Adequacy of school menus and national school food program requirements: a systematic review

Silva, Jacilene Alcântara; Oliveira, Tafnes; Ribeiro, Isabella; Fernandes, Matheus Santos de Sousa; Santos, Gabriela

doi:10.1590/1806-93042023000000131-en

Jacilene Alcântara Silva

research design and design

data collection, analysis, and interpretation of results

writing and critical review of the manuscript

approved the final version of the article

declare that there is no conflict of interest

Faculdade de Comunicação e Turismo de Olinda. Olinda, PE, Brazil.

http://orcid.org/0000-0001-6632-4508

Tafnes Oliveira

data collection, analysis, and interpretation of results

writing and critical review of the manuscript

approved the final version of the article

declare that there is no conflict of interest

Programa de Pós-graduação em Nutrição. Centro de Ciências da Saúde. Universidade Federal de Pernambuco. Rua Alto do Reservatório. s.n. Alto José Leal. Vitória de Santo Antão, PE, Brazil. CEP: 55.08-680. Email: gabriela.cjsantos@ufpe.br

http://orcid.org/0000-0002-5904-8557

Isabella Ribeiro

data collection and analysis

interpretation of results

writing and critical review of the manuscript

approved the final version of the article

declare that there is no conflict of interest

Programa de Pós-graduação em Nutrição. Centro de Ciências da Saúde. Universidade Federal de Pernambuco. Rua Alto do Reservatório. s.n. Alto José Leal. Vitória de Santo Antão, PE, Brazil. CEP: 55.08-680. Email: gabriela.cjsantos@ufpe.br

http://orcid.org/0000-0002-3817-2073

Matheus Santos de Sousa Fernandes

research design

data analysis

critical review of the manuscript

approved the final version of the article

declare that there is no conflict of interest

Programa de Pós-graduação em Neuropsiquiatria e Ciências do Comportamento. Centro de Ciências da Saúde. Universidade Federal de Pernambuco. Recife, PE, Brazil.

http://orcid.org/0000-0002-1066-9176

Gabriela Santos

research design and design

data collection, analysis, and interpretation of results

writing and critical review of the manuscript

approved the final version of the article

declare that there is no conflict of interest

Programa de Pós-graduação em Nutrição. Centro de Ciências da Saúde. Universidade Federal de Pernambuco. Rua Alto do Reservatório. s.n. Alto José Leal. Vitória de Santo Antão, PE, Brazil. CEP: 55.08-680. Email: gabriela.cjsantos@ufpe.br

