Food HabitsOPTIMATNCT04168632
Fostering Healthy and Sustainable Diets Through School Meals
A study testing OPTIMAT in people with Food Habits, run by Karolinska Institutet at 1 site in Sweden.
Trial summary
School meals have considerable potential to shape children's diets and reduce the climate impact of meals. This study applies linear programming for developing and implementing a climate friendly, nutritious and affordable school lunch menu. Read more about this study
- Who is it for?
- Ages 6 to 16 yearsHealthy volunteers can take part
- Conditions the study is for
- Food Habits
- What is being tested?
- OPTIMAT
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,635 participants
- Where
- 1 siteSweden
- Study dates
- 7 Feb 2019to 30 Aug 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 16 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Primary schools (year 0-9)
- The schools needed to have on-site kitchens
- The schools needed to be able to provide previously used recipes for a standard four-week menu electronically
Who cannot join
- Preschools or gymnasiums
- Schools receiving catered food
- Schools that could not provide recipes electronically
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Fostering Sustainable Dietary Habits Through Optimized School Meals - an Intervention Study
School meals have considerable potential to shape children's diets and reduce the climate impact of meals. This study applies linear programming for developing and implementing a climate friendly, nutritious and affordable school lunch menu. The new menu plan will be compared to the baseine menu during a 4-week intervention trial. The outcomes will be food waste, consumption, and pupils' satisfaction with the meals before and after introducing the new meal plan by interrupted time series analysis. Our hypothesis is that school meals can be optimized to be nutritious and more climate friendly, without negatively affecting acceptance, food waste and cost.
A number of primary schools in one Swedish municipality with the same menu plan for all schools participated in the study. Their current meal supply was recorded in the form of a food list including amount and cost of each item over a 4-week period. This list was then optimized with linear programming to be as similar as possible to the baseline diet but with a 40% reduction in greenhouse gas emissions. No new foods were introduced and none were removed from the list. Nutritionally adequacy was ensured by included constraints into the model. The optimized food list was handed to a professional meal planner and a new menu plan was developed based on the revised food list. Data on food waste and consumption was collected daily during a baseline period of four weeks, and during the four-week intervention period. School lunch satisfaction was assessed twice with an online questionnaire at baseline and during the intervention. After the end of intervention, students and meal staff were interviewed regarding their experiences with the new meals.
Read the detailed description
For a period of four weeks, during the spring term of 2019, Swedish primary school children received a new school lunch menu plan which was optimized through linear programming to be as similar to the baseline menu as possible with 40% lower in greenhouse gas emissions (GHGE), is nutritionally adequate, and not more expensive.
Primary schools in three municipalities in the Stockholm Region were invited to the trial via their chief meal strategist. To be included in the intervention, the schools had to have in-house food preparation (i.e. not serve catered food) and be able to provide recipes for a standard four-week menu plan electronically (critical for the optimization process). Three schools from one of the municipalities met inclusion criteria and were thus eligible to participate in the intervention.
Recipes for an original (baseline) four-week school lunch menu plan previously served at the recruited schools were obtained through the municipality's electronic meal planning system. Each food item included has a code that can be coupled to the national food database and a national climate database for foods (Research Institutes of Sweden). These foods were considered as the baseline food supply needed to compose a new four-week school lunch menu plan. The list of foods and amounts was optimized using linear programming to be as similar as possible to the baseline list. The optimized food list was then handed to a professional meal planner who developed a new menu plan for the intervention, using all foods in the optimized food list.
To assess the effect of the new menu plan, data on daily food waste and consumption was collected at school level in each intervention school four weeks before (baseline) as well as during the four-week intervention period with a 2-week brake between measurement periods. A tool for measuring food waste and consumption in school restaurants developed by the National Food Agency in Sweden was used. The tool required weighting of all kitchen waste (both preparation waste and cooking waste); all food prepared in the kitchen; the share of the prepared food that was served but not eaten by the pupils and had to be thrown away (serving waste); the share that could be saved for future meals; and plate waste. The daily number of plates used by the pupils in the school restaurant was also recorded. These measurements were made daily by the personnel in the school kitchens during baseline as well as during the intervention period.
Data on school meal satisfaction was measured through an online questionnaire at baseline and during the last week of the intervention. Pupils in grades 5 and 8 answered the questionnaire that contained ten questions related to the school lunch. Five of the ten multiple-choice questions specifically covered their general (i.e. not for that specific day of week) sense of satisfaction with the school lunch.
Six focus group discussions (FGD) with pupils in grades 5 and 8 and three FGDs with meal staff will be conducted to explore their experiences with the intervention as well as the barriers and facilitators to scaling up.
- Conditions
- Food Habits
- Being tested
- OPTIMAT
- Keywords
- children, public meals, sustainable diets, Agenda 2030
- Medical subject headings
- Feeding Behavior
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
OPTIMATOther
The intervention was to serve a new school lunch menu plan as similar as possible to a baseline menu plan but 40% lower in greenhouse gas emissions, being nutritionally adequate and no more expensive.
| Study group | Role | What they receive |
|---|---|---|
| Intervention | Experimental | A new 4-week menu plan Receives: Other: OPTIMAT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in food waste between baseline and intervention periods
Kitchen waste, serving waste, and plate waste, total per school and per pupil
Measured: During four weeks before the intervention period and during the four week intervention.
