Traditionally, concerns and advice regarding nutrition during childhood and adolescence focused on delivering adequate nutrition to achieve optimal growth and development. However, it has been a few years since it became known that an appropriate diet is also important for prevention of disease later in life.1 The Sustainable Development Goals established by the United Nations in 2015 include the prevention and control of noncommunicable diseases, and obesity in particular, as essential priorities.2

From a preventive standpoint, the first 1000 days of life have been highlighted as being of utmost importance.3 The school-age period (including every stage: kindergarten or preschool and primary and secondary education) is also crucial.1

In developed countries, consumption of fruits and vegetables during the school-age period is lower than recommended, while, on the contrary, the intake of sugars, protein and saturated fats exceeds recommended limits.4,5 In Spain, different studies have confirmed these trends.6,7 Another aspect deserving consideration is sedentary behaviour and the decrease in the level of physical activity.2,8

Eating patterns (meal timing, meal frequency, types of foods) tend to adjust to varying needs throughout the day.9 In the sociocultural environment of Spain, the main meal takes place after noon. A substantial proportion of schoolchildren, especially those in preschool and primary school, but also secondary school students, use school lunch services.10,11 Consequently, the food consumed in the school lunch is an important part of the diet from both a quantitative and a qualitative perspective.10 It is also important from an educational and learning perspective. Different organizations and academic institutions in Spain and abroad consider the school setting as one of the most important settings for acquiring theoretical and practical skills on health and nutrition, in addition to one of the most promising settings for the prevention of obesity, as it allows intervention on inadequate dietary habits and the promotion of healthy nutrition.2,10,12,13 The school lunchroom, with the involvement of the entire educational community, should be considered a crucial educational component and a vehicle to spread awareness to families and society at large, a key element in the promotion of equality in nutritional education. We should add that school lunchrooms can also contribute to social cohesion, not only through providing access to subsidised meals, but also by improving the quality of the diet of children from low-income families or disadvantaged groups.14,15

In this article, we summarise the current situation and the regulations and recommendations or guidelines for preschool and school lunchrooms in Spain and in each of its autonomous communities (ACs). There is no specific regional or national legislation regarding meals served in child care centres (ages 0–3 years).

We also reflect on the emerging concerns about nutrition in the school setting and the changes in nutritional recommendations in the past decade. Lastly, taking into account the main references reviewed and based on the heterogeneity of the current school meal guidelines in Spain, we highlight the main points that ought to be considered in the development of future guidelines on school food services, as well as new aspects to introduce based on the most recent evidence.

In recent decades, a significant proportion of children and adolescents in Spain, as occurs in other developed countries, have lunch in school.10 In the past few years, due to the restructuring of work and school schedules, the intensive morning-only schedule (versus the full-day morning/afternoon split schedule) is becoming more frequent, yet the demand for the school lunch service has been growing at a steady pace. Based on data from the Ministry of Education, and with little variation between the different ACs, in the 2001–2002 academic year, 27% of preschool students, 24% of primary school students and 13% of secondary school students were using school lunch services, with a higher proportion of users in private versus public schools.11 In the decade that followed, there was a slight decline in the total number of users and of schools offering lunch services, possibly due to the progressive introduction of intensive morning-only schedules. However, in recent years the numbers have rebounded, so that in the 2016–2017 academic year, 34% to 45% of preschool and primary school students and 10% of secondary school students used the school lunch service. The difference between private and public schools remained, with a higher percentage of private school students using school lunch services.16

Although some of the current regulations are still from the late 20th century (Appendix 2), the most important laws and recommendations have been developed in this century. In 2008, the Committee on Nutrition of the AEP published a guideline with recommendations for school food services.10 The same year, the Ministry of Health and Consumption also published a nutritional guideline in the framework of the Perseo programme.17 In 2010, the Ministry of Education and the Ministry of Health published a consensus document about food services in schools.14 Chapter VII of Law 17/2011, of July 5, on Food Safety and Nutrition establishes specific measures for the school setting (quality of the menus, duty to provide information to the legal guardians of the students, availability of suitable meals for students with special needs) and also mentions the ban on advertising and the sale in schools of unhealthy foods and beverages (high in saturated fats, trans fats, salt and sugar).

