Sustainable School Lunches: A Comparative Analysis of Lunch Quality in Primary Schools in Warsaw and Zagreb

Górnicka, Magdalena; Keser, Irena; Kaleta, Agnieszka; Jeruszka-Bielak, Marta

doi:10.3390/app14188163

Open AccessArticle

Sustainable School Lunches: A Comparative Analysis of Lunch Quality in Primary Schools in Warsaw and Zagreb

¹

Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW), 02-787 Warsaw, Poland

²

Faculty of Food Technology and Biotechnology, University of Zagreb, 10 000 Zagreb, Croatia

³

Institute of Mechanical Engineering, Warsaw University of Life Sciences (SGGW), 02-787 Warsaw, Poland

^*

Author to whom correspondence should be addressed.

Appl. Sci. 2024, 14(18), 8163; https://doi.org/10.3390/app14188163

Submission received: 9 July 2024 / Revised: 1 September 2024 / Accepted: 9 September 2024 / Published: 11 September 2024

(This article belongs to the Special Issue Food and Nutrition and New Dietary Trends for Human Health)

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The proposed SMI-LE index can be used to plan healthier school lunches in line with the idea of a sustainable diet.

Abstract

The School Meal Index-Lunch Evaluation (SMI-LE) has been developed to assess school lunch quality. The aim of this study was to use the SMI-LE index for a comparative analysis of the quality of school meals planned in primary schools in Warsaw and Zagreb. The SMI-LE index was used to assess 4-week school meals in both cities. The collected menus were analyzed both in terms of overall quality as an average of points over 4 weeks and in terms of individual categories. According to the SMI-LE index, 4-week school lunches were rated on average 64 and 62 points out of a total of 140 points, in Warsaw and Zagreb, respectively. The majority of school lunches in Zagreb were classified as medium quality, while in Warsaw, over 50% were classified as good quality. Aspects that could be improved include an increase in vegetable availability and variety, limiting the meat dishes, and providing alternatives for children on vegetarian diets, as well as the ability to choose portion sizes. Polish schools need to change their approach to school meals. Following the example of schools in Zagreb, these could be one-course hot meals but with a wider range of raw vegetables and fruits. The current findings also highlight the importance of future research to develop standards for school food policies and investigate whether such a school food program could improve the eating habits and nutritional status of primary school children in the long term. Using the SMI-LE index to design new school meals could be a good solution to improve the quality of school meals.

Keywords:

sustainability; school lunch; quality assessment; School Meal Index-Lunch Evaluation (SMI-LE); food

1. Introduction

School meals, although implemented at a local level, have a global impact on the health of children and adolescents, as well as on the environment [1]. The concept of school meals originated in the late 19th century in individual schools as a response to widespread hunger and poverty. Today, schools, charities, and governments in Europe provide school meals to children in a variety of ways [2], but school meals remain an important part of a healthy diet, which is essential for the development, growth, and academic performance of school-aged children [3]. A well-planned school lunch can also be an excellent tool in the fight against childhood obesity and overweight, which have reached epidemic proportions in many countries around the world, including Poland and Croatia [4,5]. Although Croatia is one of the Mediterranean countries where one would expect culture and culinary traditions to have a positive impact on health, it turns out that, just like in Poland, one in three school-age children is overweight. Analyses indicate a steady increase in the incidence of overweight and obesity among Croatian and Polish children, and a worsening of this situation after the COVID-19 pandemic [6].

Research suggests that providing healthy meals in schools can help reduce the risk of diet-related diseases in children and, consequently, improve the quality of life of adults [2,7]. As shown by Ilić et al. [8], eating school meals can encourage the consumption of unprocessed or minimally processed foods. In addition, children who ate school meals had significantly lower energy intake than children who did not eat school meals. Therefore, controlling the quality of school meals and adapting them to current guidelines and nutritional recommendations seems to be an important element of public health policy. Although a menu is defined as a set of dishes for a planned meal, it can be a tool for developing healthy eating habits, preserving the food environment and culture, and providing nutrition education [9]. There are general criteria for planning school menus, but there is no consensus on the best protocol for evaluating them. The most commonly used quality assessment of menus is often based on outdated criteria and does not take into account the proven environmental impact of meals [9,10].

