Robust implementation of school food policy is needed to improve nutritional outcomes of children in European and Western Pacific countries: A systematic review

Objective: The present systematic review explored compliance status with school food policies in Europe and the Western Pacific regions, challenges and facilitators of policy compliance, and its impact on children's diets and nutrient intakes. Research Methods: An electronic search for full -text research articles published between January 2009 and July 2023 was conducted in Science Direct and PubMed scientific databases. Results: A total of 659 titles and abstracts were screened, and final data was extracted from 34 included studies. Results showed low compliance with the school food policy in Europe and the Western Pacific regions. The European schools chad better compliance than the Western Pacific, and supportive interventions improved policy adherence. Impact assessment studies reported that the implementation of the school food policy increased fruit and vegetable consumption, thus increasing nutrient intakes (vitamin A, vitamin D, iron, calcium, folate, and dietary fibers). However, its impact on the availability and consumption of foods high in fat, sugar, and salt (HFSS) was less conclusive. The effects of the policy on the school food environment indicated no significant improvement. Conclusion: Results highlighted the need for additional support and surveillance at the school level to ensure adequate policy compliance. (c) 2024 Elsevier Inc. All rights reserved.