Inequalities in availability and compliance of school food programs in Canadian elementary schools

Abstract

Abstract Background School food programs (SFP) are essential to promoting healthy eating in children. Canada lacks a federally funded and standardized SFP, resulting in a patchwork of SFP offerings. We examined SFP availability and compliance with Alberta Nutrition Guidelines for Children and Youth (ANGCY) in elementary schools from different socioeconomic settings. Methods Data were collected from 2 repeat cross-sectional surveys between 2008-2021: (1) REAL Kids Alberta (Raising healthy Eating and Active Living Kids in Alberta), a provincially representative population-based survey; and (2) APPLE Schools (A Project Promoting healthy Living for Everyone in Schools), a health promotion intervention targeting elementary schools in socioeconomically disadvantaged settings. School principals reported on availability and compliance of breakfast/snack and lunch programs with ANGCY. School-level socioeconomic characteristics included: Pampalon index (from Census data) and rural/small vs. large population centre (PC). Results Provincially, less than 50% schools offered breakfast/snack program. Lunch program was offered in over 85% schools. Over half of SFP complied with ANGCY by including 3-4 food groups (breakfast/snack: 62%, lunch: 52%). SFP availability in more vs. less deprived schools increased over time (2008: 25% vs. 26%, 2014: 58% vs. 40%). More schools located in rural/small vs. large PC offered SFP and availability increased over time (2008: 29 % vs. 18%, 2014: 56% vs. 46%). There were no consistent trends in compliance of SFP by socioeconomic characteristics. SPF availability and compliance in APPLE Schools improved from 68% to 73% and 53% to 68%, respectively. SPF availability was higher in more vs. less deprived APPLE schools (Y1: 85% vs. 54%, Y6+: 78% vs. 69%). Conclusions Higher availability and compliance of SFPs with nutrition guidelines in deprived and rural settings emphasize the critical role of SFPs in mitigating socioeconomic inequalities in healthy eating. Key messages • School food programs are essential to promoting healthy eating in children. • School food programs may play a critical role in mitigating socioeconomic inequalities in healthy eating.