{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:45:37Z","timestamp":1792795537288,"version":"4.5.0"},"reference-count":119,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Healthy Eating Research","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The school environment plays an important role in children\u2019s diets and overall health, and policies for universal free school meals have the potential to contribute to positive child health outcomes. This systematic review evaluates studies examining the association between universal free school meals and students\u2019 school meal participation rates, diets, attendance, academic performance, and Body Mass Index (BMI), as well as school finances. The search was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). A search for studies published in economically developed countries published through December 2020 was performed in PubMed, Education Resources Information Center (ERIC), Thomson Reuters\u2019 Web of Science, and Academic Search Ultimate, followed by examining the references in the resultant literature. A total of 47 studies were identified and the Newcastle-Ottawa Scale (NOS) was applied to assess bias. Nearly all studies examining universal free school meals found positive associations with school meal participation. Most studies examining universal free school meals that included free lunch found positive associations with diet quality, food security, and academic performance; however, the findings of studies examining only universal free breakfast were mixed. Research findings were similarly mixed when examining attendance as an outcome. Concerns about adverse outcomes on student BMI were not supported by the literature; in fact, several studies detected a potentially protective effect of universal free school meals on BMI. Research examining the impact of universal free meals on school finances was limited, but suggest that lower-income school districts in the U.S. may have positive financial outcomes from participation in universal free school meal provisions. Additionally, providing free meals to students may be associated with improved household incomes, particularly among lower-income families with children. Further research is needed to examine the financial implications of universal free meals for both school districts and families. Overall, universal free school meals may have multiple benefits for students and countries should consider universal free school meal provisions with strong nutrition guidelines. (PROSPERO registration: CRD42020221782).<\/jats:p>","DOI":"10.3390\/nu13030911","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T20:17:40Z","timestamp":1615493860000},"page":"911","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":353,"title":["Universal School Meals and Associations with Student Participation, Attendance, Academic Performance, Diet Quality, Food Security, and Body Mass Index: A Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Juliana F. W.","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Nutrition and Public Health, Merrimack College, 315 Turnpike Street, North Andover, MA 01845, USA"},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelie A.","family":"Hecht","sequence":"additional","affiliation":[{"name":"Institute for Research on Poverty, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7731-2382","authenticated-orcid":false,"given":"Gabriella M.","family":"McLoughlin","sequence":"additional","affiliation":[{"name":"Implementation Science Center for Cancer Control and Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA"},{"name":"Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2977-343X","authenticated-orcid":false,"given":"Lindsey","family":"Turner","sequence":"additional","affiliation":[{"name":"College of Education, Boise State University, 1910 University Drive, Boise, ID 83725-1742, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-1954","authenticated-orcid":false,"given":"Marlene B.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Rudd Center for Food Policy and Obesity, Department of Human Development and Family Sciences, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2006). Food and Nutrition Policy for Schools: A Tool for the Development of School Nutrition Programmes in the European Region, WHO Regional Office for Europe."