http://orcid.org/0000-0002-7010-5049

Associated Editor: Nathália Souza

Author, year	Sample	Place of execution	Executing institution of the PNAE	Characteristics of the menus	Evaluation method
Araujo et al.,¹³13 Araújo Lobo CG, Fechine VMR. Avaliação da parceria FNDE e IFES na execução do Programa Nacional de Alimentação Escolar (PNAE). Rev Serv Público. 2021; 72 (3): 554-82. 2021	393 students	Piauí	2 state urban public schools: School A: Full-time primary and secondary education; School B: Full-time High School;	10 quantitative menus with 30 meals according to age group (11-15 years old/16-18 years old/19-30 years old).	Quantitative analysis of menus using the per capita of each meal to assess the nutritional composition.
Alencar et al.,¹⁴14 Alencar MSS, Barros S, Borges IS, Cavalcante KN, Melo MTSM, Nunes IFOC, et al. Adequações e inadequações nos perfis antropométrico e dietético de crianças préescolares. J Hum Growth Dev. 2016; 26 (2): 234-42. 2016	114 students (2-5 years).	South zone of the Northeast city, Brazil	3 urban public schools: CMEI-A and CMEI-B: partial regime; CMEI-C: full regime.	15 daily menus according to age group (1-3 years / 4-5 years)	Quantitative analysis of menus by weighing food on a digital scale. Based on the weighing, the nutritional composition was evaluated.
Leão et al.,¹⁵15 Leão P V, Dias RM, Frazão AGF, Dias IA, Silva IRP, Corrêa NAF, et al. Nutritional analysis of the School Feeding Program menus offered in a municipality of Pará. Mundo Saúde. 2018; 42 (1): 181-98. 2018	61,521 students (34,973 from municipal education and 26,548 from state education)	Pará	210 municipal and state public schools (152 rural schools; 58 urban schools). Type of regime was not informed.	The menus were defined according to age group (1 to 3 years old / 4 to 5 years old / 6 to 10 years old / 11 to 15 years old / 16 to 18 years old / 19 to 30 years old and 31 to 60 years old). Number of evaluated menus was not informed.	Quantitative analysis of menus using the per capita of each meal to assess the nutritional composition.
Rocha et al.,¹⁶16 Rocha NP, Filgueiras MDS, Albuquerque FM, Milagres LC, Castro APP, Silva MA, et al. Análise do programa nacional de alimentação escolar no município de Viçosa, MG, Brasil. Rev Saúde Pública. 2018; 52: 16. 2018	268 students (8 a 9 years).	Minas Gerais	17 urban schools in the municipal and state public network.	Information on the number and type of menus according to the assessed age group were not informed.	Quantitative analysis of menus by weighing food on a digital scale. Based on the weighing, the nutritional composition was evaluated.
Dias et al.,¹⁷17 Dias PC, Barbosa IRO, Barbosa RMS, Ferreira DM, Soares KCB, Soares DSB, et al. Purchases from family agriculture for school feeding in Brazilian capitals. Rev Saúde Pública. 2020; 54: 73. 2020	uninformed	All Brazilian capitals	uninformed	uninformed	The analysis of the menus was carried out based on secondary data referring to the years 2016 and 2017 available on the websites of the IBGE, FNDE and MDA.
Ferreira et al.,¹⁸18 Ferreira DM, Barbosa RMS, Finizola NC, Soares DSB, Henriques P, Pereira S, et al. Perception of the operating agents about the Brazilian National School Feeding Program. Rev Saúde Pública. 2019; 53: 34. 2019	100 PNAE managers	Rio de Janeiro	Urban and rural municipal schools. Number of schools and type of regime was not informed.	uninformed	Analysis using a semistructured questionnaire with information about the percentage of purchases of food from family farming.
Ottoni et al.,¹⁹19 Ottoni IC, Oliveira BMPMd, Bandoni DHB. The National School Feeding Program as a promoter of Food and Nutrition Education actions in Brazilian schools. Mundo Saúde. 2019; 43 (2): 374-89. 2019	93 372 students	All Brazilian capitals	238 rural and urban municipal schools. Type of regime was not informed.	uninformed	Analysis using data from the FNDE.
Souza e Villar,²⁰20 Souza VMG, Villar BS. Acquisition of family farm foods in municipalities of São Paulo state: The influence of the management of the School Feeding Program and municipal characteristics. Rev Nutr. 2019; 32: e180083. 2019	uninformed	São Paulo	105 rural and urban municipal schools. Type of regime was not informed.	uninformed	Analysis through a semi-structured questionnaire applied to the director of the institution.
Machado et al.,²⁵25 Machado PMO, Schmitz BdAS, González-Chica DA, Corso ACT, Vasconcelos FAG, Gabriel CG. Compra de alimentos da agricultura familiar pelo Programa Nacional de Alimentação Escolar (PNAE): estudo transversal com o universo de municípios brasileiros. Ciênc Saúde Colet. 2018; 23 (12): 4153-64. 2018	uninformed	5184 Brazilian municipalities	Rural and urban municipal schools. Number of schools and type of regime was not informed.	uninformed	Analysis through an electronic questionnaire of the Google Docs® application applied to the nutritionist in charge of the PNAE.
Soares et al.,²²22 Soares P, Martinelli SS, Fabri RK, Veiros MB, Davó-Blanes MC, Cavalli SB. Programa Nacional de Alimentação Escolar como promotor de Sistemas Alimentares Locais, Saudáveis e Sustentáveis: uma avaliação da execução financeira. Ciênc Saúde Colet. 2018; 23 (12): 4189-97. 2018	4031 students	Paraná	23 public elementary schools. Type of regime and area of location (urban or rural) were not informed.	uninformed	Analysis of public calls obtained from the technical manager of the PNAE.
Ferigollo et al.,²³23 Ferigollo D, Kirsten VR, Heckler D, Figueredo OAT, Perez-Cassarino J, Triches RM. Products purchased from family farming for school meals in the cities of Rio Grande do Sul. Rev Saúde Pública. 2017; 51: 6. 2017	N uninformed	Rio Grande do Sul	Schools in 52 municipalities in urban and rural areas. Number of schools and type of regime was not informed.	uninformed	Analysis of public calls through telephone calls with qualified professionals from city halls.
Gabriel et al.,²⁴24 Gabriel CG, Costa LCF, Calvo MCM, Vasconcelos FAG. Planejamento de cardápios para escolas públicas municipais: reflexão e ilustração desse processo em duas capitais brasileiras. Rev Nutr. 2012; 25 (3): 363-72. 2012	97 700 students	Santa Catarina e Pará	26,522 municipal institutions in Florianópolis and 71,186 municipal institutions in Belém in the urban and rural areas of the public schools.	uninformed	Analysis through a questionnaire applied to the PNAE technical manager.

