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Accepted manuscript

What’s on the Menu? A Review of School Meal Quality Across 29 Countries

Published online by Cambridge University Press:  17 April 2026

Aisha Kanté*
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
Aulo Gelli
Affiliation:
International Food Policy Research Institute (IFPRI), Washington DC, United States
Winnie Bell
Affiliation:
Intake - Center for Dietary Assessment at FHI 360, Washington, DC, United States
Ayala Wineman
Affiliation:
Global Child Nutrition Foundation, Seattle, Washington, United States Department of Agriculture, Food, and Resource Economics, Michigan State University, East Lansing, Michigan, United States
*
Corresponding Author: Aisha Kanté, 600 S Belnord Ave, Baltimore, MD, 21224, akante2@jh.edu
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Abstract

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Objective:

The double burden of malnutrition (DBM) – the coexistence of undernutrition and overweight/obesity – poses a critical global health challenge, particularly for children and adolescents. School meal programs offer an opportunity to address the DBM by providing nutritious meals that support growth, development, and lifelong health. However, limited school meal quality data hinders effective program design. This study evaluates global school meal quality through nutrient composition analyses and the Global Diet Quality Score (GDQS)-Meal and -Menu metrics.

Design:

Data were collected from the Global Child Nutrition Foundation’s 2024 Global Survey of School Meal Programs, grey literature, and in-country stakeholders. Nutritional content was compared to age-specific Nutrient Reference Values, including Harmonized Average Requirements. The nutritional quality of meals and menus was assessed using GDQS metrics based on 25 food groups.

Setting:

Twenty-nine countries across diverse geographic and socioeconomic contexts.

Participants:

Not applicable.

Results:

Most menus met or exceeded 30% of recommended daily nutrient values. Lunches had the highest nutrient contributions, followed by snacks and breakfasts. GDQS-Meal and -Menu scores revealed variability across age groups, meal types, and countries. Overall, 57% of menus achieved high nutritional quality, 37% medium, and 6% low. Few menus lost points for unhealthy components. Diverse, balanced menus with healthy food groups scored higher, though fortification also proved nutritionally valuable.

Conclusions:

While most menus contribute significantly to daily nutrient needs, variability across countries, age groups, and meal types highlights opportunities for context-specific improvements through diversification and fortification. Learning from high-performing peer programs can help identify feasible improvements.

Information

Type
Research Paper
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society