{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:17:58Z","timestamp":1790615878787,"version":"4.1.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"DOI":"10.1038\/s41390-026-05442-1","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:39:17Z","timestamp":1790613557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between school meal attendance, dietary intake and nutritional status in Spanish school-aged children: a cross-sectional study"],"prefix":"10.1038","author":[{"given":"Mar\u00eda del Mar","family":"Ucl\u00e9s-Torrente","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema Esperanza","family":"Ruiz-Gamarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Alcalde-Llergo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Vaquero-\u00c1lvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel Mar\u00eda","family":"Blancas-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-8697","authenticated-orcid":false,"given":"Pilar","family":"Aparicio-Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Vaquero Abell\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"5442_CR1","unstructured":"World Health Organization Regional Office for Europe. WHO European Childhood Obesity Surveillance Initiative (COSI): Report on the Sixth Round of Data Collection, 2022\u20132024 (WHO Regional Office for Europe, 2025)."},{"key":"5442_CR2","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1038\/s41390-024-03626-1","volume":"97","author":"X Ou-Yang","year":"2025","unstructured":"Ou-Yang, X. et al. Weighing the future: strategic measures against rising childhood obesity. Pediatr. Res. 97, 1795\u20131797 (2025).","journal-title":"Pediatr. Res."},{"key":"5442_CR3","unstructured":"Alto Comisionado contra la Pobreza Infantil. Plan Estrat\u00e9gico Nacional para la Reducci\u00f3n de la Obesidad Infantil (2022\u20132030) (Gobierno de Espa\u00f1a, 2022)."},{"key":"5442_CR4","unstructured":"Spanish Agency for Food Safety and Nutrition. NAOS Strategy: Nutrition, Physical Activity and Obesity Prevention (Ministry of Consumer Affairs, 2024)."},{"key":"5442_CR5","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1111\/joim.13547","volume":"292","author":"C Marcus","year":"2022","unstructured":"Marcus, C., Danielsson, P. & Hagman, E. Pediatric obesity\u2014long-term consequences and effect of weight loss. J. Intern. Med. 292, 870\u2013891 (2022).","journal-title":"J. Intern. Med."},{"key":"5442_CR6","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1038\/s41572-023-00435-4","volume":"9","author":"NB Lister","year":"2023","unstructured":"Lister, N. B. et al. Child and adolescent obesity. Nat. Rev. Dis. Primers 9, 24 (2023).","journal-title":"Nat. Rev. Dis. Primers"},{"key":"5442_CR7","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1007\/s00431-022-04384-0","volume":"181","author":"JF Cabeza","year":"2022","unstructured":"Cabeza, J. F. et al. Relationship between overweight and obesity and cardiac dimensions and function in a paediatric population. Eur. J. Pediatr. 181, 1943\u20131949 (2022).","journal-title":"Eur. J. Pediatr."},{"key":"5442_CR8","first-page":"1512","volume":"12","author":"M Morales-Su\u00e1rez-Varela","year":"2025","unstructured":"Morales-Su\u00e1rez-Varela, M. et al. Obesity and mental health in childhood and adolescence: a scoping review of recent scientific evidence. Children (Basel) 12, 1512 (2025).","journal-title":"Children (Basel)"},{"key":"5442_CR9","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1017\/S0954422421000196","volume":"35","author":"CW Wallace","year":"2022","unstructured":"Wallace, C. W. & Fordahl, S. C. Obesity and dietary fat influence dopamine neurotransmission. Nutr. Res. Rev. 35, 236\u2013251 (2022).","journal-title":"Nutr. Res. Rev."},{"key":"5442_CR10","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1694170","volume":"13","author":"S Li","year":"2025","unstructured":"Li, S. et al. Effects of exercise on cognitive function in children and adolescents with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. Front. Public Health 13, 1694170 (2025).","journal-title":"Front. Public Health"},{"key":"5442_CR11","doi-asserted-by":"publisher","first-page":"2536","DOI":"10.3390\/nu12092536","volume":"12","author":"J Plaza-D\u00edaz","year":"2020","unstructured":"Plaza-D\u00edaz, J. et al. Clustering of dietary patterns and lifestyles among Spanish children in the EsNuPI study. Nutrients 12, 2536 (2020).","journal-title":"Nutrients"},{"key":"5442_CR12","unstructured":"Agencia Espa\u00f1ola de Seguridad Alimentaria y Nutrici\u00f3n. Estudio ALADINO 2023: Estudio sobre Alimentaci\u00f3n, Actividad F\u00edsica, Desarrollo Infantil y Obesidad en Espa\u00f1a (Ministerio de Derechos Sociales, Consumo y Agenda 2030, 2024)."