The Whole School Food Approach: A European framework and implementation to promote healthy and sustainable school food systems.

IntroductionDespite global commitments to eliminate malnutrition, over half the world’s population remains affected. Multisectoral nutrition interventions targeting both proximate and distal causes of malnutrition are essential across the lifespan. Yet, current data collection lacks comprehensive nutrition intervention coverage measures, risking inaccuracies in tracking progress. The One Nutrition Coverage Survey (ONCS) aims to test new and refined coverage measurement methods, assess coverage equity and guide integration into large-scale household surveys.Methods and analysisThe ONCS will be a cross-sectional, population-representative household survey conducted in four districts of Bangladesh (Rangpur, Sylhet, Dhaka and Khulna), selected for their geographic spread and urban–rural balance. A stratified multistage sampling approach will be used to select enumeration areas, and a total of approximately 3280 households randomly selected within each EA will be included in the survey. The survey will interview women of reproductive age (15–49 years), caregivers of children (0–9 years), adolescents (10–19 years) and pregnant women, collecting data on multisectoral nutrition interventions relevant to these groups. It will use both existing and new measures, while also capturing monetary and non-monetary costs for survey design to implementation. Data will be analysed to assess coverage, co-coverage and equity by sociodemographic characteristics, as well as the feasibility, accuracy and costs of the survey approach.Ethics and disseminationThe study protocol and instruments were reviewed and approved by the International Centre for Diarrhoeal Disease Research, Bangladesh’s (icddr,b) Ethical Review Board in Bangladesh and the International Food Policy Research Institute’s Institutional Review Board in Washington, DC, USA. Adults provided signed informed consent and adolescents their assent. Findings will be shared through peer-reviewed publications, conferences and presentations in Bangladesh with key stakeholders. This study will yield new tools, methods and evidence for measuring multisectoral nutrition intervention coverage, applicable to other low-income and middle-income countries. Learnings from ONCS will enhance data collection aligned with national strategies, helping governments improve coverage assessments, inform decisions and strengthen programme monitoring.

ABSTRACT This paper explores an initiative by a local government in Rättvik, Sweden, to increase the consumption of local food in the municipal kitchens. It explores public procurement of local food as a way for local governments to address sustainability and climate goals while meeting residents’ demand for ‘good’ local food. Through a qualitative case study reviewing food and procurement policies across multiple governance levels and expert interviews, this paper examines how to align food, procurement, and sustainability policies. Findings reveal innovative procurement strategies, highlighting how regulations shape local food efforts and how municipalities adapt systems to build local networks.

ABSTRACT This paper examines how Rwandan households allocate their budgets to animal-source foods (ASF) within broader food consumption patterns. While staples such as beans, cassava, and maize dominate diets, ASF remain limited, often viewed as occasional or luxury items. Using demand system analysis, we explore expenditure disparities, urban – rural differences. Findings reveal that ASF categories function largely as complements, implying vulnerability to price shocks. The study highlights a critical knowledge gap in household budgeting for ASF and connects results to food security, nutrition, and policy strategies aimed at reducing stunting and improving diets.

To describe and evaluate nutrition-related policy, system, and environmental (PSE) change strategies implemented in a rural, volunteer-run Georgia food pantry, exploring facilitators and barriers and changes in clients' perceptions of food distributed following implementation of nutrition-related PSE changes. The mixed-methods evaluation used pre-post key informant interviews, client surveys, and program documents to assess implementation and outcomes of a nutrition policy and other PSE changes. Hancock County, Georgia. Survey respondents were food pantry clients who completed surveys both in January 2021 and March 2022 (n=155). Key informants were program staff, a local coalition member, and food pantry leadership (n=9). Nutrition-related PSE changes included a nutrition policy, produce procurement partnerships, and enhanced refrigeration; an awareness campaign and nutrition education were also conducted. Facilitators included the implementation approach (e.g., encouraging small steps, joint policy development), relationship formation, and partnerships. Barriers were modest capacity (e.g., funding, other resources), staffing/volunteers, and limited experience with food policy and procurement processes. Client surveys in 2021-2022 showed canned/dried foods as most commonly received, with significant (p<.05) increases at follow-up in always receiving meat/poultry/seafood and significant decreases in always receiving canned fruits and dry beans/lentils. In both 2021 and 2022, substantial proportions of respondents reported food insecurity (>60%), having obesity (>40%), poor/fair health (>30%), and a household member with hypertension/high blood pressure (>70%). Nutrition-related PSE changes in rural food pantries to improve the healthfulness of foods distributed require substantial resources, yet if sustained, may increase client access to healthy foods and improve diets.

