[WHO-Guideline Policies and Interventions to Create Healthy School Food Environments]

Healthy nutrition in childhood and adolescence is essential for health and well-being and can be purposefully promoted through a healthy school food environment. The present WHO guideline includes policies and interventions that influence the school food environment and formulates evidence-informed recommendations towards the same goal.

Guideline development followed standardized WHO procedures, involving the WHO Nutrition Guidance Expert Advisory Group (NUGAG) and assessing the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation System (GRADE). The evidence base comprised a scoping review, a systematic literature review (literature search conducted in 04-05/2020), and a rapid review update of the literature up to 10/2023 covering three intervention areas: direct school food provision, nutrition standards and regulations, and nudging interventions. No eligible studies were identified for interventions on marketing restrictions or pricing policies.

WHO recommends using food provision at schools to increase the consumption of foods and beverages that contribute to a healthy diet. WHO also recommends setting and using nutrition standards or rules to increase the availability, purchase and consumption of foods and beverages at schools that contribute to a healthy diet and to decrease the availability, purchase and consumption of foods and beverages at schools that do not contribute to a healthy diet. Nudging interventions that modify the food environment at schools to increase the selection, purchase and consumption of foods and beverages that contribute to a healthy diet should be implemented, ideally through the simultaneous implementation of multiple nudging interventions. The implementation of this guideline should take into account local factors such as the country's nutrition situation, the socio-cultural and socio-economic context, regionally available foods, food security, climate change, dietary habits, available infrastructure, resources, political and legal frameworks, and governance structures of the WHO Member State. Furthermore, a coordinated approach with other relevant guidelines and recommendations should be pursued.