Dietary effects of introducing school meals based on the New Nordic Diet - a randomised controlled trial in Danish children. The OPUS School Meal Study

The OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (NND)) School Meal Study investigated the effects on the intake of foods and nutrients of introducing school meals based on the principles of the NND covering lunch and all snacks during the school day in a cluster-randomised cross-over design. For two 3-month periods, 834 Danish children aged 8-11 years from forty-six school classes at nine schools received NND school meals or their usual packed lunches brought from home (control) in random order. The whole diet of the children was recorded over seven consecutive days using a validated Web-based Dietary Assessment Software for Children. The NND resulted in higher intakes of potatoes (130%, 95% CI 2.07, 2.58), fish (48%, 95% CI 1.33, 1.65), cheese (25%, 95% CI 1.15, 1.36), vegetables (16%, 95% CI 1.10, 1.21), eggs (10%, 95% CI 1.01, 1.19) and beverages (6%, 95% CI 1.02, 1.09), and lower intakes of bread (13%, 95% CI 0.84, 0.89) and fats (6%, 95% CI 0.90, 0.98) were found among the children during the NND period than in the control period (all, P<0.05). No difference was found in mean energy intake (P=0.4), but on average children reported 0.9% less energy intake from fat and 0.9% higher energy intake from protein during the NND period than in the control period. For micronutrient intakes, the largest differences were found for vitamin D (42%, 95% CI 1.32, 1.53) and iodine (11%, 95% CI 1.08, 1.15) due to the higher fish intake. In conclusion, the present study showed that the overall dietary intake at the food and nutrient levels was improved among children aged 8-11 years when their habitual packed lunches were replaced by school meals following the principles of the NND.