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Dooris, M., Poland, B., Kolbe, L., De Leeuw, E., McCall, D.S., and Wharf-Higgins, J. (2007). Healthy settings. Global Perspectives on Health Promotion Effectiveness, Springer.","DOI":"10.1007\/978-0-387-70974-1_19"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Langford, R., Bonell, C.P., Jones, H.E., Pouliou, T., Murphy, S.M., Waters, E., Komro, K.A., Gibbs, L.F., Magnus, D., and Campbell, R. (2014). The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD008958.pub2"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1079\/BJN20051418","article-title":"Consistent dietary patterns identified from childhood to adulthood: The cardiovascular risk in Young Finns Study","volume":"93","author":"Raitakari","year":"2005","journal-title":"Br. J. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Movassagh, E.Z., Baxter-Jones, A.D., Kontulainen, S., Whiting, S.J., and Vatanparast, H. (2017). Tracking dietary patterns over 20 years from childhood through adolescence into young adulthood: The Saskatchewan Pediatric Bone Mineral Accrual Study. Nutrients, 9.","DOI":"10.20944\/preprints201706.0092.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1056\/NEJM199709253371301","article-title":"Predicting obesity in young adulthood from childhood and parental obesity","volume":"337","author":"Whitaker","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.4278\/0890-1171-14.4.222","article-title":"How do children\u2019s eating patterns and food choices change over time? Results from a cohort study","volume":"14","author":"Lytle","year":"2000","journal-title":"Am. J. Health Promot."},{"key":"ref_8","unstructured":"United States Department of Agriculture (2016). National School Lunch Program and School Breakfast Program: Nutrition Standards for All Foods Sold in School as Required by the Healthy, Hunger-Free Kids Act of 2010. Fed. Regist., 81, 50131\u201350151."},{"key":"ref_9","unstructured":"(2003). National Institute for Educational Policy Research, Kobe Institute. School Lunch Program in Japan."},{"key":"ref_10","unstructured":"(2020, March 01). The Education (Nutritional Standards and Requirements for School Food) (England) (Amendment) Regulations 2008, Available online: https:\/\/www.legislation.gov.uk\/uksi\/2008\/1800\/made."},{"key":"ref_11","unstructured":"The National Assembly of the Republic of Korea (2020, March 01). Enforcement Rule of the School Meals Act, Available online: http:\/\/likms.Assembly.go.kr\/law\/jsp\/main.jsp."},{"key":"ref_12","unstructured":"The Secretary of State for Education, England (2020, March 01). The Requirements for School Food Regulations 2014, Available online: https:\/\/www.legislation.gov.uk\/uksi\/2014\/1603\/pdfs\/uksi_20141603_en.pdf."},{"key":"ref_13","unstructured":"The Secretary of State for Children, Schools, and Families, England (2020, March 01). The Education Act (2008) The Education (Nutritional Standards and Requirements for School Food) (England) (Amendment) Regulations 2008, Available online: https:\/\/www.legislation.gov.uk\/uksi\/2008\/1800\/made."},{"key":"ref_14","first-page":"160","article-title":"Comparison of the nutrient-based standards for school lunches among South Korea, Japan, and Taiwan","volume":"26","author":"Kim","year":"2017","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/josh.12683","article-title":"Composition of school meals in Sweden, Finland, and Iceland: Official guidelines and comparison with practice and availability","volume":"88","author":"Juniusdottir","year":"2018","journal-title":"J. School Health"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"McGuire, S. (2012). Institute of Medicine. Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation, Oxford University Press.","DOI":"10.3945\/an.112.002733"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1017\/S0007114516002877","article-title":"The effect of healthy dietary consumption on executive cognitive functioning in children and adolescents: A systematic review","volume":"116","author":"Cohen","year":"2016","journal-title":"Br. J. Nutr."},{"key":"ref_18","unstructured":"World Health Organization (2003). Diet, Nutrition, and the Prevention of Chronic Diseases: Report of a Joint WHO\/FAO Expert Consultation, World Health Organization."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gross, S.M., Kelley, T.L., Augustyn, M., Wilson, M.J., Bassarab, K., and Palmer, A. (2019). Household Food Security Status of Families with Children Attending Schools that Participate in the Community Eligibility Provision (CEP) and Those with Children Attending Schools that are CEP-Eligible, but Not Participating. J. Hunger Environ. Nutr., 1\u201316.","DOI":"10.1080\/19320248.2019.1679318"},{"key":"ref_20","unstructured":"Beaton, M., Craig, P., Katikireddi, S., Jepson, R., and Williams, A. (2014). Evaluability assessment of free school meals for all children in P1 to P3. Proj. Rep. NHS Health Scotl. Edinb."