Background and aims Metabolic syndrome (MetS)-features are increasingly seen in childhood. Healthy school meals may help prevent lifestyle diseases from childhood, but well-designed trials are lacking. Aims We investigated the effect of providing school meals rich in fish, vegetables and fibre on MetS-markers in 8-11-year-olds at nine Danish schools without existing school meal programmes. Methods In a cluster-randomized cross-over design we assigned 834 third and fourth graders to school lunch and snacks based on the New Nordic Diet and usual home-packed lunch (control) for 3 months. We measured blood pressure, lipid profile, insulin resistance based on the Homeostasis Model of Assessment (HOMA-IR), anthropometry and body composition at baseline, month 3 and 6. Results Seventy-six% of the children were normalweight; 10% were underweight and 14% overweight/obese. The NND school meals did not affect a composite MetS-score but reduced diastolic blood pressure -0.5 mmHg (95% CI -1.0;-0.0), total cholesterol -0.05 mmol/L (-0.08;-0.02) (P=0.001), HDL cholesterol -0.02 mmol/L (-0.03;-0.00), triglyceride -0.02 mmol/L (-0.04;-0.00) (both P<0.05) and HOMA-IR -0.10 points (-0.16;-0.04) (P=0.001) compared to control in intention-to-treat-analyses (n=823). Waist circumference and BMI increased 0.5 cm (0.3;0.7) (P<0.001) and 0.03 kg/m2 (0.00;0.07) (P=0.03) relative to control, but BMI z-scores were not affected. Overall, complete-case-analyses and adjustment for parental education, puberty and physical activity confirmed these results. Conclusions Nutritionally balanced school meals improved blood pressure, plasma triglyceride and glucose homeostasis in 8-11-year-old children, despite small increases in BMI and waist circumference. OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) was funded by the Nordea Foundation.
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The 2nd international conference on nutrtion and growth, 2014