Good Practices in School Gardens and School Meals: Africa, Asia and Latin America and the Caribbean (2024)

As part of food and nutrition education actions and a component of Sustainable Schools, the Programme encourages school garden initiatives, considering their potential to transform food habits of current and future generations, training students to be aware of the impacts of food production on the environment and on agri-food systems. In addition, with the greater impact of climate change, this educational tool becomes even more relevant as it can offer concrete contributions to the mitigation of climate effects.

Since 2009, the Brazil-FAO International Cooperation Programme for School Meals, an alliance between the National Fund for Education Development (FNDE), the Brazilian Cooperation Agency (ABC) and the United Nations Food and Agriculture Organisation (FAO), has been developing activities to strengthen and institutionalise school meal programmes in Latin America and the Caribbean (LAC).

About 2 billion people in the world are overweight or obese due to a poor diet and sedentary lifestyle. Around 133.4 million Latin Americans and Caribbeans do not have access to a healthy diet. In addition, this region has the highest healthy food costs (LAC Food and Nutrition Security Overview, 2023).

Given this scenario, the cooperation has promoted actions aimed at offering healthy and adequate menus, public procurement from smallholder farming, improvement of school infrastructure and food and nutrition education actions such as school gardens, exchanges of experiences, training and technical visits between 26 LAC countries, within the framework of the Sustainable School Feeding Network (RAES).

2025 January

Global Roots (website)

Global Roots promotes regenerative, equitable, and nutritious plant-based food systems by modeling agricultural conservation projects, partnering with organizations around the world to implement whole systems change, and providing on-the-ground education programs. They are based in the USA* and the Dominican Republic** in partnership with the T. Colin Campbell Center for Nutrition Studies and are exploring other expansion areas. By recognizing the overlap between nutrition for personal and planetary health, we can drastically improve global health standards while simultaneously reducing agricultural land use requirements paving the way for increased conservation.

Objectives:

  • Expand the practice of agriculture as a form of conservation, life-enhancement, and regeneration to areas around the world.
  • Provide education opportunities on how to transition consolidated, top-down food systems to community-owned land trusts and regenerative land practices.
  • Demonstrate through model programs how transitioning inefficiently used farmland from speculative markets to locally-owned land initiatives increases healthy food options, employment opportunities, and resilient communities of health.
  • Increase peer-to-peer networking and coalition building through the Whole-Communities platform.
  • Provide technical support to promote regenerative, equitable, and nutritious plant-based food systems.

* The Brightside Farm and Nursery in the USA is the home of Global Roots. The farm is located outside of Chapel Hill, North Carolina in growing zone 8a and covers an area of 2.5 acres hosting the nursery, mixed vegetable production, and orchard. Operations of the farm and nursery are governed by the Global Roots staff and board of directors.

** The RAICES Institute education center is located in the Dominican Republic in the province of Las Hermanas Mirabal, north of Salcedo in the village of La Cumbre. The center is owned and operated by RAICES Global with program support from Global Roots and the T. Colin Campbell center for Nutrition Studies. The center hosts education programs and aims to establish plant-based communal food hubs.

2025 January

Serving hope: rethinking school meal programs in Latin America (2024)

López, D. S., Gamba, M., & Uriza-Pinzón, J. (2024). Serving hope: Rethinking school meal programs in Latin America. The Lancet Regional Health – Americas36, Article 100818. https://doi.org/10.1016/j.lana.2024.100818

Fig. 1 School meal programs in Latin America.

This article is a commentary providing a good overview and links to improving school meals programs, including issues to foster and educate on Sustainable Food Systems.

Snippets from the Article: “To bolster the effectiveness of school food programs in LAC it’s imperative to adopt innovative strategies. The above involves integrating nutritional education into the school curriculum, establishing sustainable school farms with local products, and incorporating gastronomy into SMP to enhance menu acceptance and reduce food waste. Community involvement ensures cultural relevance and supports local farmers, while technological solutions aid in addressing socioeconomic disparities, infrastructure, and logistics, facilitating better monitoring and data-driven decision-making. Moreover, long-term initiatives for enhancing school food programs should focus on aligning policies, raising awareness, capacity building, and conducting research and evaluation.”

