OPUS School Meal Study

March 3, 2017 updated by: Arne Astrup

OPUS(Optimal Well-being, Development and Health for Danish Children Through a Healthy New Nordic Diet) School Meal Study

The aim of this randomized crossover study, is to investigate the effect of school meals based on a sustainable New Nordic Diet on growth, learning abilities, well-being, sleep quality, physical activity and risk markers of cardiovascular disease (CVD), type II diabetes and osteoporosis in 8-11 year old Danish school children.

The participating 3rd and 4th grades on 9 selected primary schools will be randomized to either start receiving New Nordic Diet school meals for 3 month(mo) or to eat their habitual school lunch for 3 mo and then crossover for additional 3 mo. All participants will be examined three times; at baseline, after 3 mo and after 6 mo.

Study Overview

Study Type

Interventional

Enrollment (Actual)

834

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Copenhagen, Denmark, 1958
        • Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

8 years to 11 years (Child)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Pupils in 3rd and 4th grades
  • Primary Schools in the Zealand Region and Capital Region of Denmark
  • Schools with an available school kitchen, that can be approved by the food authorities
  • Schools where at least 60 % of the pupils in three or more classes signs up to participate in the Study

Exclusion Criteria:

  • The children should not participate in a scientific study or have participated in a scientific study within the last 4 weeks. This, however depends on the character of the other study.
  • The children must not suffer from serious food allergies or food intolerance.
  • The children must not suffer from diseases or conditions that makes them ill-suited for participation in the study, eg. malabsorptive conditions or serious mental disorders
  • The Schools must not offer an well-established common meal plan, that provides most of the pupils with healthy food on a daily basis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: NewNordicDiet first
Intervention with NND for 3 mo then no intervention for 3 mo
The study participants are provided with three daily school meals for 3 month
Other: NewNordicDiet last
No intervention for 3 mo and then intervention with NND for 3 mo
The study participants are provided with three daily school meals for 3 month

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Metabolic syndrome score
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
The metabolic syndrome score is a continuous z-score based on individual z-scores for waist circumference (WC), mean arterial pressure (MAP), serum high density lipoprotein (HDL), Serum triglyceride (TG) and Homeostasis Model Assessment (HOMA) index. It´s an internal score meaning that the basis for the score is the distribution of values in this study population at baseline.
Change during 3 month of intervention compared with change during 3 month control period
Concentration Performance
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Concentration Performance is assessed by means of a concentration test called the D2-test of Attention. Concentration Performance is derived from the number of correctly crossed out relevant items minus the errors of commission (confused).
Change during 3 month of intervention compared with change during 3 month control period

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Early Cardiovascular Risk Markers
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Systolic and diastolic blood pressure, serum blood cholesterol (total, Low Density Lipoprotein (LDL), Very Low Density Lipoprotein (VLDL) and HDL) and TG, plasma glucose, serum insulin and the HOMA index.
Change during 3 month of intervention compared with change during 3 month control period
Other metabolic syndrome scores
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Other metabolic syndrome scores will be calculated as continuous z-scores based on each of the individual z-scores for Waist Circumference (WC), Mean Arterial Pressure (MAP), serum High Density Lipoprotein (HDL), serum Triglyceride (TG) and insulin, separately, and possibly with weighted contribution of each of the risk markers to the score.
Change during 3 month of intervention compared with change during 3 month control period
Inflammatory markers
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Plasma concentrations of the cytokines Interleucin-6 (IL-6) and Tumor Necrosis Factor (TNF) alfa, the adipokine adiponectin and the acute-phase protein c-reactive protein (CRP) (measured as high-sensitive) in plasma will be used as markers of subclinical inflammation and related to the other early metabolic syndrome and cardiovascular risk markers.
Change during 3 month of intervention compared with change during 3 month control period
Illnesses and use of medicine
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Self-reported data collected by computer-assisted questionnaire interview with the parents, either personal (month 0) or by telephone (month 3 and 6). Outcomes are the number of days, during the last two weeks, with: asthma symptoms, use of asthma-medicine, hay-fever symptoms, use of hay-fever-medicine, atopic eczema, symptoms such as sore throat or fever, and the use of pain killers or antibiotics. The number of days of absence from school due to illness, the number of days of illness during weekends and holidays, and number of visits to the doctor will also be evaluated.
Change during 3 month of intervention compared with change during 3 month control period
Use of ADHD medicine
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Among those children with a diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD), the mean daily dose of methylphenidate (based on reported intake of drugs containing this substance) during the last two weeks will be evaluated.
Change during 3 month of intervention compared with change during 3 month control period
General fatty acid composition of whole-blood
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Content of saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, total n-3 and n-6 polyunsaturated fatty acids and the n-6:n-3 ratio in whole-blood measured as weight% relative to the weight of total fatty acids.
Change during 3 month of intervention compared with change during 3 month control period
Reading proficiency
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Reading proficiency is assessed by means of the Danish Sentence Reading test 2 having two measures: Percentage of correct sentences read within eight minutes. Reading speed - number of sentences reached.
Change during 3 month of intervention compared with change during 3 month control period
Mathematics proficiency
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Mathematics proficiency is assessed by means of the Danish MG test for 3rd and 4th grade. They each have one measure: Number of correct results within 45 minutes.
Change during 3 month of intervention compared with change during 3 month control period
Learning
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Student learning is assessed by means of the Danish LRS Learning Rating Scale filled out by students. The scale contains four subscales and one combined scale (sum score) adding the four subscales. The subscales cover: academic learning, social situation in school, teaching style appropriateness, and school expectations.
Change during 3 month of intervention compared with change during 3 month control period
Wellness
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Student wellness is assessed by means of the Danish WRS Wellness Rating Scale filled out by students. The scale contains five subscales and one combined scale (sum score) adding the five subscales. The subscales cover: Living environment, school, school mates, family, and self concept.
Change during 3 month of intervention compared with change during 3 month control period
Physical activity
Time Frame: Change during 3 month of intervention compared with change during 3 month control period