In response to these needs, the School Meal Index-Lunch Evaluation (SMI-LE) has been developed [10]. This tool for measuring the quality of school meals takes into account health and sustainability issues. The idea of sustainable diets includes, among others, a low environmental impact, which can be achieved by increasing plant-origin food consumption while reducing meat and meat product consumption. This general concept was expressed in the SMI-LE index by (1) an increased proportion of plant products, like legumes, vegetables, and whole grains; (2) a limited proportion of meat and meat products; and (3) the provision of varied portions to decrease food waste. Low SMI-LE values confirm the low nutritional value of planned meals [10], so this indicator can be a good predictor of the quality of school meals in general. The SMI-LE can also be used as a checklist for evaluating and planning school meals, both by those responsible for school meals and by inspectors. Therefore, the aim of this study was to use the SMI-LE index for a comparative analysis of the quality of school meals planned in primary schools in Warsaw and Zagreb.

2. Materials and Methods

2.1. Data Collection

Zagreb, the capital city of Croatia, has about 900 thousand inhabitants, which accounts for one-fifth of the total population of the Republic of Croatia. The local GDP per capita (single units) was EUR 28,271. There are 17 urban districts within the city of Zagreb [11]. Warsaw is the capital city of Poland and has about 2 million inhabitants living in 18 districts. The local GDP per capita (single units) equaled EUR 32,682 [12].

School menus available online from primary schools in Warsaw (Poland) and Zagreb (Croatia) were collected for 4 weeks (October 2023). The schools were randomly selected from the lists of public primary schools available on the city hall’s websites, which accounted for 219 schools in total in Warsaw [13] and 130 schools in Zagreb [14]. On average, 1–3 schools were considered from each district depending on the number of schools. Generally, it was the middle school on the list in a district with a low number of schools (<5); or the first and the last schools on the list when 5–10 schools were present in a district; or the first, the middle, and the last schools on the list when >10 schools were present in a district. If the menu was not available or contained incomplete data, the next school from the list was taken. The primary schools in both countries are dedicated to children and adolescents with an age of 6 or 7 to 15 years and cover 8 grades.

2.2. Quality School Lunch Assessment

The SMI-LE index was used to assess 4-week school meals in Warsaw and Zagreb. This index assesses 12 menu categories, extended for product groups such as vegetables, fruit, cereals, drinks, and vegetarian dishes, resulting in a total of 20 components (Table 1). It is calculated as the sum of the points assigned to the components depending on the answers ‘yes’ and ‘no’. A ‘no’ answer is worth 0 points, while a ‘yes’ answer is worth 10 points for the main healthy food categories (like vegetables, fruit, whole grains, dairy products, fish, vegetarian dishes, and non-sweetened beverages) or 5 points for subcategories (like the availability of dark green vegetables at least twice a week) or additional questions (like the everyday availability of at least two different portions of dishes). Exceptions from this zero–one system were introduced for three components, namely at least two different vegetables every day, raw vegetables every day, or fruit served every day, where the points were assigned for each day when such criterion was met. The SMI-LE index can range from 0 to 140 points, and the higher the sum of the points, the higher the quality of the menu. Components with ‘0’ points indicate the areas for improvement. Based on the final scores, 3 categories of school meal quality were established: (1) low, for scores of ≤35 points (≤25% of total points); (2) medium, for scores of 36–70 points (26–50% of total points); and (3) high, for scores of >70 points (>50% of the total points). More details about the SMI-LE index are presented elsewhere [10].

School menus were assessed with the SMI-LE index independently by both authors of this study (M.G. and I.K.). Krippendorff’s alpha coefficient was calculated for the inter-rater agreement. The coefficient equaled 0.89, indicating a very good agreement between both authors.

