This study looks at how a national school meal program affects the health, well-being, and learning of Danish schoolchildren aged 10 to 15 years.
The study is part of the Danish National School Meal Pilot Program (2025-2028), which provides free school meals at selected public schools. Some school classes receive free school meals, while other classes do not and are used for comparison.
Children are followed for about 1.5 years. Information is collected before and after the program using simple health measurements, questionnaires about well-being, and age-appropriate cognitive tests.
The study also uses information from Danish national registers to better understand the children's background and to study longer-term outcomes related to health, education, and social conditions. In addition, the study examines whether school meal programs are cost-effective by comparing their costs with potential benefits for children and society.
The goal of the study is to find out whether free school meals can improve children's health, well-being, and learning, and help reduce social differences.
All children attending 3rd, 4th or 7th grade in the recruited schools
No exclusion criteria will be applied
Single group
School meal classes
BehavioralNatural experiment embedded within the Danish National School Meal Pilot Program (2025-2028), which offers free school meals to selected public schools. Children receive a free school-provided meal (typically lunch) five days per week. Meals vary across schools, as each school selects its own meal provider. All meals must comply with the Nordic Nutrition Recommendations and the Danish Food-Based Dietary Guidelines, with a focus on fish, whole grains, fruits and vegetables, access to drinking water, and the promotion of children's food literacy.
Well-being/health related quality of life
Between group difference in change in the total summary score of health-related quality of life measured with the KIDSCREEN 27 child self-report questionnaire. Data is collected using an adapted video and speech assisted electronic version with a smiley scale for each answer. The questionnaire assesses the child's physical well-being (5 items), psychological well-being (7 items), peers and social support (4 items), and school environment (4 items). Autonomy and parent relation (7 items) are not used.
Psychological functioning
Between group difference in change in the total difficulties score of the Strengths and difficulties questionnaire. Assessed using child reported version of the Strengths and Difficulties Questionnaire. An overall total difficulties score is calculated, along with five subscale scores: emotional symptoms, conduct problems, hyperactivity/Inattention, relationship problems, and prosocial behavior.
Internalizing problems
Between group difference in change in the internalizing problem score of the Strengths and difficulties questionnaire, calculated as the sum of the emotional symptoms and peer problems scales scores. Assessed using the child-reported version of the Strengths and Difficulties Questionnaire.
Externalizing problems
Between group difference in change in the externalizing behavior score of the Strengths and difficulties questionnaire, calculated as the sum of conduct problems, hyperactivity/Inattention subscales scores. Assessed using the child-reported version of the Strengths and Difficulties Questionnaire.
Prosocial Behavior
Between group difference in change in the prosocial behavior score of the Strengths and difficulties questionnaire. Assessed using the child-reported version of the Strengths and Difficulties Questionnaire.
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University of Copenhagen
Lead sponsor
University of Southern Denmark
Collaborator
The Novo Nordic Foundation
Collaborator
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