ABSTRACT

Optimal nutritional status is a fundamental factor in ensuring healthy growth and development, particularly among elementary school students. Malnutrition, in the form of stunting or overweight, adversely affects children’s health and academic performance, leading to significant long-term consequences. School feeding programs have been implemented in various countries as interventions to improve access to nutritious food for students. This systematic review aims to explore the effectiveness of school feeding programs in enhancing the nutritional status of students. The research encompasses studies published between 2014 and 2024, evaluated through a search of the PubMed, Scopus, and ProQuest databases. Inclusion criteria consisted of randomized controlled trials, observational studies, and meta-analyses, adhering to PRISMA guidelines. The review identified 12 articles demonstrating that school feeding programs significantly improve nutritional status, including increases in Body Mass Index (BMI) and reductions in the prevalence of anemia among elementary school students. This study concludes that school feeding programs provide substantial benefits in enhancing students' nutritional status, with positive impacts on BMI and a decrease in anemia prevalence.

Keywords: Free School Meals Program, Primary School Students, Body Mass Index (Bmi), Anemia

ABSTRAK

Status gizi yang optimal adalah faktor fundamental untuk memastikan pertumbuhan dan perkembangan yang sehat, terutama pada siswa sekolah dasar. Malnutrisi, baik dalam bentuk stunting maupun kelebihan berat badan, berdampak negatif terhadap kesehatan dan kinerja akademik anak, serta dapat mengakibatkan konsekuensi jangka panjang. Program makan gratis di sekolah telah diterapkan di berbagai negara sebagai intervensi untuk memperbaiki akses terhadap makanan bergizi bagi siswa. Tinjauan sistematis ini bertujuan untuk mengeksplorasi efektivitas program makan gratis di sekolah dalam meningkatkan status gizi siswa. Penelitian ini mencakup studi yang diterbitkan antara tahun 2014 - 2024, yang dievaluasi melalui penelusuran di database PubMed, Scopus, dan ProQuest. Kriteria inklusi mencakup penelitian yang menggunakan uji acak terkendali, studi observasional, dan meta-analisis, mengikuti pedoman PRISMA. Hasil penelitian menghasilkan 12 artikel yang menunjukkan bahwa program makan gratis secara signifikan meningkatkan status gizi, termasuk peningkatan Indeks Massa Tubuh (IMT) dan penurunan prevalensi anemia pada siswa sekolah dasar. Kesimpulan penelitian ini adalah program makan gratis di sekolah memberikan manfaat signifikan dalam memperbaiki status gizi siswa, termasuk peningkatan IMT dan penurunan prevalensi anemia.

Kata Kunci: Program Makanan Gratis Di Sekolah, Siswa Sekolah Dasar, Indeks Massa Tubuh (Imt),Anemia

Abizari, A. R., Buxton, C., Kwara, L., Mensah-Homiah, J., Armar-Klemesu, M., & Brouwer, I. D. (2014). School feeding contributes to micronutrient adequacy of Ghanaian schoolchildren. British Journal of Nutrition, 112(6), 1019–1033. https://doi.org/10.1017/S0007114514001585

Abizari, A.-R., Ali, Z., Abdulai, S. A., Issah, F., & Frimpomaa, N. A. (2021). Free Senior High School Lunch Contributes to Dietary Quality of Nonresidential Students in Ghana. Food and Nutrition Bulletin, 42(1), 65–76. https://doi.org/10.1177/0379572120970828

Adelman, S., Gilligan, D. O., Konde-Lule, J., & Alderman, H. (2019). School feeding reduces anemia prevalence in adolescent girls and other vulnerable household members in a cluster randomized controlled trial in Uganda. Journal of Nutrition, 149(4), 659–666. https://doi.org/10.1093/jn/nxy305

Ali, M. S., Kassahun, C. W., Wubneh, C. A., Mekonen, E. G., & Workneh, B. S. (2022). Applied nutritional investigation Determinants of undernutrition among private and public primary school children: A comparative cross-sectional study toward nutritional transition in northwest Ethiopia. Nutrition, 96. https://doi.org/10.1016/j.nut.2021.111575

