Examining the literature on school-based nutrition in the republic of Malta: A scoping review
Basil H Aboul-Enein, Nada Benajiba, Suha Ballout, Patricia J Kelly, Laura E CoatsBackground
Malta has one of the highest rates of childhood overweight and obesity in Europe despite its Mediterranean setting
Methods
Using the PRISMA-ScR guidelines and the Arksey and O’Malley framework, a scoping review was conducted across 14 academic databases for literature published between 2000 and March 2026 to identify school-based nutrition studies in Malta. Eligible research included in this review examined nutrition-related activities or outcomes involving Maltese school-aged children, parents, or educators.
Results
This scoping review identified nine studies published between 2011 and 2024 that met the inclusion criteria. Most studies were cross-sectional, pilot, feasibility, quasi-experimental, or pre-post designs. Research addressed dietary assessment tools, nutrition education, parental and teacher perspectives, lifestyle behaviors, supplementation, and school-based interventions. Multicomponent interventions integrating nutrition education with environmental modifications, parental involvement, and physical activity reported some favorable changes in dietary intake and body composition; however, the small number and varied designs of the studies limit comparisons with single-component approaches. Parents and educators recognized the importance of healthy school environments but identified barriers including unhealthy food availability, limited educational resources, and insufficient nutrition training. Culturally adapted dietary assessment tools were found to be feasible and appropriate for Maltese children, although additional refinement may be needed for large-scale surveillance.
Conclusions
School-based nutrition research in Malta remains limited in scope and study design. The included studies identify promising approaches and important gaps, but do not establish the comparative effectiveness of school nutrition strategies. Future research should prioritize rigorous intervention trials, longitudinal evaluations, and studies of school nutrition policies and food environments.