Abstract

Enabling policies related to kindergarten and school food environments can be effective approaches in preventing childhood obesity. This study investigated policies and/or programs with direct or indirect effects on the food environment in kindergartens and schools in Iran. In this scoping review, we systematically searched PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran from January 1990 to October 2020, to identify literature on policies/programs affecting the food environment in kindergartens and schools in Iran. A total of 30 studies and policy documents were included in this review relevant to eight policies/programs. These programs have helped to control food availability in schools, increase nutritional awareness, positively influence physical function and school performances, and reduce malnutrition in rural kindergartens. However, improving the food environment in schools and kindergartens requires proper revisions and local adaptation of many of these policies, strengthening of cross-sectoral collaborations, provision of necessary financial and human resources, and ensuring regular monitoring and evaluation. Reflecting on Iran’s health policies and interventions provides insight into the progress achieved and challenges faced. Lessons can benefit the country itself, as well as other countries with similar contexts.

Highlights

  • Published: 13 April 2021Childhood is a critical period to establish lifelong eating habits that influence future risk of diet-related non-communicable diseases (NCDs) [1]

  • It is estimated that by 2025, the prevalence of overweight in preschool children will increase to 11% worldwide [6,7]

  • National surveys revealed that 4.6%, 4.3%, and 4.3% of children under five years of age are stunted, underweight, and wasted, respectively, and over 20% of school students have excess weight [8,9]

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Summary

Introduction

Published: 13 April 2021Childhood is a critical period to establish lifelong eating habits that influence future risk of diet-related non-communicable diseases (NCDs) [1]. Rapid semi-linear growth in children makes them more sensitive and vulnerable to undernutrition, hidden hunger, and excess weight, known as the triple burden of malnutrition [2,3]. In 2018, about 200 million under-five-year-old children suffered from wasting or stunting, at least 340 million had hidden hunger, and 18% of 5–19-year-old children and adolescents in the world were overweight and obese [4,5]. National surveys revealed that 4.6%, 4.3%, and 4.3% of children under five years of age are stunted, underweight, and wasted, respectively, and over 20% of school students have excess weight [8,9]. Micronutrient deficiencies are prevalent in this age category, e.g., zinc and vitamin D deficiencies present in 14% and 62% of 6-year-old children and 11% and 76% of adolescents, respectively [10]

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