Adolescent Nutrition in Boarding Schools: A Narrative Review of Food Systems, Nutritional Status, Food Determinants and Pathways towards the Sustainable Development Goals

Abstract

This narrative review emphasizes the school food system, multilevel determinants, intervention strategies, and health outcomes affecting adolescents in boarding schools. Boarding schools across the globe have distinct structural and cultural elements that influence dietary intake. These schools follow strict timing, a central food distribution, shared eating practices, and dietary norms. A structured literature search identified 28 eligible studies published across PubMed, Scopus, Web of Science, and Google Scholar. The evidence was thematically synthesized across the individual, institutional, and sociocultural levels, specifically for boarding school food systems characterized by repetitive food menus. Limited food diversity and autonomy in food selection were associated with inadequate micronutrient and protein intake, and undernutrition, although some boarding school settings showed overweight and obesity. Additionally, multilevel and multicomponent interventions that combine school meals, nutrition education, micronutrient strategies, and hygiene promotion produced more effective and consistent improvements in dietary education, hemoglobin levels, and anemia prevalence, as well as in meal quality, micronutrient supplementation, nutrition education, and hygiene promotion. Despite this, the anthropometric outcomes of adolescent growth were reflected in the relatively less consistent impact on anthropometric indicators, such as body mass index, with a minor magnitude. In general, the effective strategies improved dietary quality, food diversity, and the institutional food environment, thereby addressing individual, Institutional, and sociocultural determinants.