The potential of a national school food program to reduce dietary inequalities among children in Canada

Abstract Objectives Considering growing food insecurity and diet-related inequalities, Canada has introduced a national school food program (SFP). International studies have shown the benefits of SFPs for student diets, but their potential to reduce differences in dietary intake and diet quality (dietary inequalities) has not been studied. This study examines the associations of existing SFPs with dietary intake and inequalities among elementary students in Canada. Methods Data from 1442 grade 4–6 students (9–12 years of age) from 26 schools in underserved communities reported foods and beverages consumed in the past 24 h and whether these were provided as part of an SFP, brought from home, or obtained elsewhere. Inequalities in dietary intake (vegetables and fruit, milk and alternatives, free sugars, sodium) and overall diet quality of students who accessed vs. did not access SFPs were quantified using Gini coefficients. Results Students who accessed SFPs ( n = 181) reported consuming more vegetables and fruit, more milk and alternatives, and diets of better quality, compared to their peers who did not access SFPs ( n = 1261). These differences were especially pronounced among students from less affluent households. Lower inequalities in the consumption of vegetables and fruit (difference in Gini coefficients = 0.072, 95% CI 0.026–0.116), free sugars (0.055, 95% CI 0.004–0.090), and diet quality (0.019, 95% CI 0.007–0.029) were observed among students who accessed SFPs vs. those who did not. Conclusion SFPs may play an important role in improving the diets of Canadian children and reducing inequalities in dietary intake, thus highlighting their potential in promoting equitable health outcomes.