School feeding programs lead to modest but meaningful results

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Free or subsidized school meals lead to modest gains in math and school enrolment, according to a new Cochrane review that examined the global impact of school feeding programs on disadvantaged children in both high-income countries and low- and middle-income countries.

The research team, led by scientists from University of Ottawa, found that providing free or subsidized meals in schools slightly improves math achievement and enrolment rates in low- and middle-income countries (LMICs), and likely contributes to small gains in physical growth indicators such as height-for-age and weight-for-age scores.

School feeding programs aim to reduce hunger and improve children’s learning, focus, and overall health. Worldwide, many children do not get enough nutritious food to keep them healthy and ready to learn in school, and disadvantaged children are particularly vulnerable. LMICs account for almost 90% of global undernutrition. Yet in 2024, on average, only 27 percent of primary schoolchildren in low-income countries and 42 percent in lower-middle-income countries received school meals. In contrast, 58% of children in upper-middle-income countries, and 79% in high-income countries received school meals, according to a report from the World Food Programme.

Consistent improvements in growth, enrolment, and math achievement
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The review analysed 40 studies including 91,000 students across primary and secondary schools. Most studies were conducted in LMICs, including some in conflict-affected regions, expanding on earlier evidence that was limited in geographical scope.

Overall, the authors found school feeding programs in LMICs lead to a small increase in math test scores and school enrollment. They were also likely to lead to slight gains in a relative measure of a child’s height and weight for age. However, the authors found that these programs may have little to no effect on reading test scores and school attendance.

“School meals are a critical source of nourishment for children experiencing socioeconomic disadvantage,” said Jennifer Garner, a Registered Dietitian and Assistant Professor from University of Michigan School of Public Health who co-authored the review. “Given the variation in contexts and program designs studied, seeing measurable improvements in growth, enrolment, and math achievement is encouraging.”

Despite the promising findings, the authors caution that evidence from high-income countries is limited, so results should not be generalised beyond LMICs.

“School meal programs play an important role in improving health and educational outcomes for disadvantaged children,” said Elizabeth Kristjansson, lead author and Professor Emeritus from the University of Ottawa. “What we’re seeing are modest, but real results. The way I see it, we have a moral imperative to feed hungry children.”*

Calls for stronger research and greater equity
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The team emphasises the need for stronger, more standardised research to guide future policymaking. They argue that policymakers should treat research as an integral part of decisions around implementing and running school feeding programs.

They also call for more attention to equity. Dr Anita Rizvi, another author of the review from the University of Ottawa, said the “research too often focuses on average effects and misses differences between groups. We assessed outcomes by socioeconomic disadvantage and sex, but too few studies reported these data to draw firm conclusions. Future studies need larger, better-designed comparisons.”

Citation
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The study -a systematic review- School feeding programs for improving the physical and psychological health of school children experiencing socioeconomic disadvantage was published in Cochrane Database of Systematic Reviews. Authors: Elizabeth Kristjansson, Michael Dignam, Anita Rizvi, Muna Osman, Olivia Magwood, Deborah Olarte, Juliana FW Cohen, Julia Krasevec, Tanya Grover, Patrick R Labelle, Jennifer A Garner, Laura Janzen, Sydney Rossiter, Omar Dewidar, Beverley Shea, Vivian Welch & George A Wells.

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