School lunch is in general regulated through policies and agendas constituted by the perspectives of adults. In this article, we focus on children's lived experiences of school lunch with a special emphasis on emotions and how they relate to social and physical dimensions. This study draws on empathy-based stories written by 10-11 year olds (n = 171) from schools in Sweden. We identified three themes: Interaction and exposure, Routines and restrictions and Food and eating. The children's lived experiences of school lunch and the emotions attached to them are closely associated and intertwined with the socio-spatial dimension of school lunch. A pleasant meal experience seems to require harmonization between the physical and social space whilst negative experiences contain tensions between them, something that actors working with school lunch and school lunch environments should take in consideration when resourcing, planning and scheduling school lunch, and also when designing new school restaurants. ARTICLE HISTORY

Background— In the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study, repeated dietary counseling introduced in infancy and maintained until 20 years of age has led to lower intakes of saturated fat and serum low-density lipoprotein cholesterol. In this study, we examined prospectively the intervention effects on the ideal cardiovascular health concept recently described by the American Heart Association. Additionally, we investigated the association between the concept and vascular intima-media thickness and elasticity in adolescence. Methods and Results— In adolescents participating in the longitudinal, randomized, atherosclerosis-prevention STRIP study, complete data on ideal cardiovascular health metrics were available at 15 (n=394), 17 (n=376), and 19 (n=298) years of age. Aortic intima-media thickness and elasticity were measured with ultrasonography at the same ages. None of the adolescents had all 7 ideal cardiovascular health metrics. At least 5 ideal metrics was found in 60.2%, 45.5%, and 34.2% of the adolescents at 15, 17, and 19 years of age, respectively. Adolescents in the control group had an increased risk of low ideal cardiovascular health (≤3 metrics) compared with the intervention adolescents (risk ratio=1.35; 95% confidence interval=1.04–1.77). The number of ideal cardiovascular health metrics was inversely associated with aortic intima-media thickness ( P <0.0001) and directly associated with elasticity ( P =0.045). The risk of having high intima-media thickness (>85th percentile) was nearly 2-fold in adolescents with a low number of metrics (≤3) compared with those with a higher score (risk ratio=1.78; 95% confidence interval=1.31–2.43). Conclusions— Ideal cardiovascular health as determined by the AHA can be promoted in adolescents. The ideal cardiovascular health concept is beneficially associated with vascular health already in adolescence, supporting the relevance of targeting these metrics as part of primordial prevention. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00223600

Background-We previously showed that low-saturated-fat dietary intervention from infancy until 5 years of age safely and effectively reduced serum cholesterol concentration. We now report how such intervention influenced serum lipids, LDL particle size, and HDL subfractions in children when they reached the age of 7 years. Methods and Results-Healthy 7-month-old infants (nϭ1062) were randomized to the intervention (nϭ540) and control (nϭ522) groups. Each year, two individualized counseling sessions were organized to the intervention families. Serum lipid values were measured annually. The intervention boys had 0.20 to 0.39 mmol/L lower serum cholesterol values than the control boys throughout the follow-up (always PϽ0.05), but the values of the intervention and control girls did not differ. The LDL particle sizes and HDL subfractions were determined in a random subgroup of 96 intervention and 101 control children at the age of 7 years. The mean particle diameter of major LDL peak was 262.6 Å in the intervention boys and 258.5 Å in the control boys (Pϭ0.05), and 259.2 Å in the intervention girls and 261.3 Å in the control girls (Pϭ0.30). HDL 2 and HDL 3 cholesterol concentrations did not differ between the intervention and control children or between the two genders. Conclusions-The 7-year intervention favorably influenced not only the serum total and LDL cholesterol concentrations but also the LDL particle size in boys. LDL particle size remained unchanged in girls, as did HDL 2 and HDL 3 concentrations in both genders. (Circulation. 2003;108:672-677.)