The collected menus were analyzed both in terms of overall quality as an average of points over 4 weeks and in terms of individual categories. Data are presented as means and standard deviations, first calculated for each selected school and later for each quality category. The differences in SMI-LE scoring were examined by the ANOVA test. Tukey’s HSD test was used to determine the homogenous groups. Statistical analysis was conducted using STATISTICA software version 12.0 (StatSoft INC., Tulsa, OK, USA; StatSoft, Kraków, Poland). A p-value < 0.05 was considered statistically significant.

3. Results

3.1. School Lunch Characteristics

The school lunch model in Zagreb differs from that in Warsaw. In Zagreb, lunch is mainly a one-course meal, and soups are rarely served. Bread is usually served with lunch. In none of the schools is a vegetarian alternative dish available for children who do not eat meat. Salads are served less frequently. Drinking water is commonly available in canteens. In Warsaw schools, the lunch set consists of soup; a second course, which most often includes a meat dish, a starchy side dish, and salad; and fruit or a sweet dessert. Some schools provide substitutes for children on dairy-free, gluten-free, and vegetarian diets.

In Zagreb, school meals/snacks are prepared on-site (on school premises) and off-site, both in central kitchens and in private facilities (i.e., by caterers). In Zagreb and throughout Croatia [15], primary schools organize meals for children while they are at school, especially for children in the lower grades who participate in after-school activities. Schools provide up to three meals: breakfast, lunch, and afternoon snack. School meals in Zagreb have been fully financed from the central budget from January 2023, while in Warsaw, lunch is fully or partially paid by the parents, and the prices vary from EUR 1.1 to EUR 3.6 depending on, e.g., the amount of local government subsidies.

Currently, in Poland, including Warsaw, the preparation and serving of school meals varies; some schools have their own canteens, while others have canteens run by an agent or a catering company, and some meals are delivered to schools by catering companies. Meals served in the school’s own canteens are cheaper because parents only pay for food products and semi-finished products that are used to prepare the meals. In other cases, meals are fully financed by parents or institutions that subsidize meals for the “poorest” [16].

3.2. School Lunch Assessment by SMI-LE

Table 2 shows the mean scores of the SMI-LE index. The results show that these values did not differ during the whole study period or in individual weeks. The mean values indicate the medium quality of the planned menus, accounting for 46% and 44% of the maximum SMI-LE value in Warsaw and Zagreb, respectively.

The majority of school lunches in Zagreb were classified as medium quality, while in Warsaw, over 50% were classified as good (Figure 1).

3.2.1. SMI-LE Evaluation of Vegetables

Taking into account the selection of vegetables (Table 3), the evaluation results showed that the total values of the indicators were about 63% of the maximum value in Warsaw schools and 45% in Zagreb schools. Lower scores for schools in Zagreb compared to Warsaw were found for two components, i.e., providing at least two different vegetables and one raw vegetable per day, while dark green vegetables were served significantly more often in Zagreb schools than in Warsaw schools.

3.2.2. SMI-LE Evaluation of Fruit

Similarly, for fruit, the categories assessed by the SMI-LE showed a higher frequency in the menus of the Warsaw schools, which achieved 60% of the maximum score for the fruit category, while in Zagreb, the mean score was 13%. The variety of fruit was significantly higher in Warsaw schools (Table 4). This is related to the specificity of school menus in Zagreb, where fruit is most often served separately as an afternoon snack.

3.2.3. SMI-LE Evaluation of Starchy Staples

Starch products were better planned in the lunch menus of schools in Zagreb, where refined cereals and potatoes were served less frequently than in schools in Warsaw, and whole grain products were more often available (Table 5). Out of 15 points, the analyzed menus achieved 41% and 56% of the maximum value for Warsaw and Zagreb, respectively.

3.2.4. SMI-LE Evaluation of Animal Protein Sources

In Polish schools, dishes with dairy products, mainly cottage cheese, are typically planned once a week, which is not as popular in Zagreb schools. Fish and seafood were much more common in Zagreb menus, resulting in a significantly higher score in this category (Table 6). The analyzed menus scored quite well in the meat category in Warsaw schools. In this category, menus from schools in Zagreb scored significantly lower as most of them regularly served dishes based on meat, especially beef and veal.

