Food-based science curriculum yields gains in nutrition knowledge

Analysis of Nutrition Knowledge After One Year of Intervention in a National Extracurricular Athletics Program: A Cross-Sectional Study with Pair-Matched Controls of Polish Adolescents

Background: Nutrition knowledge may be translated into adequate dietary intake and proper eating habits, so adolescent education programs focusing on improving eating habits and nutrition knowledge are needed. The aim of the cross-sectional study with pair-matched controls was to assess the Consumer Nutrition Knowledge Scale (CoNKS) results and its determinants after one year of intervention in a national extracurricular athletics program within a pair-matched sample of Polish adolescents. Methods: The #goathletics Study evaluated a Polish national extracurricular athletics program, 'Athletics for all', being a voluntary and free-of-charge physical activity program organized by the Polish Athletics Association. The study allowed comparing the intervention group of adolescents aged 10-14 years, participating in the program for at least 9 months (a school year) and a pair-matched group not participating in it, while the matching was based on city, gender, and age (each group: n = 506 adolescents, n = 281 females and n = 225 males). The nutrition knowledge was assessed using a Consumer Nutrition Knowledge Scale (CoNKS), and during the analysis, the following factors were taken into account: body weight, height, Body Mass Index (BMI), waist circumference, and waist-to-height ratio (WHtR). Results: The 'Athletics for all' program participation influenced not only the total CoNKS score (p < 0.0001) but also the scores in all studied areas-within procedural nutrition knowledge (p = 0.0002), declarative nutrition knowledge on nutrients (p = 0.0001), and declarative nutrition knowledge on calories (p < 0.0001), and program participants revealed a stronger understanding of all the studied areas compared to non-participating individuals. Gender, BMI, and central obesity tendency were not associated with the total CoNKS score (p > 0.05), or any of the studied areas (p > 0.05). The statistically significant differences in the number of correct answers were observed for four items within procedural nutrition knowledge, for four items within declarative nutrition knowledge on nutrients, and for four items within declarative nutrition knowledge on calories (p < 0.05), while for all of them, 'Athletics for all' program participants revealed a stronger understanding. Conclusions: One year of intervention in a national extracurricular athletics program significantly influenced the nutrition knowledge of the studied group of adolescents aged 10-14 years. While compared with the pair-matched control group of Polish adolescents, they were characterized by a stronger understanding of all areas of nutrition knowledge.

Food, nutrition and sustainability education in Australian primary schools: a cross-sectional analysis of teacher perspectives and practices

BACKGROUND

Healthy eating patterns from sustainable food systems are crucial for population and planetary health. Primary schools are opportune settings for teaching children about food, nutrition and sustainability (FNS) though little is known about the delivery of FNS education in this sector. This study aimed to analyse current approaches to FNS education in Australian primary schools.

METHODS

A cross-sectional online survey with closed- and open-ended questions collected data about (i) teacher perceptions and attributes regarding FNS education; (ii) FNS teaching practices; and (iii) factors influencing FNS education. Statistical analyses were conducted using STATA including descriptive statistics and chi-square analyses to test for associations between categorical variables. Qualitative content and thematic analyses of open-ended questions were conducted using NVivo 14.

RESULTS

Participants were 413 Australian primary school teachers. Teachers considered FNS education as equally important to most curriculum subjects, though frequency of FNS education was low. Less than a third of teachers were trained in FNS education, had access to funding for FNS-related activities or were from schools with policies about including FNS education in the curriculum. There was a significant association between frequency of FNS education and teacher training, access to funding and presence of FNS curriculum policies (all p < 0.001). Teachers who were trained to teach nutrition, food skills or food sustainability (all p < 0.05) were more likely to teach this as both stand-alone and cross-curricular subjects. Teachers described personal factors (workload, stress, scope of practice) that influenced their FNS teaching practices, as well as factors related to students' families (family responsibility for FNS education, family food practices, family engagement in FNS activities), the curriculum (overcrowding, prioritisation, access to resources) and the broader school environment (time, facilities, funding, training).

CONCLUSIONS

Strengthening the position of FNS education in the primary school sector is an important next step for public health research, policy and practice. Researchers and policy makers should explore future opportunities for training, funding and policy approaches that prioritise FNS within the primary school curriculum and in everyday teaching practice.

Associations between Preschool Teachers' Food-Based Learning Frequency, Level of Personal Priority and Identified Resources and Challenges: A Needs Assessment

Food-based learning (FBL) is the use of food as a teaching tool in the classroom, which can expose children to healthy foods to improve preference and consumption. However, more research is needed on the use and perception of FBL in the Head Start (HS) preschool classroom. In an online survey, we explored associations between North Carolina HS teachers' (n = 168) experiences (e.g., resources, challenges, needs, and preferences) with FBL, how frequently teachers implemented it, and how much they prioritized it. We used frequencies and chi-square tests of independence to assess associations between study variables. Teachers reported using FBL regularly with access to FBL resources (e.g., books and center play materials) and experiencing challenges (e.g., lack of funding and material resources). Teachers partnered with parents and farmers markets and expressed a need for additional FBL professional development. Our needs assessment findings revealed specific resources, challenges, and perceptions significantly associated with how often teachers used FBL and their priority level. Additional research should investigate how to alleviate FBL challenges and strategies to create policy and environmental changes that facilitate early FBL.

