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.

A high inclusion rate and low drop out rate was achieved. This study will be the first to determine whether school meals based on the NND improve children's diet, health, growth, cognitive performance, and early disease risk markers.

Objective: To investigate changes in the consumption of fruits and vegetables in worksite canteens using the tools of continuous quality improvement, and to gain knowledge of practical strategies being effective in increasing the consumption. Design: Study design included baseline data collection, an 8 h training session for all canteen staff, goal setting, strategy development and implementation for each canteen, end-point data collection and a follow-up data collection 4 months from the end-point (1 year from baseline). The main outcome measurement was average grams of fruits and vegetables per lunch meal served per customer (net weight; potatoes not included). Setting: Five workplaces in Denmark: a military base, an electronic component distributor, a bank, a town hall and a waste-handling facility. Subjects: Work-site canteen managers, staff and customers. Results: There were significant increases in the total consumption of fruits and vegetables for all five work-site canteens from baseline to end-point, 70 g per customer on average (67, 54, 39, 88 and 103 g, respectively). The follow-up data collection showed that the canteens either maintained or significantly increased consumption, the average increase being 95 g per customer compared with baseline (77, 60, 86, 70 and 183 g, respectively). Conclusions: This study demonstrates a large potential for work-site canteens to increase customers' intake of fruits and vegetables at lunch and suggests a broad spectrum of strategies to compose meals that are both rich in fruits and vegetables and attractive to customers.

Objective: To analyse the 5-year sustainability of a worksite canteen intervention of serving more fruit and vegetables (F&V). Design: Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste. Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline, at end point and at 1-year follow-up. The intervention used a participatory and empowering approach, self-monitoring and networking among the canteen staff, management and a consultant. The method focused on providing ideas for increased F&V for lunch, making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options. Setting: Five Danish worksites serving from 50 to 500 meals a day: a military base, an electronic component distributor, a bank, a town hall and a waste-handling facility. Subjects: Worksite canteen managers, canteen staff. Results: Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day (18, 144, 66, 105 and 141 g, respectively). On average, the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer. Conclusions: The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach, self-monitoring, environmental change, dialogue with suppliers and networking among worksite canteens are applied.

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