The effect of school meals with fatty fish on adolescents’ self-reported symptoms for mental health: FINS-TEENS - a randomized controlled intervention trial

Figures & data

Figure 1. Flow chart over participants.

Table 1. Baseline characteristics of the study population and the different intervention groups.

	n	All	Fish (n = 137)	Meat (n = 145)	Supplement^a (n = 143)
Gender, girls, n (%)	425	224 (53)	77 (56)	72 (50)	75 (52)
Age, mean (SD)	425	14.6 (.34)	14.6 (.34)	14.6 (.33)	14.6 (.34)
BMI category ^b	396
Underweight		55 (14)	21 (17)	19 (14)	15 (11)
Normal weight		312 (79)	98 (77)	105 (78)	109 (81)
Overweight/obese		29 (7)	8 (6)	10 (8)	11 (8)
Ethnicity, non-Norwegian^c, n (%)	425	46 (11)	16 (12)	16 (11)	14 (10)
Maternal education level, n (%)	346
Elementary/high or vocational school		101 (29)	26 (24)	40 (35)	35 (29)
College/University		246 (71)	84 (76)	75 (65)	87 (60)
Paternal education level, n (%)	345
Elementary/high or vocational school		142 (41)	51 (46)	47 (41)	44 (37)
College/University		204 (59)	59 (54)	68 (59)	77 (64)
Household income, n (%)	345
< 200.000–749.999		73 (21)	21 (19)	20 (18)	32 (26)
750.000–1. 249 999		175 (51)	57 (52)	62 (54)	56 (46)
1 250 000- >2.000 000		97 (28)	32 (29)	32 (28)	33 (27)
Seafood for dinner^d, mean (SD)	425	4.1 (.95)	4.1 (.99)	4.0 (.94)	4.1 (.90)
Omega-3 supplement, n (99%)	424
Never		229 (54)	67 (49)	81 (56)	81 (57)
1–3 times/month		53 (13)	18 (13)	18 (12)	17 (12)
1–3 times/week		47 (11)	21 (15)	14 (10)	12 (8)
4–6 times/week		22 (5)	7 (5)	6 (4)	9 (6)
Daily		73 (17)	24 (18)	26 (18)	23 (16)

Table 2. Predicted changes in SDQ scores after fish (n = 137), meat (n = 145) or supplement (n = 143) intervention, different models.

	Crude SDQ scores			SDQ scores adjusted for:
				Baseline score		Baseline score & compliance
SDQ scales	Baseline Mean (SD)	12 weeks Mean (SD)	p-within^a	Change Mean (95% CI)	p-value^b	Change Mean (95% CI)	p-value^c
Emotional problems
Fish	2.9 ± 2.1	2.9 ± 2.4	0.96	0.07 (-0.18,0.31)	-	0.12 (-0.15,0.39)	-
Meat	2.6 ± 2.1	2.6 ± 2.0	0.77	0.03 (-0.21,0.27)	0.83	0.02 (-0.22,0.26)	0.61
Supplement	2.5 ± 2.2	2.6 ± 2.1	0.47	0.05 (-0.19,0.29)	0.92	0.01 (-0.26,0.26)	0.56
Conduct problems
Fish	1.6 ± 1.4	1.5 ± 1.4	0.74	−0.07 (-0.27,0.14)	-	−0.08 (-0.30,0.14)	-
Meat	1.7 ± 1.7	1.4 ± 1.4	0.01	−0.27 (-.047,-0.07)	0.13	−0.27 (-0.47,-0.07)	0.19
Supplement	1.6 ± 1.5	1.7 ± 1.5	0.26	0.10 (-0.10,0.30)	0.23	0.11 (-0.10,0.33)	0.23
Hyperactivity/in attention
Fish	3.9 ± 2.3	3.8 ± 2.2	0.41	−0.10 (-0.34,0.16)	-	−0.17 (-0.44,0.11)	-
Meat	3.9 ± 2.2	4.0 ± 2.2	0.58	0.10 (-0.15, 0.35)	0.28	0.11 (-0.14,0.35)	0.14
Supplement	3.6 ± 2.1	3.6 ± 2.1	0.88	−0.08 (-0.32,0.17)	0.92	−0.01 (-0.27,0.26)	0.44
Peer problems
Fish	1.5 ± 1.4	1.5 ± 1.4	0.88	−0.02 (-.22,0.17)	-	−0.03 (-0.24,0.18)	-
Meat	1.7 ± 1.6	1.5 ± 1.5	0.09	−0.16 (-0.35, 0.03)	0.31	−0.16 (-0.35,0.03)	0.37
Supplement	1.4 ± 1.5	1.5 ± 1.4	0.80	−0.02 (-0.21,0.17)	0.99	−0.01 (-0.22,0.19)	0.93
Prosocial behaviour
Fish	7.6 ± 1.8	7.5 ± 1.7	0.91	−0.02 (-0.25,0.22)	-	0.10 (-0.16, 0.36)	-
Meat	7.6 ± 1.7	7.5 ± 1.8	0.79	−0.03 (-0.26,0.19)	0.93	−0.04 (-0.27,0.19)	0.42
Supplement	7.6 ± 1.7	7.6 ± 1.8	0.79	0.04 (-0.19,0.26)	0.75	−0.07 (-0.31,0.18)	0.39
Total difficulties
Fish	9.9 ± 4.9	9.7 ± 5.1	0.52	−0.11 (-0.65,0.44)	-	−0.12 (-0.72,0.48)	-
Meat	9.9 ± 5.3	9.6 ± 4.6	0.23	−0.33 (-0.90,0.20)	0.57	−0.32 (-0.85,0.21)	0.62
Supplement	9.2 ± 4.9	9.4 ± 5.1	0.47	0.08 (-0.45,0.62)	0.63	0.10 (-0.48,0.67)	0.63