Andreyeva, T., & Sun, X. (2021). Universal school meals in the us: What can we learn from the community eligibility provision? Nutrients, 13(8). https://doi.org/10.3390/nu13082634

Annan, R. A., Apprey, C., Asamoah‐Boakye, O., Okonogi, S., Yamauchi, T., & Sakurai, T. (2019). The relationship between dietary micronutrients intake and cognition test performance among school‐aged children in government‐owned primary schools in Kumasi metropolis, Ghana. Food Science & Nutrition, 7(9), 3042–3051. https://doi.org/10.1002/fsn3.1162

Annan, R. A., Apprey, C., Asamoah-Boakye, O., Okonogi, S., Yamauchi, T., & Sakurai, T. (2019). The relationship between dietary micronutrients intake and cognition test performance among school-aged children in government-owned primary schools in Kumasi metropolis, Ghana. Food Science and Nutrition, 7(9), 3042–3051. https://doi.org/10.1002/fsn3.1162

Argaw, D., Hussen Kabthymer, R., Endale, T., Wudneh, A., Daniel Meshesha, M., Tadesse Hirbu, J., Bayisa, Y., Abebe, L., Tilahun, R., Aregawi, S., Temesgen Alemu, K., & Molla, W. (2022a). Stunting and associated factors among primary school children in Ethiopia: School-based cross-sectional study. International Journal of Africa Nursing Sciences, 17. https://doi.org/10.1016/j.ijans.2022.100451

Argaw, D., Hussen Kabthymer, R., Endale, T., Wudneh, A., Daniel Meshesha, M., Tadesse Hirbu, J., Bayisa, Y., Abebe, L., Tilahun, R., Aregawi, S., Temesgen Alemu, K., & Molla, W. (2022b). Stunting and associated factors among primary school children in Ethiopia: School-based cross-sectional study. International Journal of Africa Nursing Sciences, 17. https://doi.org/10.1016/j.ijans.2022.100451

Asigbee, F. M., Whitney, S. D., & Peterson, C. E. (2018). The Link Between Nutrition and Physical Activity in Increasing Academic Achievement. Journal of School Health, 88(6), 407–415. https://doi.org/10.1111/josh.12625

Ayogu, R. N. B., Eme, P. E., Anyaegbu, V. C., Ene-Obong, H. N., & Amazigo, U. V. (2018). Nutritional value of school meals and their contributions to energy and nutrient intakes of rural school children in Enugu and Anambra States, Nigeria. BMC Nutrition, 4(1). https://doi.org/10.1186/s40795-018-0216-0

Baek, D., Choi, Y., & Lee, H. (2019a). Universal welfare may be costly: Evidence from school meal programs and student fitness in South Korea. Sustainability (Switzerland), 11(5). https://doi.org/10.3390/su11051290

Cohen, J. F. W., Hecht, A. A., McLoughlin, G. M., Turner, L., & Schwartz, M. B. (2021a). Universal school meals and associations with student participation, attendance, academic performance, diet quality, food security, and body mass index: A systematic review. Nutrients, 13(3), 1–41. https://doi.org/10.3390/nu13030911

Cohen, J. F. W., Hecht, A. A., McLoughlin, G. M., Turner, L., & Schwartz, M. B. (2021b). Universal school meals and associations with student participation, attendance, academic performance, diet quality, food security, and body mass index: A systematic review. Nutrients, 13(3), 1–41. https://doi.org/10.3390/nu13030911

Crookston, B. T., Dearden, K. A., Alder, S. C., Porucznik, C. A., Stanford, J. B., Merrill, R. M., Dickerson, T. T., & Penny, M. E. (2011). Impact of early and concurrent stunting on cognition. Maternal and Child Nutrition, 7(4), 397–409. https://doi.org/10.1111/j.1740-8709.2010.00255.x

Davis, W., Kreisman, D., & Musaddiq, T. (2024). THE EFFECT OF UNIVERSAL FREE SCHOOL MEALS ON CHILD BMI. Education Finance and Policy, 19(3), 461–491. https://doi.org/10.1162/edfp_a_00409