“Fulfilling Sustainable Development Goals (SDGs) targeting hunger mitigation and universal food access within the framework of SMPs is crucial for global well-being. Enhancing quality and coverage in SMP across LAC is essential, requiring concerted efforts to improve nutrition, promote sustainable development, and advance global health.”

2025 January

Sustainable School Feeding Network (RAES)

The Sustainable School Feeding Network (RAES) is a strategy of the Brazil-FAO International Cooperation in school feeding, developed by the Government of Brazil, through the Brazilian Cooperation Agency (ABC/MRE) and the National Fund for Educational Development (FNDE/MEC), with the support of the Food and Agriculture Organization of the United Nations (FAO).

The RAES was a response of these Brazilian institutions to the United Nations Decade of Action for Nutrition (2016-2025), promulgated by the UN General Assembly in 2016 following the recommendations of the Second International Conference on Nutrition, held in Rome in 2014. The Decade documents the commitment of world leaders to adopt national policies to eradicate hunger and malnutrition and to transform of food systems in favour of nutritious diets and access to healthy food for all people.

From the “Joint declaration of commitment to advances in school feeding policy in Latin America and the Caribbean”:

* Items listed in bold and italics particularly support Sustainable Food Systems:

Collaboratively define and build a regional school feeding agenda that contributes to the development of the priority themes of the School Feeding Programmes (SFPs) at the national level, especially regarding to:
– Financing national programmes;
– Expanding student coverage;
* Ensuring participatory governance;
* Promoting healthy diets;
* Implementing food and nutrition education (FNE);

– Providing adequate environments for food storage, preparation, and provision;
* Implementing and strengthening of local public procurement from family farming;
* Enhancing SFPs’ role in building more inclusive and resilient agrifood systems to tackle climate change challenges;

– Addressing other themes defined by RAES member countries.

Sustainability and food systems concepts in dietetic training standards in speaking Spanish countries (2023)

Carvajal Useche KC, Rangel Palacio N, Carlsson L. Sustainability and food systems concepts in dietetic training standards in speaking Spanish countries. Rev Esp Nutr Hum Diet. 2023; 27(4): 315-24. doi: https://doi.org/10.14306/renhyd.27.4.1939 (open source)

Follow the link to read the full article in both Spanish and English.

Key Messages

  • Four Spanish-speaking nations include at least partial coverage of sustainable food systems dimensions in their dietetic training and practice standards: Colombia, Mexico, Paraguay and Peru. This is 66% of those for which standards exist, and similar to international content.
  • Mexican and Peruvian standards require robust commitment to social and environmental sustainability in practice (values). Mexican education is guided by relatively low level of cognitive complexity (knowledge of, “understand”); Peruvian practice standards required a higher level (up to “create”).
  • The standards in Paraguay and Colombia contribute to food systems sustainability competence through primarily food and nutrition security-related standards, concepts inseparable from sustainable food systems. Colombia explicitly recognizes the purview of nutritionists as throughout food systems (production to consumption).
  • Opportunities exist for increasing the focus on food systems sustainability as a guiding paradigm for food and nutrition work, in the context of urgent global priorities to climate change and sustainable development.

Abstract

Introduction: Global calls for action to support sustainable development through food systems and nutrition provide context to examine to what degree nutrition and dietetics professionals are equipped for this challenge. The purpose of this research is to investigate content related to sustainable food systems in training standards from Spanish-speaking countries and examine what level of knowledge is required.

Methodology: Researchers conducted a content analysis of documents informing nutrition and dietetics training standards for content related to sustainable food systems, including dimensions of these complex topics. Relevant content was then analyzed according to the level of cognitive complexity per Bloom’s Revised Taxonomy.

Results: Of 21 eligible countries, documents describing competencies, standards or codes of ethics were found for six, four of which included relevant standards: Colombia, Mexico, Paraguay, and Peru. Overall, there was minimal comprehensive inclusion of sustainable food systems, but partial inclusion of one or more important sustainability dimensions. These were required at a mix of levels of cognitive complexity.

Conclusions: This research adds to a small body of evidence documenting the state of readiness of nutrition and dietetics professionals to contribute to sustainable development. It highlights a moderate level of readiness in four Spanish-speaking countries, and opportunities for increased emphasis on comprehensive sustainability-informed education and training standards, which can help prepare practitioners for effective practice.