3.2.5. SMI-LE Evaluation of Vegetarian Dishes

Vegetarian dishes were rare on the menus, and the total mean value equaled 25% in Warsaw and 18% in Zagreb of the maximum points assigned to this category in the SMI-LE index. Schools in Zagreb scored much lower in this category, but they served additional vegetable dishes for everyone much more often than schools in Warsaw (Table 7). Dishes based on legumes were planned with a similar frequency in both cities. Schools in Zagreb, unlike some schools in Warsaw, did not plan alternative dishes for children on a vegetarian diet.

3.2.6. SMI-LE Evaluation of Sweet and Fried Dishes

Sweet dishes such as pasta or pancakes with fruit, as well as fried dishes, were the highest-scoring foods in the analyzed schools, regardless of the city (Table 8). Sweet dishes are typically served once a week in Polish schools, while in Zagreb, such practices are more common for school breakfasts.

3.2.7. SMI-LE Evaluation of Beverages

In Zagreb schools, children have unlimited access to drinking water in canteens, and other drinks are not included on the menu. In the case of schools in Warsaw, both sweetened beverages (like compotes, juices, and nectars) and water are often served every day. However, in some schools, there is no information about the water availability in the canteen. As a result, there were large differences in the scores for this category among the schools (Table 9).

3.3. School Lunch Example According to SMI-LE

Based on the evaluated school meals and using the developed SMI-LE index, we propose a weekly menu in accordance with the principles of healthy eating and sustainable development that can be implemented in primary schools in Warsaw and Zagreb (Table 10). It is based on the concept of a one-course meal, as in Zagreb schools, but includes more desirable food products according to dietary guidelines, as in Warsaw schools.

4. Discussion

The results of the qualitative assessment of school menus did not differ between the two capital cities, despite the generally different approaches to their design. They scored over 60 out of 140 SMI-LE points on average, and their overall quality was rated as medium. Aspects that could be improved include an increase in vegetable availability and variety, limiting the meat dishes, and providing alternatives for children on vegetarian diets, as well as the ability to choose portion sizes. Descriptive analysis showed that a typical lunch for primary school pupils in Zagreb consisted of a hot dish with rice, pasta, or bread and, more often, cooked vegetables, while the proportion of fruit and raw vegetables in the lunch was very low. In Warsaw, the school lunch was more comprehensive and consisted of two courses, namely soup and the main course with vegetables, as well as dessert in the form of fruit or sweets. In addition, the lunch menu was more likely to include dairy products. The obtained results allowed us to propose a school lunch that, by combining both approaches, will improve the quality of the meal in accordance with nutritional recommendations and limit the impact on the environment. Taking into account the observations and results of the qualitative assessment, it appears that both countries lack a national program for school meal policy, as is in the case of the Scandinavian countries [1,2]. So far, in accordance with the recommendations of the Council of the European Union, the state in both Poland and Croatia is obliged to provide children in need with free and effective access to at least one healthy school meal on each school day. In both countries, the National Strategy for the Implementation of the School Scheme “Program for Schools” has been implemented, according to which fruit and vegetables, as well as milk and dairy products, are provided free of charge to children in the first–fifth grades of primary schools [17,18]. Sweden, Finland, and Estonia introduced free school meals for all pupils many years ago and strictly defined the quality of school meals [19]. The authors presented the positive long-term effects of the Swedish school lunch program, emphasizing that the program was introduced in a wealthy country where children did not face food insecurity, but parents lacked knowledge about healthy eating habits. It was made clear that ensuring adequate quality and standards of school meals is of great importance for children’s health and development and should be a health policy consideration in other countries. The results of studies in other countries, such as Denmark, France, and Greece, have also shown that good-quality school meals improve some health parameters, including reducing the risk of being overweight or obese [20].

