Cross-sectional study of prepared foods sold in Indonesian school canteens to inform childhood obesity programs and policies

Childhood obesity is an increasing concern in Indonesia, yet little is known about the content and sources of foods offered in Indonesian school food environments. This study aimed to examine the composition and preparation of foods sold in primary school canteens, and to identify potential modifications to address diet-related obesity risk. A cross-sectional survey of canteen vendors (<i>n</i> = 10) and structured observations of prepared foods (<i>n</i> = 112) sold in canteens were conducted across eight private and public primary schools in Central Java, Indonesia. Foods were categorized by food group, preparation method, and meal type, and associations with factors such as cost, location of sale, and the individual responsible for preparation were analysed using chi-square and <i>t</i>-test analyses. Among all prepared foods observed, 73.2% were classified as main meals and 26.8% as desserts, with parents often playing a central role in food preparation. Nearly half (47.3%) of non-beverage items were deep-fried, and the majority of dishes did not align with Indonesian Balanced Nutrition Guidelines. A compositional analysis of each main meal's ingredients revealed that 29.3% lacked protein and 90.2% did not contain vegetables. Foods that were not deep-fried were priced significantly higher than deep-fried foods (x̄ = Rp.1846 ($0.11) vs Rp.1406 ($0.09); <i>p</i> < 0.001). Overall, the majority of prepared foods available to schoolchildren were low in nutritional quality, with limited fruits and vegetables and heavy reliance on frying. These findings highlight the need for strategies that combine parent education on healthy food preparation with economic incentives to increase the accessibility of healthier food options within Indonesian school canteens.