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Maternal and pediatric nutrition

Differences in the effects of school meals on children’s cognitive performance according to gender, household education and baseline reading skills

European Journal of Clinical Nutrition volume 70, pages 1155–1161 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

We previously found that the OPUS School Meal Study improved reading and increased errors related to inattention and impulsivity. This study explored whether the cognitive effects differed according to gender, household education and reading proficiency at baseline.

Subjects/Methods:

This is a cluster-randomised cross-over trial comparing Nordic school meals with packed lunch from home (control) for 3 months each among 834 children aged 8 to 11 years. At baseline and at the end of each dietary period, we assessed children’s performance in reading, mathematics and the d2-test of attention. Interactions were evaluated using mixed models. Analyses included 739 children.

Results:

At baseline, boys and children from households without academic education were poorer readers and had a higher d2-error%. Effects on dietary intake were similar in subgroups. However, the effect of the intervention on test outcomes was stronger in boys, in children from households with academic education and in children with normal/good baseline reading proficiency. Overall, this resulted in increased socioeconomic inequality in reading performance and reduced inequality in impulsivity. Contrary to this, the gender difference decreased in reading and increased in impulsivity. Finally, the gap between poor and normal/good readers was increased in reading and decreased for d2-error%.

Conclusions:

The effects of healthy school meals on reading, impulsivity and inattention were modified by gender, household education and baseline reading proficiency. The differential effects might be related to environmental aspects of the intervention and deserves to be investigated further in future school meal trials.

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Acknowledgements

We thank all of the schools, teachers, children and their families for their interest and participation in the study and the biotechnicians, interns, students and scientific staff for their great contribution. We also owe a special thanks to Bente Maribo for administering the d2-test of attention and for the extensive work on correcting tests. The OPUS project ‘Optimal well-being, development and health for Danish children through a healthy New Nordic Diet’ was supported by a grant from the Nordea Foundation (Grant No. 02-2010-0389). Danæg A/S, Naturmælk, Lantmännen A/S, Skærtoft Mølle A/S, Kartoffelpartnerskabet, AkzoNobel Danmark, Gloria Mundi and Rose Poultry A/S provided foods in kind for the study. Sources of funding and donation had no role in design, analysis or writing of this article.

Author contributions

AA and KFM conceived the work. LBS, CTD, RAP, SMD, MFH, CBD, NE, IT and KFM designed the work that led to submission and acquired data. LBS, LL and KFM played an important role in interpreting the results. LBS drafted the manuscript. All authors revised the manuscript and approved the final version.

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Authors and Affiliations

  1. Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark

    L B Sørensen, C T Damsgaard, R A Petersen, S-M Dalskov, M F Hjorth, A Astrup, L Lauritzen & K F Michaelsen

  2. Department of Education, Faculty of Arts, Aarhus University, Copenhagen, Denmark

    C B Dyssegaard & N Egelund

  3. Division of Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark

    I Tetens

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  1. L B Sørensen
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Correspondence to L B Sørensen.

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Competing interests

AA has received royalties from sale of New Nordic Diet cookbooks from FDB/Coop. All other authors have no conflicts of interest.

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Sørensen, L., Damsgaard, C., Petersen, R. et al. Differences in the effects of school meals on children’s cognitive performance according to gender, household education and baseline reading skills. Eur J Clin Nutr 70, 1155–1161 (2016). https://doi.org/10.1038/ejcn.2016.99

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