Abstract
In 2020, a state of emergency was declared to control the devastating impact of coronavirus, leading to temporary school closures in Japan, meaning that school lunches were not provided to the majority of schoolchildren. Using questionnaires completed by participants’ guardians, we examined the relationship between household income and the quality of meals in Japanese schoolchildren before, during, and after the state of emergency. Participants (1111 children, 10–14 years old) were chosen to form a nationally representative sample of the Japanese population. “Well-balanced dietary intake” was defined as the intake of (i) meat, fish, or eggs and (ii) vegetables. The desired prevalence was defined as equal to or more than twice a day. Household income was divided into quartiles. “Well-balanced dietary intake” was lower in all households during the state of emergency compared with before. The proportion of those with a “well-balanced dietary intake” at least twice a day was notably low in both Q3 and Q4 during the state of emergency compared with before the declared state of emergency; relative risk increase (95% CI) were Q1: −19.0% (−19.6% to −18.4%), p < 0.001, Q2: −21.3% (−22.1% to −20.6%) p < 0.001, Q3: −25.4% (−26.1% to −24.7%), p < 0.001, and Q4: −34.8% (−35.6% to −34.0%), p < 0.001. The interaction p (vs. Q1) of Q2, Q3, and Q4 were all <0.001. Guardians from low-income households had significantly higher rates of having less: time, psychological room, and financial position to prepare meals during the state of emergency. Our results suggest that schoolchildren’s quality of meals worsened during the state of emergency, especially in low-income households, because school lunches were not provided.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1], continues to spread worldwide, posing a serious threat to our healthcare and causing social and economic impacts everywhere [2,3,4]
Weight, and Body mass index (BMI) distributions of study participants were similar to representative distributions of Japanese children [26,27,28]; distribution differed by household income level (p < 0.001)
During the COVID-19 state of emergency in Japan, school lunches were not provided to most Japanese schoolchildren due to nationwide temporary school closures [7]
Summary
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1], continues to spread worldwide, posing a serious threat to our healthcare and causing social and economic impacts everywhere [2,3,4]. The Japanese Government declared a nationwide state of emergency on 16 April 2020, based on the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response (Act No 31 of 2012) [5]. During the fiscal year 2018, the Japanese Government provided school lunches to 99.1% of schoolchildren in their elementary years (6–11 years of age) and 89.9% in their junior high years (12–15 years of age). School lunches were not provided in schools that were temporarily closed during the COVID-19 state of emergency: schoolchildren were required to have their lunch at home during this period. The Standards for the School Lunch Program requires school lunches to contain at least a third of children’s daily energy and nutritional requirements, including vitamin A (≥40%), vitamin B1 (≥40%), vitamin B2 (≥40%), Ca (≥50%), Fe (≥40%), and fiber (≥40%) [11]. It is important to determine the quality of meals for schoolchildren when their opportunities for lunch depend on the home
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