# Wholesome Lunch to the Whole Classroom: Short‐ and Longer‐Term Effects on Early Teenagers' Weight

**Authors:** Shiko Maruyama, Sayaka Nakamura

PMC · DOI: 10.1002/hec.4959 · Health Economics · 2025-03-18

## TL;DR

A Japanese school lunch program helps reduce obesity in low-income teenagers and the benefits last years after graduation.

## Contribution

The study provides causal evidence of a school lunch program's long-term obesity-reducing effects for low-income students.

## Key findings

- The school lunch program significantly reduces obesity in children from low socioeconomic backgrounds.
- The obesity-reducing effects persist for at least a few years after graduation.
- There is little evidence that the program reduces underweight.

## Abstract

Previous studies on the effect of school lunch programs on child obesity have been hampered by effect heterogeneity, self‐selection, and stigma‐induced under‐reporting, having produced mixed findings. Its potential long‐lasting effect has also been debated. We study the body‐weight effect of a Japanese school lunch program, which provides nutritional lunch to all students at participating municipal junior highs. The lack of means testing and individual participation choice offers causal estimates of actual participation for a diverse and representative group of children. By exploiting almost universal school lunch coverage for elementary school children nationwide, we construct a difference‐in‐differences (DID) framework. Using the 1975–1994 National Nutrition Survey, a nationally representative household survey with measured height and weight, we find a regressive benefit of school lunch: while no statistically significant effect is found for the full sample, we find significant obesity‐reducing effects for the subsamples of children with low socioeconomic backgrounds. This obesity‐reducing effect remains at least a few years after graduation, implying effect through not only nutritional contents but also guiding healthy eating behavior. We find little evidence that school lunch reduces underweight. Propensity score weighting, the DID analysis for percentiles, and various falsification tests confirm the robustness of our estimates.

## Linked entities

- **Diseases:** obesity (MONDO:0011122)

## Full-text entities

- **Diseases:** obesity (MESH:D009765), underweight (MESH:D013851)

## Full text

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## Figures

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## References

92 references — full list in the complete paper: https://tomesphere.com/paper/PMC12166539/full.md

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Source: https://tomesphere.com/paper/PMC12166539