Funding: MITACS Global Research Internship.

Harvard Law School Center for Health Law and Policy Innovation (Website) 

The Harvard Law School Center for Health Law and Policy Innovation (CHLPI) advocates for legal, regulatory, and policy reforms in health and food systems, with a focus on the health, public health, and food needs of systemically marginalized individuals. CHLPI’s broad range of initiatives aim to expand access to high-quality health care and nutritious, affordable food; to reduce health- and food-related disparities; to develop community advocacy capacity; and, to promote more equitable, sustainable and effective health care and food systems. CHLPI’s Food is Medicine initiative promotes access to healthy food as an essential component of holistic health care that should be considered a reimbursable, core medical service and advances key legal and policy levers that help to increase access to healthy foods. Some of CHLPI’s work to date includes releasing two national reports: Food is Medicine: Opportunities in Public and Private Health Care for Supporting Nutritional Counseling and Medically Tailored, Home-Delivered Meals and Food is Prevention: The Case for Integrating Food and Nutrition Interventions into Healthcare. CHLPI is a clinical teaching program of Harvard Law School and mentors students to become skilled, innovative, and thoughtful practitioners as well as leaders in public health, and food law and policy.

Practice Greenhealth (website)

Practice Greenhealth is a membership and networking organization for sustainable health care, delivering environmental solutions to hospitals and health systems across the United States. More than 1 in every 3 hospitals in the USA is part of the network. Members and partners include hospitals and health care systems, health care providers, manufacturers and service providers, architectural, engineering and design firms, group purchasing organizations, and affiliated nonprofit organizations. Working closely with Practice Greenhealth, Health Care Without Harm seeks to transform health care worldwide so it reduces its environmental footprint and becomes a leader in the global movement for environmental health and justice. Practice Greenhealth has a page dedicated to food improve the health of patients, staff, and the surrounding community by serving sustainable food.

Environmentally sustainable hospital foodservices: Drawing on staff perspectives to guide change (2021 January)

Citation: Carino S, Collins J, Malekpour S, Porter J. Environmentally sustainable hospital foodservices: Drawing on staff perspectives to guide change. Sustainable Production and Consumption. 2021/01/01/;25:152-61. https://doi.org/10.1016/j.spc.2020.08.003 (note: there is a paywall to access the full study)

Relevant to: 

Dietitians-Nutritionists working in hospitals or in food services.

Question: 

Forty-six stakeholders working across the hospital supply chain in three Australian hospitals were interviewed regarding their perspectives on: (1) sustainable and unsustainable practices in hospital food provision; (2) barriers and enablers of sustainable practices; and (3) future recommendations for implementing sustainable foodservice practices.

Bottom line for nutrition practice: 

This paper identifies specific sustainable and unsustainable practices across the hospital food chain under the following categories:

  • procurement;
  • food processing (central production kitchen);
  • food service model/ menu design;
  • meal ordering and selection;
  • food preparation;
  • patient consumption;
  • food waste;
  • waste management.

The abstract below summarizes current sustainable and unsustainable practices as well as barriers and enablers to improving sustainability. Future recommendations were generated under 3 themes:

  • (1) practice recommendations;
  • (2) knowledge generation/ sharing recommendations and
  • (3) leadership and policy recommendations. 

The authors emphasize the importance of involving staff in making changes, and suggest that creating best practice guidelines for sustainability within food services could address one of the key barriers identified.

Abstract:

Foodservice is a key contributor to environmental impacts of the healthcare sector, in particular hospitals. Driving towards sustainable solutions in foodservices can bring financial and social benefits, whilst allowing hospitals to position themselves as leaders towards a sustainable food system and healthcare sector. Such a change depends on those working directly or indirectly with foodservices. Staff possess valuable knowledge, ideas, motivation and responsibility for improving the environmental sustainability of the foodservice system.

The aim of this study was to explore the perspectives of staff working across the hospital food supply chain towards: (1) sustainable practices in hospital food provision; (2) existing barriers and enablers; and (3) recommendations for implementing sustainable foodservice practices in the future.

Through qualitative inquiry, semi-structured interviews were conducted with individuals at operational and management levels responsible for policy, purchasing, production, onsite plating and delivery and waste disposal at three hospitals in Australia. Framework analysis was used to synthesise transcribed data into practices, barriers and enablers, and recommendations. Interviews (n=46 participants) identified current sustainable practices including those related to recyclable packaging, effective equipment and technology and efficient processes.

