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School-based nutrition education: lessons learned and new perspectives

Published online by Cambridge University Press:  01 February 2001

Carmen Pérez-Rodrigo  and
Javier Aranceta
Carmen Pérez-Rodrigo*
Affiliation:
Community Nutrition Unit, Department of Public Health, Bilbao, Spain
Javier Aranceta
Affiliation:
Community Nutrition Unit, Department of Public Health, Bilbao, Spain
*
*Corresponding author: E-mail bisaludpublica@jet.es
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Abstract

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Nutrition is a major environmental influence on physical and mental growth and development in early life. Food habits during infancy can influence preferences and practices in later life and some evidence suggests fair to moderate tracking of food habits from childhood to adolescence1–4. Studies support that good nutrition contributes to improving the wellbeing of children and their potential learning ability, thus contributing to better school performance5–7. Children and young people who learn healthy eating habits, are encouraged to be physically active, to avoid smoking and to learn to manage stress, have the potential for reduced impact of chronic diseases in adulthood4–8. Nutrition education is a key element to promoting lifelong healthy eating and exercise behaviours and should start from the early stages of life8–11; it should also address the specific nutritional needs associated with pregnancy, including reinforcing breastfeeding12.

Food habits are complex in nature and multiple conditioning factors interact in their development13. Young children do not choose what they eat, but their parents decide and prepare the food for them. During infancy and early childhood the family is a key environment for children to learn and develop food preferences and eating habits. As they grow and start school, teachers, peers and other people at school, together with the media and social leaders, become more important. Progressively children become more independent and start making their own food choices. The peer group is very important for adolescents and has a major influence in developing both food habits and lifestyles13.

Community trials suggest that nutrition education is an accessible effective tool in health promotion programmes with a focus on the development of healthy eating practices14, 15.

Keywords

Children's food habitsNutrition educationSchool mealsEvaluation
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 1a , February 2001 , pp. 131 - 139
Copyright
Copyright © CABI Publishing 2001

