Abstract

Objective: To examine approaches for managing school menus for special diets in Italy, highlighting regional variations and proposing strategies for improvement.

Materials and Methods: An online survey was developed by dietitians with expertise in ketogenic dietary therapies (KDTs) (n=2), inherited metabolic disorders (IMDs) (n=5), both KDTs and IMDs (n=1) and food services (n=2). The survey was distributed via e-mail to dietitians affiliated with the Technical Scientific Association of Food, Nutrition and Dietetics (ASAND) and with the Nutrition and Dietetics working group of the Italian Society for the Study of Inborn Errors of Metabolism and Newborn Screening (SIMMESN). The questionnaire included sections tailored to food service and clinical dietitians.

Results: A total of 165 dietitians participated, with 41% working in school food services and 21% specializing in IMDs or KDTs. Both clinical and food service dietitians reported challenges in managing IMD diets; ketogenic diets were perceived as significantly more complex, particularly by clinical dietitians. Major barriers included inadequate staff training in school food service, a lack of standardized protocols, and limited availability of specialized foods. Participants emphasized the importance of interdisciplinary collaboration, training programs, and standardized guidelines in improving school meal management.

Conclusions: Ensuring appropriate school nutrition for children with metabolic disorders is essential. Addressing existing gaps through policy development, professional training, and interdisciplinary collaboration is critical to optimizing dietary management and fostering inclusive school environments.