Physical activity is measured using actigraphy. Outcome measures will be counts/min, time spent in sedentary, light, moderate and vigorous activities.

Questions regarding TV-watching, playing with videogames and physical activity, will help identify activity-pattern.

Change during 3 month of intervention compared with change during 3 month control period
Sleep
Time Frame: Change during 3 month of intervention compared with change during 3 month control period

Sleep is measured using actigraphy with the monitor placed on the right hip for all students and on the non-dominant wrist for a sub-sample. Using a sleep diary, total sleep time and sleep efficiency will be derived from these actigraphy measurements.

In addition, at month 0, the abbreviated version of the Children's Sleep Habits Questionnaire (CSHQ) is used to identify sleep problems.

Change during 3 month of intervention compared with change during 3 month control period
Fitness
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Fitness is measured using the Andersen test, which is an intermittent running test to estimate maximal oxygen uptake (mL*min-1*kg-1).
Change during 3 month of intervention compared with change during 3 month control period
Dietary intake
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Dietary intake is measured as micro-and macronutrients as well as food groups (e.g. fish and fruit/vegetables) by means of a 7-day dietary survey, which is a web based recall record method developed especially for children. Families without internet access can use a paper version of a 7-day dietary survey. The meal time perception is measured as well.
Change during 3 month of intervention compared with change during 3 month control period
Body weight and body mass index (BMI)
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Body weight (in kg, BMI and BMI z-score calculated on the basis of the current references from the World Health Organization (WHO)
Change during 3 month of intervention compared with change during 3 month control period
Body composition
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Body composition will be determined by Dual energy X-ray Absorptiometry (DXA) scanning. The parameters included are total body Fat Free Mass Index (FFMI in kg/m2), total body Fat Mass Index (FMI in kg/m2), total body fat percentage and the ratio between android and gynoid fat mass in kg.
Change during 3 month of intervention compared with change during 3 month control period
Appetite-regulating hormones
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Leptin and ghrelin. If resources are available at the end of the study period, ghrelin will be separated in acylated and deacylated ghrelin, and both the effect of the intervention on total, acylated, deacylated and the ratio between acylated:deacylated ghrelin will be assessed. If the resources are too tight at the end of the study, only total ghrelin will be used.
Change during 3 month of intervention compared with change during 3 month control period
Vitamin D status
Time Frame: Baseline and change during 3 month of intervention compared with change during 3 month control period
Serum concentrations of 25-hydroxyvitamin D [25(OH)D] will be used as marker of vitamin D status, related to food intake and time of season.
Baseline and change during 3 month of intervention compared with change during 3 month control period
Bone Health
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
Bone Health will be evaluated by DXA scanning (total body and spine Bone Mineral Content (BMC), Bone Mineral Density (BMD), and Bone Area (BA). Osteocalcin and serum Parathyreoideahormon (PTH) are also included as markers of bone health.
Change during 3 month of intervention compared with change during 3 month control period
General fatty acid composition in whole-blood
Time Frame: Change during 3 month intervnetion compared with change during 3 month control period
Change during 3 month intervnetion compared with change during 3 month control period
Iron status
Time Frame: Change during 3 month intervention compared with 3 month control period
Whole-blood hemoglobin and serum ferritin will be used as measures of iron status
Change during 3 month intervention compared with 3 month control period
Attention - other measures
Time Frame: Change during 3 month of intervention compared with change during 3 month control period

The following five measures from the attention test D2 will be used:

TN=Total Number of items processed E%=Percentage of errors

Change during 3 month of intervention compared with change during 3 month control period
Omega-3 index in whole-blood
Time Frame: Change during 3 month of intervention compared with change during 3 month control period
The Omega-3 index in whole-blood is defined as the weight percentage of eicosapentaenoicacid + the weight percentage of docosahexaenoic acid in whole-blood
Change during 3 month of intervention compared with change during 3 month control period

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Genotyping
Time Frame: Baseline
SNPs in genes related to metabolic pathways, messenger molecules, receptors or other genes that may affect efficacy measures in OPUS School Food Project
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2011

Primary Completion (Actual)

June 1, 2012

Study Completion (Actual)

June 1, 2012

Study Registration Dates

First Submitted

October 20, 2011

First Submitted That Met QC Criteria

October 20, 2011

First Posted (Estimate)

October 24, 2011

Study Record Updates

Last Update Posted (Actual)

March 6, 2017

Last Update Submitted That Met QC Criteria

March 3, 2017

Last Verified

March 1, 2017

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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