School-based interventions and policies encourage youths to include and consume fruits and vegetables at lunchtime via school lunches, but limited research has examined how these behaviours compare when youths have home-packed lunches. The objective of the present study was to compare fruit and vegetable contents and consumption among students having school or home-packed lunches over the school week.

Participants were observed over five consecutive days at school lunchtime. Trained analysts estimated students’ lunchtime fruit and vegetable contents and consumption using digital imaging. Mixed models examined associations between fruit and vegetable dietary behaviours and lunch source (school v. home-packed), controlling for student gender, grade and school.

Three elementary schools in northern California, USA.

Fourth-, fifth- and sixth-grade students (nchildren 315; nobservations 1421).

Students were significantly less likely to have and to consume fruits and vegetables (all P<0·05) when having home-packed lunches, compared with when having school lunches. Among those who did have or did consume these foods, having a home-packed lunch was associated with consuming significantly less fruit (P<0·05) but no differences for other dietary outcomes.

The study adds to a growing body of literature indicating shortfalls in fruit and vegetable contents and consumption associated with having a home-packed lunch, relative to having a school lunch. Findings suggest that school-based interventions, particularly when targeting home-packed lunches, should focus on whether or not these foods are included and consumed, with less emphasis on quantities.

Nutrient and food standards exist for school lunches in English primary schools although packed lunches brought from home are not regulated. The aim of the present study was to determine nutritional and dietary differences by lunch type.

A cross-sectional survey was carried out in 2007 assessing diet using the Child and Diet Evaluation Tool (CADET), a validated 24 h estimated food diary. The data were analysed to determine nutritional and dietary intakes over the whole day by school meal type: school meals and packed lunches.

Fifty-four primary schools across England.

Children (n 2709) aged 6–8 years.

Children having a packed lunch consumed on average 11·0 g more total sugars (95 % CI 6·6, 15·3 g) and 101 mg more Na (95 % CI 29, 173 mg) over the whole day. Conversely, children having a school meal consumed, on average, 4·0 g more protein (95 % CI 2·3, 5·7 g), 0·9 g more fibre (NSP; 95 % CI 0·5, 1·3 g) and 0·4 mg more Zn (95 % CI 0·1, 0·6 mg). There was no difference in daily energy intake by lunch type. Children having a packed lunch were more likely to consume snacks and sweetened drinks; while children having a school meal were more likely to consume different types of vegetables and drink water over the whole day.

Compared with children having a school meal, children taking a packed lunch to school consumed a lower-quality diet over the whole day, including higher levels of sugar and Na and fewer vegetables. These findings support the introduction of policies that increase school meal uptake.

To compare the key differences between school lunches and packed lunches as eaten in eleven secondary schools in England, 21 months after the food-based standards for school lunch became mandatory, but before the introduction of nutrient-based standards.

Data on 358 school lunches and 139 packed lunches were collected in May and June 2008 from pupils attending secondary schools in Sheffield, Manchester, Leicester City and Essex. Fieldwork was conducted over five consecutive school days at each school. Fieldworkers randomly selected five pupils taking a school lunch and five pupils bringing a packed lunch each day. All food and drink items chosen by pupils were weighed and recorded. Leftovers were also weighed.

Eleven state-maintained, co-educational secondary schools from four local authorities in England.

Four hundred and ninety-seven pupils aged 11–16 years.

Pupils taking school lunches, on average, had significantly higher intakes of energy, protein, carbohydrate, NSP, vitamin C, folate, Fe and Zn than pupils bringing a packed lunch to school. Mean intakes of protein, fat and vitamin C from both types of lunch met the nutrient-based standards and school lunches also met standards for carbohydrate, NSP and energy.

Nutrient intakes from school lunches were more favourable than those from packed lunches, but typically failed to meet nutrient-based standards for school food. A combination of continued improvements to school food, educating pupils to make healthier choices and policies to encourage pupils to eat at school or bring healthier packed lunches is needed.

To compare the key differences between school lunches and packed lunches as consumed in a nationally representative sample of primary schools, 6–8 months after the nutrient-based standards for school lunch became mandatory.