References

1Nicklas, TA, Webber, LS, Srinivasan, SR, Berenson, GS. Secular trends in dietary intakes and cardiovascular risk factors of 10-year-old children: the Bogalusa Heart Study (1973–1988). Am. J. Clin. Nutr. 1993; 57: 930–7.CrossRefGoogle Scholar
2Kelder, SH, Perry, CL, Klepp, KI, Lytle, LL. Longitudinal tracking of adolescent smoking, physical activity and food choice behaviors. Am. J. Public Health 1994; 84: 1121–6.CrossRefGoogle ScholarPubMed
3Singer, MR, Moore, LI, Garrahie, EJ, Ellison, RC. The tracking of nutrient intake in young children: the Framingham Children's Study. Am. J. Public Health 1995; 85: 1673–7.CrossRefGoogle ScholarPubMed
4Resnicow, K, Smith, M, Baranowski, T, Baranowski, J, Vaughan, R, Davis, M. 2-year tracking of children's fruit and vegetable intake. J. Am. Diet Assoc. 1998; 98: 785–9.CrossRefGoogle ScholarPubMed
5Nicklas, TA, Webber, LS, Johnson, CC, Srinivasan, SR, Berenson, GS. Foundations for health promotion with youth: a review of observations from the Bogalusa Heart Study. J. Health Educ. 1995; 26(Suppl 2): S18–26.CrossRefGoogle Scholar
6Aldinger, CE, Jones, JT. Healthy Nutrition: An essential element of a Health-Promoting School. WHO Information Series on School Health. Document four. Geneva: WHO, 1998.Google Scholar
7ADA. Position of the American Dietetic Association: Dietary guidance for healthy children aged 2 to 11 years. J. Am. Diet Assoc. 1999; 99: 93–101.CrossRefGoogle Scholar
8CDC. Guidelines for school health programs to promote lifelong healthy eating. J. Sch. Health 1997; 67: 9–26.CrossRefGoogle Scholar
9Hornak, L, Block, G, Lane, S. Influence of selected environmental and personal factors on dietary behavior for chronic prevention: a review of the literature. J. Nutr. Educ. 1997; 29: 306–12.CrossRefGoogle Scholar
10CDC. Guidelines for school and community health programs to promote lifelong physical activity among young people. MMRW 1997; 46: RR-6.Google Scholar
11Foerster, SB, Heimendinger, J, DiSogra, LK, Pivonka, E. The National 5 a Day — for Better Health! Program: an American Nutrition and Cancer Prevention Initiative. In: Wheelock, W, ed. Implementing Dietary Guidelines for Healthy Eating. London: Chapman & Hall, 1997: 447–9.Google Scholar
12Yngve, A, Sjöström, M. Promotion of breastfeeding in Europe – challenges and possibilities (submitted).Google Scholar
13Birch, LL, Fisher, JO. Development of eating behaviors among children and adolescents. Pediatrics 1998; 101: 539–49.CrossRefGoogle ScholarPubMed
14Kelder, SH, Perry, CL, Lytle, LA, Klepp, KI. Community-wide youth nutrition education: long-term outcomes of the Minnesota Heart Health Program. Health Educ. Res. 1995; 10: 119–31.CrossRefGoogle ScholarPubMed
15Luepker, RV, Perry, CL, McKinlay, SM, Nader, PR, Parcel, GS, Stone, EJ. et al. Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group. JAMA 1996; 275: 768–76.CrossRefGoogle ScholarPubMed
16Roe, L, Hunt, P, Bradshaw, H, Rayner, M. Health promotion interventions to promote healthy eating in the general population: a review. London: HEA, 1997.Google Scholar
17WHO. European Network of Health Promoting Schools. A joint WHO-CE-CEC Project. Copenhagen: WHO-Euro, 1993.Google Scholar
18Allensworth, D, Wyche, J, Lawson, E, Nicholson, , eds. Defining a comprehensive school health program: an interim statement. Washington DC: National Academy Press, 1995: 2.Google Scholar
19Dixey, R, Heindl, I, Loureiro, I, Pérez-Rodrigo, C, Snel, J, Warnking, P. Healthy eating for young people in Europe. Nutrition education in Health Promoting Schools. Copenhagen: European Network of Health Promoting Schools, 1999.Google Scholar
20Friel, S, Kelleher, C, Campbell, P, Nolan, G. Evaluation of the nutrition education at Primary School (NEAPS) programme. Public Health Nutr. 1999; 2: 549–55.CrossRefGoogle ScholarPubMed
