School-based healthy eating initiatives

79 Pages·2002·0.62 MB·English

by  Health Promotion

Healthy Eating Healthy Living Program 2000

School-based healthy eating
initiatives:

Recommendations for success

Tracey Setter
Antigone Kouris-Blazos
Mark Wahlqvist

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Healthy Eating Healthy Living Program 2000

Professor Mark Wahlqvist, Director
Dr. Antigone Kouris-Blazos, Co-Director
Ms Tracey Setter, Project Officer

Healthy Eating Healthy Living Program (Appendix 2)
C/O Asia Pacific Health & Nutrition Centre
Monash Asia Institute,
level 8, Menzies Building
Wellington Road,
Clayton, Victoria 3800
URL: http://www.healthyeatingclub.com
Email: [email protected]

Other monographs in this series (Appendix 2):

Wood B, Ross K, Kouris-Blazos A. Healthy Eating for Nutritionally Vulnerable
Groups. Some Health Promotion Initiatives. Healthy Eating Healthy Living Program,
Monash University, Victoria 2000.
Gill T, Setter T, Kouris-Blazos A, Wahlqvist M. Healthy Weight and Physical
Activity Interventions in Victoria: the current situation and recommendations for the
future. Healthy Eating Healthy Living Program, Monash University, Victoria 2000.
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Healthy Eating Healthy Living Program 2000

Acknowledgments

The authors acknowledge the contribution made by the co-ordinators and staff of
organizations who assisted us in the search for this material.

This collection is not complete and could never be so. If we have inadvertently
omitted a program report we will be pleased to review it for inclusion on the HEHLP
website (www.healthyeating.org).

The recommendation is made to conduct a prospective review of programs in the
future.

The Healthy Eating Healthy Living Program was funded by the Victorian Health
Promotion Foundation (VicHealth) for this purpose.
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Contents
SUMMARY
....................................................................................................................5
INTRODUCTION....................................................................................................................8
WHY USE THE SCHOOL AS A SETTING FOR NUTRITION EDUCATION?............9
AIMS AND OBJECTIVES...................................................................................................10
METHODS.............................................................................................................................11
RESULTS................................................................................................................................14
A) CANTEENS........................................................................................................................15
Strengths and weaknesses................................................................................................15
Barriers............................................................................................................................16
Outcomes..........................................................................................................................16
Evaluation........................................................................................................................17
Future implications..........................................................................................................17
B) CURRICULUM....................................................................................................................18
Strengths and Weaknesses................................................................................................18
Barriers............................................................................................................................19
Outcomes..........................................................................................................................20
Evaluation........................................................................................................................21
Future Implications..........................................................................................................21
DISCUSSION.........................................................................................................................22
A) CANTEENS........................................................................................................................25
B) CURRICULUM (AND POLICY).............................................................................................26
C) COMBINATION OF CANTEEN AND CURRICULUM................................................................27
THE HEALTH PROMOTING SCHOOLS APPROACH.................................................27
ESSENTIAL ELEMENTS OF SCHOOL PROGRAMS...................................................28
RECOMMENDATIONS AND CONCLUSIONS...............................................................29
REFERENCES.......................................................................................................................33

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Healthy Eating Healthy Living Program 2000

Summary

The role of nutrition education in schools has long been a contentious issue. Nutrition
is often cast aside in favour of subjects perceived to be of greater importance such as
English and mathematics. Nutrition programs when implemented in schools, often
receive little funding, time and support, so it becomes difficult to run a program,
especially an efficient and effective program. As such researchers, project officers and
teachers are often faced with an information deficit when it comes to designing,
implementing and evaluating a nutrition program in a school.

The authors of this report attempt to break down the barriers of information
dissemination regarding healthy eating programs in schools, with a view to providing
recommendations to ensure success. The main focus was on nutrition programs run in
Victorian and Australian schools from 1990-2000, while also drawing on the
experience of programs implemented in other countries.

