Mexico is a middle income country in which the dual burden of obesity and undernourishment is highly present. To address these challenges in the context of regional diversity, Mexico has been gradually adapting its school feeding programme, which serves breakfast to over 6 million schoolchildren. The School Breakfast programme has been transformed from a centrally managed one, covering only some States to a decentralized national programme that covers about a quarter of elementary school students. Programme quality is ensured through coordination and guidelines at the national level, emphasizing nutritional content. Decentralization has allowed Mexico to build an affordable, manageable and locally appropriate programme.