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Background  Evidence for whether the nutrient intakes of Japanese schoolchildren differ according to household income is sparse.    Objective  We investigated the role of school lunches for nutrient adequacy among Japanese primary school children using dietary reference intakes in a cross-sectional survey.    Design  Participants were 10- to 11-year-old (5th grade) children from 19 public primary schools in four prefectures of East Japan, and 836 children were analyzed. The participants completed 24-h dietary records with photographs of their meals for 4 consecutive days, composed of 2 days with and 2 days without a school lunch. −Children’s household income was obtained from questionnaires that were completed by the participants’ guardians and divided into the following three categories: low (0.2236–2.2361 million yen;  n  = 319), middle (2.3333–2.8868 million yen;  n  = 194), and high (3.1305–6.3640 million yen;  n  = 323). Logistic regression analyses were used to estimate the odds ratios for whether participants had poor nutrient intakes, with adjustment for confounders.    Results  On days without a school lunch, the prevalence of nutrient shortages was significantly higher compared with those on days with a school lunch for most macro- and micronutrients among all three levels of household income. Children from low-income households had higher rates of nutrient shortages for vitamin B 6 , pantothenic acid, K, Mg, P, Fe, and Zn than those from middle-income households on days without a school lunch ( P  = 0.004, 0.001, 0.001, 0.006, 0.037, <0.001, and 0.015, respectively), but those differences were not significant on days with a school lunch.    Conclusion  The findings suggest that school lunches are important for achieving adequate nutrient intakes in schoolchildren and reduce disparities of adequate nutrient intake by household income levels.

Nutrient adequacy of Japanese schoolchildren on days with and without a school lunch by household income