},{"key":"ref_21","unstructured":"Poppendieck, J. (2011). Free for All: Fixing School Food in America, Univ of California Press."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1097\/00008486-199912000-00004","article-title":"More than test scores: Results of the Universal School Breakfast Pilot in Minnesota","volume":"15","author":"Wahlstrom","year":"1999","journal-title":"Top. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.pmedr.2016.11.016","article-title":"The contribution of the USDA school breakfast and lunch program meals to student daily dietary intake","volume":"5","author":"Cullen","year":"2017","journal-title":"Prev. Med. Rep."},{"key":"ref_24","unstructured":"Gearan, E., Fox, M.K., Niland, K., Dotter, D., Washburn, L., Connor, P., Olsho, L., and Wommack, T. (2019). School Nutrition and Meal Cost Study Final Report Volume 2: Nutritional Characteristics of School Meals. Math. Policy Res., Available online: https:\/\/fns-prod.azureedge.net\/sites\/default\/files\/resource-files\/SNMCS-Volume2.pdf."},{"key":"ref_25","unstructured":"Fox, M.K., Gearan, E., Cabili, C., Dotter, D., Niland, K., Washburn, L., Paxton, N., Olsho, L., LeClair, L., and Tran, V. (2019). School Nutrition and Meal Cost Study Final Report Volume 4: Student Participation, Satisfaction, Plate Waste, and Dietary Intakes. Math. Policy Res., Available online: https:\/\/fns-prod.azureedge.net\/sites\/default\/files\/resource-files\/SNMCS-Volume4.pdf."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1016\/j.jand.2016.04.010","article-title":"Eating school lunch is associated with higher diet quality among elementary school students","volume":"116","author":"Au","year":"2016","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jneb.2014.07.007","article-title":"Nutritional comparison of packed and school lunches in pre-kindergarten and kindergarten children following the implementation of the 2012\u20132013 national school lunch program standards","volume":"46","author":"Farris","year":"2014","journal-title":"J. Nutr. Educ. Behav."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.jand.2018.01.010","article-title":"Eating school meals daily is associated with healthier dietary intakes: The Healthy Communities Study","volume":"118","author":"Au","year":"2018","journal-title":"J. Acad. Nutri. Diet."},{"key":"ref_29","unstructured":"Pellikka, K., Manninen, M., and Taivalmaa, S. (2019). School Meals for All. School Feeding: Investment in Effective Learning\u2013Case Finland, Finnish National Agency for Education. Viitattu 25.8. 2019."},{"key":"ref_30","unstructured":"European Commission (2020, August 01). School Food Policy Fact Sheets; Sweden, 2013. Available online: https:\/\/ec.europa.eu\/jrc\/sites\/jrcsh\/files\/jrc-school-food-policy-factsheet-sweden_en.pdf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s10460-020-10137-2","article-title":"Sustainability transitions in agri-food systems: Insights from South Korea\u2019s universal free, eco-friendly school lunch program","volume":"37","author":"Gaddis","year":"2020","journal-title":"Agric. Hum. Values"},{"key":"ref_32","unstructured":"Scottish Government (2020, August 01). Maternal and Child Health: Free School Meals, Available online: https:\/\/www.gov.scot\/policies\/maternal-and-child-health\/free-school-meals\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.5264\/eiyogakuzashi.76.S2","article-title":"The history, current status, and future directions of the school lunch program in Japan","volume":"76","author":"Ishida","year":"2018","journal-title":"Jpn. J. Nutr. Diet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1017\/S1368980017000374","article-title":"School lunches in Japan: Their contribution to healthier nutrient intake among elementary-school and junior high-school children","volume":"20","author":"Asakura","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_35","unstructured":"Levin, M., and Neuberger, Z. (2013). A guide to implementing community eligibility. Food Res. Action Center Cent. Budg. Policy Priorities Oct., 1, Available online: https:\/\/citeseerx.ist.psu.edu\/viewdoc\/download?doi=10.1.1.397.1428&rep=rep1&type=pdf."},{"key":"ref_36","unstructured":"Food Research and Action Center (FRAC) (2020). Community Eligibility Report 2020, Food Research and Action Center (FRAC). Available online: https:\/\/frac.org\/cep-report-2020."