Author, year	Nutritional Adequacy
Author, year	Energy (Kcal)	PTE (g)	CHO (g)	LIP (g)	Vit. A (μg)	Vit. C (mg)	Calcium (mg)	Iron (mg)	Sodium (mg)
Araújo et al.,¹³13 Araújo Lobo CG, Fechine VMR. Avaliação da parceria FNDE e IFES na execução do Programa Nacional de Alimentação Escolar (PNAE). Rev Serv Público. 2021; 72 (3): 554-82. 2021	11-15 years: 86.2% ↓	11-15 years: 99%	11-15 years: 91%	11-15 years: 63.3% ↓	11-15 years: 35.72% ↓	11-15 years: 101%	11-15 years: 32.13% ↓	11-15 years: 227% ↑	-
	16-18 years: 76.1% ↓	16-18 years: 93.8%	16-18 years: 80.36 ↓	16-18 years: 55.8% ↓	16-18 years: 87.1% ↓	16-18 years: 87.1% ↓	16-18 years: 32.13% ↓	16-18 years: 187.1% ↑
	19 - 30 years: 80.8% ↓	19 - 30 years: 90.26%	19 - 30 years: 85.4% ↓	19 - 30 years: 59.3% ↓	19 - 30 years: 70% ↓	19 - 30 years: 70% ↓	19 - 30 years: 41.77% ↓	19 - 30 years: 250.4 ↑
Alencar et al.,¹⁴14 Alencar MSS, Barros S, Borges IS, Cavalcante KN, Melo MTSM, Nunes IFOC, et al. Adequações e inadequações nos perfis antropométrico e dietético de crianças préescolares. J Hum Growth Dev. 2016; 26 (2): 234-42. 2016	CMEI-A (1 - 3 years): 126.4%↑	CMEI-A (1 - 3 years): 188.6%↑	CMEI-A (1 - 3 years): 135.3%↑	CMEI-A (1 - 3 years): 67.8%↓	CMEI-A (1 - 3 years): 459.5%↑	CMEI-A (1 - 3 years): 1157.6%↑	CMEI-A (1 - 3 years): 62.3%↓	CMEI-A (1 - 3 years): 191.4%↑	-
	CMEI-B (1 - 3 years): 78.1%↓	CMEI-B (1 - 3 years): 153.2%↑	CMEI-B (1 - 3 years): 69.7%↓	CMEI-B (1 - 3 years): 53.9%↓	CMEI-B (1 - 3 years): 64.4%↓	CMEI-B (1 - 3 years): 368%↑	CMEI-B (1 - 3 years): 34.8%↓	CMEI-B (1 - 3 years): 108.6%
	CMEI-C (1 - 3 years): 135.9%↑	CMEI-C (1 - 3 years): 126.3%↑	CMEI-C (1 - 3 years): 128%↑	CMEI-C (1 - 3 years): 136.6%↑	CMEI-C (1 - 3 years): 72.8%↓	CMEI-C (1 - 3 years): 335.8%↑	CMEI-C (1 - 3 years): 106%↓	CMEI-C (1 - 3 years): 75.1%↓
	CMEI-A (4 - 5 years): 93.6%	CMEI-A (4 - 5 years): 141.3%↑	CMEI-A (4 - 5 years): 100.1%	CMEI-A (4 - 5 years): 49.8%↓	CMEI-A (4 - 5 years): 344.6%↑	CMEI-A (4 - 5 years): 694.6%↑	CMEI-A (4 - 5 years): 38.9%	CMEI-A (4 - 5 years): 134%↑
	CMEI-B (4 - 5 years): 57.9%↓	CMEI-B (4 - 5 years): 114.9%↑	CMEI-B (4 - 5 years): 51.6%↑	CMEI-B (4 - 5 years): 39.3%↓	CMEI-B (4 - 5 years): 48.3%↓	CMEI-B (4 - 5 years): 220.8%↑	CMEI-B (4 - 5 years): 21.8%↓	CMEI-B (4 - 5 years): 76%↓
