{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:21:00Z","timestamp":1788337260097,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"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\/Objectives: For many schoolchildren\u2014particularly those in low-resource areas\u2014the school lunch is the most reliable balanced meal of the day, so its composition is a direct determinant of dietary equity. The aim of this study was to quantify urban\u2013rural disparities in school lunch food composition at national scale and to test whether they persist once county socioeconomic structure is controlled. Methods: Using 12,688,008 dish records from 3894 schools across all 22 Taiwanese counties over 24 months (May 2024\u2013April 2026), retrieved from the Ministry of Education\u2019s School Food Registry Platform, we constructed four dish-level dietary composition indicators\u2014plant-forward, organic, processed, and whole-grain shares\u2014and analyzed county-month panels (N = 418) using hierarchical regression with weighted least squares and heteroskedasticity-consistent standard errors. Results: The four dimensions followed distinct urban\u2013rural patterns. Plant-forward provision exhibited a stable urban-to-rural decline. Organic and whole-grain provision displayed a suppressor structure: rural disadvantage disappeared\u2014and reversed\u2014once county income was controlled, revealing latent local supply capacity masked by income disparities. Processed-dish use, once income and population density were accounted for, was concentrated in lower-income, more densely populated counties rather than rural ones, indicating an urban concentration pattern rather than a rural deficit. A 2017 traceable-food pilot policy still exhibited a legacy effect on organic procurement seven years after its nationwide rollout. Conclusions: School meal programs thus deliver systematically different dietary environments to children in different places. Narrowing these gaps, rather than raising national averages, should be the core criterion for evaluating school lunch reform, with interventions differentiated across dietary dimensions.<\/jats:p>","DOI":"10.3390\/nu18172871","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:53:11Z","timestamp":1788335591000},"page":"2871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Urban\u2013Rural Disparities in School Lunch Food Composition: Evidence from 12.7 Million Dish Records in Taiwan\u2019s National School Food Registry"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-9881","authenticated-orcid":false,"given":"Hui-Min","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Bio-Industry Communication and Development, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei 106, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7861-0341","authenticated-orcid":false,"given":"Jiun-Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Bio-Industry Communication and Development, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei 106, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-2819","authenticated-orcid":false,"given":"Kuo-Chen","family":"Wu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Mass Communication, National Taiwan Normal University, 7F, General Building, No. 129-1, Sec. 1, Heping E. Rd., Taipei 106, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1038\/sj.ijo.0801486","article-title":"Prevalence and trends of obesity among schoolchildren in Taiwan: The Taipei Children Heart Study","volume":"25","author":"Chu","year":"2001","journal-title":"Int. J. Obes."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.habitatint.2017.12.004","article-title":"Childhood overweight\/obesity and social inequality in peri-urban regions of Taipei, Taiwan","volume":"73","author":"Chang","year":"2018","journal-title":"Habitat Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/j.1468-0009.2009.00548.x","article-title":"Schools and obesity prevention: Creating school environments and policies to promote healthy eating and physical activity","volume":"87","author":"Story","year":"2009","journal-title":"Milbank Q."},{"key":"ref_4","unstructured":"Morgan, K., and Sonnino, R. (2008). The School Food Revolution: Public Food and the Challenge of Sustainable Development, Earthscan."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"i2716","DOI":"10.1136\/bmj.i2716","article-title":"Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: Systematic review and dose-response meta-analysis of prospective studies","volume":"353","author":"Aune","year":"2016","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1017\/S1368980018003762","article-title":"Ultra-processed foods: What they are and how to identify them","volume":"22","author":"Monteiro","year":"2019","journal-title":"Public Health Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/ajcn\/79.1.6","article-title":"Poverty and obesity: The role of energy density and energy costs","volume":"79","author":"Drewnowski","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_8","unstructured":"Ministry of Education (Taiwan) (2026, April 30). School Food Registry Platform (SFRP), Available online: https:\/\/fatraceschool.k12ea.gov.tw\/."