many modifications, including a shift in focus from addressing under- to over-nutrition. Most recently, the US Congress passed the Healthy, Hunger-Free Kids Act of 2010 to help address hunger and obesity among the nation's children. The purpose of this paper is to provide a brief overview of the NSLP.
Methods: This paper is based on a review of relevant technical documents, peer-reviewed literature and grey literature. The authors also used their collective school lunch research and practice experience to identify the most salient points to address.
Results: The following areas of the NSLP are presented: how it is administered; recent changes to the meal patterns and nutrition standards; revenue and costs; research and evaluation conducted after passage of the Healthy, Hunger-Free Kids Act; and current initiatives to enhance the NSLP.
Conclusions: The Healthy, Hunger-Free Kids Act improved the NSLP meal patterns and nutrition standards by aligning them with the Dietary Guidelines for Americans. Early published research on the impact of the updated meal patterns and nutrition standards on student dietary outcomes is promising and efforts to further enhance the NSLP are being implemented across the nation.