Objective To analyze the leftover food situation among students in key monitored counties under the Rural Compulsory Education Student Nutrition Improvement Program in Henan province in 2021, and to provide scientific evidence for improving the current situation of food waste and strengthening nutrition and health education.

Methods In 2021, a stratified random cluster sampling method was used to select 4 832 primary and secondary school students from four key monitored counties implementing the Rural Compulsory Education Student Nutrition Improvement Program in Henan province. Their height and weight were measured, and a questionnaire survey was conducted to analyze their usual leftover food situation and the satisfaction of students who ate at school with the school meals.

Results Among the 4 832 surveyed students, 33.35% reported leftovers during their usual meals. Among those who had leftovers, the frequency of leftovers was mainly 1–4 days per week (46.64%), the amount of leftovers was mainly "only a little left" (74.52%), the types of leftovers were mainly staple foods (54.23%) and vegetables (42.69%), and the main reasons for leftovers were “too much food provided, couldn’t finish it” (38.56%) and “dislike this kind of food” (27.64%). Among the students who ate at school, 12.28% felt that the school meals were too salty, 22.98% felt that the school meals were too greasy, and only 32.49% liked the food provided by the school. Logistic regression analysis showed that township schools (OR=2.055, 95%CI: 1.645–2.567), middle school (OR=1.171, 95%CI: 1.015–1.352), and snacking frequency of 3–4 times/week (OR=1.934, 95%CI: 1.601–2.336) were risk factors for student leftovers, while non–boarding students (OR=0.567, 95%CI;0.477–0.672) and overweight/obesity (OR=0.830, 95%CI:0.717–0.961) were protective factors.

Conclusions There is a certain degree of leftover food among students in key monitored counties under the Rural Compulsory Education Student Nutrition Improvement Program in Henan province, and student satisfaction with the food provided by schools is low. School location, school level, boarding status, nutritional status, and snacking frequency are influencing factors for leftovers.