title: [Design and implementation of a questionnaire to evaluate the dietary quality of school meals].
abstract: BACKGROUND
  The school canteen provides a substantial proportion of the daily nutritional intake for many children. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality.
  
  
  OBJECTIVE
  To design a questionnaire for assessing the dietary quality of school meals, quickly and easily.
  
  
  METHODS
  A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the food-frequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05.
  
  
  RESULTS
  The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality.
  
  
  CONCLUSIONS
  A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations.
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: Beatriz
authors.initials: B
authors.lastname: de Mateo Silleras
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: M Alicia
authors.initials: MA
authors.lastname: Camina Martín
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: Berta
authors.initials: B
authors.lastname: Ojeda Sainz
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Carreño Enciso
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: de la Cruz Marcos
authors.affiliation: Servicio de Pediatría, Hospital Clínico Universitario, Valladolid, España.. bdemateo@yahoo.com.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Marugán de Miguelsanz
authors.affiliation: Área de Nutrición y Bromatología, Departamento de Pediatría, Facultad de Medicina, Universidad de Valladolid, Valladolid.. bdemateo@yahoo.com.
authors.forename: Paz
authors.initials: P
authors.lastname: Redondo del Río
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004032:Diet; D005260:Female; D005522:Food Services / Q000592:standards*; D006801:Humans; D008297:Male; D062407:Meals; D018673:Nutrition Policy; D011446:Prospective Studies; D012574:Schools; D011795:Surveys and Questionnaires