},{"key":"ref_37","unstructured":"Logan, C.W. (2014). Community Eligibility Provision Evaluation, United States Department of Agriculture, Food and Nutrition Service, Office."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"101945","DOI":"10.1016\/j.econedurev.2019.101945","article-title":"Free lunch for all? The impact of universal school lunch on student misbehavior","volume":"74","author":"Altindag","year":"2020","journal-title":"Econ. Educ. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1002\/pam.22175","article-title":"Let them eat lunch: The impact of universal free meals on student performance","volume":"39","author":"Schwartz","year":"2020","journal-title":"J. Policy Anal. Manag."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.2105\/AJPH.2020.305743","article-title":"Impact of The Community Eligibility Provision of the Healthy, Hunger-Free Kids Act on Student Nutrition, Behavior, and Academic Outcomes: 2011\u20132019","volume":"110","author":"Hecht","year":"2020","journal-title":"Am. J. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and Group, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_42","unstructured":"(2020, August 01). PROSPERO International Prospective Register of Systematic Reviews. Available online: https:\/\/www.crd.york.ac.uk\/prospero\/."},{"key":"ref_43","unstructured":"Organization for Economic Co-Operation and Development (OECD) List of OECD Member countries."},{"key":"ref_44","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D.A., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2020, August 01). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_45","unstructured":"Wells, G., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2014). Newcastle-Ottawa Quality Assessment Scale Cohort Studies, University of Ottawa."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"80","DOI":"10.13105\/wjma.v5.i4.80","article-title":"Assessing the quality of studies in meta-analyses: Advantages and limitations of the Newcastle Ottawa Scale","volume":"5","author":"Luchini","year":"2017","journal-title":"World J. Meta-Anal."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Lo, C.K.-L., Mertz, D., and Loeb, M. (2014). Newcastle-Ottawa Scale: Comparing reviewers\u2019 to authors\u2019 assessments. BMC Med. Res. Methodol., 14.","DOI":"10.1186\/1471-2288-14-45"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.econedurev.2013.06.007","article-title":"Not just for poor kids: The impact of universal free school breakfast on meal participation and student outcomes","volume":"36","author":"Schwartz","year":"2013","journal-title":"Econ. Educ. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1086\/671013","article-title":"Changes in meal participation, attendance, and test scores associated with the availability of universal free school breakfasts","volume":"87","author":"Ribar","year":"2013","journal-title":"Soc. Serv. Rev."},{"key":"ref_50","unstructured":"McLaughlin, J.E., Bernstein, L.S., Crepinsek, M.K., Daft, L.M., and Murphy, J.M. (2020, August 01). Evaluation of the School Breakfast Program Pilot Project: Findings from the First Year of Implementation. Food and Nutrition Services, USDA, Available online: https:\/\/files.eric.ed.gov\/fulltext\/ED481251.pdf."},{"key":"ref_51","unstructured":"Bernstein, L.S., McLaughlin, J.E., Crepinsek, M.K., and Daft, L.M. (2004). Evaluation of the School Breakfast Program Pilot Project: Final Report. Special Nutrition Programs. Report Number CN-04-SBP, US Department of Agriculture."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.jand.2019.03.001","article-title":"Serving breakfast free to all students and type of breakfast serving model are associated with participation in the School Breakfast Program","volume":"119","author":"Soldavini","year":"2019","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1746-1561.2010.00552.x","article-title":"Prevalence of food insecurity and utilization of food assistance program: An exploratory survey of a Vermont middle school","volume":"81","author":"Khan","year":"2011","journal-title":"J. Sch. Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"630","DOI":"10.3945\/jn.115.225516","article-title":"Breakfast-skipping and selecting low-nutritional-quality foods for breakfast are common among low-income urban children, regardless of food security status","volume":"146","author":"Dykstra","year":"2016","journal-title":"J. Nutr."