21Pérez-Rodrigo, C, Aranceta, J. Nutrition education for school-children living in a low-income urban area in Spain. J. Nutr. Educ. 1997; 29: 267–73.CrossRefGoogle Scholar
22Nicklas, TA, Johnson, CC, Farris, R, Rice, R, Lyon, L, Shi, R. Development of school-based nutrition intervention for high school students: Gimme 5. Am. J. Health Promot. 1997; 11: 315–22.CrossRefGoogle ScholarPubMed
23Lytle, LA, Achterberg, CL. Changing the diet of America's children: what works and why? J. Nutr. Educ. 1995; 27: 250–60.CrossRefGoogle Scholar
24Urbick, B, Jack, V, Westerhof, A, Katz, B. Good nutrition for UK youth: Bridging the gap between adults and children June, 1999. Surrey: CKC, Leatherhead Food Research Association, 1999.Google Scholar
25Anderson, AS, Cox, DN, McKellar, S, Reynolds, J, Lean, ME, Mela, DJ. Take Five, a nutrition education intervention to increase fruit and vegetable intakes: impact on attitudes towards dietary change. Br. J. Nutr. 1998; 80: 133–40.CrossRefGoogle ScholarPubMed
26ADA Statement. Promoting healthy eating behaviors: The role of school environments. Washington DC: USDA, Food, Nutrition and Consumer Services, 1999.Google Scholar
27Contento, IR. The effectiveness of nutrition education and implications for nutrition education policy, programs and research — a review of research. J. Nut. Educ. 1995; 27: 279–418.Google Scholar
28Bandura, A. Social Foundations for thought and action. Englewood Cliffs, NJ: Prentice Hall, 1986.Google Scholar
29Prochaska, JO, Velicer, WF. The transtheoretical model of health behavior. Am. J. Health Prom. 1997; 12: 38–48.CrossRefGoogle ScholarPubMed
30Finckenor, M, Byrd-Bredbenner, C. Nutrition intervention group program based on preaction-stage-oriented change processes of the Transtheoretical Model promotes long-term reduction in dietary fat intake. J. Am. Diet Assoc. 2000; 100: 335–42.CrossRefGoogle ScholarPubMed
31Nicklas, TA, Johnson, CC, Myers, L, Farris, RP, Cunningham, A. Outcomes of a high school program to increase fruit and vegetable consumption: Gimme 5 – A fresh nutrition concept for students. J. Sch. Health 1998; 68: 248–53.CrossRefGoogle ScholarPubMed
32Glanz, K, Mullis, RM. Environmental interventions to promote healthy eating: a review of models, programs, and evidence. Health Educ.Q. 1988; 15: 395–415.CrossRefGoogle ScholarPubMed
33Raizman, DJ, Montgomery, DH, Osganian, SK, Ebzery, MK, Evans, MA, Nicklas, TA, Zive, MM, Hann, BJ, Snyder, Mp, Clesi, AL. CATCH: food service program process evaluation in a multicenter trial. Health Educ. Q. 1994(Suppl 2): S51–71.CrossRefGoogle Scholar
34Stockley, L. The promotion of healthier eating: a basis for action. London: Health Education Authority, 1993.Google Scholar
35Contento, IR, Balch, GI, Bronner, YL. et al. Inservice preparation in nutrition education for professionals and paraprofessionals. J. Nutr. Educ. 1995; 27: 347–54.Google Scholar
36Contento, IR, Kell, DG, Keiley, MK, Corcoran, RD. A formative evaluation of the American Cancer Society changing the Course nutrition education curriculum. J. Sch. Health 1992; 62: 411–6.CrossRefGoogle ScholarPubMed
37Edmunson, EW, Luton, SC, McGraw, SA, Kelder, SH, Layman, AK, Smyth, MH, Bachman, KJ, Perdersen, SA, Stone, EJ. CATCH: classroom process evaluation in a multicenter trial. Health Educ. Q. 1994(Suppl 2): S27–50.CrossRefGoogle Scholar
38Snel, J. et al. Voeding de beste basis voor school [Food: the best basis for school]. A nutrition education teaching pack for primary schools (4–12 year olds). The Hague (The Netherlands): Netherlands Nutrition Centre, 1997.Google Scholar
39DiSogra, L, Glanz, K. The 5 A Day virtual classroom: An online strategy to promote healthful eating. J. Am. Diet Assoc. 2000; 100: 349–52.CrossRefGoogle Scholar
40Tones, K, Dixey, R, Green, J. Process indicators at the local level. Part B. Developing and evaluating the curriculum of the Health Promoting Schools. Brussels: Commission of the European Communities. World Health Organization. Council of Europe. Université Libre de Bruxelles, 1997: 1–34.Google Scholar