Data on 6580 pupils’ school lunches and 3422 pupils’ packed lunches were collected between February and April 2009 from pupils attending primary schools in England. Fieldwork was conducted over five consecutive school days. Fieldworkers randomly selected ten pupils taking a school lunch and five pupils bringing a packed lunch each day at each school, and recorded and weighed all food and drink items consumed, as well as any leftovers.

A nationally representative sample of 136 state-maintained primary schools in England.

A total of 10 002 pupils aged 4–12 years.

Mean intakes of protein, fat, saturated fat and vitamin C from both types of lunch met the nutrient-based standards. Pupils taking school lunches on average consumed significantly more protein, NSP, vitamin A, folate and Zn and less fat, saturated fat, non-milk extrinsic sugars (NMES), Na, Ca, vitamin C and Fe than pupils taking packed lunches. Energy intakes were low in both groups.

Packed lunches were less likely to accord with food-based or nutrient-based standards than school lunches. Higher levels of Na, NMES, fat and percentage energy from saturated fat emphasise the difficulties associated with optimising nutrient intakes from packed lunches.

To describe the lunchtime choices and nutritional intake of primary-school-aged children in England 4 months after the introduction of interim food-based standards for school lunches.

Cross-sectional 2 d weighed food records collected in January and February 2007.

Six primary schools in Sheffield, England.

One hundred and twenty-three pupils aged 8–10 years.

Vegetables (81 % v. 8 %) and cakes and biscuits (43 % v. 23 %) were chosen more frequently by pupils consuming a school lunch, while fruit (40 % v. 36 %), meat products (18 % v. 14 %), confectionery (72 % v. 0 %), savoury snacks (69 % v. 0 %) and drinks not meeting the school food standards (40 % v. 0 %) were chosen more often by pupils eating a packed lunch. Mean energy intake was lower in the school lunch group compared with the packed lunch group (1402 (sd 573) v. 2192 (sd 619), P = 0·005). Nutrient density (per MJ energy) was significantly better in school meals for key nutrients including protein (9·8 (sd 2·7) v. 6·3 (sd 1·9) g), fat (7·4 (sd 2·7) v. 10·6 (sd 2·8) g), NSP (2·8 (sd 1·3) v. 1·1 (sd 0·4) g), vitamin A (151·3 (sd 192·8) v. 69·1 (sd 55·6) μg), folate (29·6 (sd 11·6) v. 17·0 (sd 7·0) μg), iron (1·3 (sd 0·3) v. 0·9 (sd 0·3) mg) and zinc (1·1 (sd 0·4) v. 0·7 (sd 0·3) mg).

Schools were largely compliant with the interim food-based standards for school meals 4 months after their introduction. Within the context of the new standards, children taking a school lunch are more likely to eat a more nutritious lunch, in terms of less high-fat/salt/sugar foods and nutrient density. The introduction of nutrient-based standards is warranted. Efforts to improve the lunchtime intake of children taking a packed lunch are also required.

To describe the ‘Smart Lunch Box’ intervention and provide details on feedback from the participants on the acceptability and usability of the intervention materials.

A cluster randomised controlled trial, randomised by school. English schools were stratified on percentage free-school-meals eligibility and attainment at Key Stage 2. A ‘Smart Lunch Box’ with supporting materials and activities on healthy eating was delivered to parents and children via schools in the intervention group. Feedback forms containing information on a total of fifteen intervention items were filled out by the parents and/or children participating in the intervention and were collected after each of the three phases of the intervention.

Eighty-nine primary schools in England, Scotland, Wales and Northern Ireland, randomly selected; forty-four schools in the intervention arm.

A total of 1294 children, aged 9–10 years, took part in the trial. Of the 604 children in the intervention arm, 343 provided feedback after at least one of the three phases.

A median of twelve items out of a total of fifteen were used by responders. The two intervention items most likely to be used were the individual food boxes and the cooler bags. Whether a participant liked an item significantly affected whether they used it for all items except the cooler bag, fruity face and individual food boxes.

Practical intervention items aimed at parents are likely to be used in the longer term and therefore may be appropriate for use in an intervention strategy to improve packed lunches.