{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:50:28Z","timestamp":1785919828539,"version":"3.56.0"},"reference-count":11,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Pediatric cardiometabolic health in the United States is declining, driven by rising rates of obesity, prediabetes, and type 2 diabetes. School lunch programs provide a unique opportunity to influence children\u2019s dietary behaviors, reaching millions of students across diverse socioeconomic backgrounds each day. Increasing the availability of plant-based meals in school lunch programs may help reduce modifiable cardiometabolic risk factors and serve as a cost-effective, population-level strategy to promote long-term cardiovascular health. Methods: We conducted a cross-sectional narrative policy review of school lunch programs across all 50 U.S. states and the District of Columbia. Publicly available state statutes, regulations, school nutrition guidance, government reports, and educational resources were systematically reviewed to identify official statewide policies or guidance explicitly supporting plant-based or vegetarian meals. Jurisdictions were classified as providing either Explicit Support or Not Specified according to predefined coding criteria. We also assessed whether jurisdictions specified the frequency of plant-based meal offerings. Results: Only 3 of 51 jurisdictions (5.9%)\u2014California, the District of Columbia, and Illinois\u2014provided explicit statewide support for plant-based meal options. The remaining 48 jurisdictions (94.1%) did not explicitly promote or support plant-based meals in official statewide school nutrition policies or guidance. No jurisdiction mandated the frequency of plant-based meal offerings, although the District of Columbia provided non-binding guidance encouraging regular inclusion. Conclusions: Explicit statewide support for plant-based or vegetarian school meals remains rare in the United States. Strengthening state-level policies and developing standardized guidance on the inclusion and frequency of plant-based meals in school lunch programs may represent a feasible population-level strategy to improve dietary quality and reduce future pediatric cardiometabolic risk.<\/jats:p>","DOI":"10.3390\/nu18152556","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:14:46Z","timestamp":1785917686000},"page":"2556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["State-Level Promotion of Plant-Based School Meals in the United States: A National Policy Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1945-5817","authenticated-orcid":false,"given":"Vishakha","family":"Modak","sequence":"first","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5005-1211","authenticated-orcid":false,"given":"Aditya","family":"Karthikeyan","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8399-4706","authenticated-orcid":false,"given":"Natali","family":"Sorajja","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-3994","authenticated-orcid":false,"given":"Sridhar","family":"Mangalesh","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyansh","family":"Shah","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3310-4792","authenticated-orcid":false,"given":"Sharanya","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Gashi","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Faillace","sequence":"additional","affiliation":[{"name":"Jacobi Medical Center, Albert Einstein College of Medicine, New York City Health + Hospitals, 1400 Pelham Parkway, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1161\/CIR.0000000000001435","article-title":"2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement from the American Heart Association","volume":"153","author":"Lichtenstein","year":"2026","journal-title":"Circulation"},{"key":"ref_2","unstructured":"US Department of Agriculture, and US Department of Health and Human Services (2026, April 25). Dietary Guidelines for Americans, 2020\u20132025, Available online: https:\/\/www.dietaryguidelines.gov\/sites\/default\/files\/2020-12\/Dietary_Guidelines_for_Americans_2020-2025.pdf."},{"key":"ref_3","unstructured":"US Department of Agriculture, and US Department of Health and Human Services (2026, May 06). Dietary Guidelines for Americans, 2025\u20132030, Available online: https:\/\/www.dietaryguidelines.gov."},{"key":"ref_4","unstructured":"Food Research & Action Center (2025). The Reach of School Breakfast and Lunch During the 2023\u20132024 School Year, FRAC. Available online: https:\/\/frac.org\/reach-report-2025."},{"key":"ref_5","unstructured":"Centers for Disease Control and Prevention (2026, May 06). School Meals|School Nutrition, Available online: https:\/\/www.cdc.gov\/school-nutrition\/school-meals\/index.html."},{"key":"ref_6","unstructured":"United States Department of Agriculture, Food and Nutrition Service (2026, May 06). Child Nutrition Programs: Meal Patterns Consistent with the 2020\u20132025 Dietary Guidelines for Americans Final Rule\u2014Summary of Provisions, Available online: https:\/\/fns-prod.azureedge.us\/sites\/default\/files\/resource-files\/DGARuleFinalSummary5.2.24.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/S0140-6736(25)01201-2","article-title":"The EAT\u2013Lancet Commission on healthy, sustainable, and just food systems","volume":"406","author":"Thilsted","year":"2025","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1017\/S1368980012000870","article-title":"Nutritional quality and acceptability of a weekly vegetarian lunch in primary-school canteens in Ghent, Belgium: \u2018Thursday Veggie Day\u2019","volume":"15","author":"Heath","year":"2012","journal-title":"Public Health Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dahmani, J., Nicklaus, S., Grenier, J.-M., and Marty, L. (2022). Nutritional quality and greenhouse gas emissions of vegetarian and non-vegetarian primary school meals: A case study in Dijon, France. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.997144"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1377\/hlthaff.2020.01102","article-title":"Alignment of US school lunches with the EAT-Lancet healthy reference diet\u2019s standards for planetary health","volume":"39","author":"Poole","year":"2020","journal-title":"Health Aff."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Modak, V., Karthikeyan, A., Mangalesh, S., Kaushik, S., Shah, P., Gashi, E., and Faillace, R. (2026, January 17\u201320). Abstract WE559: State Support for Plant-Based Meals in U.S. School Lunch Programs: A National Policy Analysis. Proceedings of the (AHA EPI Conference), Boston, MA, USA.","DOI":"10.1161\/cir.153.suppl_1.WE559"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2556\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:24:51Z","timestamp":1785918291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/15\/2556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":11,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["nu18152556"],"URL":"https:\/\/doi.org\/10.3390\/nu18152556","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]}}}