Fe and n-3 long-chain PUFA (n-3 LCPUFA) have both been associated with cognition, but evidence remains inconclusive in well-nourished school-aged children. In the Optimal Well-Being, Development and Health for Danish Children through a Healthy New Nordic Diet (OPUS) School Meal Study, the 3-month intervention increased reading performance, inattention, impulsivity and dietary intake of fish and Fe. This study investigated whether the intervention influenced n-3 LCPUFA and Fe status and, if so, explored how these changes correlated with the changes in cognitive performance. The study was a cluster-randomised cross-over trial comparing school meals with packed lunch (control). At baseline and after each treatment, we measured serum ferritin, whole-blood n-3 LCPUFA and Hb, and performance in reading, mathematics and d2-test of attention. Data were analysed using mixed models (n 726) and principal component analysis of test performances (n 644), which showed two main patterns: 'school performance' and 'reading comprehension'. The latter indicated that children with good reading comprehension were also more inattentive and impulsive (i.e. higher d2-test error%). The intervention improved 'school performance' (P = 0·015), 'reading comprehension' (P = 0·043) and EPA + DHA status 0·21 (95 % CI 0·15, 0·27) w/w % (P < 0·001), but it did not affect serum ferritin or Hb. At baseline, having small Fe stores was associated with poorer 'school performance' in girls, but with better 'reading comprehension' in both boys and girls. Both baseline EPA + DHA status and the intervention-induced increase in EPA + DHA status was positively associated with 'school performance', suggesting that n-3 LCPUFA could potentially explain approximately 20 % of the intervention effect. These exploratory associations indicate that increased fish intake might explain some of the increase in reading performance and inattention in the study.Key words: School meals: Iron: n-3 PUFA: Cognitive performance: School performance Fe deficiency (ID) is one of the most prevalent nutrient deficiencies in the world, but it is mainly seen in high-risk groups -that is, infants, preschool-aged children and women (1) . Similarly, there is a potential risk of insufficient n-3 long-chain PUFA (n-3 LCPUFA) status in otherwise well-nourished children, as dietary intake is lower than recommended and endogenous synthesis is likely to be insufficient (2,3) . However, Fe and n-3LCPUFA are important nutrients for optimal brain development in childhood (4) . DHA (22 : 6n-3) is accumulated in the brain, and it has been shown to have an important role in neuronal growth, differentiation, myelination and monoamine neurotransmission (5,6) . Fish is the main source of n-3 LCPUFA, and maternal fish intake and blood DHA status during pregnancy has been associated with offspring neurological and cognitive development (7)(8)(9)(10) . that early n-3 LCPUFA intake may have beneficial effects on visual and cognitive development in early life (11) . In adolescents, fish consumptio...