},{"key":"ref_55","first-page":"40","article-title":"Everyone Eats for Free--Piloting Provision 2","volume":"61","author":"Rivas","year":"1994","journal-title":"Sch. Bus. Aff."},{"key":"ref_56","unstructured":"Robinson, R.A. (1994). Food Assistance: Early Results of USDA\u2019s No-Fee School Meal Pilot Program, Government Accountability Office (GAO). Report to U.S."},{"key":"ref_57","unstructured":"Brown, K. (2009). School Meal Programs: Experiences of the States and Districts That Eliminated Reduced-Price Fees, US Government Accountability Office. Report to the Chairman, Committee on Education and Labor, House of Representatives; GAO-09-584."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3281","DOI":"10.1017\/S1368980019002246","article-title":"Impact of the Community Eligibility Provision on meal counts and participation in Pennsylvania and Maryland National School Lunch Programs","volume":"22","author":"Pokorney","year":"2019","journal-title":"Public Health Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1093\/tbm\/ibz090","article-title":"Community eligibility and other provisions for universal free meals at school: Impact on student breakfast and lunch participation in California public schools","volume":"9","author":"Turner","year":"2019","journal-title":"Transl. Behav. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1111\/josh.12942","article-title":"Community Eligibility Provision and School Meal Participation among Student Subgroups","volume":"90","author":"Tan","year":"2020","journal-title":"J. Sch. Health"},{"key":"ref_61","unstructured":"Kitchen, S., Tanner, E., Brown, V., Payne, C., Crawford, C., Dearden, L., Greaves, E., and Purdon, S. (2013). Evaluation of the Free School Meals Pilot, Department for Education."},{"key":"ref_62","unstructured":"MacLardie, J., Martin, C., Murray, L., and Sewel, K. (2008). Evaluation of the Free School Meals Trial for P1 to P3 Pupils, Scottish Government Social Research."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1111\/ecca.12147","article-title":"Take-up of Free School Meals: Price Effects and Peer Effects","volume":"82","author":"Holford","year":"2015","journal-title":"Economica"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.amepre.2013.11.013","article-title":"Impact of the new US Department of Agriculture school meal standards on food selection, consumption, and waste","volume":"46","author":"Cohen","year":"2014","journal-title":"Am. J. Prev. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1016\/j.jand.2018.07.009","article-title":"The impact of 1 year of healthier school food policies on students\u2019 diets during and outside of the school day","volume":"118","author":"Cohen","year":"2018","journal-title":"J. Acad. Nutr Diet."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1016\/j.jada.2006.08.013","article-title":"Dietary effects of universal-free school breakfast: Findings from the evaluation of the school breakfast program pilot project","volume":"106","author":"Crepinsek","year":"2006","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1159\/000066399","article-title":"Diet, breakfast, and academic performance in children","volume":"46","author":"Kleinman","year":"2002","journal-title":"Ann. Nutr. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"101253","DOI":"10.1016\/j.pmedr.2020.101253","article-title":"Using digital imagery to quantify students\u2019 added sugar intake at lunch in Title I schools with universal free meals","volume":"20","author":"Adams","year":"2020","journal-title":"Prev. Med. Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/wmh3.248","article-title":"Can food insecurity be reduced in the United States by improving SNAP, WIC, and the community eligibility provision?","volume":"9","author":"Poblacion","year":"2017","journal-title":"World Med. Health Policy"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/1475-2891-5-33","article-title":"Changes in dietary pattern in 15 year old adolescents following a 4 month dietary intervention with school breakfast\u2013a pilot study","volume":"5","author":"Ask","year":"2006","journal-title":"Nutr. J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1017\/S1368980010001886","article-title":"Free healthy breakfasts in primary schools: A cluster randomised controlled trial of a policy intervention in Wales, UK","volume":"14","author":"Murphy","year":"2011","journal-title":"Public Health Nutr."