The report is broken into two sections; one section focuses on canteen-based program,
while the other focuses on curriculum-based programs. Results indicate that it is more
effective to implement a program across the entire school that includes both the
canteen and the curriculum, and the school environment as a whole; canteens can sell
only healthy foods and still be very profitable; and practical, hand-on lessons such as
cooking are the most effective way for students to learn. It was also apparent that
Victoria seems to be lacking with regards to nutrition education in comparison with
other Australian states.

Key recommendations emerging from this review have been stated
below:

1. One-off unsupported interventions, such as talks by health
professionals, are ineffective (2).
Nutrition education needs to be sequential and implemented in every year level
from kindergarten to year 12.
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2. Establishment of a central system or database in Victoria where
teachers and project officers can access details on all nutrition
education programs implemented in schools.
A government funded centre that can act as a clearinghouse would be ideal. The
Healthy Eating Information Web-Centre has begun the clearinghouse process by
making information about healthy eating programs available on the Internet
(http://www.healthyeating.org/health-professionals/projects.htm). The availability
of these programs in such a centre (or library) would reduce the incidence of
teachers having to design an entire program or develop a curriculum from scratch
because they would be able to get at least an idea of the elements they need to
include to ensure success.

3. Establish a team of project officers to design, implement and
evaluate nutrition education programs for Victorian primary and
secondary schools.
Many Health Promotion graduates have difficulty finding a job, but graduate
positions such as these would be ideal and would allow them to put the skills they
learnt at university to use.

4. All states of Australia should have a canteen accreditation program
run by its state canteen association.
If it were compulsory for all Australian canteens to be accredited, then we would
be well on the way to creating healthy schools for our children because the
canteen is an effective way to improve the eating habits of children while they are
at school.

5. Explore other avenues to communicate the nutrition message.
Using other classes as an outlet to teach nutrition to students may be as effective
as having a specialised health or nutrition class. For example, computer classes are
one of the most favoured by students and so could be an ideal way for children to
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learn about nutrition in a practical and hands-on environment. Interactive
computer based learning is ideal when teacher time is limited and allows children
to move at their own pace (6, 43).

6. Train and educate teachers about nutrition on a regular basis.
In most cases it is the classroom teacher who teaches the students about nutrition.
It is therefore logical that they receive appropriate training and support. In-service
training programs that allow time release for teachers would be the most
appropriate because it would mean that teachers do not have to take time out of
their already busy schedule to attend training. Due to time constraints on both
teachers and the curriculum, nutrition education goals and objectives need to be
clear so that the few hours that are spent on nutrition education are spent as
productively as possible (31).

7. Encourage Home Economics classes in schools.
Studies have shown that cooking skills seem to be diminishing in today’s youth
(42), so eliminating home economics from the curriculum would just be a step back
in teaching important life skills to students. More studies are needed to
demonstrate whether learning how to cook actually increases cooking skills, and
in addition, whether eating habits improve as a result of increased cooking skills.

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Introduction
The last few decades have seen much activity in health promotion in schools. Health
education is a very contentious issue with regards to school curriculum (1), and has
had to fight for many years for time in the school curriculum and for resources within
schools (2). Health and nutrition have often been cast aside in favour of subjects
perceived to be of more importance such as English, mathematics and physical
education, however, good nutrition results in good health and ultimately prevention of
disease. Prevention of health problems is likely to cost less than treatment in the long
run (3), which suggests that health must be seen to be of greater importance in the
school curriculum than is currently the case.

Nutrition education in schools will ultimately result in a more knowledgeable and
healthier population. Each individual has something to gain from incorporating
nutrition education into the school curriculum. Students would be happier and
healthier and miss less days of school (thus increasing knowledge); parents would not
have to take days off work to care for sick children; businesses, whether large or
small, would have decreased absenteeism and thus decreased costs (don’t have to
replace absent staff) and increased profit. Overall the population would be healthier
and rates of obesity, diabetes, cardiovascular disease, and other associated diseases
would decrease thus reducing the burden on the health system. As such, the
Australian Government should aim to influence the food supply through nutrition
education and improved relationships with health, education, and industry and
consumer bodies (4).

