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School-based nutrition programs in Greece and Cyprus show favorable changes in BMI and dietary intakeSchool Nutrition Programs Show Potential for Better Student Health

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Key Takeaway
Note that school-based nutrition programs show positive trends in BMI and diet, but evidence is limited by heterogeneity.

This scoping review synthesizes evidence from 21 articles regarding school-based nutrition interventions for students in Greece and the Republic of Cyprus. The review evaluated outcomes including body mass index (BMI), physical activity, dietary intake, nutrition-related knowledge, and household food security. The authors noted that 8 studies reported favorable changes in BMI, while shorter interventions often yielded null or mixed results. Dietary intake, including fruit and vegetable consumption and Mediterranean-diet adherence, showed favorable changes in 11 studies. Additionally, favorable changes were reported for physical activity levels and nutrition-related knowledge, while 2 studies reported improvements in household food security.

The authors noted significant limitations, including substantial heterogeneity in intervention design, duration, target populations, and outcome measures. The evidence base from Cyprus is specifically noted as very limited, and the review did not include a formal critical appraisal of the included studies. These factors preclude firm conclusions regarding the comparative effectiveness of the interventions.

For clinical and public health practice, the findings suggest that while school-based programs may influence student health metrics, there is a need for more rigorous longitudinal designs and standardized outcome assessments. Culturally tailored strategies and more consistent data collection are recommended to strengthen the evidence base for these programs in the region.

A review of 21 articles looked at school-based nutrition programs for students in Greece and the Republic of Cyprus. The review looked at several factors, including body mass index (BMI), physical activity, and how much fruit and vegetables students ate. It also looked at nutrition knowledge and household food security.

The findings showed some positive changes. Specifically, 11 studies reported better dietary habits, including more fruit and vegetable consumption and better adherence to the Mediterranean diet. Some studies also showed improvements in physical activity and nutrition knowledge. While 8 studies reported favorable changes in BMI, shorter programs showed mixed results.

It is important to note that the evidence is currently limited and varied. The studies used different designs and lengths, and there was very little data from Cyprus. Because the evidence is not yet consistent, these results do not prove that every program will work the same way. Experts suggest that longer, more standardized programs are needed to better understand how these programs help students over time.

What this means for you:
School nutrition programs show some positive links to better diets and activity, but more consistent research is needed.

Common questions

What specific dietary changes were found in students?

The review of 21 articles found that 11 studies reported favorable changes in dietary intake. This included students eating more fruit and vegetables and showing better adherence to the Mediterranean diet. These findings suggest that school-based programs can influence the types of food students choose to eat.

Did these programs improve physical activity and knowledge?

Yes, the review reported favorable changes in physical activity levels across 3 studies. Additionally, the review found that students showed improvements in nutrition-related knowledge. These results suggest that school programs can help students become more active and informed about their health.

Were there any reported safety concerns or side effects?

The review did not report any adverse events, serious side effects, or issues with how well the programs were tolerated by the students. However, the evidence base is currently limited and varied, so these findings do not guarantee specific results for every student.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
School nutrition programs assist towards ensuring access to nutrient-dense meals as well as reducing food access inequities. Following the economic crisis, state-driven nutrition interventions have continued to expand in Greece and the Republic of Cyprus. This scoping review aimed to map and synthesize the characteristics, theoretical frameworks, delivery methods and reported outcomes of school-based nutrition interventions conducted in Greece and Cyprus. A scoping review was conducted across 13 databases for relevant intervention studies published up to and including April 2026 following the PRISMA Extension for Scoping Reviews and the Arksey and O’Malley framework. A total of 21 articles were included in this review. The majority of studies (n = 19) were conducted in Greece and only two in Cyprus. The duration of the interventions varied considerably (1 month-6 years). The theoretical frameworks identified included: Social Cognitive Theory (n = 3), Theory of Planned Behavior (n = 2), and Social Learning Theory (n = 2). Several reported favorable changes in body mass index (BMI) (n = 8), physical activity levels (n = 3), dietary intake (n = 11) (including fruit and vegetable consumption and Mediterranean-diet adherence) and nutrition-related knowledge. A smaller number of studies (n = 2) examined school food-aid programs and reported improvements in household food security. Null or mixed findings for anthropometric outcomes were also observed, particularly in shorter interventions. The available studies frequently reported favorable changes in selected nutrition-related outcomes. However, substantial heterogeneity in intervention design, duration, target populations and outcome measures, the very limited evidence base from Cyprus, and the absence of formal critical appraisal preclude firm conclusions about comparative effectiveness. Future research should prioritize rigorous longitudinal designs, broader and standardized outcome assessment, and culturally tailored strategies to strengthen the evidence base for school-based nutrition programs in the region.
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