The importance of school lunches to the overall dietary intake of children in Sweden: a nationally representative study

Objective: School lunches have potential to foster healthy diets in all children, but data on their importance are relatively scarce. The current study aimed to describe the dietary intake from school lunches by sex and school grade, and to assess how the daily intake, school lunch intake and the daily intake provided by lunch differ by sex and parental education. Design: Cross-sectional. All foods and drinks consumed for 1-3 weekdays were self-reported. Energy, absolute and energy-adjusted intakes of nutrients and food groups were calculated per weekday and per school lunch. Mixed-effects linear models assessed sociodemographic differences in dietary intakes. Nutrient and energy density at lunch and during the rest of the day were compared. Setting: Seventy-nine Swedish primary schools. Participants: Pupils in grades 5 and 8 (N 2002), nationally representative. Results: Lunch provided around half of daily vegetable intake and two-thirds of daily fish intake. Nutrient density was higher and energy density lower at lunch compared with the rest of the day (P < 0 center dot 001). Boys had greater energy-adjusted intakes of red/processed meat and lower intakes of vegetables and dietary fibre compared with girls (P < 0 center dot 001), overall and at lunch. Daily energy-adjusted intakes of most nutrients/food groups were lower for pupils of lower-educated parents compared with pupils of parents with higher education, but at lunch, only Fe and fibre intakes were significantly lower in this group. Conclusions: School lunches are making a positive contribution to the diets of Swedish children and may mitigate well-established sex differences and social inequalities in dietary intake.