41Valentine, S, Barnett, A. Working Group. Food and Nutrition. Guidance of food and nutrition in primary teacher training. London: Department of Health, Ministry of Agriculture, Fisheries and Food, 1999.Google Scholar
42Renaud, L, Chevalier, S, Dufour, R, O'Loughlin, J, Beaudet, N, Bourgeois, A, Ouellet, D. Evaluation of the implementation of an educational curriculum: optimal interventions for the adoption of an educational program of health in elementary schools. Can. J. Public Health 1997; 88: 351–3.CrossRefGoogle ScholarPubMed
43Kealey, KA, Peterson, AV Jr, Gaul, MA, Dinh, KT. Teacher training as a behavior change process: principles and results from a longitudinal study. Health Educ. Behav. 2000; 27: 64–81.CrossRefGoogle ScholarPubMed
44Baranowski, T, Hearn, M, Baranowski, JC. et al. Teach Well: the relation of teacher wellness to elementary student health and behaviour outcomes: baseline subgroup comparisons. J. Health Educ. 1995; 26: S61–71.CrossRefGoogle Scholar
45Weber Cullen, K, Baranowski, T, Baranowski, J, Hebert, D, deMoor, C, Davis Hearn, M, Resnicow, K. Influence of school organizational characteristics on the outcomes of a school health promotion program. J. Sch. Health 1999; 69: 376–80.CrossRefGoogle Scholar
46ADA. Position of the American Dietetic Association: Local support for nutrition integrity in schools. J. Am. Diet Assoc. 2000; 100: 108–11.CrossRefGoogle Scholar
47Aranceta, J, Pérez Rodrigo, C. Consumo de alimentos y estado nutricional de la población escolar de Bilbao. Guías alimentarias para la población escolar. Bilbao: Area de Salud y Consumo. Excmo. Ayuntamiento de Bilbao, 1996.Google Scholar
48Pérez, Rodrigo, Klepp, KI, Yngve, A, Aranceta, J, Stockley, L, Sjöstrom, M. The school setting: an opportunitty for the implementation of Dietary Guidelines (in press).Google Scholar
49Caldwell, D, Nestle, M, Rogers, W. School nutrition services. In: Marx, E, Wooley, SF, eds. Health is academic. New York NY: Teachers College Press, 1998.Google Scholar
50Collins Pateman, B, McKinney, P, Kann, P, Leavy Small, M, Warren, W, Collins, JL. School food service. J. Sch. Health 1995; 65: 327–32.CrossRefGoogle ScholarPubMed
51Gordon, AR, Devaney, BL, Burghardt, JA. Dietary effects of the National School Lunch Program and the School Breakfast Program. Am. J. Clin. Nutr. 1995; 61: 221S–31.CrossRefGoogle ScholarPubMed
52Meyer, MK. Top predictors of middle/junior high school student's satisfaction with school foodservice and nutrition programs. J. Am. Diet Assoc. 2000; 100: 100–3.CrossRefGoogle ScholarPubMed
53Donnelly, JE, Jacobsen, DJ, Legowski, P, Johnson, S, McCoy, P. Family-style foodservice can meet US dietary Guidelines for elementary school children. J. Am. Diet Assoc. 2000; 100: 103–5.CrossRefGoogle ScholarPubMed
54Story, M, Mays, RW, Bishop, DB, Perry, CL, Taylor, G, Smyth, M, Gray, C. 5-a-day Power Plus: process evaluation of a multicomponent elementary school program to increase fruit and vegetable consumption. Health Educ. Behav. 2000; 27: 187–200.CrossRefGoogle ScholarPubMed
55Crockett, SJ, Perry, CL, Pirie, P. Nutrition intervention strategies preferred by parents: Results of a marketing survey. J. Nutr. Educ. 1989; 21: 90–4.CrossRefGoogle Scholar
56Nader, PR, Sellers, DE, Johnson, C, Perry, CL, Stone, EJ, Cook, KC, Bebchuk, J, Luepker, RV. The effect of adult participation in a school-based family intervention to improve children's diet and physical activity: the Child and Adolescent Trial for Cardiovascular Health. Prev. Med. 1996; 25: 455–64.CrossRefGoogle Scholar
57Andrien, M, Closset, A, Cotelle, B, Green, J, Halbardier, V, Heindl, I, Loureiro, I, Maree, M, Pérez-Rodrigo, C, Snel, J, Tones, K. Planning and evaluating nutrition education in schools. A guide. Liége (Belgium): CERES, 1998.Google Scholar