	CMEI-C (4 - 5 years): 100.1%	CMEI-C (4 - 5 years): 93.1%	CMEI-C (4 - 5 years): 95.3%	CMEI-C (4 - 5 years): 100.4%	CMEI-C (4 - 5 years): 54.6%↓	CMEI-C (4 - 5 years): 212.8%↑	CMEI-C (4 - 5 years): 66.3%↓	CMEI-C (4 - 5 years): 52.6%↓
Leão et al.,¹⁵15 Leão P V, Dias RM, Frazão AGF, Dias IA, Silva IRP, Corrêa NAF, et al. Nutritional analysis of the School Feeding Program menus offered in a municipality of Pará. Mundo Saúde. 2018; 42 (1): 181-98. 2018	Nursery: 143.7%↑	Nursery: 157.5%↑	Nursery: 133.8%↑	Nursery: 167.9%↑	Nursery: 101.4%	Nursery: 274.2%↑	Nursery: 149.8%↑	Nursery: 165.3%↑	Nursery: 83.4%↓
	Preschool: 77.1% ↓	Preschool: 92%	Preschool: 67.2% ↓	Preschool: 95.4%	Preschool: 32.9% ↓	Preschool: 66% ↓	Preschool: 21% ↓	Preschool: 35% ↓	Preschool: 191.9% ↑
	Elementary 1: 62.9% ↓	Elementary 1: 69.2% ↓	Elementary 1: 55.8% ↓	Elementary 1: 73.2% ↓	Elementary 1: 21.7% ↓	Elementary 1: 42.7% ↓	Elementary 1: 15.1% ↓	Elementary 1: 38.9% ↓	Elementary 1: 162.5% ↑
	Elementary 2: 43.4% ↓	Elementary 2: 47.8% ↓	Elementary 2: 38.5% ↓	Elementary 2: 50.4% ↓	Elementary 2: 15.5% ↓	Elementary 2: 24.9% ↓	Elementary 2: 12.2% ↓	Elementary 2: 33.3% ↓	Elementary 2: 162.5% ↑
	High School: 30.2% ↓	High School: 30.9% ↓	High School: 26.5% ↓	High School: 40.5% ↓	High School: 15% ↓	High School: 14.3% ↓	High School: 12.3% ↓	High School: 19.2% ↓	High School: 101.8%
	EJA 1: 31.6% ↓	EJA 1: 31.6% ↓	EJA 1: 26% ↓	EJA 1: 42.2% ↓	EJA 1: 16.1% ↓	EJA 1: 14.7% ↓	EJA 1: 15.2% ↓	EJA 1: 23.1% ↓	EJA 1: 85.1% ↓
	EJA 2: 32.7% ↓	EJA 2: 32.5% ↓	EJA 2: 26.9% ↓	EJA 2: 43.7% ↓	EJA 2: 16.1% ↓	EJA 2: 15.7% ↓	EJA 2: 13.8% ↓	EJA 2: 29% ↓	EJA 2: 85.1% ↓
Rocha et al.,¹⁶16 Rocha NP, Filgueiras MDS, Albuquerque FM, Milagres LC, Castro APP, Silva MA, et al. Análise do programa nacional de alimentação escolar no município de Viçosa, MG, Brasil. Rev Saúde Pública. 2018; 52: 16. 2018	Municipal school: 69.1%↓	Municipal school: 76.1% ↓	Municipal school: 74.8% ↓	Municipal school: 62.8% ↓	Municipal school: 63.4% ↓	Municipal school: 35.1% ↓	Municipal school: 25.1% ↓	Municipal school: 94.4%	-
	State school: 67.4% ↓	State school: 84.0% ↓	State school: 65.5% ↓	State school: 58.6% ↓	State school: 118.8% ↑	State school: 22.8% ↓	Esc estaduais: 10,0% ↓	State school: 55.5% ↓	-