Table 3. Predicted changes in SDQ scores for participants with high SDQ scores at baseline after fish, meat or supplement intervention, different models.

		Crude SDQ scores			SDQ scores adjusted for:
					Baseline score		Baseline score & compliance
SDQ scales	n	Baseline Mean (SD)	12 weeks Mean (SD)	p-within^a	Change Mean (95% CI)	p-value^b	Change Mean (95% CI)	p-value^c
Emotional problems (≥ 5)
Fish	26	6.4 ± 1.3	6.0 ± 1.9	0.25	−0.31 (-0.92,0.30)	-	−0.21 (-0.89,0.47)	-
Meat	31	5.8 ± 1.1	4.7 ± 1.5	<0.01	−1.20 (-1.75,-0.64)	0.04	−1.20 (-1.76,-0.63)	0.03
Supplement	29	6.1 ± 1.4	5.2 ± 1.9	<0.01	−0.82 (-1.39,-0.25)	0.23	−0.91 (-0.89,0.47)	0.17
Conduct problems (≥ 4)
Fish	13	4.5 ± 1.1	2.9 ± 1.9	<0.01	−1.64 (-2.39,-0.89)	-	−1,38 (-2,23,-0,48)	-
Meat	19	5.1 ± 1.4	3.5 ± 1.5	<0.01	−1.53 (-2.16,-0.91)	0.83	−1,56 (-2,19,-0.93)	0.75
Supplement	17	4.5 ± 0.6	3.5 ± 1.5	<0.01	−0.98 (-1.63,-0.32)	0.18	−1,14 (-1,87,-0.41)	0.71
Hyperactivity/inattention (≥ 6)
Fish	33	7.2 ± 1.3	6.2 ± 1.5	<0.01	−0.90 (-1.44,-0.37)	-	−0.88 (-1.50,-0.26)	-
Meat	31	7.1 ± 1.1	6.6 ± 1.4	0.07	−0.44 (-0.99,0.11)	0.23	−0.44 (-1.00,0.12)	0.28
Supplement	29	6.8 ± 1.0	5.6 ± 2.1	<0.01	−1.32 (-1.89,-0.75)	0.29	−1.35 (-2,0,-0.66)	0.37
Peer problems(≥ 4)
Fish	15	4.3 ± 0.5	2.9 ± 1.1	<0.01	−1.47 (-2.28,-0.65)	-	−1.26 (-2.15,-0.38)	-
Meat	18	4.8 ± 1.2	3.1 ± 1.9	<0.01	−1.95 (-2.70,-1.20)	0.78	−1.95 (-2.69,-1.22)	0.72
Supplement	11	5.0 ± 1.0	3.6 ± 1.2	0.03	−1.31 (-2.23,-0.39)	0.32	−1.26 (-2.15,-0.38)	0.20
Prosocial behaviour (≤ 5)
Fish	20	4.6 ± 1.0	5.6 ± 1.4	<0.01	0.84 (0.15,1.52)	-	0.88 (0.15,1.61)	-
Meat	19	4.4 ± 1.2	5.5 ± 1.9	0.02	1.05 (0.35,1.75)	0.63	1.06 (0.35,1.77)	0.69
Supplement	21	4.7 ± 0.6	5.5 ± 1.3	0.02	0.76 (1.0, 1.42)	0.86	0.7 (-0.02,1.45)	0.75
Total difficulties (≥15)
Fish	25	17.8 ± 2.9	16.4 ± 3.9	0.02	−1.54 (-3.01,0–08)	-	−1.88 (-3.60,-0.15)	-
Meat	26	18.6 ± 3.5	14.3 ± 3.6	<0.01	−4.11 (-5.55,-2.67)	0.02	−4.10 (-5.54,-2.65)	0.06
Supplement	20	18.0 ± 2.6	15.3 ± 4.7	<0.01	−2.78 (-4.42,-1.14)	0.27	−2.38 (-4.34,-0.42)	0.73