What 2,431 Italian Teachers Reveal About the Secret to Healthier School Lunches

When it comes to getting children to eat more fruit, vegetables, and legumes, the answer may lie less in classroom nutrition lessons and more in the quality of the food on the plate and the people deciding what goes on it. That is the central message of a new nationwide study from Italy, published in BMC Public Health, which surveyed 2,431 teachers across all twenty of the country’s regions to understand how the school food environment shapes what children actually eat. The findings arrive at a moment when governments across Europe are rethinking public food procurement and school meal standards, and they offer a rare, large-scale, quantified look at which levers in the school system appear most strongly connected to healthier eating behaviors in young children.

Italy provides an unusually interesting setting for this kind of research. National guidelines establish standards for school catering, but the country’s highly decentralized governance means that responsibility for meal quality, supplier selection, and stakeholder engagement is dispersed across municipalities and regions. The result is a patchwork: two schools in different towns, or even in different neighborhoods of the same city, can operate under markedly different rules, budgets, and catering arrangements. This variability is precisely what makes Italy a natural laboratory for studying how different dimensions of the school food environment relate to children’s diets, because the differences between schools are real, structural, and measurable rather than hypothetical.

The research team, led by Veronica Vitali, Giulia Tiboldo, Alessandro Varacca, and Elena Castellari of the Università Cattolica del Sacro Cuore, designed a questionnaire that probed five broad areas of the school food environment: governance, infrastructure, food provision, educational activities, and family engagement. Teachers, who observe children’s eating habits daily and often participate in mealtime supervision, served as informants about both the characteristics of their schools and the consumption patterns of their students. The survey captured details such as the types of meals offered, the presence of school gardens and kitchen facilities, the involvement of parents and local stakeholders in food decisions, and the frequency of nutrition-related educational activities.

One of the study’s most technically interesting features is its analytical approach. Rather than treating each questionnaire item as a standalone measure, the researchers used Item Response Theory, a family of statistical models originally developed in psychometrics, to construct three latent indices. The first, quality of the offer (QO), captures the overall quality of the food provided by the school. The second, quality of educational activities (QA), measures the richness and frequency of nutrition education. The third, role of stakeholders in governance (RSG), quantifies how actively parents, teachers, and other actors participate in decisions about school food. Latent indices of this kind are valuable because they aggregate many noisy individual indicators into a single, more reliable score, reducing measurement error and allowing researchers to compare schools along meaningful dimensions.

With these indices in hand, the team turned to ordinal logistic regression, a statistical technique suited to outcomes that fall into ordered categories, such as low, medium, and high consumption of a given food group. The models estimated how the three indices, together with school-level characteristics like school type and location, were associated with teacher-reported consumption of fruit, vegetables, and legumes. The sample itself was diverse: sixty percent of respondents taught in kindergartens, sixty-three percent worked in urban areas, and the split between state-recognized private schools and public schools was nearly even, at fifty-four and forty-six percent respectively. This breadth strengthens the case that the patterns observed are not artifacts of a single school type or region.

The headline result concerns the quality of the offer. Across all three food groups, the QO index showed the strongest and most consistent associations with teacher-reported consumption. In other words, schools where the food provision itself scored higher, encompassing the quality and characteristics of the meals served, were also the schools where teachers reported that children ate more fruit, vegetables, and legumes. This is a deceptively simple finding with potentially large implications: it suggests that what schools actually serve may matter more for children’s diets than the educational programming wrapped around it. Children, it seems, respond to their food environment in a fairly direct way, and improving the plate may be the most reliable route to improving the diet.

Governance also emerged as a meaningful factor, though with more modest effect sizes. Higher scores on the stakeholder governance index were associated with a probability of high vegetable consumption higher by 2.5 percentage points, and a probability of high legume consumption higher by 2.0 percentage points. While these shifts may sound small, in a population-level intervention context even a couple of percentage points across an entire school system can translate into substantial changes in dietary intake. The finding aligns with a growing body of work on participatory food governance, which argues that when parents, teachers, and communities have a genuine voice in school food decisions, the resulting environments better reflect local needs and sustain higher standards over time.

Perhaps the most striking negative result involves nutrition education. The quality of educational activities index showed no significant association with consumption of any of the three food groups. For anyone who has assumed that teaching children about healthy eating is the key to changing what they eat, this is a sobering data point. The study does not claim that education is worthless; rather, it suggests that, at least as measured in this survey and in the Italian context, structural and governance-related dimensions of the school food environment carry more weight than classroom-based nutrition activities. It is a finding that echoes a broader theme in behavioral science: environments often shape behavior more powerfully than information does, and a child who is served high-quality meals daily may internalize healthy eating patterns regardless of how many nutrition posters hang in the hallway.

School type mattered as well. Kindergartens showed higher quality-of-offer scores, by 0.132 on the latent scale, compared with primary schools, and children in kindergartens were associated with higher probabilities of high fruit consumption, by 4.0 percentage points, and high legume consumption, by 6.9 percentage points, relative to their primary school counterparts. This pattern is consistent with developmental research showing that early childhood is a critical window for establishing food preferences, and it hints that the Italian system may do a better job of feeding its youngest students than its older ones. Whether the advantage reflects stricter catering standards for younger children, more attentive mealtime supervision, or simply age-related differences in eating behavior is a question the authors flag for future work.

The study’s authors are careful about the limits of what can be concluded. The data are cross-sectional and rely on teacher reports rather than direct dietary measurement, so the associations described cannot be read as causal effects, and the relationships may evolve over time. Still, the research makes a substantive contribution to ongoing debates about school meal governance and public food procurement, particularly in decentralized systems like Italy’s where national guidelines coexist with wide local variation. As policymakers across Europe and beyond grapple with how to build healthier and more sustainable food systems, the Italian evidence offers a clear directional signal: invest in the quality of the food itself and in the engagement of the people who govern it, and treat nutrition education as a complement rather than a substitute. The lunch tray, it turns out, may be the most important classroom in the school.

Subject of Research: The association between school food environment quality, governance, and children's fruit, vegetable, and legume consumption in Italian schools

Article Title: School food environment and healthy eating in Italian schools: evidence from a nationwide teacher survey

Article References: Vitali, V., Tiboldo, G., Varacca, A., & Castellari, E. (2026). School food environment and healthy eating in Italian schools: evidence from a nationwide teacher survey. BMC Public Health. https://doi.org/10.1186/s12889-026-29605-1

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29605-1

Keywords: school food environment, school meals, children's dietary behaviors, school food governance, Item Response Theory, Italy, public health, nutrition education, fruit and vegetable consumption, public food procurement, BMC Public Health, kindergarten