Public Health Nutrition最新文献

{"title":"The environmental impact of diet in Latin American populations: a systematic review with meta-analysis.","authors":"C Araya-Bastias, J M F Garzillo, S Parra-Soto, J J Anderson, D Lee, J P Pell, C Celis-Morales","doi":"10.1017/S1368980026102584","DOIUrl":"https://doi.org/10.1017/S1368980026102584","url":null,"abstract":"<p><strong>Objective: </strong>To examine and synthesize data on the environmental impact of diet in Latin America.</p><p><strong>Design: </strong>A systematic review was conducted in April 2024, using Medline, Embase, Web of Science and Scopus databases, and updated in March 2025. We synthesized the evidence on the most reported environmental impact indicators. Meta-analysis was conducted to derive pooled estimates for individual countries of the mean dietary carbon and water footprints per person/per day; crude and energy-standardised (to 8,368 kJ (2,000 kcal)) values and stratified by dietary assessment method (DAM) and sociodemographic variables.</p><p><strong>Setting: </strong>Latin America.</p><p><strong>Participants: </strong>Latin American populations.</p><p><strong>Results: </strong>Of the 4,266 studies screened, 31 were included. Data on environmental impact of diet were reported for eight Latin American countries, with most coming from Brazil. Dietary water footprint ranged from 2,078 in Chile to 3,215 L/person/day/8,368 kJ in Brazil. Dietary carbon footprint ranged from 2.1 to 7.3 kgCO₂-equivalents/person/day/8,368 kJ, in Peru and Argentina, respectively. The pooled standardised carbon footprint mean was 4.1 (95% CI 2.6-5.5, I²=100%) kgCO₂-equivalents/person/day/8,368 kJ with no significant differences between DAM (p=0.86). A higher carbon footprint was observed in individuals with higher education level and urban residence (p<0.05).</p><p><strong>Conclusion: </strong>The available evidence suggested a wide variation in dietary environmental impact between Latin American countries, but a paucity of studies conducted in countries other than Brazil. Standardised approach to estimate the environmental impact of diet across the region, and analytical perspectives in further research would support the development of country-relevant evidence-based public policies for sustainable diets in Latin America.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-41"},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between adherence to the DASH diet and depression and anxiety severity in the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study population.","authors":"Sanaz Soltani, Hamid Reza Rahimi, Najmeh Seifi, Mahyaar Omouri-Kharashtomi, Narges Norouzkhani, Mahsa Ahsan, Mehrnoosh Mohtarami, Fatemeh Mohammadian Sadabad, Negin Sarvari, Gordon A Ferns, Majid Ghayour-Mobarhan","doi":"10.1017/S1368980026102110","DOIUrl":"https://doi.org/10.1017/S1368980026102110","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to investigate the association between adherence to the DASH diet and the risk of depression and anxiety severity in a large group of Iranian adults.</p><p><strong>Design: </strong>In this cross-sectional study, dietary intakes were assessed using a validated 65-item food frequency questionnaire. The Beck Anxiety Inventory and the Beck Depression Inventory II were used to assess anxiety and depression, respectively. Ordinal logistic regression was applied to evaluate the association between DASH diet and depression and anxiety severity.</p><p><strong>Setting: </strong>Mashhad stroke and heart atherosclerosis disorder (MASHAD) study.</p><p><strong>Participants: </strong>6537 and 6539 adults aged 35-65 years for depression and anxiety, respectively.</p><p><strong>Results: </strong>We found no significant association between adherence to the DASH diet and depression severity, in the total participants as well as both gender in either crude (total: OR: 0.98; 95% CI: 0.87-1.09, men: OR: 0.88; 95% CI: 0.73-1.07, and women: OR: 1.01; 95% CI: 0.88-1.17) or fully adjusted models (total: OR: 1.03; 95% CI: 0.91-1.16, men: OR: 0.95; 95% CI: 0.78-1.17, and women: OR: 1.04; 95% CI: 0.90-1.21). Regarding anxiety, we found that men in the third tertile of DASH diet score had lower risk of experiencing more severe anxiety compared to those in the first tertile (OR: 0.80; 95% CI: 0.67-0.96). However, after controlling for potential confounders, this relationship became non-significant (OR: 0.89; 95% CI: 0.74-1.07). In the total participants as well as women, we failed to find any significant association between adherence to the DASH diet and anxiety severity either before (total: OR: 0.97; 95% CI: 0.87-1.09, women: OR: 1.05; 95% CI: 0.92-1.21) or after controlling for possible confounders (total: OR: 1.01; 95% CI: 0.90-1.12, women: OR: 1.06; 95% CI: 0.92-1.22).</p><p><strong>Conclusions: </strong>We found no significant association between adherence to DASH diet and depression and anxiety severity among adults.