Health and education are very closely linked (2). Recent reports have suggested that
children learn better if they are healthy, and are more successful academically (3). If
children are not well nourished or are hungry they may lack concentration and be
disruptive in class, they may also be late or absent from school more days than
adequately nourished children, and may also experience learning difficulties (2,5).

Eating behaviours are generally formed in childhood so it is important to teach
children how to choose healthy foods (6) and why nutrition is important in the
formative years. Recent reports suggest that children learn better and more quickly if
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they are healthy (7). As such, food plays an important role in the life of a child. Not
only does it provide them with the nutrients essential for growth and development, but
many celebrations or cultural events also centre around consumption of or abstinence
from food (8). Family resources such as income and proportion of money spent on
food may also play a large role in influencing children’s attitudes toward food and
food preferences (1).
Literature that evaluates nutrition programs in schools is limited and patchy (2,5). It is
not uncommon for school nutrition programs to remain unevaluated, which may be
due to limited funds or resources, or even to a lack of health promotion knowledge.
Many schools implement nutrition programs without reading past literature or
program reports (5) and so may develop a program identical to one in the past, with no
warning of possible weaknesses to their method or barriers to the program.

The basis of this report is to attempt to break down the barriers of information
dissemination regarding healthy eating programs in schools, with a view to providing
recommendations to ensure success. Currently, there appears to be no research that
has looked into the differences in the education and health outcomes between schools
who have adopted a health promoting schools approach and those who teach health
mostly in the classroom (7). Information such as this (if available) needs to be more
accessible to health professionals and teachers who may be running these programs in
schools.

Why use the school as a setting for nutrition education?
The school is an ideal setting to conduct health promotion programs because children
spend the majority of their time at school, sometimes more time than they spend with
their parents. The school is the biggest influence in children’s lives next to the family
(3). During the school years (especially at primary school) children’s minds and bodies
are still forming so they are more receptive to health messages at this age (9). Schools
provide close contact with the teacher (especially in primary schools) and can reach
all children regardless of socio-economic status, ethnicity or location (2). As such, the
school is naturally an ideal place to conduct nutrition education programs (10).

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Childhood is a critical time for establishing healthy eating habits and behaviours (11),
and if children are taught how to choose healthy, nutritious foods early in life, they are
more likely to continue these behaviours into adulthood. It is now thought that
promoting positive health attitudes and behaviours at an early age may be more
effective than attempting to change established health-compromising behaviours at a
later age (12). If positive health behaviours are not taught at school, children have a
greater risk of developing disease later in life (5).

Families increasingly have two working parents, or one-parent families, and more
children are buying their lunch at school or making their own at home (1).
Convenience and fast foods are also now more available than they used to be, and as a
result, parents are increasingly unable to monitor their children’s food habits (6), so it
is important that children have the knowledge and ability to choose healthy foods
themselves.

Aims and Objectives
The aims of this report are:
1. To report on the evidence base for effective health promotion initiatives on
healthy eating relating to Victorian and Australian schools.
2. Outline the current situation in Victoria with regards to healthy eating initiatives
in schools in a) canteens and b) curriculum.
3. To provide recommendations based on available evidence from Australia and
overseas, of the essential components of healthy eating programs to ensure
success.
4. To make the programs assessed available on the ‘Healthy Eating Information
Web-Centre’ at http://www.healthyeating.org/health-professionals/projects.htm

Research questions to be answered in this assessment are:
• Is it adequate for schools to implement only a canteen-based intervention, or
should it be implemented in conjunction with a curriculum-based intervention?
• Is it better for canteens to sell only healthy foods or can they also sell some ‘junk’
food?
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