To assess the frequency and correlates of meal-kit use across five countries using population-level data. Online surveys conducted in 2022 assessed meal-kit use in the past week. Binary logistic regression models examined sociodemographic and nutrition-related correlates of meal-kit use, including self-reported home meal preparation and cooking skills, commercially prepared meal consumption and healthy eating, weight change and sustainability efforts. Canada, Australia, the UK, the USA and Mexico. 20,401 adults aged 18-100 years. Overall, 14 % of participants reported using meal-kits in the past week. Use was highest in the USA (18 %) and lowest in Canada (9 %). Meal-kit use was greater among individuals who were younger, male, of minority ethnicity, had high educational attainment, had higher income adequacy or had children living in the household (P < 0·01 for all). Use was greater for those who participated in any food shopping (v. none), those who prepared food sometimes (3-4 d/week or less v. never) and those who reported 'fair' or better cooking skills (v. poor; P < 0·05 for all). Consuming any 'ready-to-eat' food (v. none) and visiting restaurants more recently (v. > 6 months ago; P < 0·001 for all) were associated with greater meal-kit use. Eating fruits/vegetables more than 2 times/d and engaging in diet modification efforts were also associated with increased meal-kit use, as was engaging in weight change or sustainability efforts (P < 0·001 for all). Meal-kits tend to be used by individuals who make efforts to support their health and sustainability, potentially valuing 'convenient' alternatives to traditional home meal preparation; however, use is concentrated amongst those with higher income adequacy.

The double burden of malnutrition and nutrient inadequacy, characterized by the coexistence of underweight or excess body weight, is increasingly prevalent among adolescents in low- and middle-income countries, including Thailand. This study aimed to determine the prevalence of this double burden and to identify sociodemographic predictors of nutrient inadequacy among Thai secondary school adolescents. This cross-sectional survey was conducted in one province of Southern, Thailand with 1,205 students, aged 13–18 years. Sociodemographic data were collected through a self-administered questionnaire. Nutritional status was assessed using World Health Organization Body mass index-for-age z-scores, while dietary intake was measured through 24-hour dietary recalls. Nutrient adequacy was evaluated according to the Thai Recommended Dietary Intakes. Chi-square tests and multiple binary logistic regression analyses were applied to examine associations between sociodemographic variables and nutrient inadequacy. Results showed the prevalence of thinness and excess body weight was 24.2% and 23.1%, respectively. Inadequate intake of calcium, vitamin C, zinc, selenium, and magnesium exceeded 95% in all groups. Predictors of nutrient inadequacy included breakfast skipping, large family size, male gender, younger age, and physical inactivity. The findings highlight that Thai adolescents face widespread micronutrient deficiencies regardless of weight status. School and community-based interventions tailored to age and gender are needed to address the double burden of malnutrition by collaborating with school health educators to improve screening, nutritional knowledge, advocate for school food policies, and foster healthy environments.

Purpose: This study aims to provide a comparative evaluation of the affordability of healthy diets in Türkiye and BRICS countries (Brazil, Russia, India, China, South Africa, Egypt, Ethiopia, Indonesia, Iran and the United Arab Emirates) during the years 2017 and 2021. The study focuses on understanding the evolution of diet-related economic challenges and the structural disparities affecting food affordability in emerging economies. Design/Methodology/Approach: A Multi-Criteria Decision-Making (MCDM) framework is used incorporating the Statistical Variance (SV) method for objective weighting of criteria and two decisionmaking techniques — CoCoSo and MARCOS—for ranking country performances. Data for the analysis are obtained from FAOSTAT and other international databases, covering key nutrition cost indicators such as Cost of a Healthy Diet (CoHD), Cost of Starchy Staples (CoSS), and Number of Unaffordable (NUA). Findings: Results show that NUA was the most significant indicator in both years, reflecting its dominant role in healthy diet access. The importance of CoSS increased significantly in 2021, likely due to postpandemic market disruptions. Türkiye, Russian Federation, and UAE ranked highest in affordability across both years. On the other hand, countries such as India and Egypt experienced persistent challenges. MARCOS and CoCoSo methods provided consistent and complementary rankings, validating the robustness of the integrated MCDM approach. Originality/Value: This research is among the first to apply a combined SV–CoCoSo–MARCOS approach to compare the affordability of healthy diets over time across Türkiye and BRICS countries. The integration of dynamic MCDM methods with updated cross-country nutrition data provides a valuable contribution to the literature on nutrition economics and food policy.