Change in food consumption between baseline and intervention periods
Food consumption, total per school and per pupil
Measured: During four weeks before the intervention period and during the four week intervention.
Change in school meal satisfaction between baseline and intervention periods
Pupils' rating of school meals with the "SkolmatSverige" student questionnaire (ten questions referring to the school lunch with face validity with a varying number of response options)
Measured: Once during the four weeks preceding the intervention as well as once during the last week of intervention.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Nov 2019
- Study start7 Feb 2019
- Primary completion30 May 2019
- Study completion30 Aug 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Food HabitsStudies of the same condition, open and under way.
- More trials run by Karolinska InstitutetThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Three schools from one municipality in the Region Stockholm met inclusion criteria and were eligible to participate in the intervention. These schools all served the baseline followed by the new menu. Each period lasted four weeks.
- Masking
- None (open label)
- Enrolment
- 1,635 participants (actual)
Sponsor and investigators
- Lead sponsor
- Karolinska Institutet
- Sponsor type
- University, hospital or other
- Collaborators
- The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (FORMAS), Göteborg University, University College Copenhagen
- Responsible party
- Principal investigator, Liselotte Schäfer Elinder, Karolinska Institutet
- Investigators
- Liselotte Schäfer Elinder, professor, Principal investigator, Karolinsk Institutet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04168632
- Sponsor's protocol ID
- 2016-00353
- Other IDs
- 2016-00353, 2016
- Acronym
- OPTIMAT
- Status last verified
- Jan 2022
- First submitted
- 14 Nov 2019
- Last updated
- 4 Feb 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Eustachio Colombo P, Patterson E, Schafer Elinder L, Lindroos AK, Sonesson U, Darmon N, Parlesak A. Optimizing School Food Supply: Integrating Environmental, Health, Economic, and Cultural Dimensions of Diet Sustainability with Linear Programming. Int J Environ Res Public Health. 2019 Aug 21;16(17):3019. doi: 10.3390/ijerph16173019.
PubMed 31438517Eustachio Colombo P, Elinder LS, Patterson E, Parlesak A, Lindroos AK, Andermo S. Barriers and facilitators to successful implementation of sustainable school meals: a qualitative study of the OPTIMAT-intervention. Int J Behav Nutr Phys Act. 2021 Jul 3;18(1):89. doi: 10.1186/s12966-021-01158-z.
PubMed 34217304Eustachio Colombo P, Patterson E, Lindroos AK, Parlesak A, Elinder LS. Sustainable and acceptable school meals through optimization analysis: an intervention study. Nutr J. 2020 Jun 24;19(1):61. doi: 10.1186/s12937-020-00579-z.
PubMed 32580743
Study at a glance
From the registry record, last updated by the sponsor on 4 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Fostering Sustainable Dietary Habits Through Optimized School Meals - an Intervention Study
- ClinicalTrials.gov ID
- NCT04168632
- Acronym / sponsor ID
- OPTIMAT / 2016-00353
- Conditions
- Food Habits
- Keywords
- children, public meals, sustainable diets, Agenda 2030
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,635 participants (actual)
- Lead sponsor
- Karolinska InstitutetUniversity, hospital or other
- Collaborators
- The Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (FORMAS), Göteborg University, University College Copenhagen
- Study start
- 7 Feb 2019 (actual)
- Primary completion
- 30 May 2019 (actual)
- Study completion
- 30 Aug 2019 (actual)
- First posted
- 19 Nov 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
School meals have considerable potential to shape children's diets and reduce the climate impact of meals. This study applies linear programming for developing and implementing a climate friendly, nutritious and affordable school lunch menu. The new menu plan will be compared to the baseine menu during a 4-week intervention trial. The outcomes will be food waste, consumption, and pupils' satisfaction with the meals before and after introducing the new meal plan by interrupted time series analysis. Our hypothesis is that school meals can be optimized to be nutritious and more climate friendly, without negatively affecting acceptance, food waste and cost.
A number of primary schools in one Swedish municipality with the same menu plan for all schools participated in the study. Their current meal supply was recorded in the form of a food list including amount and cost of each item over a 4-week period. This list was then optimized with linear programming to be as similar as possible to the baseline diet but with a 40% reduction in greenhouse gas emissions. No new foods were introduced and none were removed from the list. Nutritionally adequacy was ensured by included constraints into the model. The optimized food list was handed to a professional meal planner and a new menu plan was developed based on the revised food list. Data on food waste and consumption was collected daily during a baseline period of four weeks, and during the four-week intervention period. School lunch satisfaction was assessed twice with an online questionnaire at baseline and during the intervention. After the end of intervention, students and meal staff were interviewed regarding their experiences with the new meals.
Detailed description
For a period of four weeks, during the spring term of 2019, Swedish primary school children received a new school lunch menu plan which was optimized through linear programming to be as similar to the baseline menu as possible with 40% lower in greenhouse gas emissions (GHGE), is nutritionally adequate, and not more expensive.
