A randomized controlled trial of the effect of school food and dining room modifications on classroom behaviour in secondary school children

Background/Objectives: Adequate nutrition is considered important for learning, but there is little robust research on the association between diet and learning in school-aged children in industrialized countries. This study investigated the effect of tailored modifications to the food and dining experience in secondary schools on learning-related behaviours. Subjects/Methods: In 2008, 12 co-educational secondary schools in England were recruited. Schools were randomly allocated to receive a tailored action plan and support to modify their food provision and dining environment over a 15-week period (intervention or to control). Learning-related behaviours were systematically observed during post-lunchtime classes at all schools. Observations were made by trained observers using a validated protocol to determine whether pupils were 'on-task' (concentrating and alert) or 'off-task' (disruptive or disengaged). Results: In total, 156 pupils were observed (control n = 58, intervention n = 98) at baseline (12 210 and 20 560 observations, control and intervention, respectively) and at follow-up (16 846 and 23 462, respectively). On-task and off-task behaviours were similar across treatment groups at baseline. At follow-up, intervention group pupils were 18% more likely to be on-task (odds ratio (OR) 1.18, 95% confidence interval ((95% CI) 1.05-1.33) and 14% less likely to be off-task (OR 0.86, 95% CI 0.75-0.98) compared with control group pupils. Conclusions: This study suggests that modifying food provision and the dining environment can improve learning-related behaviours of secondary school pupils in the post-lunch period. This finding supports ongoing investment and interventions by local authorities across the United Kingdom to improve school food and lunchtime dining facilities. European Journal of Clinical Nutrition (2011) 65, 32-38; doi:10.1038/ejcn.2010.227; published online 27 October 2010