BackgroundRetail food environments in the UK use intense marketing strategies to promote the purchase and consumption of less-healthy foods that are associated with ill-health. To help address this issue, the Food (Promotion and Placement) regulations were introduced in England from October 2022, banning the placement of foods high in fat, salt, or sugar (HFSS) at checkouts, aisle-ends, and entrances in qualifying retail settings. Ahead of their introduction, this study examined health experts’ (i) perspectives on the likely effectiveness of these regulations and (ii) recommendations to enhance their impact.MethodsThis cross-sectional qualitative study aimed to recruit health experts to partake in focus groups/semi-structured interviews via MS Teams. Data were collected, coded, and analysed by three researchers with input from senior colleagues, using Braun and Clarke’s reflexive thematic analysis method.ResultsData were collected between October 2021 and March 2022 from 28 health experts, including public health and food policy academics (n = 9) and experts from civil society organisations (n = 19). Health experts perceived regulations as a major policy innovation which recognised businesses’ role in driving poor dietary choices that contribute to obesity. They also raised concerns about the outdated nutrient profiling model, limited regulatory scope, and weak enforcement. They were apprehensive about the potential for disproportionate impacts on smaller businesses and certain consumer groups. To enhance the impact of the regulations, they recommended funding independent and diverse evaluations, mandating the reporting of business sales data, and strengthening enforcement efforts. To improve the regulations’ effectiveness, they also suggested establishing mechanisms to refine regulatory guidance and introducing complementary policies within the food system.ConclusionsHealth experts believed that the regulations represent a significant step to curb the promotion of unhealthy foods in retail environments but will be insufficient on their own to improve population diet. To maximise their impact, a systems approach is essential, addressing shortcomings of the regulations, supporting smaller retailers in adopting health initiatives, and implementing thorough monitoring and evaluation. The regulations must form part of a comprehensive set of policies across various sectors, including manufacturing and retail, to accelerate food system transformation and address the dietary drivers of ill-health.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04484-2.

Introduction. In Colombia, food policies have been shaped by neoliberalism and market logic, leading to their implementation under assistance-oriented models guided by a top-down approach, which, in turn, constructs a passive recipient subject. Objective. To analyze the tensions of Medellín’s food policy in relation to implementation gaps from the perception of the actors involved in 2023. Methods. The analysis was conducted from a hermeneutical perspective and based on the integrationist approach to public policy analysis. Methods included documentary review of governmental texts and constructivist grounded theory; techniques comprised content analysis and semi-structured interviews with participants involved in the policy. Results. Among the most relevant findings, a lack of comprehensive perspective in service delivery and a predominance of food supplementation were identified in the implementation of Medellín’s food policy. This results in an approach centered on food security and social risk management, which distorts the human rights framework and its universal scope. Although this diverges from the principles established during policy formulation, it aligns with governmental interests focused on meeting goals through quantitative indicators. Conclusions. The participants’ voices highlight the need to incorporate alternative approaches into policy implementation to reduce implementation gaps and to construct recommendation narratives oriented toward effective implementation.

This study aimed to assess lipid quality indices in various dairy products. A total of seventy samples representing seven commonly consumed dairy products, including milk, yogurt, doogh, kashk, cheese, cream, and ice cream, were randomly collected from chain stores in Iran. The fatty acid composition of these samples was analyzed using gas chromatography (GC), and lipid quality indices were calculated using the appropriate equations. The results showed that cream and fermented dairy products had the highest concentrations of short-chain fatty acids (SCFAs), while ice cream had the lowest levels of SCFAs but the highest concentration of conjugated linoleic acid (CLA), which accounted for 7.27% of the total fatty acids. Cheese and cream were rich in medium-chain fatty acids (MCFAs), whereas yogurt contained the highest proportion of long-chain saturated fatty acids, making up 46% of the total fatty acids. Additionally, ice cream exhibited the most favorable lipid quality indices, characterized by lower atherogenicity (AI: 1.70 ± 0.87) and thrombogenicity (TI: 2.54 ± 0.32), along with a superior hypocholesterolemic/hypercholesterolemic (H/H) ratio of 0.92 ± 0.16. Overall, significant differences (p < 0.05) were found among the primary groups of fatty acids and their corresponding healthy lipid indices, depending on the type of dairy products analyzed. These findings can assist food policy makers in identifying practical solutions for the development of the dairy industry and in promoting healthier dairy products to support public health.

