Association of Frequency of School Meal Consumption and Student Dietary Intake During COVID-Related School Closures

OBJECTIVES: Healthy school meals can improve student nutritional status leading to improved immune health and reduced risk of COVID infection. However school closures during COVID affected the content, packaging, and distribution of school meals at a time when the need for healthy meals was especially critical. In this study, we assess the relationship between frequency of school meals consumed and student dietary intake during COVID-19. METHODS: A cross-sectional design was used to obtain frequencies of prior day dietary intake by online survey of fourth and fifth grade students (n = 2408) in 67 California schools and school-based afterschool sites in October 2020-May 2021. Multilevel Poisson regression was used to determine the association between school meal consumption and dietary intake. RESULTS: Compared to not eating any school meals, eating one and two school meals were each significantly associated with higher frequency of fruit intake (by 22% and 30%, respectively), vegetable intake (by 13% and 31%, respectively), and sugar-sweetened beverage (SSB) intake (by 13% and 23%, respectively). One school meal was associated with higher fruit drink and flavored milk intakes whereas two school meals was associated with intake of a wider array of SSBs. Likewise, two school meals was associated with intake of a wider variety of vegetables than one school meal. Higher intake of both fruit and 100% fruit juice were associated with intake of both one and two school meals. CONCLUSIONS: These findings suggest school meals were an important source of fruits and vegetables in many schools closed due to COVID-19, but measures may be needed to reduce the consumption of flavored milk and other SSBs. FUNDING SOURCES: The project was funded by the United States Department of Agriculture's Supplemental Nutrition Assistance Program- Education through a contract with the California Department of Public Health.