The Impact of Modifying Food Service Practices in Secondary Schools Providing a Routine Meal Service on Student's Food Behaviours, Health and Dining Experience: A Systematic Review and Meta-Analysis

The education sector is recognised as an ideal platform to promote good nutrition and decision making around food and eating. Examining adolescents in this setting is important because of the unique features of adolescence compared to younger childhood. This systematic review and meta-analysis examine interventions in secondary schools that provide a routine meal service and the impact on adolescents’ food behaviours, health and dining experience in this setting. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Cochrane Handbook recommendations. Studies published in English searched in four databases and a hand search yielded 42 interventions in 35 studies. Risk of bias was assessed independently by two reviewers. Interventions were classified using the NOURISHING framework, and their impact analysed using meta-analysis, vote-counting synthesis or narrative summary. The meta-analysis showed an improvement in students selecting vegetables (odds ratio (OR): 1.39; 1.12 to 1.23; p = 0.002), fruit serves selected (mean difference (MD): 0.09; 0.09 to 0.09; p < 0.001) and consumed (MD: 0.10; 0.04 to 0.15; p < 0.001), and vegetable serves consumed (MD: 0.06; 0.01 to 0.10; p = 0.024). Vote-counting showed a positive impact for most interventions that measured selection (15 of 25; 41% to 77%; p = 0.002) and consumption (14 of 24; 39% to 76%; p = 0.013) of a meal component. Interventions that integrate improving menu quality, assess palatability, accessibility of healthier options, and student engagement can enhance success. These results should be interpreted with caution as most studies were not methodologically strong and at higher risk of bias. There is a need for higher quality pragmatic trials, strategies to build and measure sustained change, and evaluation of end-user attitudes and perceptions towards intervention components and implementation for greater insight into intervention success and future directions (PROSPERO registration: CRD42020167133).

Artificial Intelligence (AI) for Sustainable Institutional Food Systems: Implementation of AI Tools for School Nutrition Program Management in the United States of America

School food programs can improve the nutritional status at community level, and can be a powerful tool to facilitate a transition to sustainable food systems, particularly through their purchasing methods and meal/waste management. Artificial Intelligence (AI) can enable or inhibit transitions to sustainability, due to its capacity to facilitate transformational change and disruption. Thus, AI can have major impacts on achieving the United Nations' Sustainable Development Goals (SDGs), including those related to food systems. This paper focuses on critically exploring different aspects during the implementation of a software project in US schools that used AI techniques to enable agility and provide healthy food options for schoolchildren. Participant observation, semi-structured interviews, and document analysis were used to inform the case study and uncover the new processes developed using the technology. As a key barrier to the effective management of school food programs and nutrition is the administrative load associated with statutory compliance, this case study demonstrates the difference that AI-powered tools can make in alleviating the weight of administrative processes. An Information and Communication Technology (ICT)-enabled boundary spanning framework is used to extend the case study toward an analysis of the systems, boundaries, relationships and perspectives which starts mapping the areas where the private sector, public institutions and civil society can meet to fast-track sustainable transition activities, particularly in the context of food systems. This article presents some possible approaches to facilitating these activities, inviting policy makers to bridge the gap with businesses and use business agility to support common societal goals to achieve sustainable food systems.

An ethnographic study exploring factors that minimize lunch waste in Tokyo elementary schools

OBJECTIVE

To explore factors that minimize lunch waste in Tokyo elementary schools and to consider how such factors can be modified and applied in US schools.

DESIGN

Focused ethnographic study using interviews, observation, participant observation and document review. Data were analysed using thematic analysis.

SETTING

Tokyo, Japan.

PARTICIPANTS

Five school dietitians participated in the study. Data collection methods included in-depth interviews, observation of nutrition education lessons, participant observation of school lunchtime and review of relevant school documents (e.g. lunch menus, food waste records).

RESULTS

Five themes emerged from the analysis: (i) reinforcement of social norms to eat without waste; (ii) menu planning to increase exposure to unfamiliar and/or disliked foods; (iii) integration of food and nutrition education into the school curriculum; (iv) teacher lunchtime practices related to portion sizes, distributing leftover food and time management; and (v) engagement of students in reducing school lunch waste. Practical and tangible applications to US schools include measuring and reporting lunch waste to influence social norms, teaching students about the importance of reducing food waste, offering flexible school lunch portion sizes and providing students with meaningful opportunities to contribute to solving the problem of school lunch waste.

CONCLUSIONS

Japan offers a model for minimizing school lunch waste through a holistic approach that includes factors that operate at and interact across multiple levels of society. Modifying and applying such an approach in US schools is worth considering given the urgent need to address food waste in order to support healthy diets and sustainable food systems.