Author, year	Place of execution	Purchasing information source	Purchase of products from family farming
Dias et al.,¹⁷17 Dias PC, Barbosa IRO, Barbosa RMS, Ferreira DM, Soares KCB, Soares DSB, et al. Purchases from family agriculture for school feeding in Brazilian capitals. Rev Saúde Pública. 2020; 54: 73. 2020	All Brazilian capitals	Website of the Ministry of Agrarian Development and transparency portal	↑ 30% of PNAE resources
Ferreira et al.,¹⁸18 Ferreira DM, Barbosa RMS, Finizola NC, Soares DSB, Henriques P, Pereira S, et al. Perception of the operating agents about the Brazilian National School Feeding Program. Rev Saúde Pública. 2019; 53: 34. 2019	38 municipalities from Rio de Janeiro	Semi-structured questionnaire built by the researchers	↑ 30% of PNAE resources
Ottoni et al.,¹⁹19 Ottoni IC, Oliveira BMPMd, Bandoni DHB. The National School Feeding Program as a promoter of Food and Nutrition Education actions in Brazilian schools. Mundo Saúde. 2019; 43 (2): 374-89. 2019	749 Brazilian municipalities	Not informed	43,3% of the municipalities carry out purchases; Information on % resource allocation was not provided.
Souza e Villar,²⁰20 Souza VMG, Villar BS. Acquisition of family farm foods in municipalities of São Paulo state: The influence of the management of the School Feeding Program and municipal characteristics. Rev Nutr. 2019; 32: e180083. 2019	25 municipalities from São Paulo	Structured questionnaire	↑ 30% of PNAE resources
Machado et al.,²⁵25 Machado PMO, Schmitz BdAS, González-Chica DA, Corso ACT, Vasconcelos FAG, Gabriel CG. Compra de alimentos da agricultura familiar pelo Programa Nacional de Alimentação Escolar (PNAE): estudo transversal com o universo de municípios brasileiros. Ciênc Saúde Colet. 2018; 23 (12): 4153-64. 2018	5,565 Brazilian municipalities from all Brazilian regions	Structured questionnaire	Southeast region: ↓ 30% of PNAE resources Other regions: ↑ 30% of PNAE resources
Soares et al.,²²22 Soares P, Martinelli SS, Fabri RK, Veiros MB, Davó-Blanes MC, Cavalli SB. Programa Nacional de Alimentação Escolar como promotor de Sistemas Alimentares Locais, Saudáveis e Sustentáveis: uma avaliação da execução financeira. Ciênc Saúde Colet. 2018; 23 (12): 4189-97. 2018	23 elementary education units in Paraná	Public calls, bids and accountability of the PNAE.	29.5% of the funds transferred by the FNDE were used to purchase
Ferigollo et al.,²³23 Ferigollo D, Kirsten VR, Heckler D, Figueredo OAT, Perez-Cassarino J, Triches RM. Products purchased from family farming for school meals in the cities of Rio Grande do Sul. Rev Saúde Pública. 2017; 51: 6. 2017	52 municipalities from Rio Grande do Sul	Websites and municipal public transparency portals.	71.2% of municipalities: ↑ 30% of PNAE resources
Gabriel et al.,²⁴24 Gabriel CG, Costa LCF, Calvo MCM, Vasconcelos FAG. Planejamento de cardápios para escolas públicas municipais: reflexão e ilustração desse processo em duas capitais brasileiras. Rev Nutr. 2012; 25 (3): 363-72. 2012	Florianópolis and Belém	Script with open questions about the functioning of the PNAE applied to program managers	0% of PNAE resources

[1] Associated Editor: Nathália Souza

Brasil

Brasil

Adequacy of school menus and national school food program requirements: a systematic review

Abstract

Objectives:

Methods:

Results:

Conclusion: