School nutrition programmes--do they fulfil their purpose?

School meals in the USA have been in operation for half a century, yet no associated benefits have been claimed, apart from a slight increase in weight-for-age. In the UK, Netherlands and other European countries, associated benefits have been slight or scarcely apparent. In developing populations, school meals, although little practised, appear less beneficial than expected. In western populations evaluations have been entirely incommensurate with extent and cost of the practice, for, largely, only assessments of dietary intake and anthropometric parameters have been studied. There has been insufficient enquiry into which intakes of nutrients, and which percentiles of growth standards, relate most meaningfully to scholastic prowess, biochemical and clinical parameters in youth, and health experience in later years. Since school meals, a highly emotional subject, are strongly bound up with national agriculture, and clearly are unlikely to discontinue, the authors consider that attempted modifications should be in line with current recommendations of authoritative dietary bodies, i.e. to encourage reduction in fat intake and an increased intake of fibre-containing foods.