title: School lunches in Japan: their contribution to healthier nutrient intake among elementary-school and junior high-school children.
abstract: OBJECTIVE
  The role of school lunches in diet quality has not been well studied. Here, we aimed to determine the contribution of school lunches to overall nutrient intake in Japanese schoolchildren.
  
  
  METHODS
  The study was conducted nationwide under a cross-sectional design. A non-consecutive, three-day diet record was performed on two school days and a non-school day separately. The prevalence of inadequate nutrient intake was estimated for intakes on one of the school days and the non-school day, and for daily habitual intake estimated by the best-power method. The relationship between food intake and nutrient intake adequacy was examined.
  
  
  METHODS
  Fourteen elementary and thirteen junior high schools in Japan.
  
  
  METHODS
  Elementary-school children (n 629) and junior high-school children (n 281).
  
  
  RESULTS
  Intakes between the school and non-school days were significantly different for ≥60 % of nutrients. Almost all inadequacies were more prevalent on the non-school day. Regarding habitual intake, a high prevalence of inadequacy was observed for fat (29·9-47·7 %), dietary fibre (18·1-76·1 %) and salt (97·0-100 %). Inadequate habitual intake of vitamins and minerals (except Na) was infrequent in elementary-school children, but was observed in junior high-school children, particularly boys.
  
  
  CONCLUSIONS
  School lunches appear to improve total diet quality, particularly intake of most vitamins and minerals in Japanese children. However, excess intakes of fat and salt and insufficient intake of dietary fibre were major problems in this population. The contribution of school lunches to improving the intakes of these three nutrients was considered insufficient.
authors.affiliation: 1Department of Environmental and Occupational Health,School of Medicine,Toho University,Tokyo,Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Asakura
authors.affiliation: 2Department of Social and Preventive Epidemiology,School of Public Health,The University of Tokyo,7-3-1 Hongo, Bunkyo-ku,Tokyo 113-0033,Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D002648:Child; D002652:Child Behavior; D003430:Cross-Sectional Studies; D015930:Diet Records; D000072001:Diet, Healthy; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D005522:Food Services; D015438:Health Behavior; D006801:Humans; D007564:Japan; D062409:Lunch; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D009753:Nutritive Value; D064167:Recommended Dietary Allowances; D012574:Schools
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D018977:Micronutrients
keywords: Diet quality; Japan; Nutrient intake; School lunch; Schoolchildren