title: [Secondary school menu in Madrid (Spain): knowledge and adherence to the Spanish National Health System recommendations].
abstract: OBJECTIVE
  To establish the degree of knowledge and adherence to the Spanish National Health System recommendations on nutrition in schools in the Autonomous Community of Madrid.
  
  
  METHODS
  Cross-sectional study of a random sample of 182 secondary schools from Madrid, during 2013-2014 school year. Information on the characteristics of the schools and the knowledge of the recommendations was collected by internet and telephone interviews, as well as a copy of the school menu. The average number of rations per week offered for each food item and the percentage of schools within the recommended range were calculated. The overall adherence was obtained as the mean of food items (0-12) within the range.
  
  
  RESULTS
  65.5% of the schools were unaware of the national recommendations. The supply of rice, pasta, fish, eggs, salad and fruit was lower than recommended, whereas for meat, accompaniment and other desserts was higher. The percentage of schools within the range for each food item varied between 13% and 95%. The mean of overall adherence was 6.3, with no differences depending on whether the menu was prepared or not at schools or there was or not a person in charge of nutrition standards.
  
  
  CONCLUSIONS
  The degree of adherence to the recommendations was variable, being advised to increase the supply of cereals, eggs, fish, salad and fruit. Programs for dissemination and implementation of the recommendations, leaded by trained professionals, are required to improve the nutritional value of school menu.
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España; Hospital Universitario de Burgos, Burgos, España. Electronic address: bberradre@saludcastillayleon.es.
authors.forename: Belén
authors.initials: B
authors.lastname: Berradre-Sáenz
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Royo-Bordonada
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España.
authors.forename: María José
authors.initials: MJ
authors.lastname: Bosqued
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Moya
authors.affiliation: Escuela Nacional de Sanidad, Madrid, España.
authors.forename: Lázaro
authors.initials: L
authors.lastname: López
mesh_terms: D003430:Cross-Sectional Studies; D004032:Diet; D005502:Food / Q000145:classification; D005522:Food Services; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008612:Menu Planning; D009313:National Health Programs; D018673:Nutrition Policy; D012574:Schools; D013030:Spain; D014505:Urban Population
keywords: Comedor escolar; Dietary recommendations; Enseñanza secundaria; Food services; Menú escolar; Recomendaciones alimentarias; School menu; Secondary school