Primary schools in three municipalities in the Stockholm Region were invited to the trial via their chief meal strategist. To be included in the intervention, the schools had to have in-house food preparation (i.e. not serve catered food) and be able to provide recipes for a standard four-week menu plan electronically (critical for the optimization process). Three schools from one of the municipalities met inclusion criteria and were thus eligible to participate in the intervention.
Recipes for an original (baseline) four-week school lunch menu plan previously served at the recruited schools were obtained through the municipality's electronic meal planning system. Each food item included has a code that can be coupled to the national food database and a national climate database for foods (Research Institutes of Sweden). These foods were considered as the baseline food supply needed to compose a new four-week school lunch menu plan. The list of foods and amounts was optimized using linear programming to be as similar as possible to the baseline list. The optimized food list was then handed to a professional meal planner who developed a new menu plan for the intervention, using all foods in the optimized food list.
To assess the effect of the new menu plan, data on daily food waste and consumption was collected at school level in each intervention school four weeks before (baseline) as well as during the four-week intervention period with a 2-week brake between measurement periods. A tool for measuring food waste and consumption in school restaurants developed by the National Food Agency in Sweden was used. The tool required weighting of all kitchen waste (both preparation waste and cooking waste); all food prepared in the kitchen; the share of the prepared food that was served but not eaten by the pupils and had to be thrown away (serving waste); the share that could be saved for future meals; and plate waste. The daily number of plates used by the pupils in the school restaurant was also recorded. These measurements were made daily by the personnel in the school kitchens during baseline as well as during the intervention period.
Data on school meal satisfaction was measured through an online questionnaire at baseline and during the last week of the intervention. Pupils in grades 5 and 8 answered the questionnaire that contained ten questions related to the school lunch. Five of the ten multiple-choice questions specifically covered their general (i.e. not for that specific day of week) sense of satisfaction with the school lunch.
Six focus group discussions (FGD) with pupils in grades 5 and 8 and three FGDs with meal staff will be conducted to explore their experiences with the intervention as well as the barriers and facilitators to scaling up.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Three schools from one municipality in the Region Stockholm met inclusion criteria and were eligible to participate in the intervention. These schools all served the baseline followed by the new menu. Each period lasted four weeks.
| Arm | Type | Receives |
|---|---|---|
| Intervention | Experimental | Other: OPTIMATA new 4-week menu plan |
Who may qualify
- Ages
- 6 to 16 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Primary schools (year 0-9)
- The schools needed to have on-site kitchens
- The schools needed to be able to provide previously used recipes for a standard four-week menu electronically
Key exclusion criteria (3 listed)
- Preschools or gymnasiums
- Schools receiving catered food
- Schools that could not provide recipes electronically
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| OPTIMATThe intervention was to serve a new school lunch menu plan as similar as possible to a baseline menu plan but 40% lower in greenhouse gas emissions, being nutritionally adequate and no more expensive. | Other | Intervention |
Primary outcome
Change in food waste between baseline and intervention periods
Time frame: During four weeks before the intervention period and during the four week intervention.
Kitchen waste, serving waste, and plate waste, total per school and per pupil
Change in food consumption between baseline and intervention periods
Time frame: During four weeks before the intervention period and during the four week intervention.
Food consumption, total per school and per pupil
Change in school meal satisfaction between baseline and intervention periods
Time frame: Once during the four weeks preceding the intervention as well as once during the last week of intervention.
Pupils' rating of school meals with the "SkolmatSverige" student questionnaire (ten questions referring to the school lunch with face validity with a varying number of response options)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Feb 2022.
- Background: PubMed 31438517Eustachio Colombo P, Patterson E, Schafer Elinder L, Lindroos AK, Sonesson U, Darmon N, Parlesak A. Optimizing School Food Supply: Integrating Environmental, Health, Economic, and Cultural Dimensions of Diet Sustainability with Linear Programming. Int J Environ Res Public Health. 2019 Aug 21;16(17):3019. doi: 10.3390/ijerph16173019.
- Derived from this study: PubMed 34217304Eustachio Colombo P, Elinder LS, Patterson E, Parlesak A, Lindroos AK, Andermo S. Barriers and facilitators to successful implementation of sustainable school meals: a qualitative study of the OPTIMAT-intervention. Int J Behav Nutr Phys Act. 2021 Jul 3;18(1):89. doi: 10.1186/s12966-021-01158-z.
- Derived from this study: PubMed 32580743Eustachio Colombo P, Patterson E, Lindroos AK, Parlesak A, Elinder LS. Sustainable and acceptable school meals through optimization analysis: an intervention study. Nutr J. 2020 Jun 24;19(1):61. doi: 10.1186/s12937-020-00579-z.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Liselotte Schäfer Elinder, professor principal investigator
Karolinsk Institutet
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing OPTIMAT in people with Food Habits, run by Karolinska Institutet at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in food waste between baseline and intervention periods (time frame: During four weeks before the intervention period and during the four week intervention.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04168632, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Feb 2022.