58Davis, M, Baranowski, T, Resnikow, K, Baranowski, J, Doyle, C, Smith, M, Wang, DT, Yaroch, A, Herbert, D. Gimme 5 fruit and vegetables for fun and health: process evaluation. Health Educ. Behav. 2000; 27: 167–76.CrossRefGoogle ScholarPubMed
59Nicklas, TA, O'Neil, CE. Process of conducting a 5-a day intervention with high school students: Gimme 5 (Louisiana). Health Educ. Behav. 2000; 27: 201–12.CrossRefGoogle ScholarPubMed
60Perry, CL, Sellers, DE, Johnson, C, Pedersen, S, Bachman, KJ, Parcel, GS. et al. The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation and feasibility for elementary schools in the United States. Health Educ. Behav. 1997; 24: 716–35.CrossRefGoogle ScholarPubMed
61Resnikow, K, Davis, M, Smith, M, Lazarus-Yaroch, A, Baranowski, T, Baranowski, J, Doyle, C, Wang, DT. How best to measure implementation of school health curricula: a comparison of three measures. Health Educ. Res. 1998; 13: 239–50.CrossRefGoogle Scholar
62Reynolds, KD, Franklin, FA, Leviton, LC, Maloy, J, Harrington, KF, Yaroch, AL, Person, S, Jester, P. Methods, results and lessons learned from process evaluatiom of the high 5 school-based nutrition intervention. Health Educ. Behav. 2000; 27: 177–86.CrossRefGoogle Scholar
63Baranowski, T, Stables, G. Process evaluations of the 5-a-day projects. Health Educ. Behav. 2000; 27: 157–66.CrossRefGoogle ScholarPubMed
64Gortmaker, SL, Peterson, K, Wiecha, J, Sobol, AM, Dixit, S, Fox, MK, Laird, N. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch. Pediatr. Adolesc. Med. 1999; 153: 409–18.CrossRefGoogle Scholar
65Baranowski, T, Davis, M, Resnikow, K, Baranowski, J, Doyle, C, Lin, LS, Smith, M, Wang, DT. Gimme 5 fruit, juice and vegetables for fun and health: outcome evaluation. Health Educ. Behav. 2000; 27: 96–111.CrossRefGoogle ScholarPubMed
66Achterberg, CH. Qualitative methods in nutrition education research. J. Nutr. Educ. 1988; 20: 244–50.CrossRefGoogle Scholar
67Perry, CL, Bishop, DB, Taylor, G, Murray, DM, Mays, RW, Dudovitz, BS, Smyth, M, Story, M. Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul, Minnesota. Am. J. Public Health 1998; 88: 603–9.CrossRefGoogle ScholarPubMed
68Gortmaker, SL, Cheung, LW, Peterson, KE, Chomitz, G, Cradle, JHM, Dart, H, Fox, MK, Bullock, RB, Sobol, AM, Colditz, G, Field, AE, Laird, N. Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: Eat Well and Keep Moving. Arch. Pediatr. Adolesc. Med. 1999; 153: 975–83.CrossRefGoogle ScholarPubMed
69Nader, PR, Stone, EJ, Lytle, LA, Perry, CL, Osganian, SK, Kelder, S, Webber, LS, Elder, JP, Montgomery, D, Feldman, HA, Wu, M, Johnson, C, Parcel, GS, Luepker, RV. Three-year maintenance of improved diet and physical activity: the CATCH cohort. Child and Adolescent Trial for Cardiovascular Health. Arch. Pediatr. Adolesc. Med. 1999; 153: 695–704.CrossRefGoogle ScholarPubMed
70Manios, Y, Moschandreas, J, Hatzis, C, Kafatos, A. Evaluation of a health and nutrition education program in primary school children of Crete over three-year period. Prev. Med. 1999; 28: 149–59.CrossRefGoogle ScholarPubMed
71Reynolds, KD, Franklin, FA, Binkley, D, Raczynski, JM, Harrington, KF, Kirk, KA, Person, S. Increasing the fruit and vegetable consumption of fourth-graders: results from the High 5 Project. Prev. Med. 2000; 30: 309–19.CrossRefGoogle ScholarPubMed
72US Department of Health and Human Services. Centers for Disease Control and Prevention, CDC. SHI. School Health Index for physical activity and healthy eating. A self-assessment and planning guide. Elementary school. Atlanta 2000.Google Scholar
73US Department of Health and Human Services. Centers for Disease Control and Prevention, CDC. SHI. School Health Index for physical activity and healthy eating. A self-assessment and planning guide. Middle school/High school. Atlanta 2000.Google Scholar