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1017\/S1368980013003133","article-title":"Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9\u201311-year-old schoolchildren in Wales","volume":"17","author":"Moore","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12966-015-0238-9","article-title":"A cross-sectional observational study of the nutritional intake of UK primary school children from deprived and non-deprived backgrounds: Implications for school breakfast schemes","volume":"12","author":"Jenkins","year":"2015","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1017\/S1368980009990772","article-title":"Serving of free school lunch to secondary-school pupils\u2013a pilot study with health implications","volume":"13","author":"Ask","year":"2010","journal-title":"Public Health Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1177\/1403494817704108","article-title":"Intervention study on school meal habits in Norwegian 10\u201312-year-old children","volume":"45","author":"Bere","year":"2017","journal-title":"Scand. J. Public Health"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Vik, F.N., Van Lippevelde, W., and \u00d8verby, N.C. (2019). Free school meals as an approach to reduce health inequalities among 10\u201312-year-old Norwegian children. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7286-z"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Vik, F.N., N\u00e6ss, I.K., Heslien, K.E., and \u00d8verby, N.C. (2019). Possible effects of a free, healthy school meal on overall meal frequency among 10\u201312-year-olds in Norway: The School Meal Project. BMC Res. Notes, 12.","DOI":"10.1186\/s13104-019-4418-6"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Spence, S., Matthews, J., McSweeney, L., Rowland, M., Orango, P., and Adamson, A. (2020). Implementation of Universal Infant Free School Meals: A pilot study in NE England exploring the impact on Key Stage 1 pupil\u2019s dietary intake. Public Health Nutr., 1\u201322.","DOI":"10.1017\/S1368980020004875"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1467-3010.2010.01872.x","article-title":"Children\u2019s nutritional intake as part of the Eat Well Do Well scheme in Kingston-upon-Hull\u2013a pilot study","volume":"36","author":"Gatenby","year":"2011","journal-title":"Nutr. Bull."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1093\/eurpub\/cky041","article-title":"Universal school lunch programme closes a socioeconomic gap in fruit and vegetable intakes among school children in Japan","volume":"28","author":"Yamaguchi","year":"2018","journal-title":"Eur. J. Public Health"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Munday, K., and Wilson, M. (2017). Implementing a health and wellbeing programme for children in early childhood: A preliminary study. Nutrients, 9.","DOI":"10.3390\/nu9091031"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1017\/S0007114514000634","article-title":"Dietary effects of introducing school meals based on the New Nordic Diet\u2013a randomised controlled trial in Danish children. The OPUS School Meal Study","volume":"111","author":"Andersen","year":"2014","journal-title":"Br. J. Nutr."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Sabinsky, M.S., Toft, U., Sommer, H.M., and Tetens, I. (2019). Effect of implementing school meals compared with packed lunches on quality of dietary intake among children aged 7\u201313 years. J. Nutr. Sci., 8.","DOI":"10.1017\/jns.2018.29"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1136\/jech-2012-201540","article-title":"Effects of a free school breakfast programme on children\u2019s attendance, academic achievement and short-term hunger: Results from a stepped-wedge, cluster randomised controlled trial","volume":"67","author":"Mhurchu","year":"2013","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_85","first-page":"171","article-title":"Effectiveness of a school food aid programme in improving household food insecurity; a cluster randomized trial","volume":"30","author":"Dalma","year":"2020","journal-title":"Eur. J. Public Health"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1093\/eurpub\/ckv223","article-title":"The impact of a school food aid program on household food insecurity","volume":"26","author":"Petralias","year":"2016","journal-title":"Eur. J. Public Health"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/jn\/nxy267","article-title":"Access to the school breakfast program is associated with higher attendance and test scores among elementary school students","volume":"149","author":"Bartfeld","year":"2019","journal-title":"J. Nutr."