Demilew, Y. M., & Nigussie, A. A. (2020). The relationship between school meals with thinness and stunting among primary school students, in Meket Wereda, Ethiopia: Comparing schools with feeding and non-feeding program. BMC Nutrition, 6(1). https://doi.org/10.1186/s40795-020-00358-3

Desjardins, F., Ouedraogo, S., & Tremblay, P.-A. (2023). The Multi-Scalar Reality in the Governance of NPOs and EÉSS in School Feeding: The Key Role of Expressing a Common Goal to Rally Stakeholders | La réalité multiscalaire dans la gouvernance des OSBL et EÉSS en alimentation scolaire : le rôle clé de l’expre. Canadian Journal of Nonprofit and Social Economy Research, 14(2). https://doi.org/10.29173/cjnser678

Destaw, Z., Wencheko, E., Kidane, S., Endale, M., Challa, Y., Tiruneh, M., Tamrat, M., Samson, H., Shaleka, D., & Ashenafi, M. (2022). Impact of school meals on educational outcomes in Addis Ababa, Ethiopia. Public Health Nutrition, 25(9), 2614–2624. https://doi.org/10.1017/S1368980022000799

Fang, G., & Zhu, Y. (2022). Long-term impacts of school nutrition: Evidence from China’s school meal reform. World Development, 153. https://doi.org/10.1016/j.worlddev.2022.105854

Fanjiang, G., & Kleinman, R. E. (2007). Nutrition and performance in children. Current Opinion in Clinical Nutrition and Metabolic Care, 10(3), 342–347. https://doi.org/10.1097/MCO.0b013e3280523a9e

FAO, IFAD, UNICEF, WFP, & WHO. (2023). The State of Food Security and Nutrition in the World 2023. Dalam The State of Food Security and Nutrition in the World 2023. FAO; IFAD; UNICEF; WFP; WHO; https://doi.org/10.4060/cc3017en

Gelli, A., Aurino, E., Folson, G., Arhinful, D., Adamba, C., Osei-Akoto, I., Masset, E., Watkins, K., Fernandes, M., Drake, L., & Alderman, H. (2019). A school meals program implemented at scale in Ghana increases height-for-age during midchildhood in girls and in children from poor households: A cluster randomized trial. Journal of Nutrition, 149(8), 1434–1442. https://doi.org/10.1093/jn/nxz079

Grace L. Demerin, M. (2023). Effect of School-Based Feeding Program Implementation of Elementary Schools on Learners’ Academic Performance. International Journal of Research Publications, 120(1). https://doi.org/10.47119/IJRP1001201320234484

Grantham-McGregor, S. (2005). Can the provision of breakfast benefit school performance? Food and Nutrition Bulletin, 26(2 SUPPL. 2). https://doi.org/10.1177/15648265050262s204

Hayes, D., Contento, I. R., & Weekly, C. (2018). Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive Nutrition Programs and Services in Schools. Journal of the Academy of Nutrition and Dietetics, 118(5), 913–919. https://doi.org/10.1016/j.jand.2018.03.005

Hecht, A. A., Pollack Porter, K. M., & Turner, L. (2020). Impact of the community eligibility provision of the healthy, hunger-free kids act on student nutrition, behavior, and academic outcomes: 2011-2019. American Journal of Public Health, 110(9), 1405–1410. https://doi.org/10.2105/AJPH.2020.305743

Hock, K., Barquera, S., Corvalán, C., Goodman, S., Sacks, G., Vanderlee, L., White, C. M., White, M., & Hammond, D. (2022). Awareness of and Participation in School Food Programs in Youth from Six Countries. Journal of Nutrition, 152, 85S-97S. https://doi.org/10.1093/jn/nxac052

Illøkken, K. E., Bere, E., Øverby, N. C., Høiland, R., Petersson, K. O., & Vik, F. N. (2017). Intervention study on school meal habits in Norwegian 10-12-year-old children. Scandinavian Journal of Public Health, 45(5), 485–491. https://doi.org/10.1177/1403494817704108

Ismail, M. R., Gilliland, J. A., Matthews, J. I., & Battram, D. S. (2021). Process evaluation of the Centrally Procured School Food Program (CPSFP) in Ontario, Canada: School-level perspectives. Health Education Research, 36(5), 554–567. https://doi.org/10.1093/her/cyab023

