Public Primary School Compliance with School Canteen Policy in Riyadh, Saudi Arabia: A Cross-Sectional Study

<b>Background/Objectives:</b> The Ministry of Health and Education in Saudi Arabia established school canteen guidelines that have been mandatory since 2014. Only one previous study has investigated the compliance of public high schools with these guidelines. The aim of this study is to explore public primary school compliance with the school canteen policy guidelines set by the Saudi Ministry of Health and Education. <b>Methods:</b> A cross-sectional study with a total of 80 public primary schools randomly selected from five regions in Riyadh, Saudi Arabia, was conducted. School canteens were explored using a school canteen checklist provided by the Ministry of Education. The checklist contains a list of items grouped into healthy and unhealthy foods. A final assessment for alignment with the checklist was classified as either poor, average, or good. Canteen staff were provided with a structured questionnaire on the day of the school visit to gather their opinions and feedback regarding the canteen. <b>Results:</b> A total of 70% of schools showed an average rating for alignment with the Ministry of Health and Education guidelines; however, most of the items available in canteens were unhealthy. The canteen staff recommended adding healthier options like milk, fruit, and vegetables to school canteens. Furthermore, canteen staff reported issues in regard to expensive foods and a lack of choice in healthy food options. <b>Conclusions:</b> This study has shown that public primary schools in Riyadh, Kingdom of Saudi Arabia (KSA), have an average rating alignment with the Ministry of Health and Education's school food policy guidelines. This study highlights the need for improvement in the Saudi Ministry of Education's checklist, particularly regarding the availability of healthy foods, including milk, fruits, vegetables, and other nutritious items.