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"101999","DOI":"10.1016\/j.econedurev.2020.101999","article-title":"Free lunch for all! the effect of the community eligibility provision on academic outcomes","volume":"77","author":"Gordanier","year":"2020","journal-title":"Econ. Educ. Rev."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jand.2019.07.022","article-title":"Universal Access to Free School Meals through the Community Eligibility Provision Is Associated with Better Attendance for Low-Income Elementary School Students in Wisconsin","volume":"120","author":"Bartfeld","year":"2020","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/ejcn.2014.263","article-title":"Do healthy school meals affect illness, allergies and school attendance in 8-to 11-year-old children? A cluster-randomised controlled study","volume":"69","author":"Laursen","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0277-9536(82)90423-3","article-title":"Nutrition and school achievement","volume":"16","author":"Popkin","year":"1982","journal-title":"Soc. Sci. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1746-1561.2007.00276.x","article-title":"The relationship between school absence, academic performance, and asthma status","volume":"78","author":"Moonie","year":"2008","journal-title":"J. Sch. Health"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1080\/00220670209596607","article-title":"Mathematics and science achievement: Effects of motivation, interest, and academic engagement","volume":"95","author":"Singh","year":"2002","journal-title":"J. Educ. Res."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jsp.2017.11.001","article-title":"Chronic absence, eighth-grade achievement, and high school attainment in the Chicago Longitudinal Study","volume":"67","author":"Smerillo","year":"2018","journal-title":"J. Sch. Psychol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1080\/19320248.2020.1727807","article-title":"Universal Free School Meal Programs in Vermont Show Multi-domain Benefits","volume":"15","author":"Taylor","year":"2020","journal-title":"J. Hunger Environ. Nutr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1377\/hlthaff.2020.00133","article-title":"Impact Of The Healthy, Hunger-Free Kids Act On Obesity Trends: Study examines impact of the Healthy, Hunger-Free Kids Act of 2010 on childhood obesity trends","volume":"39","author":"Kenney","year":"2020","journal-title":"Health Aff."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/josh.12828","article-title":"Updated Nutrition Standards for School Meals Associated With Improved Weight Outcomes for Boys in Elementary School","volume":"89","author":"Vericker","year":"2019","journal-title":"J. Sch. Health"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e030676","DOI":"10.1136\/bmjopen-2019-030676","article-title":"Can the Healthy Primary School of the Future offer perspective in the ongoing obesity epidemic in young children? A Dutch quasi-experimental study","volume":"9","author":"Bartelink","year":"2019","journal-title":"BMJ Open"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.2105\/AJPH.2011.300134","article-title":"Competitive foods, discrimination, and participation in the National School Lunch Program","volume":"101","author":"Bhatia","year":"2011","journal-title":"Am. J. Public Health"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1746-1561.2009.00438.x","article-title":"Participation in the national school lunch program: Importance of school-level and neighborhood contextual factors","volume":"79","author":"Mirtcheva","year":"2009","journal-title":"J. Sch. Health"},{"key":"ref_101","unstructured":"Dahl, M.W., and Scholz, J.K. (2011). The National School Lunch Program and School Breakfast Program: Evidence on Participation and Noncompliance, Institute for Research on Poverty, University of Wisconsin-Madison. Available online: http:\/\/www.econ.wisc.edu\/~scholz\/Research\/Lunch.pdf."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3102\/0013189X10362578","article-title":"Student eligibility for a free lunch as an SES measure in education research","volume":"39","author":"Harwell","year":"2010","journal-title":"Educ. Res."},{"key":"ref_103","unstructured":"Glantz, F.B., Berg, R., Porcari, D., Sackoff, E., and Pazer, S. (2020, August 01). School Lunch Eligible Non-Participants: Final Report. Food and Consumer Services, USDA. Available online: https:\/\/fns-prod.azureedge.net\/sites\/default\/files\/EligNonPart-Pt1.pdf."