Food environments are the point of intersection where people engage with the food system. As such, they are a key consideration for food policy and governance in countries across the world. This collection of articles draws upon research conducted in a range of countries and predominantly, but not exclusively, urban settings. Research presented here expands on the way food environments have traditionally been explored in academic studies since the 1990s, introducing novel methodologies for assessment and incorporating the digital food environment, as well as food aid resources. Contemporary research must contend with the theoretical challenge of conceptualizing food environments in relation to wider social forces and changes. The more practical challenge is to inform improvements to neighbourhood food environments whilst avoiding the associated propensity to further perpetuate fragmented and short‐term responses to food inequalities.

Using real-world food price and greenhouse gas emissions data for locally available food items in 171 countries, we measure how healthy diets could be obtained with the lowest possible emissions, compared with costs and emissions of the least expensive options and foods most commonly consumed. We find that foods with the lowest greenhouse gas emissions for a healthy diet would emit 0.67 kgCO2e. A healthy diet using the least expensive items in each country would emit 1.65 kgCO2e and cost US$3.68 in 2021, while using foods most commonly consumed would emit 2.44 kgCO2e and cost US$9.96. Animal-source foods and starchy staples account for 91% of the difference in emissions between the lowest-cost and lowest-emission diets. Other food groups, especially fruits and vegetables, vary widely in cost but not in emissions. Results show how changes in food policy and choice can most cost-effectively support healthier and more sustainable diets worldwide.

Introduction Healthy, sustainably sourced school meals are considered a means to advance health, environmental, and economic goals within food systems. Achieving these benefits in practice, however, often requires navigating a complex, multi-level policy and governance landscape. In England, two interrelated policy areas that govern school meals are the School Food Standards and public procurement rules. Policy change is needed to improve outcomes, particularly given the lack of implementation provision. To highlight this, the paper introduces the concept of implementation settings to examine how school food policy and procurement are enacted in practice. Methods The study draws on a qualitative case study that introduced British-grown beans into primary school meals in two English local authorities. Data were collected through semi-structured interviews with policy actors across national and local government, schools, academies, caterers, and the voluntary sector, as well as from academic literature and policy documents. The analysis focused on diverse governance arrangements within implementation settings. Results Findings reveal a fragmented school food governance landscape in England, characterised by diverse arrangements and variable implementation outcomes, as diverse policy actors have been delegated or have assumed differing responsibilities. These dynamics highlight significant governance variability in how national school food policy is enacted, with local innovation and entrepreneurship driving positive outcomes. Discussion By foregrounding implementation settings as a critical site of governance, the paper advances understanding of the social, institutional, and contextual conditions that enable or constrain effective school food policy implementation. It further argues that local collaborative innovation offers important but partial pathways forward. Consistently positive food system outcomes also require strong national leadership and structural reforms. The study provides both practical and theoretical insights for those seeking to understand, navigate, and transform institutional food systems governance.

In public health, collaborative efforts aimed at improving food environments have gained momentum, yet the subtleties of value co-creation remain underexamined. Value co-creation is defined as the shared value generated by a group of participants through interactions. This study explores the perspectives of multiple stakeholders involved in developing a Toolkit designed to assist food retailers in implementing healthy food policies. Six semi-structured interviews were conducted with collaborators between August and September 2023 and analyzed using thematic analysis guided by a value co-creation framework. The interview data yielded 12 subthemes, grouped into three themes for reporting: 1) partner engagement, which includes factors fostering an interactive atmosphere; 2) partner capabilities, reflecting the networks, skills, and knowledge essential for successful collaboration; and 3) partner experience, which emphasizes the benefits and learning valued during the Toolkit’s development. Results showed that effective communication, transparency, and leadership are key drivers of collaborative success, whereas challenges included workload management and the need for clear governance structures. Comparisons with existing literature highlight the importance of these factors in fostering sustainable partnerships within public health initiatives. The findings stress the need for organizations to adopt co-creation as standard practice and recommend establishing strong frameworks to support ongoing collaboration. Additionally, further research is needed to deepen the understanding of the complexities involved in multi-partner interactions and their implications for policy implementation in food retail settings. This study offers valuable insights to enhance future public health initiatives through effective co-creation strategies.

Rice is a strategic commodity that plays an important role in maintaining national food security. However, rice production in Indonesia still fluctuates due to variations in harvest area, productivity, climate conditions, and differences in regional characteristics. This condition demands a predictive model capable of providing more accurate production estimates to support food policy planning. This research aims to predict national rice production by comparing two methods: Multiple Linear Regression and Random Forest Regression, using data from the Central Bureau of Statistics (BPS) and Nasa Power for the period 2018–2024. The analysis stages include data preprocessing, data exploration, categorical variable transformation, splitting data into training and testing sets, model training, and evaluation using Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and the coefficient of determination (R²). The research results show that harvested area is the most dominant factor influencing rice production, followed by productivity, year, and province. Based on the evaluation results, Random Forest provided the best performance with an MAE value of 40,599.94, an RMSE of 77,153.07, and an R² of 0.9991. The low error value and the proximity of the prediction to the actual data indicate that this model is better at capturing non-linear patterns and inter-regional variations compared to Multiple Linear Regression. Overall, Random Forest can be an effective method for predicting national rice production and can be further developed in subsequent research by incorporating climate variables or other external factors.