},{"key":"ref_9","unstructured":"Executive Yuan (Taiwan) (2026, August 16). School Lunch Quality Improvement Measures and Future Refinements [\u5b78\u6821\u5348\u9910\u54c1\u8cea\u63d0\u5347\u4f5c\u70ba\u53ca\u672a\u4f86\u7cbe\u9032\u63aa\u65bd], Available online: https:\/\/www.ey.gov.tw\/File\/A6D66CD88E08E6DF."},{"key":"ref_10","unstructured":"New Taipei City Government (2022). Implementation Plan for the School-Lunch Domestic Traceable Ingredient Incentive [\u65b0\u5317\u5e02\u5b78\u6821\u5348\u9910\u63a1\u7528\u570b\u7522\u53ef\u6eaf\u6e90\u98df\u6750\u734e\u52f5\u91d1\u5be6\u65bd\u8a08\u756b], (Revised June 2022)."},{"key":"ref_11","unstructured":"Ministry of Education (Taiwan) (2026, August 16). Response on School Lunch Issues (Press Statement), Available online: https:\/\/www.edu.tw\/News_Content.aspx?n=9E7AC85F1954DDA8&s=C22F047FB3E6F182."},{"key":"ref_12","unstructured":"Agriculture and Food Agency, Ministry of Agriculture (Taiwan) (2026, April 30). School Lunch \u20183 Labels & 1 QR\u2019 Domestic Traceable Food Program, Available online: https:\/\/4b1q.moa.gov.tw\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"251","DOI":"10.2307\/2586011","article-title":"Increasing returns, path dependence, and the study of politics","volume":"94","author":"Pierson","year":"2000","journal-title":"Am. Polit. Sci. Rev."},{"key":"ref_14","unstructured":"(2026, August 16). School Health Act (\u5b78\u6821\u885b\u751f\u6cd5), Article 23. Laws & Regulations Database of the Republic of China, Available online: https:\/\/law.moj.gov.tw\/LawClass\/LawAll.aspx?PCode=H0020050."},{"key":"ref_15","unstructured":"Ministry of Education, and Ministry of Agriculture (Taiwan) (2026, August 16). Guideline on the Use of Domestic Traceable Ingredients for School Lunches [\u5b78\u6821\u5348\u9910\u63a1\u7528\u570b\u7522\u53ef\u6eaf\u6e90\u98df\u6750\u6307\u5357], Available online: https:\/\/fatraceschool.k12ea.gov.tw\/newsattachfiles\/5319."},{"key":"ref_16","unstructured":"Ministry of Education (Taiwan) (2020). School Lunch Food Content and Nutritional Standards (\u5b78\u6821\u5348\u9910\u98df\u7269\u5167\u5bb9\u53ca\u71df\u990a\u57fa\u6e96), (Revised 28 December 2020)."},{"key":"ref_17","unstructured":"Raudenbush, S.W., and Bryk, A.S. (2002). Hierarchical Linear Models: Applications and Data Analysis Methods, Sage. [2nd ed.]."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hox, J.J., Moerbeek, M., and van de Schoot, R. (2010). Multilevel Analysis: Techniques and Applications, Routledge. [2nd ed.].","DOI":"10.4324\/9780203852279"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1037\/0033-2909.86.2.420","article-title":"Intraclass correlations: Used to assess rater reliability","volume":"86","author":"Shrout","year":"1979","journal-title":"Psychol. Bull."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/ije\/dyl267","article-title":"Are socially disadvantaged neighborhoods deprived of health-related community resources?","volume":"36","author":"Pearce","year":"2007","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1068\/a40112","article-title":"Quality food, public procurement, and sustainable development: The school meal revolution in Rome","volume":"41","author":"Sonnino","year":"2009","journal-title":"Environ. Plan. A"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1177\/1757913913517976","article-title":"The association between organic school food policy and school food environment: Results from an observational study in Danish schools","volume":"134","author":"He","year":"2014","journal-title":"Perspect. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1017\/S1368980012005101","article-title":"The Brazilian school feeding programme: An example of an integrated programme in support of food and nutrition security","volume":"16","author":"Sidaner","year":"2013","journal-title":"Public Health Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s10460-008-9173-6","article-title":"The emergence and framing of farm-to-school initiatives: Civic engagement, health and local agriculture","volume":"26","author":"Bagdonis","year":"2009","journal-title":"Agric. Hum. Values"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jrurstud.2010.02.002","article-title":"Market diversification and social benefits: Motivations of farmers participating in farm-to-school programs","volume":"26","author":"Izumi","year":"2010","journal-title":"J. Rural Stud."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:58:53Z","timestamp":1788335933000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/17\/2871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":25,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18172871"],"URL":"https:\/\/doi.org\/10.3390\/nu18172871","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}