Impact of multi-component school food environment interventions on adiposity and food consumption in children and adolescents: systematic review and meta-analysis.
Vilela L, Duarte C, et al. • Cadernos de saude publica • 2025
While multi-component school food environment interventions showed a small but significant reduction in waist circumference and improvements in some dietary behaviors, their effectiveness in preventing obesity remains inconclusive, with no consistent effects observed for body mass index or body fat percentage.
Key Findings
Results
Multi-component school food environment interventions produced a small but statistically significant reduction in waist circumference.
Databases searched included MEDLINE, SciELO, CENTRAL, Clinical Trials, Scopus, Embase, and Web of Science
Review was conducted following PRISMA guidelines
Results
Multi-component school food environment interventions were associated with reductions in unhealthy food intake and improvements in specific dietary components.
Interventions were linked to lower intake of unhealthy foods
Reductions were observed in total energy intake, total fat, and saturated fat consumption
Vegetable consumption increased following interventions
These dietary outcomes were reported across the 51 eligible studies
Results
No consistent effects of multi-component school food environment interventions were observed for body mass index (BMI) or body fat percentage.
Despite small significant reductions in waist circumference, BMI showed no consistent intervention effect
Body fat percentage also showed no consistent intervention effect
Study quality varied and intervention designs and implementation strategies were heterogeneous
Authors note results should be interpreted cautiously due to heterogeneity
Conclusions
The effectiveness of multi-component school food environment interventions in preventing childhood obesity remains inconclusive.
51 studies were identified as eligible from a search across seven major databases
Intervention designs and implementation strategies were heterogeneous across studies
Study quality varied across the included studies
Authors conclude that 'strengthening policies and ensuring long-term, structured interventions are crucial for meaningful and sustained health improvements in school settings'
Vilela L, Duarte C, Rocha L, Carvalho B, Carmo A, Gratão L, et al.. (2025). Impact of multi-component school food environment interventions on adiposity and food consumption in children and adolescents: systematic review and meta-analysis.. Cadernos de saude publica. https://doi.org/10.1590/0102-311XEN152824