With the exception of the autonomous cities of Ceuta and Melilla, which are held to national regulations, all ACs have regional competencies and have their own regulations for school meal services (Appendix 2). Nearly all ACs have their own guidelines with nutritional recommendations for school menus and those that do not offer nutritional guidance or educational materials for support in their websites. Taking into account the goal of promoting a healthy diet, nutritional recommendations must address the composition of the diet (types of foods to eat, frequency, proportions, amounts, requirements for age) and specify which foods should be limited or even banned. We would also advise including meal standards and examples of daily menus, as well as specifying which drinks are recommended and addressing specific situations, diseases or other health-related issues.1,4,10,17–19 To facilitate comprehension of the classification of foods by group (legumes, fruit, vegetables, dairy, etc), basic nutrients and recommended frequency of consumption (daily, weekly, occasional), guidelines often make use of graphic representations, such as the food pyramid or the healthy eating plate,20,21 or to colour schemes: green, yellow, red.1 Most guidelines at the AC level touch on these aspects, although they differ in the details (Table 1).

Order of 24 November 1992 established the possible models for the management of school food services: direct management by the school or indirect management through a contract or agreement with either an independent business or a public agency/city council providing the service. Direct management was the predominant approach at the beginning of this century,22 but the outsourcing model has become widespread, usually with a cold-chain approach in which private companies provide schools with meals prepared in company sites that are transported in trays and served after minimal handling on the school premises.23 Although data were not available for every AC, 63.6% of schools used external catering services and 36.4% cooked meals in kitchens in the school premises, with Galicia having the greatest number of schools with kitchens onsite and Andalusia the least.23

In the first years of this century, several studies on school menus warned of their unhealthy nature, as they provided low amounts of vegetables, fruit and fish and excessive amounts of meat, as well as usually hypercaloric desserts (processed dairy products, canned fruit in syrup or even sweets) and with excessive use of unhealthy cooking methods (fried or ultraprocessed foods).10

Reports from recent years reflect a trend toward improvement in terms of the number of servings and frequency of consumption of foods relative to current nutritional guidelines.15,22,24–31 However, all of them found that efforts must still be made to achieve adequate intakes of fruit, vegetables, whole grains, legumes, beans and fish, and to reduce the intake of meat or dairy products and the use of unhealthy cooking methods (precooked means, high-fat meat products, fried foods).

Nutritional guidelines are developed specifically for a given AC, age group and geographical region. While ensuring adequate growth and development during childhood and adolescence is an essential objective, at present the main concern is the prevention of obesity and noncommunicable diseases associated with excess weight or an unhealthy diet. To this end, new guidelines, as reflected in recent publications of the WHO, must include messages and advice on different areas, not only related to nutrition, but also to education and society.2,47

The general objectives pursued by school meal guidelines are the following: the promotion of healthy dietary habits that will contribute to improving the health of schoolchildren and prevent some diseases currently increasing in prevalence in Spain, like excess weight, to help all professionals involved in catering services to develop more appropriate menus for the school setting, and to provide guidance to schools in the selection of the healthiest menus for their food services.

We already mentioned the heterogeneity of the current guidelines for school-based food services in Spain. Considering the information reviewed for the writing of this article and taking as reference the previous document published by the Committee on Nutrition of the Asociación Española de Pediatría (Spanish Association of Paediatrics)10 and the school food service guideline of the Ministry of Health and Consumption of Spain,17 for practical purposes, Table 2 summarises the basic points to consider in future guidelines for school food services along with new points to introduce based on the most recent evidence.

The authors have no conflicts of interest to declare.