Background: Little is known about differences in the characteristics of and problems associated with school lunch provision for food allergy among day nurseries, kindergartens, elementary schools, and junior high schools.
Objectives and Methods: For the purpose of establishing institution-specific, flexible strategies for school lunch provision for food allergy, we investigated the actual conditions of such provision among day nurseries, kindergartens, elementary schools, and junior high schools in Tochigi Prefecture and performed a comparative analysis.
Results: We found that (i) there were no significant between-institution differences in the retention rate for food allergic children receiving school lunch provision; (ii) compared to other institutions, day nurseries were more likely to require an instruction from a physician to commence the school lunch provision, many of which supplied elimination and alternative diets; and (iii) all institutions were faced with difficulties associated with school lunch provision for food allergy, with elementary schools and junior high schools citing "facility and equipment deficiencies" at a particularly high rate.
Conclusions: The study revealed differences in the characteristics of and problems associated with school lunch provision for food allergy across the institutions. The results suggest the necessity of school lunch provision for food allergy to consider the characteristic of each institution's lunch system.
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