  • Unsustainable practices included restrictions on sourcing food, packaging that cannot be separated or recycled, rigid foodservice models and menu, waste production and processes.
  • Enablers to improve sustainability included the power of individuals to influence change, education on recycling, knowledge generation, audits and grants for innovative research, rebates and quality improvement processes.
  • Barriers included competing priorities, poor communication, lack of training opportunities and knowledge, infection control restrictions, lack of policy, funding, and time between meal ordering and delivery.
  • Participants proposed practice changes across the food supply chain and recommended generation and sharing of knowledge, leadership and policy support.
  • Perspectives of individuals within foodservice reveal shared motivation and desire for sustainable foodservices, with support needed from leaders and policy.
  • Future research should use a co-design approach involving staff to create and implement sustainable strategies within hospitals. To see widespread and timely change, action is needed towards effective and meaningful policy.

Details of results: 

In providing a background to the study, the authors note that the health care supply chain accounts for 71% of health care greenhouse gas emissions, and food is part of the supply chain. In addition to emissions, food also accounts for freshwater and land use, among other environmental impacts, so it is an important consideration for sustainability. The authors stress that examining the way food is managed in hospitals, including studying decisions points at each part of the hospital food supply chain, is important to effectively mitigating environmental impacts. They also suggest that there is a lack of research examining this issue from a systems perspective.

Interviewees included: policy makers; group purchasers; health service managers; central production kitchen staff; food preparation (food services staff, managers and supervisors); nurses; dietitians and waste management staff.

Some specific sustainable practices identified but not listed in the abstract include: “use of water technology to prevent the need for chemical cleaning products”; “use of metal trays”; “electronic menus”; decreasing time between ordering and delivery; “chemical free kitchen”; “patient meal time assistance”; “food waste audit and research”; waste management innovation (p. 155). Other unsustainable practices identified include: lack of organic meat or cage free alternatives; not following standardized recipes; relying on meat and dairy for protein; plastic packaging for individual pre portioned meals; patient difficulty to open items (leading to food waste); food waste technology not provided or working. 

Key barriers and enablers were categorized under several themes. First, under “people and their power and motivation” (p.156), individuals who advocated for change as well as the power of a sustainability team were identified as enablers; it was also noted that patient feedback on food quality enables change, as this is required to meet performance indicators. Second, “competing priorities for action” (p.156) was noted as a barrier, such as infection control requirements which restricted the reuse of unopened, individually pre-packaged foods. Third, while “education training and knowledge generation/ sharing” (p.156) can be an enabler (noting the powerful influence of data), gaps exist (e.g., in orientation training; lack of awareness of best practices). Next, many gaps exist under “policy influence”, including lack of best practice standards. Sustainable procurement can also be difficult as a result of supply contracts. Interviewees also noted that sustainability should be legislated if governments consider it a priority. Finally, foodservice systems can present opportunities (e.g., opening a new kitchen), but gaps were also identified (e.g., food waste resulting from delays between meal ordering and delivery, and as a result of offering a wide range of meal options).

Future recommendations were generated under three themes. First, “practice recommendations” (p. 158) included strategies such as reducing the frequency of meat on the menu and including more plant based options; reducing time between ordering and meal delivery; soliciting patient feedback; reducing food packaging; creating a vegetable garden on site and using generated compost on it. Second “knowledge generation/ sharing recommendations” (p. 158) included recommendations such as the creation of best practice guidelines, increased communication about effective strategies, using business cases to support practices, learning from other institutions, and including sustainability information in orientation sessions. Third, “leadership and policy recommendations” (p. 158) included actions such as funding a sustainability officer and creating a hospital sustainability policy which includes food.

Of additional interest: 

Editor’s comment:  

Interested Dietitians-Nutritionists may want to access the full article, as it identifies many practical actions at various points along the hospital food chain. 

Open access link to article: 

N/A – there is a pay wall to access the article (see citation above)

Conflict of interest/ Funding: 

The authors reported no conflict of interests.   

