Abstract
BACKGROUND: The Norwegian Directorate of Health has issued school meal guidelines to advocate for the availability of healthy food options. However, awareness and adherence among school officials and canteen staff are low. Moreover, the broadly formulated guidelines complicate evaluation and selection of appropriate foods. Nutri-Score might be a potential tool for guiding and evaluating food procurements. OBJECTIVE: We aimed to 1) examine agreement between the Nutri-Score and the school meal guidelines, 2) investigate the potential of using Nutri-Score to guide food procurements through proposing food-group-specific ranges, and 3) propose realistic goals for food purchases in value (money spent) for recommended and non-recommended foods based on Nutri-Score distribution in a sample of schools. DESIGN: A list of all foods procured in all high school canteens in Viken County, Norway, from January 2021 to June 2023 was obtained. The Nutri-Score 2023 version was calculated on all products. Based on the school meal guidelines, foods had been classified into three categories by nutrition experts: foods recommended to be offered, foods recommended to be offered in limited amounts, and foods recommended not to be offered. Agreement and disagreement were assessed using boxplots and cross tables. Linear regression presented as scatter plots was used to investigate relevant goals for food purchases. RESULTS: There was overall good agreement between the Nutri-Score and the Norwegian school meal guidelines. We propose that foods with Nutri-Score A and B can be recommended, but for some food groups, such as bread toppings, Nutri-Score C and D can also be recommended. A goal for food procurements could be minimum 65% of total value spent on products with Nutri-Score A or B and maximum 15% on products with Nutri-Score E (C-E for beverages). CONCLUSION: Nutri-Score could be an effective, complementary tool for guiding and evaluating food purchases in alignment with school meal guidelines.