The impact of Ka Ora, Ka Ako, New Zealand’s free, healthy school lunch program on children’s health and wellbeing

Since 2020, New Zealand’s free, healthy lunch program, Ka Ora, Ka Ako, has been implemented in qualifying schools from high-deprivation areas. The aim of this study was to measure its impact on student health and wellbeing. A quasi-experimental study compared health and wellbeing outcomes for Year 5 and Year 9 students in Hawke’s Bay in participating versus non-participating schools using surveys of eating behaviours, food insecurity, wellbeing (WHO-5 questionnaire), and body size (anthropometry) in 2020 and 2023. Compared to students from 14 non-Ka Ora, Ka Ako schools (n = 741/690), students from 13 Ka Ora, Ka Ako schools (n = 447/399 2020/2023) had: generally lower vegetable and fruit consumption at baseline, but non-significant increases in any vegetables (p = 0.149) and any fruit (p = 0.09) over time; higher unhealthy food consumption at baseline which significantly improved over time (p = 0.04); higher food insecurity with no significant change over time; no difference at baseline or change in quality of life scores; substantially higher overweight/obesity prevalence at baseline (66.7% versus 38.0%), and no changes over time (62.0% versus 37.4% at follow up, p = 0.157). Ka Ora, Ka Ako has resulted in improvements in eating patterns, but longer duration is needed to determine the impact on overweight/obesity.