Jacksaint, S., & Johana Elizabeth, V. (2020). Anthropometric nutritional status, socioeconomic status and academic performance in school children aged 6 to 12 years. Nutricion Clinica y Dietetica Hospitalaria, 40(1), 74–81. https://doi.org/10.12873/401saintila

Jayalakshmi, R., & Jissa, V. T. (2017). Nutritional status of Mid-Day Meal programme beneficiaries: A cross-sectional study among primary schoolchildren in Kottayam district, Kerala, India. Indian journal of public health, 61(2), 86–91. https://doi.org/10.4103/ijph.IJPH_320_15

Jessiman, P. E., Carlisle, V. R., Breheny, K., Campbell, R., Jago, R., Robinson, M., Strong, S., & Kidger, J. (2023a). A qualitative process evaluation of universal free school meal provision in two London secondary schools. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15082-3

Mohammed, B., Belachew, T., Kedir, S., & Abate, K. H. (2023a). Effect of school feeding program on body mass index of primary school adolescents in Addis Ababa, Ethiopia: A prospective cohort study. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.1026436

Mohammed, B., Belachew, T., Kedir, S., & Abate, K. H. (2023b). Effect of school feeding program on body mass index of primary school adolescents in Addis Ababa, Ethiopia: A prospective cohort study. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.1026436

Mohapatra, M. K., Pradhan, A., Tiwari, D., Yunus, S., Patro, B. K., Behera, B. K., Sahu, S., Bhatia, V., Bhattacharya, S., Paithankar, P., & Dutta, A. (2023). Effectiveness of Fortified Mid-Day Meal in Reducing Anemia Among School Children in Dhenkanal, Odisha: A Quasi-Experimental Study. Food and Nutrition Bulletin, 44(2), 79–87. https://doi.org/10.1177/03795721231172253

Muktarbek kyzy, A. (2019). School attendance: demographic differences and the effect of a primary school meal programme in Kyrgyzstan. Educational Research and Evaluation, 25(7–8), 381–411. https://doi.org/10.1080/13803611.2020.1862677

Parnham, J. C., Chang, K., Millett, C., Laverty, A. A., von Hinke, S., Pearson-Stuttard, J., de Vocht, F., White, M., & Vamos, E. P. (2022). The Impact of the Universal Infant Free School Meal Policy on Dietary Quality in English and Scottish Primary School Children: Evaluation of a Natural Experiment. Nutrients, 14(8). https://doi.org/10.3390/nu14081602

Pelletier, J. E., Laska, M. N., MacLehose, R., Nelson, T. F., & Nanney, M. S. (2016). State-level trends and correlates for cross-sector collaboration on school nutrition and physical education activities, 2000-2012. Preventing Chronic Disease, 13(7). https://doi.org/10.5888/pcd13.160032

Pelletier, J. E., Laska, M. N., MacLehose, R., Nelson, T. F., & Nanney, M. S. (2017). Evidence-based policies on school nutrition and physical education: Associations with state-level collaboration, obesity, and socio-economic indicators. Preventive Medicine, 99, 87–93. https://doi.org/10.1016/j.ypmed.2017.02.005

Ramaswamy, G., Yadav, K., Goel, A. D., Yadav, V., Arora, S., Vohra, K., Khanam, A., & Kant, S. (2022). Effect of iron-fortified rice on the hemoglobin level of the individuals aged more than six months: A meta-analysis of controlled trials. Journal of Family Medicine and Primary Care, 11(12), 7527–7536. https://doi.org/10.4103/jfmpc.jfmpc_409_22

Roberts, M., Tolar-Peterson, T., Reynolds, A., Wall, C., Reeder, N., & Rico Mendez, G. (2022). The Effects of Nutritional Interventions on the Cognitive Development of Preschool-Age Children: A Systematic Review. Nutrients, 14(3). https://doi.org/10.3390/nu14030532

Schirm, A. L., & Kirkendall, N. J. (2012). Using American Community Survey data to expand access to the School Meals Programs. Dalam Using American Community Survey Data to Expand Access to the School Meals Programs. https://doi.org/10.17226/13409

