School food interventions and nutrition-related outcomes in Europe: A scoping review.

Abstract

To map, synthesize and assess evidence on European school food interventions and effectiveness on nutrition-related outcomes in children and adolescents aged ≤19 years. This scoping review followed PRISMA-ScR guidelines. We searched PubMed, Scopus, Web of Science, and the Education Resources Information Center for studies published between January 2020 and February 2026, following a published protocol. Two researchers independently screened titles, abstracts, and full texts. One researcher extracted the data using a standardized tool. The search identified 900 articles, of which 65 met the inclusion criteria. Most interventions (n = 52) were implemented in primary or secondary schools. Educational interventions (n = 43) were associated with positive dietary behaviors, such as higher fruit and vegetable intake, as well as favorable weight-related outcomes. Food provision (n = 10), including free school meals, was associated with healthier dietary intake and lower food insecurity. Multicomponent approaches (n = 12) were associated with sustained improvements in dietary intake and favorable anthropometric outcomes. Equity-focused interventions (n = 33) were associated with improvements in food security, dietary intake, and body mass index in the targeted populations. School food interventions in Europe are associated with positive shifts in dietary behaviors and weight-related outcomes. Future research should strengthen equity integration, expand early childhood approaches, and promote long-term policy support to enhance impact and sustainability.