School meals do more than fill a lunch tray. A new Cochrane review finds that free or subsidized school feeding programs lead to modest but meaningful improvements in children’s learning and physical growth, especially in low- and middle-income countries where undernutrition remains widespread.
“School meals are a critical source of nourishment for children experiencing socioeconomic disadvantage,” said Jennifer Garner, a registered dietitian and assistant professor at the University of Michigan School of Public Health who co-authored the review.
The team analyzed 40 studies involving 91,000 students across primary and secondary schools, most of them in low- and middle-income countries.
The review found that providing regular meals at school led to small increases in math test scores and school enrollment, along with slight improvements in height-for-age and weight-for-age measures. Researchers also noted that many children worldwide still lack consistent access to nutritious food that supports healthy growth and learning. In low-income countries, an average of only 27% of primary schoolchildren received school meals in 2024, compared with 79% in high-income countries.
Although the results were not large, they were consistent across many settings, including some conflict-affected regions.
“Given the variation in contexts and program designs studied, seeing measurable improvements in growth, enrolment, and math achievement is encouraging,” Garner said.
The evidence also came with important limits. The authors found little to no effect on reading scores or school attendance, and they cautioned that there is not enough research from high-income countries to apply the findings more broadly.
“School meal programs play an important role in improving health and educational outcomes for disadvantaged children,” said lead author Elizabeth Kristjansson of the University of Ottawa. “What we’re seeing are modest, but real results.”
The researchers also highlighted a major gap. Too few studies reported outcomes by socioeconomic status or sex, limiting the ability to understand who benefits most. As co-author Anita Rizvi noted, “Research too often focuses on average effects and misses differences between groups.” She called for larger and more standardized trials that can better guide policymaking.
While more evidence is needed, the findings point to a consistent message: nutritious meals at school help support children’s development, particularly in places where food insecurity is common.
This review was funded by Dubai Cares through the World Food Programme and by the London School of Hygiene and Tropical Medicine. Several authors reported affiliations with organizations involved in nutrition or school feeding research, but none were involved in the editorial process for this review.