Abstract
Background: Food insecurity is increasing due to economic recession, resulting in childhood malnutrition, a risk factor for adult morbidities. Strategies to prevent and combat it are being implemented. This study aimed to evaluate the menus used in school feeding programs and their impact on the health and well-being of children in South Africa. Methods: A cross-sectional survey of nine primary schools in four South African provinces—Gauteng, Western Cape, NorthWest , and KwaZulu-Natal—was conducted between April 2022 and May 2022. Three schools were randomly selected per province, totaling 36 respondents—comprising a principal/NSNP coordinator, a teacher, and a food handler per school. An observational checklist was also employed. Weekly menus at each school were obtained, and dietary intake data were evaluated using the NutriSurvey application and the South African Food Composition table. Qualitative data were thematically analyzed using an inductive approach in Atlas. Ti software, while Microsoft Excel was utilized for the checklist. Results: The surveys indicated that in-school nutrition programs have positively impacted schoolchildren's well-being and academic performance. Menu evaluation revealed that most National School Nutrition Programme (NSNP) lunch meals did not provide up to 25-30% of the children's recommended dietary allowance (RDA), but the Tiger Brands Foundation (TBF) breakfast augmented this by providing an additional 10-20% of the RDAs. Regarding breakfast meals, the highest mean RDA met per week was for calcium (21%), while Gauteng lunch had the highest mean RDA met values for most nutrients, including protein (15%), vitamin A (78%), vitamin B9 (37%), vitamin B12 (140%), vitamin C (33%), and iron (29%). The health checklist showed that all respondents affirmed that the children were generally healthy. Conclusion: The school feeding menus contribute to the percentage of RDAs met for essential nutrients and the well-being of children, although the contribution is not significant, as not all RDAs meet the 25-30% requirement. However, incorporating foods like meat (despite being expensive), eggs and fruits into the menus could enhance protein supply and increase the percentage of RDAs met.