Silva, L., Malcolm, A., Cooklin Urbano, S., Couzens, L., Clark, E., & Dyakova, M. (2023). Impact of universal free school meals on health and equity: international policy scoping review. European Journal of Public Health, 33(Supplement_2). https://doi.org/10.1093/eurpub/ckad160.1085

Spill, M. K., Trivedi, R., Thoerig, R. C., Balalian, A. A., Schwartz, M. B., Gundersen, C., Odoms-Young, A., Racine, E. F., Foster, M. J., Davis, J. S., Davis, J. S., & MacFarlane, A. J. (2024). Universal Free School Meals and School and Student Outcomes: A Systematic Review. JAMA network open, 7(8), e2424082. https://doi.org/10.1001/jamanetworkopen.2024.24082

Tooher, R., Collins, J., Braunack-Mayer, A., Burgess, T., Skinner, S. R., O’Keefe, M., Watson, M., & Marshall, H. S. (2017). Intersectoral collaboration to implement schoolbased health programmes: Australian perspectives. Health Promotion International, 32(2), 312–321. https://doi.org/10.1093/heapro/dav120

Turner, L., Guthrie, J. F., & Ralston, K. (2019a). Community eligibility and other provisions for universal free meals at school: Impact on student breakfast and lunch participation in California public schools. Translational Behavioral Medicine, 9(5), 931–941. https://doi.org/10.1093/tbm/ibz090

UNICEF, WHO, & World Bank Group. (2023). Levels and trends in child malnutrition.

Velardo, S., Fane, J., Jong, S., & Watson, M. (2020). Nutrition and Learning in the Australian Context. Dalam Health and Education Interdependence (hlm. 159–177). Springer Singapore. https://doi.org/10.1007/978-981-15-3959-6_9

Verguet, S., Gautam, P., Ali, I., Husain, A., Meyer, S., Burbano, C., Lloyd-Evans, E., Coco, M., Mphangwe, M., Saka, A., Bundy, D. A. P., & Angrist, N. (2023). Investing in school systems: Conceptualising returns on investment across the health, education and social protection sectors. BMJ Global Health, 8(12). https://doi.org/10.1136/bmjgh-2023-012545

Vik, F. N., Van Lippevelde, W., & Øverby, N. C. (2019b). Free school meals as an approach to reduce health inequalities among 10-12- year-old Norwegian children. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7286-z

Warner, M. E. (2015). Profiting from public value? The case of social impact bonds. Dalam Creating Public Value in Practice: Advancing the Common Good in a Multi-Sector, Shared-Power, No-One-Wholly-in-Charge World. https://doi.org/10.1201/b18116

Zailani, H., Owolabi, O. A., & Sallau, A. B. (2023). Contribution of school meals to the recommended nutrient and energy intake of children enrolled in the National Homegrown School Feeding Program in Zaria, Nigeria. Archives de Pediatrie, 30(7), 471–476. https://doi.org/10.1016/j.arcped.2023.07.004

Zenebe, M., Gebremedhin, S., Henry, C. J., & Regassa, N. (2018). School feeding program has resulted in improved dietary diversity, nutritional status and class attendance of school children. Italian Journal of Pediatrics, 44(1). https://doi.org/10.1186/s13052-018-0449-1

Zuercher, M. D., Cohen, J. F. W., Hecht, C. E., Hecht, K., Ritchie, L. D., & Gosliner, W. (2022). Providing School Meals to All Students Free of Charge during the COVID-19 Pandemic and Beyond: Challenges and Benefits Reported by School Foodservice Professionals in California. Nutrients, 14(18). https://doi.org/10.3390/nu14183855

Zuercher, M. D., Orta-Aleman, D., Cohen, J. F. W., Hecht, C. A., Hecht, K., Polacsek, M., Patel, A. I., Ritchie, L. D., & Gosliner, W. (2024). The Benefits and Challenges of Providing School Meals during the First Year of California’s Universal School Meal Policy as Reported by School Foodservice Professionals. Nutrients, 16(12). https://doi.org/10.3390/nu16121812