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Objective: Previous research indicates that head teachers in Sweden frequently fail to see school lunch as part of the educational activities of a school. This study contributes to an understanding of how head teachers in Sweden perceive and experience current national policy intentions related to school lunch.

Design: Qualitative inquiry.

Setting: Ten municipal state schools in Sweden.

Method: Individual semi-structured interviews were conducted with 10 head teachers responsible for the compulsory education of 6- to 15-year-olds in state schools. Data from digitally recorded and transcribed interviews were thematically analysed.

Results: Head teachers primarily saw school lunch as a means to ensure pupils were fed and energised. Their focus tended to be on what followed after school lunch in the form of academic performance and mood, rather than the stated intentions of national school meal policy. Head teachers stressed the value of a free and nutritious school lunch for social equality, and the importance of good collaboration with food service managers and school meal personnel, despite the difficulty of achieving this.

Conclusion: This paper highlights a gap between head teachers' perspectives with respect to school lunch and official intentions stated in Swedish national school meals policy. The meanings head teachers saw as connected to school lunch were those of social equality and ensuring pupils were fed, rather than the wider potential envisioned by the authorities. This paper identifies factors that affect the possibility of realising national policy intentions for school lunch in Sweden.

This action research study explores how co-developing school meals can be taken as a case for education for sustainable development, as integrated to home economics education. We analyse a seven-month-process of collaborative participation in a Finnish secondary school conducted with two home economics teachers, a school food manager, and students during a voluntary home economics course. Data include interviews, multi-professional meetings, and professional reflections of the named school staff members (N = 3), as well as students’ (N = 8; 7th grade; aged 13–14 years) learning diaries, interviews and feedback questionnaire. We develop the term shared food sense (joint understanding, collective application, re-definition of co-action) as a conceptual tool for analysing food-related learning outcomes of the collaborative process. Analyses focused on 1) tensions emerging during the participatory work and 2) outcomes achieved through negotiation and collaboration, including roles that became possible for students to enact. Results show that collaboration succeeded in offering young people opportunities to influence and voice their opinions of school meals, as well as novel modes of interaction across the school’s social. However, students’ experiences of the participatory work varied, and power hierarchies among the different participating groups remained rather unchanged, demonstrating tensions between ideals and realities of participation.

This chapter highlights conditions for a pleasant school lunch based on experiences and perceptions from pupils, teachers, and head teachers. The empirical part of the study is based on a qualitative design using empathy-based stories, individual interviews, and a qualitative analysis of open comments from a questionnaire. Henri Lefebvre's theory of social production of space constitutes the theoretical framework, placing emphasis on how school lunch is experienced, perceived and conceived. The results show that these pupils, teachers and head teachers share the perception of school lunch as a space for socializing. Additionally, they show that conditions for a pleasant school lunch experience, chief among them the environment and time available, are not always favorable. The results presented in this chapter indicate that physical and organizational dimensions of school lunch need to be given more attention.

Background: An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases.

Objective: The purpose of this study was to investigate what types of VF 4th grade pupils (10–11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender.

Design: A cross-sectional study design was used where pupils’ VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated.

Results: The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123).

Discussion: This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden.

Conclusions: The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.

In Sweden, pupils eat tax-funded school lunches, often in the company of teachers. This article focuses on Swedish compulsory school grade (ages 7-15) teachers' (n = 823) perceptions of the school lunch in terms of intentions and daily practice. Analysis was based on written answers for an open-ended question that was part of a questionnaire focusing on teachers' attitudes towards school lunch as a pedagogical activity. It was found that participating teachers saw the potential of the school lunch, placing emphasis on the social interaction that takes place in the school restaurant and the possibility of meeting pupils in a more informal setting. However, a key outcome was teachers' depictions of the struggle between ideals and reality with the effect that teachers were not always provided with favourable conditions for school lunch interactions. It is important to address this in order to improve meal-time practices and the experience of school lunch.

Lifestyle interventions with weight loss can improve insulin sensitivity in type 2 diabetes (T2D), but mechanisms are unclear. We explored circulating and skeletal muscle metabolite signatures of altered peripheral (pIS) and hepatic insulin sensitivity (hIS) in overweight and obese T2D individuals that were randomly assigned a 12-week Paleolithic-type diet with (diet-ex, n = 13) or without (diet, n = 13) supervised exercise. Baseline and post-intervention measures included: mass spectrometry-based metabolomics and lipidomics of skeletal muscle and plasma; pIS and hIS; ectopic lipid deposits in the liver and skeletal muscle; and skeletal muscle fat oxidation rate. Both groups lowered BMI and total % fat mass and increased their pIS. Only the diet-group improved hIS and reduced ectopic lipids in the liver and muscle. The combined improvement in pIS and hIS in the diet-group were associated with decreases in muscle and circulating branched-chain amino acid (BCAA) metabolites, specifically valine. Improved pIS with diet-ex was instead linked to increased diacylglycerol (34:2) and triacylglycerol (56:0) and decreased phosphatidylcholine (34:3) in muscle coupled with improved muscle fat oxidation rate. This suggests a tissue crosstalk involving BCAA-metabolites after diet intervention with improved pIS and hIS, reflecting reduced lipid influx. Increased skeletal muscle lipid utilization with exercise may prevent specific lipid accumulation at sites that perturb insulin signaling.

