title: Associations between school meal-induced dietary changes and metabolic syndrome markers in 8-11-year-old Danish children.
abstract: OBJECTIVE
  We recently showed that provision of Nordic school meals rich in fish, vegetables and potatoes and with reduced intakes of fat improved blood pressure, insulin resistance assessed by the homeostatic model (HOMA-IR), and plasma triacylglycerol despite increasing waist circumference in Danish 8-11-year-olds. This study explored whether intake or biomarkers of key dietary components in the schools meals were associated with these metabolic syndrome (MetS) markers during the 6-month intervention.
  
  
  METHODS
  Data from 7-day dietary records and measurements of whole-blood docosahexaenoic acid (DHA, 22:6n-3), blood pressure, fasting blood MetS markers, waist circumference and android/total fat mass assessed by dual-energy X-ray absorptiometry collected at baseline, 3 and 6 months from 523 children were analyzed in linear mixed-effects models adjusted for puberty, growth and fasting.
  
  
  RESULTS
  After adjustment for multiple testing, whole-blood DHA was negatively associated with HOMA-IR (P < 0.001) and triacylglycerol (P < 0.0001). Potato intake was positively associated with waist circumference (P < 0.01), but not with android/total fat mass (P = 0.94). Intakes of whole-grain as well as dietary fiber, protein and fat were not associated with any of the MetS markers.
  
  
  CONCLUSIONS
  DHA in whole-blood, an indicator of DHA and fish intake, seemed to be the main diet-related predictor of the beneficial effects of the school meals on MetS markers. Increased potato intake was associated with increased waist circumference, but this may not only be due to an increase in abdominal fat, as no association was seen with fat distribution.
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark. ctd@nexs.ku.dk.
authors.forename: Camilla T
authors.initials: CT
authors.lastname: Damsgaard
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Ritz
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Stine-Mathilde
authors.initials: SM
authors.lastname: Dalskov
authors.affiliation: Department of Food Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.|Nutritional Epidemiology Unit, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Rikard
authors.initials: R
authors.lastname: Landberg
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Ken D
authors.initials: KD
authors.lastname: Stark
authors.affiliation: Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Biltoft-Jensen
authors.affiliation: Division of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark.
authors.forename: Inge
authors.initials: I
authors.lastname: Tetens
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Arne
authors.initials: A
authors.lastname: Astrup
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Kim F
authors.initials: KF
authors.lastname: Michaelsen
authors.affiliation: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: Lotte
authors.initials: L
authors.lastname: Lauritzen
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D016000:Cluster Analysis; D018592:Cross-Over Studies; D003718:Denmark; D000072001:Diet, Healthy; D004043:Dietary Fiber / Q000008:administration & dosage / Q000032:analysis; D004281:Docosahexaenoic Acids / Q000097:blood; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005399:Fishes; D005522:Food Services; D005638:Fruit; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D062407:Meals; D024821:Metabolic Syndrome / Q000097:blood*; D012574:Schools; D017747:Seafood; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D014675:Vegetables; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004043:Dietary Fiber; D014280:Triglycerides; D004281:Docosahexaenoic Acids
keywords: Alkylresorcinols; Child; Metabolic syndrome; Nordic; n-3 PUFA