Background: Schools provide an opportunity for developing strategies to create healthy food environments for children. The present study aimed to analyze the Healthy School Canteen (HSC) policy and identify challenges of its implementation to improve the school food environment in Iran. Methods: This mixed method study included two qualitative and quantitative phases. In the qualitative phase, triangulation approach was applied by using semi-structured interviews with key informants, documents review and direct observation. Data content analysis was conducted through policy analysis triangle framework. In the quantitative phase, food items available in 64 canteens of primary schools of Tehran province were gathered. The food’s nutrient data were evaluated using their nutrition facts label. The number and proportion of foods that met the criteria based on Iran’s HSC guideline and the World Health Organization nutrient profile model for the Eastern Mediterranean Region (WHO-EMR) were determined. Results: The main contextual factors that affected adoption of HSC policy included health (nutritional transition, high prevalence of non-communicable diseases and unhealthy food environment in and around the schools), political (upstream supportive policies and joint memorandums about health children between the Ministry of Health and Medical Education and Ministry of Education), structural (the lack of unified stewardship, inadequate human resource capacity, poor inter-sectional cooperation), economic (school financial problems, poor fiscal supportive of food policies), and socio-cultural (mothers working outside the home, the role of children’s peer group, low nutrition knowledge of school principals) factors. Assessment of the school canteens showed that a large proportion of available foods did not comply with the national guidelines (54.7 ± 2.54%) and WHO-EMR model (85.6 ± 2.34%). The main reasons identified for incomplete implementation of the policy were inadequate physical and economic infrastructure to set up standard school canteens, lack of scientific criteria for food categorization, poor monitoring, high price of healthy foods, and conflict of interest among the actors. Conclusion: The majority of foods and beverages available in the school canteens did not comply with national and regional standards. Iran HSC policy needs to be improved by using an evidence-based approach and active interaction between all key actors.

Enabling policies related to kindergarten and school food environments can be effective approaches in preventing childhood obesity. This study investigated policies and/or programs with direct or indirect effects on the food environment in kindergartens and schools in Iran. In this scoping review, we systematically searched PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran from January 1990 to October 2020, to identify literature on policies/programs affecting the food environment in kindergartens and schools in Iran. A total of 30 studies and policy documents were included in this review relevant to eight policies/programs. These programs have helped to control food availability in schools, increase nutritional awareness, positively influence physical function and school performances, and reduce malnutrition in rural kindergartens. However, improving the food environment in schools and kindergartens requires proper revisions and local adaptation of many of these policies, strengthening of cross-sectoral collaborations, provision of necessary financial and human resources, and ensuring regular monitoring and evaluation. Reflecting on Iran’s health policies and interventions provides insight into the progress achieved and challenges faced. Lessons can benefit the country itself, as well as other countries with similar contexts.

Frequent consumption of Energy Drinks (EDs) is associated with numerous health problems, including overweight and obesity, particularly among children and adolescents. The extensive promotion, wide accessibility, and relatively low cost of EDs have significantly increased their popularity among this age group. This paper examines policies/programs that, directly and indirectly, contribute to reducing ED consumption in children and adolescents and shares global experiences to help policymakers adopt evidence-based policies. A systematic search was performed using PubMed, Scopus, and Web of Science databases from January 2000 to June 2024, along with reputable international organization websites, to find literature on policies aimed at reducing ED consumption among children and adolescents. All sources meeting the inclusion criteria were included without restrictions. Titles and abstracts were initially screened, followed by a full-text review. After evaluating the quality of the selected studies, data were extracted and, along with information from the selected documents, compiled into a table, detailing the country, policy type, and the effectiveness and weaknesses of each policy. Out of 12166 reviewed studies and documents, 84 studies and 70 documents met the inclusion criteria. 73 countries and territories have implemented policies like taxation, sales bans, school bans, labeling, and marketing restrictions on EDs. Most employ fiscal measures, reducing consumption despite enforcement challenges. Labeling, access restrictions, and marketing bans are common but face issues like black markets. This scoping review outlines diverse strategies adopted by countries to reduce ED consumption among children and teenagers, such as taxation, school bans, sales restrictions, and labeling requirements. While heightened awareness of ED harms has reinforced policy efforts, many Asian and African nations lack such measures, some policies remain outdated for over a decade, and existing policies face several challenges. These challenges encompass industry resistance, governmental disagreements, public opposition, economic considerations, and the intricacies of policy design. Considering this, countries should tailor policies to their cultural and social contexts, taking into account each policy's strengths and weaknesses to avoid loopholes. Inter-sectoral cooperation, ongoing policy monitoring, updates, and public education campaigns are essential to raise awareness and ensure effective implementation.

Increased exposure to advertising of unhealthy food products is one of the main risk factors for the increased prevalence of childhood obesity and non-communicable diseases. This scoping review aimed to investigate the characteristics and effects of food advertisements targeted at children in Iran and review the existing regulations on food marketing targeted at children in the country. In this study, we searched Web of Science, Scopus, PubMed, Google, and Google scholar, in addition to Iranian scientific search engines, including Iranian Research Institute for Information Science and Technology (Iran.doc), Scientific Information Database (SID), Iranmedex, Magiran, and Civilica up to December 2020 to find any literature about food marketing to children in Iran and current related regulations and policies in the country. A total of 23 eligible studies were selected for this review. Most of the studies had focused on television as the media to assess. The main food products advertised with reference to children included: Salty snacks, including cheese puffs, chips, cheese fish snacks, puffed corn, and sweet snacks such as ice creams, cakes/biscuits/cookies and candies, beverages/drinks/soft drinks/fruit juices, dried fruits and fruit rolls, and chocolates. Strategies that most commonly used in marketing foods to children in Iran were emotional appeals, misleading messages/claims, use of music and known characters to children, as well as conveying happiness and/or security. The main reported violation of food regulations included using obese children, either as consumers or presenters of the product. In Iran the advertising of unhealthy food products for the general population is banned; however, it is weakly implemented. There are a limited number of regulations that have addressed children explicitly in this regard. The main barriers identified in partial implementation of regulations included weakness in scientific criteria, legal enforcement guarantee, poor intersectoral collaboration, inadequate infrastructures, and poor monitoring. Policies and regulations in food marketing need to clearly address children as an important audience. It is suggested future policies focused on children cover all forms of food marketing and consider all types of persuasive food marketing strategies targeted at children.