},{"key":"ref_104","unstructured":"Gordon, N., and Ruffini, K. (2019). Schoolwide Free Meals and Student Discipline: Effects of the Community Eligibility Provision. Educ. Financ. Policy, 1\u201350."},{"key":"ref_105","unstructured":"Kho, A. (2018). Three Essays on School Reform, Vanderbilt University."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1002\/pam.21909","article-title":"The effect of breakfast in the classroom on obesity and academic performance: Evidence from New York City","volume":"35","author":"Corcoran","year":"2016","journal-title":"J. Policy Anal. Manag."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"e59","DOI":"10.2105\/AJPH.2013.301470","article-title":"Evaluation of the New York City breakfast in the classroom program","volume":"103","author":"Seoh","year":"2013","journal-title":"Am. J. Public Health"},{"key":"ref_108","first-page":"23","article-title":"The effect of universal-free school breakfast on milk consumption and nutrient intake","volume":"5","author":"Nolen","year":"2015","journal-title":"Food Stud."},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Davis, W., and Musaddiq, T. (2018). Estimating the effects of subsidized school meals on child health: Evidence from the community eligibility Provision in Georgia schools. SSRN, 3155354.","DOI":"10.2139\/ssrn.3155354"},{"key":"ref_110","unstructured":"Rothbart, M.W., Schwartz, A.E., and Gutierrez, E. (2020). Paying for Free Lunch: The Impact of CEP Universal Free Meals on Revenues, Spending, and Student Health, Center for Policy Research, Maxwell School, Syracuse University."},{"key":"ref_111","unstructured":"Holford, A., and Rabe, B. (2020). Going Universal\u2014The Impact of Free School Lunches On Child Body Weight Outcomes, Institute for Social and Economic Research."},{"key":"ref_112","unstructured":"Alex-Petersen, J., Lundborg, P., and Rooth, D.-O. (2020, August 01). Long-Term Effects of Childhood Nutrition: Evidence from a School Lunch Reform. Available online: https:\/\/www.econstor.eu\/bitstream\/10419\/177038\/1\/dp11234.pdf."},{"key":"ref_113","unstructured":"Rogus, S., Guthrie, J., and Ralston, K. (2020, August 01). Characteristics of School Districts Offering Free School Meals to All Students Through the Community Eligibility Provision of the National School Lunch Program. Economic Research Service, USDA 2018, Available online: https:\/\/www.ers.usda.gov\/webdocs\/publications\/89948\/err-255.pdf?v=4916.5."},{"key":"ref_114","unstructured":"Rabe, B., and Holford, A. (2020, August 01). Impact of the Universal Infant Free School Meal Policy. Institute for Social and Economic Research 2020. Available online: https:\/\/mk0nuffieldfounpg9ee.kinstacdn.com\/wp-content\/uploads\/2019\/11\/ISER_Impact_of_the_Universal_Infant_Free_School_Meal_policy.pdf."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1068\/c0457","article-title":"Universal versus targeted benefits: The distributional effects of free school meals","volume":"23","author":"Morelli","year":"2005","journal-title":"Environ. Plan. C Gov. Policy"},{"key":"ref_116","unstructured":"Sellen, P., Huda, N., Gibson, S., and Oliver, L. (2020, August 01). Evaluation of Universal Infant Free School Meals. Available online: https:\/\/dera.ioe.ac.uk\/30988\/1\/UIFSM-evaluation-7.pdf."},{"key":"ref_117","unstructured":"Cook, J., Bovell, A., Poblacion, A., Cutts, D.B., de Cuba, S.E., Pasquariello, J., Sheward, R., and Chung, R. (2020, August 01). The $1.2 Billion Child Health Dividend. Children\u2019s HealthWatch 2017. Available online: https:\/\/childrenshealthwatch.org\/wp-content\/uploads\/FINAL-What-If-brief-for-web.pdf."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Smith, T.A., Mojduszka, E.M., and Chen, S. (2020). Did the New School Meal Standards Improve the Overall Quality of Children\u2019s Diets?. Appl. Econ. Perspect. Policy.","DOI":"10.2139\/ssrn.3631335"},{"key":"ref_119","unstructured":"Potamites, E., and Gordon, A. (2020, August 01). Children\u2019s Food Security and Intakes from School Meals. Mathematica Policy Research 2010, Available online: https:\/\/www.ers.usda.gov\/webdocs\/publications\/84357\/ccr-61.pdf?v=4130.8."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/3\/911\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:34:13Z","timestamp":1760160853000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/3\/911"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,11]]},"references-count":119,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["nu13030911"],"URL":"https:\/\/doi.org\/10.3390\/nu13030911","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,11]]}}}