Increasing and diversifying the supply of fruits and vegetables in schools is a criterion that urgently needs to be improved. Their availability, in addition to the quality of the raw materials, attractive presentation, and children’s preferences, increases the chances of their higher consumption in this age group [21,22]. Given that childhood is a critical period for the development of eating habits, it is very important to adopt a healthy diet that includes sufficient amounts of fruit and vegetables [23,24]. Moreover, in many European countries, children’s fruit and vegetable consumption does not meet World Health Organization targets [25]. Research suggests that the school environment may be conducive to the frequent, daily consumption of fruit and vegetables, so menus should be based on the high availability and variety of these groups [26,27]. In schools in Warsaw, fruit is served with lunch, while in Zagreb, it is served as an afternoon snack. Neither of these patterns seems to be correct, as too much food is served for one meal in Warsaw, while in Zagreb, only about one-third of children eat an afternoon snack and miss the fruit serving [8]. Perhaps the best solution would be to serve fruit for a morning snack. According to a study of Dutch children aged 6–9 years, fruits and vegetables served as the only snack (without other products) during the 10:00 am break encouraged children to eat them [26]. We also know that children do not like vegetables in salads and are more likely to eat them if they are served as separate products.

School meals can have a positive impact on children’s diets, especially when they are planned and prepared according to dietary guidelines. The proposed weekly menu, which was developed on the basis of SMI-LE criteria, is based on current guidelines and dietary recommendations [28,29,30,31]. The answer to the question “what is a healthy school meal?” is based on the dietary elements commonly considered important for diet quality: eating fruit and vegetables and starchy foods as a major part of the diet; increasing the consumption of fruit; vegetables (criteria 1–3; 4–5 SMI-LE), especially dark green ones (criterion 3 SMI-LE); legumes (criterion 11 SMI-LE); whole grains (criterion 6 SMI-LE); low-fat dairy products (criterion 9 SMI-LE); lean protein (criterion 14 SMI-LE); and products high in healthy fats, such as fish (criterion 10 SMI-LE). The guidelines also recommend limiting the consumption of highly processed foods, foods high in saturated and trans fats (SMI-LE criteria 7 and 16); fried foods (SMI-LE criterion 17); red meat (SMI-LE criterion 15); added sugars (SMI-LE criterion 16); and sugar-sweetened beverages (SMI-LE criteria 18 and 19); and consuming a variety of foods (all SMI-LE criteria) in appropriate proportions (SMI-LE criterion 20). In general, these most common suggestions are consistent with WHO guidelines [31] and national dietary recommendations [29,30]. Increasing the frequency of vegetarian meals in school canteens (i.e., meals without meat or fish (SMI-LE criteria 11–13)) was proposed as a theoretical solution to reduce greenhouse gas emissions while maintaining the good nutritional quality of meals [32]. SMI-LE was designed to monitor key aspects of diet quality, addressing aspects of health and sustainability that are universal to European countries.

From an educational and health perspective, eating a nutritious and balanced lunch every day improves a child’s ability to function in the classroom [19]. The results of Ilić et al. [15] underlined that school feeding can have a positive impact on the diversity of children’s diets, and children who ate numerous and more complex school meals had better quality meals. In addition, children who ate school meals were more likely to consume dark green leafy vegetables than children who ate fewer or no school meals [15]. The results suggest that meals in Croatian schools are prepared mostly from less processed foods [8]. On the other hand, the results of the analysis of the nutritional quality of standard school meals served in 18 primary schools in northern Croatia [33] showed high consumption of cereal products, meat, cakes, and sweets, and a lack of consumption of fruit, vegetables, fish, and legumes.

The results of qualitative research in selected schools in Poland [16] showed that meals offered in school canteens take into account pupils’ preferences and not always nutritional recommendations. It was emphasized that the quality of meals in school canteens depends not only on the quality of the food but also on the skills and commitment of the staff responsible for planning and preparing the meals. Greater attention needs to be paid to the development and application of quality criteria in purchasing food products. Moreover, the ability to prepare attractive and balanced meals, specifically with legumes and vegetables using seasonal and local products, should be considered. For sustainable goals, the use of surplus food to avoid food waste and the use of modern kitchen equipment should be advised. A better solution seems to be a one-course lunch (as in the schools in Zagreb) but with an extended vegetable offer in the form of a buffet.