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrients, Foods and Drinks promoted by School Nutrition Policies in the United States and Academic Performance: A Systematic Review.","authors":"Sydney Miller, Emma Sanchez-Vaznaugh, Megan Smith, Nancy Barba, Brisa N Sánchez","doi":"10.1017/S1368980026102572","DOIUrl":"https://doi.org/10.1017/S1368980026102572","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review synthesizes existing research on the relationship between dietary intake-specifically concerning food and beverage items promoted or restricted by U.S. federal school nutrition policies-and child academic performance, a salient predictor of long-term health.</p><p><strong>Design: </strong>We used keywords to search three databases. Along with other inclusion criteria, studies had to assess and report: (i) a measure of intake of food groups/nutrient promoted or restricted by U.S. school nutrition policies; (ii) a measure of academic performance and (iii) a measure of the association between both.</p><p><strong>Results: </strong>We identified 39 studies, all of which utilized observational designs, and 7 of which were considered higher quality based off the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies, published by the National Heart, Lung, and Blood Institute. Thirty-five studies reported evidence that children had better academic outcomes when they had an increased intake of food groups and nutrient items promoted by school nutrition policies, and/or a decreased intake of the food groups and nutrient items limited by school nutrition policies.</p><p><strong>Conclusion: </strong>These findings suggest that food groups and nutrient items governed by or promoted in school nutrition policies may shape children's learning, and contribute to downstream social determinants of health. Research on the population-level influences of school nutrition policies on children's academic outcomes is warranted.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-36"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the Availability of Hyper-Palatable Foods in US Food Stores and Household Purchasing Behavior.","authors":"Tera L Fazzino, Piali Dey Bristi, Lynn Chollet-Hinton, Cassandra Sutton","doi":"10.1017/S1368980026102614","DOIUrl":"https://doi.org/10.1017/S1368980026102614","url":null,"abstract":"<p><strong>Objective: </strong>Hyper-palatable foods (HPF) have strong reinforcing properties, and their presence in food stores may skew purchasing toward HPF, even when healthier foods are available. However, the availability of HPF in US food stores is unknown. The study aims were to 1) quantify the prevalence of HPF in US stores; 2) characterize US household expenditures on HPF per shopping occasion; and 3) examine demographic and health characteristics associated with HPF purchasing.</p><p><strong>Design: </strong>Proprietary scanner data representing 1) foods available and sold in US food stores, and 2) foods purchased during US household shopping occasions, were analyzed across four years (2015-2018).</p><p><strong>Setting: </strong>n/a.</p><p><strong>Participants: </strong>US food stores (>34900 per year) provided weekly data on all foods/beverages available and sold. Samples of US households (>45000 per year) used scanners to report all food/beverage purchases during their shopping occasions.</p><p><strong>Results: </strong>Across years, HPF comprised over two-thirds of foods available per store (M=67.1%; SD = 6.9) and of weekly sales (M= 70.4%; SD = 9.0). HPF comprised the majority of foods purchased by households (M=59.4%; SD = 34.6) and on average accounted 60.3% of household food expenditures (SD= 35.7) per shopping occasion. Health risk characteristics including self-reported type 2 diabetes diagnosis and self-reported obesity diagnosis were associated with significantly higher proportionate expenditures on HPF, relative to those without such diagnoses (beta values = 1.412 to 1.584; p values < .0001).</p><p><strong>Conclusions: </strong>HPF comprised >65% of available foods in US food outlets. Household purchasing of HPF during shopping occasions closely paralleled HPF availability in stores.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rice and beans: the nutritious, sustainable and affordable staple of the Brazilian diet.","authors":"Gabriela Lopes da Cruz, Kelly Garton, Boyd Swinburn, Maria Laura da Costa Louzada","doi":"10.1017/S1368980026102602","DOIUrl":"https://doi.org/10.1017/S1368980026102602","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the consumption of rice and beans in Brazil, two staples of the Brazilian diet, by describing their consumption according to sociodemographic characteristics and assessing its association with nutritional quality, environmental impact, and affordability of the diet.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Brazil.</p><p><strong>Participants: </strong>We analysed food consumption data from 46,164 individuals aged 10 years and older, based on the most recent Household Budget Survey (2017-2018) in Brazil. The survey used a two-stage cluster sampling design and provides nationally representative data, covering all regions, states, metropolitan areas, capitals, and urban and rural zones in Brazil.