Determinants of the Availability of Special Diet Meals in Public Schools from Kraków (Poland): A Cross-Sectional Analysis

<b>Background/Objectives:</b> Special diets can be required for medical, religious, cultural, or ethical purposes. This study examined the relationship between the organization of school nutrition and the availability of special diet meals among students in public primary and secondary schools in Kraków (Poland). <b>Methods:</b> An observational study was conducted in 2022 using a web-based survey targeting managers of primary (<i>n</i> = 68) and secondary schools (<i>n</i> = 18), as well as parents of attending students (<i>n</i> = 1730). Factors associated with providing special diets were analyzed using generalized linear models with robust variance estimators. <b>Results</b>: According to school managers, the availability of special diet meals was associated with employing a dietitian responsible for menu planning, the presence of students with disability certificates, students' participation in school meal programs, and higher per-child nutrition costs. Based on parental reports, 16.01% of all students followed a special diet, most often due to medical recommendations, with a higher prevalence observed among secondary school students (26.7%). Special diets were reported more frequently for children with food intolerances and allergies, obesity, chronic conditions, or disability certificates. Adjusted models also indicated slightly higher probabilities of being on a special diet among students attending secondary schools or sports classes compared with their peers. <b>Conclusions</b>: Improving the availability of special diet meals in schools requires legislative action, adequate funding, and institutional support, including investments in kitchen infrastructure and the employment of dietitians. These measures are particularly important in institutions enrolling children with disabilities to ensure equitable access to appropriate nutrition.