Objective: To review and synthesize existing national and state organizations' policies related to the nutritional quality of snacks served in after-school programmes (ASP; 15.00-18.00 hours) in the USA.
Design: Systematic review of websites and corresponding documentation describing national and state-level ASP organizations' policies, standards, guidelines and/or recommendations for the nutritional quality of snacks served within the ASP setting.
Setting: ASP can play a critical role in a child's daily dietary intake. State and national organizations have developed policies to assist ASP in selecting nutritionally appropriate snacks, yet no widely accepted standards exist. By reviewing the extent of existing policies, recommendations for uniform policies can be made.
Subjects: Policy documentation.
Results: A total of seventeen organizations representing five unique snack policies comprised of thirteen different food items were identified. The most widely recognized snack policy, which the majority of state and national ASP organizations endorsed and upon which other snack policies were modelled, was the US Department of Agriculture reimbursement programmes. Consistently, policies endorsed serving fruits/vegetables, whole grains and milk/dairy products, and limiting foods high in fats/sugar/energy (calories). Two policies focused predominantly on total energy and macronutrient composition of snacks, a single policy suggested limits on sugar-sweetened beverages, and three endorsed serving water daily. A proposed set of general guidelines for ASP was developed based on uniformity in recommendations across policies.
Conclusions: The proposed set of nutritional guidelines will assist policy makers and ASP providers in selecting and serving nutritionally appropriate snacks that contribute to a child's overall healthful daily dietary intake.