</p><p><strong>Results: </strong>In Brazil, rice and beans accounted for 10.75% and 6.33% of total daily energy intake, respectively. Their consumption was important across all sociodemographic groups analysed. Rice and beans intake was associated with nutritional quality, reduced environmental impact, and lower diet costs. Higher combined consumption of rice and beans was associated with a 44.49% reduction in nutritional inadequacies in the diet, a 17.64% decrease in carbon footprint, a 21.05% decrease in water footprint, and a 38.03% reduction in total diet cost, compared to lower consumption.</p><p><strong>Conclusions: </strong>Promoting increased consumption of rice and beans in Brazil offers a culturally appropriate solution in response to the global call for healthier and more sustainable diets, and is the most effective approach to improve human health and environmental sustainability in an affordable way in Brazil.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-28"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-processed food consumption in Scotland: A nationally representative analysis of sociodemographic patterns and dietary contributions.","authors":"Josephine Curtis, Nick Townsend","doi":"10.1017/S1368980026102559","DOIUrl":"https://doi.org/10.1017/S1368980026102559","url":null,"abstract":"<p><strong>Objective: </strong>To quantify ultra-processed food (UPF) intake in Scotland, identify key contributing food groups, and examine sociodemographic associations using nationally representative data.</p><p><strong>Design: </strong>Cross-sectional analysis of 2021 Scottish Health Survey data using two-day dietary recalls via Intake24 classified by NOVA. UPF intake was calculated as percentage of total energy intake (%TEI) and grams per day (g/day). Multivariable linear regression assessed associations with sex, age, ethnicity, income, socioeconomic classification, highest educational qualification, urban/rural location, region, and Scottish Index of Multiple Deprivation (SIMD) quintiles.</p><p><strong>Setting: </strong>Nationally representative sample of Scottish households.</p><p><strong>Participants: </strong>Individuals aged 16 or over with complete dietary and sociodemographic data (n = 2,645).</p><p><strong>Results: </strong>Mean energy intake was 1,637.8 kcal/day (95% CI 1615.8, 1659.8). Mean UPF consumption was 666.9 g/day (95% CI: 647.9, 685.9), amounting to 919.9 kcal/day (95% CI 901.1, 938.6), representing 55.4% of TEI (95% CI: 54.7, 56.2) and 28.2% of total food weight. The main contributors to UPF intake were cereal products (244.8 kcal/day, 27.0% of UPF kcal), confectionery (170.3 kcal/day, 17.9%), and meats (153.6 kcal/day, 16.2%). Sandwiches (99.9% UPF), salty snacks (94.1%), and dietary supplements (90.5%) showed highest UPF proportions by food groups. Adjusted analyses revealed greater UPF consumption (%TEI) among: males (β = -3.3, p < 0.001), younger adults (β = -2.8 per decade, p < 0.001), White participants (β = +12.9 vs Non-White, p < 0.001), and lower SIMD quintile (β = -1.8 per quintile, p < 0.001). Similar patterns emerged for absolute intake (g/day).</p><p><strong>Conclusions: </strong>UPF dominates Scotland's diet, with inequitable distribution across sociodemographic groups. Policy actions - such as adopting NOVA in dietary guidelines and restricting UPF marketing - are urgently needed to address this public health crisis.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-27"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Patterns of U.S. Older Adults and Their Associations with Diet Quality, Health, and Food Insecurity.","authors":"Anniebelle J Sassine, Edwina A Wambogo, Alanna J Moshfegh, Nadine R Sahyoun","doi":"10.1017/S1368980026102560","DOIUrl":"https://doi.org/10.1017/S1368980026102560","url":null,"abstract":"<p><strong>Objective: </strong>Identify dietary patterns among U.S. older adults and examine their associations with sociodemographic and health characteristics including economic and physical-functioning-related food insecurity.</p><p><strong>Design: </strong>Secondary analysis of dietary intake data from the 2013-2018 What We Eat in America component of NHANES. Dietary patterns were derived using cluster analysis and compared by diet quality (HEI-2020), demographic characteristics, health indicators, and multidimensional food insecurity.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>A nationally representative sample of 5,062 adults aged ≥60 years.</p><p><strong>Results: </strong>Five dietary patterns were identified. The largest pattern, \"Juices, smoothies, grain drinks, and soups\" (53.0%), was characterized by the lowest mean energy and protein intake and a moderate HEI-2020 score (66.0 ± 0.8). In contrast, the \"Cooked cereals and yogurt\" pattern (10.8%) had the highest HEI-2020 score (72.3 ± 1.4) and more favorable health indicators. Patterns high in processed meats and baked goods-\"Cured meats, sandwiches, and sweet bakery products\" (18.1%) and \"Meats, alcohol, and quick breads\" (11.0%)-had the lowest diet quality scores (48.5 ± 1.0 and 58.3 ± 1.6, respectively) and were more common among younger older adults, males, current smokers, and individuals with obesity. Food insecurity due to both economic constraints and physical functioning limitations was most prevalent in the lower-quality soft-food pattern and least prevalent in the \"Seafood and vegetables\" pattern (0.5%).