Objective: To assess prospectively the consumption of fruit and vegetables and its' correlation to the parental consumption in boys and girls taking part in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study). Hypothesis: Nutrition counselling focused on cardiovascular health effects vegetable and fruit consumption. Design: A prospective, randomised, clinical trial. Subjects: Children were recruited to the STRIP study between 1989 and 1992. At the age of 7 months, children were randomised to the intervention (n ¼ 540) or the control group (n ¼ 522) and were followed up until the age of 11 years. Intervention: Families in the intervention group have, since randomisation, received biannual individualised dietary counselling aimed at reduction of cardiovascular risk factors, especially saturated fat intake. Food records were used to assess fruit and vegetable consumption of children and parents. Results: The percentage of total energy intake provided by fruit and vegetables decreased when the children grew older (P for age o0.001). The 1-to 10-year-old intervention boys consumed more vegetables (mean difference 3.18 g/day; CI 1.48-4.86; Po0.001) and fruit (mean difference 10.1 g/day; CI 5.28-14.94; Po0.001) than did the control. Mother's consumption correlated with the consumption of their daughters and sons, whereas father's consumption correlated only with the consumption of their sons. Conclusions: Finnish children taking part in the atherosclerosis prevention study had a remarkably low fruit and vegetable consumption, which furthermore decreased with age. The children's consumption correlated with the parental consumption, except between boys and mothers. A slight intervention effect was present only among boys.

No abstract

Objective: To evaluate the longitudinal impact of dietary counseling on children's nutrient intake.Design: A prospective, randomized, clinical trial.Participants: Children were recruited to the study between December 1, 1989, and May 30, 1992. At the age of 7 months, children were randomized to the intervention group (n= 540) or the control group (n =522) and were followed up until the age of 10 years.Intervention: Families in the intervention group have, since randomization, received regularly individualized counseling about how to modify the quality and quantity of fat in the child's diet, the goal being an unsaturatedsaturated fat ratio of 2:1.

Objective: To examine the effects of child-oriented dietary intervention on parental eating attitudes and dietary behaviour. Design: In the prospective, randomized Special Turku Coronary Risk Factor Intervention Project for Children (the STRIP study), a cohort of Finnish families took part in a nutritional intervention trial focused on the quality of their children's fat intake since the age of 8 months. Health-related and hedonic eating attitudes of the parents were measured after 10 years of dietary intervention using a validated Health and Taste Attitude Scales (HTAS) questionnaire (n 660). Parents' eating behaviour was studied using a 1 d food record (n 491). Setting: Finland. Subjects: Mothers and fathers (n 660) of the STRIP children. Results: The parents of the intervention families had a higher level of interest in healthy eating compared with control parents. The interest in natural products or hedonic eating attitudes did not differ between the groups. The parents' general health interest was associated with low saturated fat intake, fruit and vegetable consumption, fibre intake and seeking pleasure in eating, but it was not associated with BMI. The intervention also improved the quality of dietary fat among parents with the lowest level of interest in healthy eating. Conclusions: Parents' general health interest was associated with regular dietary counselling as well as with healthier food choice behaviour. However, the dietary intervention that focused especially on the quality of the child's fat intake also enhanced specific changes in the family's fat consumption without a high level of interest in healthy eating.

BackgroundSchool meals, if both nutritious and attractive, provide a unique opportunity to improve health equality and public health.ObjectiveTo describe the study rationale, data collection, and background of participants in the study ‘Prospects for promoting health and performance by school meals in Nordic countries’ (ProMeal). The general aim was to determine whether overall healthiness of the diet and learning conditions in children can be improved by school lunches, and to capture the main concerns regarding school lunches among children in a Nordic context.DesignA cross-sectional, multidisciplinary study was performed in Finland, Iceland, Norway, and Sweden on pupils (n=837) born in 2003.ResultsIn total 3,928 pictures of school lunches were taken to capture pupils’ school lunch intake. A mean of 85% of all parents responded to a questionnaire about socioeconomic background, dietary intake, and habitual physical activity at home. Cognitive function was measured on one occasion on 93% of the pupils during optimal conditions with a Stroop and a Child Operation Span test. A mean of 169 pupils also did an Integrated Visual and Auditory Continuous Performance Test after lunch over 3 days. In total, 37,413 10-sec observations of classroom learning behavior were performed. In addition, 753 empathy-based stories were written and 78 focus groups were conducted. The pupils had high socioeconomic status.ConclusionsThis study will give new insights into which future interventions are needed to improve pupils’ school lunch intake and learning. The study will provide valuable information for policy making, not least in countries where the history of school meals is shorter than in some of the Nordic countries.