Objective: Glucagon and amino acids may be regulated in a feedback loop called the liver-alpha-cell axis with alanine or glutamine as suggested signal molecules. We assessed this concept in individuals with type 2 diabetes in the fasting state, after ingestion of a protein-rich meal, and during weight loss. Moreover, we investigated if postprandial glucagon secretion and hepatic insulin sensitivity were related.

Methods: This is a secondary analysis of a 12-week weight-loss trial (Paleolithic diet ± exercise) in 29 individuals with type 2 diabetes. Before and after the intervention, plasma glucagon and amino acids were measured in the fasting state and during 180 min after a protein-rich mixed meal. Hepatic insulin sensitivity was measured using the hyperinsulinemic-euglycemic clamp with [6,6-2H2]glucose as a tracer.

Results: The postprandial increase of plasma glucagon was associated with the postprandial increase of alanine and several other amino acids but not glutamine. In the fasted state and after the meal, glucagon levels were negatively correlated with hepatic insulin sensitivity (rS = −0.51/r = −0.58, respectively; both P < 0.05). Improved hepatic insulin sensitivity with weight loss was correlated with decreased postprandial glucagon response (r = −0.78; P < 0.001).

Conclusions: Several amino acids, notably alanine, but not glutamine could be key signals to the alpha cell to increase glucagon secretion. Amino acids may be part of a feedback mechanism as glucagon increases endogenous glucose production and ureagenesis in the liver. Moreover, postprandial glucagon secretion seems to be tightly related to hepatic insulin sensitivity.

This study is a secondary analysis of a randomized controlled trial using Paleolithic diet and exercise in individuals with type 2 diabetes. We hypothesized that increased adherence to the Paleolithic diet was associated with greater effects on blood pressure, blood lipids and HbA1c independent of weight loss. Participants were asked to follow a Paleolithic diet for 12 weeks and were randomized to supervised exercise or general exercise recommendations. Four-day food records were analyzed, and food items characterized as “Paleolithic” or “not Paleolithic”. Foods considered Paleolithic were lean meat, poultry, fish, seafood, fruits, nuts, berries, seeds, vegetables, and water to drink; “not Paleolithic” were legumes, cereals, sugar, salt, processed foods, and dairy products. A Paleo ratio was calculated by dividing the Paleolithic calorie intake by total calorie intake. A mul-tiple regression model predicted the outcome at 12 weeks using the Paleo ratio, group affiliation, and outcome at baseline as predictors. The Paleo ratio increased from 28% at baseline to 94% after the intervention. A higher Paleo ratio was associated with lower fat mass, BMI, waist circumference, sys-tolic blood pressure, and serum triglycerides at 12 weeks, but not with lower HbA1c levels. The Paleo ratio predicted triglyceride levels independent of weight loss (p = 0.046). Moreover, an increased monounsaturated/saturated fatty acids ratio and an increased polyunsaturated/saturated fatty acids ratio was associated with lower triglyceride levels independent of weight loss. (p = 0.017 and p = 0.019 respectively). We conclude that a higher degree of adherence to the Paleolithic diet recommendations improved fat quality and was associated with improved triglyceride levels independent of weight loss among individuals with type 2 diabetes.

The Swedish National Agency for Education states that educational provision should involve pupil opportunities for interdisciplinary work and the experience of learning in different ways. In this context, the current study aimed to explore the actual operation of interdisciplinary teaching (IDT) in Swedish compulsory schools, i.e. from preschool (6 years) to grade 9 (16 years) regarding nutrition and health. To investigate this, two web-based nationwide questionnaires were sent out in 2014 to compulsory schools in Sweden. One questionnaire was aimed at teachers in five subjects: Home and Consumer Studies (HCS), Natural Science Subjects (NSS) (Biology, Chemistry, Physics), and Physical Education and Health (PEH). The second questionnaire was for school principals. A total of 388 teachers and 216 principals answered the respective questionnaire. The study showed that 40% of the teachers and 59% of the principals reported that their school worked in an interdisciplinary way regarding nutrition and health education. Practical scheduling problems and a lack of time for planning were seen as the main barriers by both teachers and principals, but to a much larger extent by teachers. A prerequisite for successful IDT is that teachers have a chance to meet and plan, and this study indicates that frame factors have a critical impact on what is possible regarding IDT in Swedish schools. It is crucial that principals appreciate their part in facilitating IDT. Increased interdisciplinary teaching for nutrition and health (IDT-NH) might increase school potential for the better integration of knowledge and understanding about the importance of lifestyle for health, the environment and society.

School lunch is in general regulated through policies and agendas constituted by the perspectives of adults. In this article, we focus on children’s lived experiences of school lunch with a special emphasis on emotions and how they relate to social and physical dimensions. This study draws on empathy-based stories written by 10–11 year olds (n = 171) from schools in Sweden. We identified three themes: Interaction and exposure, Routines and restrictions and Food and eating. The children’s lived experiences of school lunch and the emotions attached to them are closely associated and intertwined with the socio-spatial dimension of school lunch. A pleasant meal experience seems to require harmonization between the physical and social space whilst negative experiences contain tensions between them, something that actors working with school lunch and school lunch environments should take in consideration when resourcing, planning and scheduling school lunch, and also when designing new school restaurants.