</p><p><strong>Conclusions: </strong>Distinct dietary patterns exist among U.S. older adults, with substantial variation in diet quality, health characteristics, and food insecurity. Interventions should address both economic and functional barriers to support nutrient-dense, texture-appropriate diets in older adults.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-34"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant foods biodiversity in National food composition databases - The Italian case.","authors":"Silvia Lisciani, Elisabetta Toti, Emanuela Camilli, Stefania Marconi, Catherine Leclercq","doi":"10.1017/S1368980026102547","DOIUrl":"https://doi.org/10.1017/S1368980026102547","url":null,"abstract":"<p><strong>Objective: </strong>To assess the biodiversity richness of plant foods of the Italian Food Composition Database (IFCDB) at the species and below the species level, and its evolution over time.</p><p><strong>Design and setting: </strong>The biodiversity richness of plant foods in the IFCDB was assessed by counting the number of species and by identifying and categorizing biodiverse plant foods, i.e. foods described below the species level (subspecies, variety, cultivar) as well as wild and neglected and underutilized species. This assessment was also performed with the FAO Biodiversity Indicator.</p><p><strong>Participants: </strong>This study analyzed the current IFCDB which contains 900 records of food items, with 80% of data derived from analytical determinations.</p><p><strong>Results: </strong>The 2019 IFCDB's edition includes 114 plant species; for 32 of them, one or more biodiverse foods were identified for a total of 86 records, corresponding to 21% of the plant foods recorded. This marks a substantial increase from the 2000's edition, which included 112 plant species and 48 biodiverse foods, corresponding to 16% of the plant foods recorded.</p><p><strong>Conclusions: </strong>The IFCDB demonstrates progress in integrating plant food biodiversity, crucial for promoting sustainable diets and, consequently, sustainable food systems. Enhanced access to food composition data of biodiverse plant foods is required for the development and labeling of biodiverse processed plant foods and to increase the biodiversity richness of menus in community catering. This study may stimulate efforts in assessing and enhancing biodiversity richness of food composition tables in other countries.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-28"},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of sustainability claims on packaged food.","authors":"Mariel Keaney, Eden M Barrett, Mike Rayner, Simone Pettigrew, Alexandra Jones","doi":"10.1017/S1368980026102511","DOIUrl":"https://doi.org/10.1017/S1368980026102511","url":null,"abstract":"<p><strong>Objective: </strong>Global food systems have a key influence on both health and sustainability. Dietary shifts that promote health and sustainability are regarded as a critical synergistic pathway for advancing human and planetary health. In response, consumer interest in the sustainability of food systems has prompted the use of claims highlighting positive sustainability attributes displayed on-pack. This study assessed the prevalence and types of sustainability claims displayed on packaged food in Australia.</p><p><strong>Design: </strong>Claims data on packaged food were collected at five supermarkets in Sydney in 2024. We determined the prevalence of sustainability claims overall, by claim category and format (text or logo).</p><p><strong>Setting: </strong>Australia.</p><p><strong>Participants: </strong>None.</p><p><strong>Results: </strong>Over a third of products displayed at least one sustainability claim, the most prevalent being natural and vegan. Text claims were far more prevalent than logos (84% v 16% of total claims identified on pack, respectively).</p><p><strong>Conclusions: </strong>Frequent use of broad and unspecific sustainability claims raises challenges for substantiation, and there is a risk that consumers are being misled. Our findings support the need for stronger regulation, including criteria for terms used in claims, to improve consumer trust and comparability across products.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-26"},"PeriodicalIF":3.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's on the Menu? A Review of School Meal Quality Across 29 Countries.","authors":"Aisha Kanté, Aulo Gelli, Winnie Bell, Ayala Wineman","doi":"10.1017/S1368980026102456","DOIUrl":"https://doi.org/10.1017/S1368980026102456","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Setting: </strong>Twenty-nine countries across diverse geographic and socioeconomic contexts.</p><p><strong>Participants: </strong>Not applicable.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":" ","pages":"1-38"},"PeriodicalIF":3.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}