(P17-006-23) Measuring and Improving the Quality of School Meals: The Global Diet Quality Score (GDQS)-Meal and Menu Metrics

Objectives: School feeding programs operate in almost every country and play a significant role in the nutrition of school-aged children globally, especially in low- and middle-income countries where school feeding reaches approximately 330 million children (GCNF, 2022). However, despite the wide reach of these programs, we lack metrics to rigorously assess the quality of meals served in institutional procurement settings, like schools, globally. The Global Diet Quality Score (GDQS)-Meal and Menu metrics have been developed to fill this gap.

Methods: A global scoping review of potential approaches for measuring meals and menus was undertaken and the Global Diet Quality Score (GDQS) was selected as the foundation for this work (Bromage et al., 2021). The GDQS features core measurement principles, including the ability to capture both nutrient inadequacy and risk of non-communicable diseases (NCDs); ease of data collection and tabulation; the ability to capture detailed information on food groups and food items reported; established validity of the underlying metric; and global relevance.

Results: Building off the scientific constructs and validity of the GDQS, the GDQS-Meal and Menu metrics were developed to capture information about the quality of meals served. Modifications made to the GDQS to adapt it for use at the Meal and Menu level included reducing the gram cut-offs for children less than 10 years old, giving partial points to recognize smaller quantities of foods served, and awarding points for fortification and biofortification. For the GDQS-Menu metric, the score was further sensitized to reflect the diversity of foods served over multiple days. The GDQS-Meal and Menu metrics are in the early stages of being used for the design, monitoring, and evaluation of school meals and are being integrated into tools and systems of the United Nations World Food Program.

Conclusions: The GDQS-Meal and Menu metrics provide a globally standardized way of measuring the quality of meals and menus served in schools and other institutional food service settings such as hospitals, prisons, and cafeterias. Anticipated future work includes developing an app for data collection, expanding to measure the environmental impacts of the meal served, and providing guidance for school meal planners for improved meals and menus.

Funding Sources: The Rockefeller Foundation