},{"key":"5442_CR13","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1111\/josh.13365","volume":"93","author":"C Merlo","year":"2023","unstructured":"Merlo, C., Smarsh, B. L. & Xiao, X. School nutrition environment and services: policies and practices that promote healthy eating among K\u201312 students. J. Sch. Health 93, 762\u2013777 (2023).","journal-title":"J. Sch. Health"},{"key":"5442_CR14","doi-asserted-by":"publisher","first-page":"911","DOI":"10.3390\/nu13030911","volume":"13","author":"JFW Cohen","year":"2021","unstructured":"Cohen, J. F. W., Hecht, A. A., McLoughlin, G. M., Turner, L. & Schwartz, M. B. Universal school meals and associations with student participation, attendance, academic performance, diet quality, food security, and body mass index: a systematic review. Nutrients 13, 911 (2021).","journal-title":"Nutrients"},{"key":"5442_CR15","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13911","volume":"26","author":"N Blecha","year":"2025","unstructured":"Blecha, N. et al. Evaluation of school food policies for secondary schools in Europe: results for health, acceptance, and affordability from a scoping review. Obes. Rev. 26, e13911 (2025).","journal-title":"Obes. Rev."},{"key":"5442_CR16","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1001\/jama.2020.9517","volume":"324","author":"K Kinderknecht","year":"2020","unstructured":"Kinderknecht, K., Harris, C. & Jones-Smith, J. Association of the Healthy, Hunger-Free Kids Act with dietary quality among children in the US National School Lunch Program. JAMA 324, 359\u2013368 (2020).","journal-title":"JAMA"},{"key":"5442_CR17","unstructured":"Instituto Nacional de Estad\u00edstica. Atlas de Distribuci\u00f3n de Renta de los Hogares 2023 (Instituto Nacional de Estad\u00edstica, 2024)."},{"key":"5442_CR18","unstructured":"Stewart, A., Marfell-Jones, M., Olds, T. & de Ridder, H. International Standards for Anthropometric Assessment (International Society for the Advancement of Kinanthropometry, 2011)."},{"key":"5442_CR19","unstructured":"Centers for Disease Control and Prevention. Growth Charts: CDC Growth Charts Data Files (Centers for Disease Control and Prevention, Atlanta, GA, USA, 2000)."},{"key":"5442_CR20","unstructured":"World Health Organization. Growth Reference Data for 5\u201319 Years: BMI-for-Age (World Health Organization, Geneva, Switzerland, 2007)."},{"issue":"(Suppl. 2)","key":"5442_CR21","first-page":"555","volume":"114","author":"National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents.","year":"2004","unstructured":"National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114((Suppl. 2)), 555\u2013576 (2004).","journal-title":"Pediatrics"},{"key":"5442_CR22","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1079\/PHN2004556","volume":"7","author":"L Serra-Majem","year":"2004","unstructured":"Serra-Majem, L. et al. Food, youth and the Mediterranean diet in Spain: development of KIDMED, Mediterranean Diet Quality Index in children and adolescents. Public Health Nutr. 7, 931\u2013935 (2004).","journal-title":"Public Health Nutr."},{"key":"5442_CR23","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez, M. \u00c1. S., Baviera, L. C. B. & Committee on Nutrition and Breastfeeding of the Asociaci\u00f3n Espa\u00f1ola de Pediatr\u00eda. School lunch menus in Spain: a review on recommendations and policy. An. Pediatr. (Engl. Ed.) 95, 55.e1\u201355.e9 (2021).","DOI":"10.1016\/j.anpede.2021.01.006"},{"key":"5442_CR24","unstructured":"Red BEDCA. Base de Datos Espa\u00f1ola de Composici\u00f3n de Alimentos (BEDCA) (Agencia Espa\u00f1ola de Seguridad Alimentaria y Nutrici\u00f3n & Fundaci\u00f3n Espa\u00f1ola para la Nutrici\u00f3n, Madrid, Spain)."},{"key":"5442_CR25","unstructured":"Agencia Espa\u00f1ola de Seguridad Alimentaria y Nutrici\u00f3n. Alimentaci\u00f3n saludable. Recomendaciones para la alimentaci\u00f3n en la primera infancia (0\u20133 a\u00f1os) (Ministerio de Consumo, 2022)."},{"key":"5442_CR26","volume":"14","author":"European Food Safety Authority.","year":"2017","unstructured":"European Food Safety Authority. Dietary reference values for nutrients: summary report. EFSA Support. Publ. 14, e15121 (2017).","journal-title":"EFSA Support. Publ."},{"key":"5442_CR27","unstructured":"Federaci\u00f3n Espa\u00f1ola de Sociedades de Nutrici\u00f3n, Alimentaci\u00f3n y Diet\u00e9tica. Ingestas Diet\u00e9ticas de Referencia (IDR) para la poblaci\u00f3n espa\u00f1ola (Ediciones Universidad de Navarra (EUNSA), 2010)."},{"key":"5442_CR28","doi-asserted-by":"publisher","DOI":"10.1016\/j.foodpol.2025.102901","volume":"134","author":"M Bitler","year":"2025","unstructured":"Bitler, M. et al. Effects of school meals on nutrition: evidence from the start of the school year. Food Policy 134, 102901 (2025).","journal-title":"Food Policy"},{"key":"5442_CR29","doi-asserted-by":"publisher","first-page":"e093244","DOI":"10.1136\/bmjopen-2024-093244","volume":"15","author":"A Locke","year":"2025","unstructured":"Locke, A. et al. Impacts of global school feeding programmes on children\u2019s health and wellbeing outcomes: a scoping review. BMJ Open 15, e093244 (2025).","journal-title":"BMJ Open"},{"key":"5442_CR30","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.24082","volume":"7","author":"MK Spill","year":"2024","unstructured":"Spill, M. K. et al. Universal free school meals and school and student outcomes: a systematic review. JAMA Netw. Open 7, e2426103 (2024).","journal-title":"JAMA Netw. Open"},{"key":"5442_CR31","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","volume":"403","author":"NCD Risk","year":"2024","unstructured":"Risk, N. C. D. Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 403, 1027\u20131050 (2024).","journal-title":"Lancet"},{"key":"5442_CR32","doi-asserted-by":"publisher","first-page":"104220","DOI":"10.1016\/j.numecd.2025.104220","volume":"35","author":"S Alfaro-Gonz\u00e1lez","year":"2025","unstructured":"Alfaro-Gonz\u00e1lez, S. et al. Adherence trends to the Mediterranean diet in Spanish youth: a systematic review and meta-analysis. Nutr. Metab. Cardiovasc. Dis. 35, 104220 (2025).","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"5442_CR33","doi-asserted-by":"publisher","first-page":"738","DOI":"10.3390\/nu14040738","volume":"14","author":"MDM Bibiloni","year":"2022","unstructured":"Bibiloni, M. D. M. et al. Determinants of adherence to the Mediterranean diet in Spanish children and adolescents: the PASOS study. Nutrients 14, 738 (2022).","journal-title":"Nutrients"},{"key":"5442_CR34","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1093\/nutrit\/nuad059","volume":"82","author":"S Dur\u00e3o","year":"2024","unstructured":"Dur\u00e3o, S., Wilkinson, M., Davids, E. L., Gerritsen, A. & Kredo, T. Effects of policies or interventions that influence the school food environment on children\u2019s health and nonhealth outcomes: a systematic review. Nutr. Rev. 82, 332\u2013360 (2024).","journal-title":"Nutr. Rev."},{"key":"5442_CR35","doi-asserted-by":"publisher","first-page":"04051","DOI":"10.7189\/jogh.11.04051","volume":"11","author":"D Wang","year":"2021","unstructured":"Wang, D., Shinde, S., Young, T. & Fawzi, W. W. Impacts of school feeding on educational and health outcomes of school-age children and adolescents in low- and middle-income countries: a systematic review and meta-analysis. J. Glob. Health 11, 04051 (2021).","journal-title":"J. Glob. Health"},{"key":"5442_CR36","unstructured":"UNICEF. Child Food Poverty: Nutrition Deprivation in Early Childhood (United Nations Children\u2019s Fund, 2024)."},{"key":"5442_CR37","first-page":"1020","volume":"11","author":"A Gallego","year":"2024","unstructured":"Gallego, A. et al. Socioeconomic status and rate of poverty in overweight and obesity among Spanish children and adolescents. Children (Basel) 11, 1020 (2024).","journal-title":"Children (Basel)"},{"key":"5442_CR38","doi-asserted-by":"publisher","first-page":"420","DOI":"10.3390\/nu16030420","volume":"16","author":"V Calcaterra","year":"2024","unstructured":"Calcaterra, V. et al. Assessment of epicardial fat in children: its role as a cardiovascular risk factor and how it is influenced by lifestyle habits. Nutrients 16, 420 (2024).","journal-title":"Nutrients"},{"key":"5442_CR39","unstructured":"European Commission. School Meals in the European Union (Publications Office of the European Union, 2025)."},{"key":"5442_CR40","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980026102456","volume":"29","author":"A Kant\u00e9","year":"2026","unstructured":"Kant\u00e9, A., Gelli, A., Bell, W. & Wineman, A. What\u2019s on the menu? A review of school meal quality across twenty-nine countries. Public Health Nutr 29, e108 (2026).","journal-title":"Public Health Nutr"}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05442-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05442-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05442-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:39:23Z","timestamp":1790613563000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05442-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":40,"alternative-id":["5442"],"URL":"https:\/\/doi.org\/10.1038\/s41390-026-05442-1","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"12 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"All participants gave permission for data use and later publication.","order":2,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"All the participants provided consent to participate.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"All participants and their parents\/legal guardians received detailed information about the objectives, risks, and benefits of the study and provided written informed consent. Participation was voluntary, and participants could withdraw at any time without justification.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"During the preparation of this work, the author(s) used Grammarly to review the grammar and style of the writing. After using this tool\/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.","order":5,"name":"Ethics","label":"Declaration of generative AI and AI-assisted technologies in the manuscript preparation process","group":{"name":"EthicsHeading","label":"Ethics"}}]}}