Countries recognized as having good sustainable consumption practices in schools like Sweden and Slovenia have included the use of local and organic foods in their national dietary guidelines. Finland, for example, recommends that schools plan their purchases based on local and seasonal products, and some schools and municipalities donate surplus food from school meals for further use [2].

A key barrier to offering free or subsidized school meals is the potential for them to be perceived as ‘unattractive’, both in terms of content and presentation. This can lead to more attractive options being sought nearby, both in and out of school [2]. To address this issue, it is important for school meals to be perceived as ‘attractive’, and the introduction of new balanced and varied meals needs to be supported by nutrition education and other activities through social media campaigns to address low uptake and food waste [8,33,34]. Strategies for reducing organic and inorganic waste through composting, recycling, and portion control should be developed as part of sustainable school kitchen practices [35,36,37,38,39]. In a systematic review [40] and a previous study [41], some solutions were identified that can also be used in Polish and Croatian schools to improve school lunch consumption. These include (i) providing students with 30 min lunch breaks; (ii) offering students a choice among at least two options for each meal component (especially fruits and vegetables); (iii) fruit and vegetables pre-cutting; (iv) increasing the palatability/cultural appropriateness of meals; and (v) limiting access to competing foods. Undoubtedly, taking Portugal as an example, the school canteen should be the only main source of food in primary schools, as there are no snack bars and vending machines in primary schools [42].

The research findings justify the need to implement sustainable school food systems and take them into account when planning menus for communities, including school-age children. In addition, they point to problems that prevent schools from offering planned menus, including the non-delivery of goods, the poor quality of products, the degree of ripeness of fruit and vegetables, and the low acceptance of planned menus [9,10]. In this context, there is a strong need for the presence of a dietician in the school environment, who plays an important role in nutrition education and the development of menus based on current knowledge, considering the different needs of school children, including, for example, the adaptation of menus for children on elimination diets.

Nevertheless, this study has some limitations that can be addressed in future research. Firstly, we assessed the menus that were declared by schools and available on school’s websites and not the real meals served to children in school canteens. Secondly, the index is only qualitative and does not include the quantities of foods consumed by schoolchildren. Moreover, we do not know the schoolchildren’s liking of the dishes served in school canteens, the meal leftovers, and the scale of food waste, which are all combined and related to sustainability. Third, although the index is used for a qualitative and not quantitative evaluation, our previous study showed that the nutritional value of the menus corresponded to the quality category [10]. Menus representing the low-quality category provided the lowest content of minerals such as calcium, magnesium, iron, and potassium but the highest sodium. Additionally, the content of folates was the lowest and did not reach 30–35% of the Dietary Recommended Intakes for a child aged 10–12 years with moderate physical activity. By contrast, menus from the good-quality category were characterized by the highest nutritional value. The mean values of the calcium content were much below the references, regardless of the quality category. Interestingly, the proposed weekly menu with the assumed typical portions for a child 10–12 years old meets the DRIs for the crucial nutrients analyzed, except calcium. Thus, other meals served to primary schoolchildren should focus on that mineral to meet its daily recommendations.

Finally, although this is a small-scale pilot study, its results also allow for the planning of an intervention study and evaluation process in other schools in Europe.

In conclusion, we believe that, despite the abovementioned limitations, the proposed index for a rapid qualitative assessment of weekly school meals provides the basis for improving other aspects of the school food system and more conscious planning in relation to other sustainable consumption objectives. Many aspects of the current situation need to be improved, including a new and profound renewal of the food system.

5. Conclusions

The results of this study show that the current quality of school lunches consumed by primary school pupils in Warsaw and Zagreb needs to be improved, particularly in terms of increasing the consumption of fruit, vegetables, and legumes and reducing the consumption of meat. Polish schools need to change their approach to school meals. Following the example of schools in Zagreb, these could be one-course hot meals but with a wider range of raw vegetables and fruits. The current findings also highlight the importance of future research to develop standards for school food policies and investigate whether such a school food program could improve the eating habits and nutritional status of primary school children in the long term. The quality of school meals should be a top priority for public health professionals and governments to ensure the long-term health of populations and the environment. Using the SMI-LE index to design new school meals could be a good solution to improve the quality of school meals.