This study aims to analyze consumer preferences for free-range and broiler chicken in traditional markets in Kupang City. Data were collected from 50 respondents selected through accidental sampling at three purposively chosen traditional markets—Oebobo, Oeba, and Inpres Naikoten—between 5 and 25 October 2025. Primary data were obtained through interviews and questionnaires, while secondary data were sourced from institutional reports and relevant literature. Descriptive statistics were used to identify consumer characteristics and attribute evaluations, followed by an independent samples t-test or Mann–Whitney U test to assess differences in preferences between the two types of chicken. The results show that consumers exhibit a stronger preference for free-range chicken due to its richer flavor profile, firmer texture, and greater perceived health value, positioning it as a premium-quality product. In contrast, broiler chicken is primarily chosen for its affordability, high market availability, and practicality in food preparation, making it the most feasible option for daily household consumption. The Mann–Whitney U test returned a significance value of &lt; 0.05 for all assessed attributes, confirming statistically significant differences in consumer preferences between the two chicken types. Overall, these findings indicate distinct market segmentation, where free-range chicken appeals to consumers who prioritize sensory quality and health attributes, while broiler chicken dominates routine demand driven by economic and efficiency considerations. The results are expected to serve as a strategic reference for market actors and policymakers in developing poultry marketing strategies and food policy interventions

Association between the diagnosis of diet-related non-communicable diseases and the use of nutritional labeling among Mexican, Mexican American, and non-Mexican American adults: a cross-sectional study from the International Food Policy Study 2021-2022.

Abstract Natural Language Processing (NLP) offers significant opportunities to support the Sustainable Development Goals (SDGs), including Zero Hunger. While many NLP applications have been documented for SDGs such as healthcare and education, its application to food security remains largely unexplored. This paper addresses this knowledge gap through a comprehensive scoping review focused on NLP for food security policymaking. Six key application areas were identified: (1) Early warning systems for food insecurity, (2) Understanding public discourse on food related issues, (3) Knowledge generation and management from food policy and program documents, (4) Understanding dietary habits, (5) Food item classification, and (6) Addressing data gaps in food security statistics and crisis response. However, limited deployment hinders real-world impact. Establishing authentic partnerships from the outset will be essential for the successful and sustained implementation of NLP projects that advance progress toward ending hunger and achieving food security and improved nutrition for all.

Non-communicable diseases (NCDs) account for 74% of global deaths, with low- and middle-income countries (LMICs) bearing a disproportionate burden. In Bangladesh, NCDs are responsible for 66% of all deaths, projected to rise to 75% by 2030. A major contributor to this trend is the high consumption of free sugars, particularly through sugar-sweetened beverages (SSBs). Although SSB taxation has been shown to reduce sugar consumption and improve health outcomes, Bangladesh has yet to implement such a tax. This study explores the perspectives of key stakeholders involved in the development of a proposed sugar tax on foods and non-alcoholic beverages in Bangladesh. A qualitative study was conducted, involving thirty key informant interviews with interest holders from government, private industry, civil society, and public health sectors. Data was analyzed thematically. The study examined the feasibility, challenges, and opportunities associated with implementing a sugar tax in Bangladesh. Several factors were identified as barriers to the development of a sugar tax. These include a policy paradigm influenced by socio-cultural beliefs that resist regulatory food policies, lack of leadership from the Ministry of Health, strong opposition from the private industry, and limited awareness among key policymakers about the link between diet and non-communicable diseases (NCDs). The power imbalance between the private sector and public health authorities further hinders progress. Despite these challenges, interviewees suggested measures to support the tax's adoption, including strengthening the Ministry of Health's leadership, promoting inter-ministerial collaboration, and increasing public awareness through media advocacy. The lack of government leadership and strong industry opposition present significant obstacles to implementing a sugar tax in Bangladesh. To overcome these challenges, sustained advocacy for decisive leadership and consistent government and public health messaging is crucial. A coordinated approach will be necessary to advance this policy and effectively address diet-related non-communicable diseases (NCDs).