External relevant links: 

Corresponding author:

Stefanie.carino@monash.edu

Sustainable Institutional Food Procurement Insights, lessons, and recommendations from a Churchill Fellowship (2022)

Governments have few sources of leverage over increasingly globalized food systems – but public procurement is one of them. When sourcing food for schools, hospitals and public administrations, Governments have a rare opportunity to support more nutritious diets and more sustainable food systems in one fell swoop,” – Olivier De Schutter United Nations Special Rapporteur On The Right To Food (2014)

In May and June of 2022, the author of the report on Sustainable Institutional Procurement, Leah Galvin attended meetings and site visits in the USA, Canada, England, Denmark, Sweden, and Finland where the was researching models and approaches that increase the procurement by public institutions of local, healthy and/ or sustainable food. Public food can create public good – economically, environmentally, socially and for our health. Public (government funded) food procurement by institutions can be driven by a range of values: the kind of food purchased, from whom it is purchased and the production method. Institutions include – hospitals, universities, aged care, preschools, schools, prisons, workplace canteens/catering and community meal programs such as meals on wheels.

Author Leah Galvin, recipient of the 2019 Churchill Fellow explains: In writing this report I have had practitioners, government policymakers, food systems advocates, philanthropic investors, and food service and institutional procurement professionals in mind. You can read it all or just cherry-pick parts which are most helpful to you. Much of it is practical, and translatable to the Australian context and I hope affirming for those keen to values-based procurement widely practiced. If you have a sustainability mindset, this report can provide you with a new way to think about how our food system is part of the emissions reduction solution, because sustainable institutional food procurement in Australia, remains the sleeping giant of food systems transformation.

Also see Leah’s infographic on the same topic at this link in this #ICDAsfsToolkit.

Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review (2022)

Ronto R, Saberi G, Leila Robbers GM, Godrich S, Lawrence M, et al. (2022) Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review. PLOS Global Public Health 2(3): e0000209. https://doi.org/10.1371/journal.pgph.0000209

Open access link to article: 

https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000209

Relevant to: 

Public health nutrition, sustainability 

Question: 

To identify effective interventions to promote intake of protein-rich foods from lower ecological footprint.

Bottom line for nutrition practice: 

There is a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.

Abstract: 

Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources.

Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods; purchase, or selection of meat/plant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review.

The results were narratively synthesised. Included studies were categorised into individual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of individual level interventions (52%) aimed to reduce red/processed meat intake among people with current/past chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.

Details of results: 

Limitations

  • One limitation of this review is that most of the included studies have been conducted in high income countries and only a few studies were conducted in low- and middle-income countries (LMIC). This might be due to the fact that plant-based diet concept in high income countries has received increased attention in the last five years and LMICs have not prioritised it as a significant nutrition and environmental issue due to dealing with other diet related issues such as undernutrition and nutrient deficiencies. Research indicates that meat intake in LMIC has been associated with wealth as the rise in income has resulted in significant animal-derived food consumption in these countries [85].
  • Furthermore, most studies used self-reported measures to measure dietary behaviours which may increase biases [86].
  • Also, this review was limited to the literature published in English language and did not included articles published in grey literature, therefore it may be we missed some important research written in other languages. Finally, the majority of individual level behaviour change interventions included people who may be highly motivated to change their dietary behaviour such as cancer survivors, people at risk of developing chronic conditions, limiting the generalizability of the data to general population.

Results

The present review identified effective individual and micro-environmental behaviour change interventions which showed promising results in reducing protein intake from high ecological footprint sources.

  • The findings suggest that individual behaviour change interventions such as education, counselling and self-monitoring interventions might be useful strategies to educate people to change their dietary behaviours to more sustainable ones. However, there is a need to test these strategies among the general population longitudinally.
  • In addition, our findings showed that altering food environments using nudging and choice architecture approaches can achieve positive dietary changes but there is a need for development and evaluation of interventions in general settings (macro-environments) and explore motivations in sustainable food purchasing behaviours.

Our findings inform future research for development and evaluation of interventions and strategies to encourage greater adoption of sustainable and healthy diets.

Of additional interest: 

  • See the article reference list

Editor’s comment:  

n/a

Conflict of interest/ Funding:  

None to declare

External relevant links:  

n/a

Corresponding author: 

Dr Rimante Ronto
Department of Health Sciences, Macquarie University, Australia
Rimante.ronto@mq.edu.au