Author Contributions

Conceptualization, M.G. and I.K.; methodology, M.G. and M.J.-B.; formal analysis, M.G., A.K. and I.K.; investigation, M.G. and I.K.; resources, M.G.; visualization, A.K. and M.J.-B.; writing—original draft preparation, M.G., A.K. and I.K.; writing—review and editing, A.K. and M.J.-B.; supervision, M.J.-B. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors on request.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Classification of school lunches in Zagreb and Warsaw by the quality category based on SMI-LE scoring *. * The SMI-LE rating was as follows: low quality: ≤35 points; medium quality: 36–70 points; good quality: >70 points.

Table 1. School Meal Index-Lunch Evaluation (SMI-LE) criteria and scoring for week menu assessment.

Food Groups	Criteria			Scoring (Points)			Comments	Maximum Scoring for Each Food Group
Food Groups	Criteria			0	5	10	Comments	Maximum Scoring for Each Food Group
Vegetables	1.	≥2 different vegetables every day		No		Yes	2 points for each day	20
	2.	Raw vegetables every day		No	Yes		1 point for each day
	3.	Dark green vegetables: ≥2 times/week		No	Yes
Fruit	4.	Fruit every day		No		Yes	2 points for each day	15
Fruit	5.	≥3 different fruits/week		No	Yes			15
Grains	6.	Whole grain product: ≥2 times/week		No		Yes		15
Grains	7.	Refined grain product: ≤2 times/week		No	Yes			15
Potatoes	8.	As a starchy product in a second dish: ≤2 times/week		No	Yes			5
Dairy	9.	Dairy product/dish: ≥2 times/week		No		Yes	without added sugars	10
Fish	10.	Fish and sea foods: ≥1 time/week		No		Yes		10
Vegetarian dish	11.	Vegetarian dish based on legume for all students: 1 time/week		No		Yes		25
	12.	Additional vegetarian dish (not sweet, without fish) for all students: 1 time/week		No	Yes
	13.	Vegetarian alternative for vegetarians: every day		No		Yes
Meat	14.	Meat: ≤2 times/week		No	Yes			10
Meat	15.	Red meat: ≤1 time/week		No	Yes			10
Sweet dish	16.	Sweet dish: ≤1 time/week		No	Yes			5
Fried food	17.	Fried food: ≤2 times/week		No	Yes			5
Beverages	18.	Water or tea without added sugar: every day		No		Yes		15
Beverages	19.	Juice, compote ≤ 2 times/week		No	Yes			15
Portion size	20.	At least 2 different every day		No	Yes			5
			Range of points					0–140

Table 2. The total average points for primary school lunches in Warsaw and Zagreb according to the SMI-LE index *.

SMI-LE	Warsaw n = 50	Zagreb n = 25	p-Value
4-weeks (Mean ± SD)	64 ± 17	62 ± 11	0.17
1st week	61 ± 16 ^a	63 ± 12 ^a	0.65
2nd week	68 ± 18 ^b	60 ± 11 ^a	0.04 **
3rd week	60 ± 15 ^a	63 ± 10 ^a	0.40
4th week	67 ± 17 ^a	60 ± 17 ^a	0.09

* Maximum scoring: 140 points; ** statistically significant, p-value < 0.05; the same letters in the same column indicate homogenous groups (p-value < 0.05 Tukey’s HSD test).

Table 3. The comparison of SMI-LE scores for vegetables in school menus between Warsaw and Zagreb.

Vegetable	Warsaw	Zagreb	p
Sum of points (max. 20)	12.6 ± 3.5	8.7 ± 2.4	0.0001 *
≥2 different vegetables every day (max. 10)	6.7 ± 2.2	3.0 ± 1.9	<0.0001 *
Raw vegetables every day (max. 5)	3.3 ± 0.9	1.6 ± 0.7	<0.0001 *
Dark green vegetables: ≥2 times/week (max. 5)	2.6 ± 1.2	4.2 ± 0.9	<0.0001 *