Healthy lifestyle interventions within the curriculum in school-age children: systematic review and meta-analysis

Childhood obesity is a major public health challenge. Previous research has identified the impact of school-based interventions for preventing and treating obesity; we hypothesized that when curricular changes are integrated, results could be exponentiated. This study aimed to systematically review and conduct a meta-analysis of the published literature analyzing information about school-based interventions inserted in the curriculum. The Cochrane Handbook methodology was followed. An electronic search was conducted in five databases, with a specific design strategy per database. Randomized controlled trials or quasi-experimental studies of children with nutrition and physical activity (PA) interventions inserted into the school curricula were included. The risk of bias was assessed with the Risk of Bias tool. The mean differences were pooled using a fixed-effects model for the meta-analysis. The certainty of the evidence was evaluated according to the guidelines of the Grading of the Recommendations, Assessment, Development, and Evaluations working group (Protocol ID: CRD42021270557). After the screening and selection process, 12 studies were included. The interventions identified, based on the school curricula, include classroom activities and homework, among others. A meta-analysis with five intervention groups presented an overall mean difference of -0.14 body mass index (BMI) Z-score (95% CI: -0.25, -0.03) after this intervention with high certainty of the evidence. This systematic review and meta-analysis suggest that nutrition and PA lessons inserted into the curricula and supported with additional activities (i.e. homework, workshops, etc.) could increase nutrition knowledge and improve attitudes toward fruit, vegetables, and water consumption, and BMI Z-score reduction.

Integration of Food-based Learning With Science in the Preschool Classroom: Implementation Gaps and Opportunities

OBJECTIVE

To explore Head Start teachers' use and integration of food-based learning (FBL) with science learning in the Head Start classroom.

DESIGN

Phenomenological approach using in-depth semistructured telephone interviews.

SETTING

North Carolina Head Start preschools.

PARTICIPANTS

Thirty-five Head Start lead and assistant teachers.

PHENOMENON OF INTEREST

All interviews were transcribed verbatim. Authors coded interview data for emergent themes.

ANALYSIS

Eleven primary themes were identified during analysis and inductively organized using the Systems Thinking Iceberg Model.

RESULTS

Teachers described most frequently using FBL during mealtimes. Teachers stated they felt successful when children were engaged and willing to try a new food. However, they struggled to connect food to science concepts. Teachers reported several motivators (eg, improving health) and barriers (eg, food waste) to integrating FBL. Teachers prioritized preparing children for kindergarten, but most teachers did not see how FBL could help them achieve this goal.

CONCLUSIONS AND IMPLICATIONS

Head Start teacher professional development programs could impact all 4 levels of the Systems Thinking Model to improve teachers' perceptions, underlying structures, and mental models regarding integrative FBL. Additional research is warranted to investigate the adoption, implementation, and potential impact of FBL on academic outcomes.

Formative evaluation of a STEAM and nutrition education summer program for low-income youth

In-depth formative evaluations are vital for curriculum development and program planning but are often not conducted before a program pilots. A formative evaluation of Project stRIde was conducted to gain insight from experts and identify revisions to the curriculum. Project stRIde is a science, technology, engineering, arts, and mathematics (STEAM) and nutrition-based curriculum developed for 4th and 5th grade students from low-income and diverse families. Nine experts spanning the fields of nutrition education, cultural competency, elementary education, summer programs, and STEAM outreach were recruited to participate in an expert content review (ECR) survey and virtual interviews. Seven core themes were identified: effectively promoting student engagement, increased guidance or support needed, activity too difficult for age, time, confidence in teaching lessons, cultural appropriateness, and strengths of curriculum in promoting STEAM education and innovation. Across the lessons, all reviewers agreed that the lessons were accurate, incorporated STEAM concepts, and were culturally appropriate for this population. Future major edits to the curriculum include creating supplemental videos, modifying some activities for age level, and incorporating more opportunities for participant engagement. Overall, an ECR is an effective way to examine a program's strengths and limitations and should be included in the beginning stages of program planning.

Fun with food - A parent-child community cooking intervention reduces parental fear and increases children's perceived competence

Cooking is being promoted as a preventative strategy for numerous health outcomes. However, there has been a reported decline in opportunities for children to learn in the home environment due to parental barriers such as time and concerns around children conducting certain skills. Therefore, this study aimed to understand the impact of a parent-child community cooking intervention on children's perceived cooking competence and interest in cooking and parental perceptions around including children in cooking. 'Fun with Food' was a four-week parent-child cooking intervention based on Experiential Learning Theory and designed by Home Economists. A mixed-method approach was undertaken to understand the effectiveness of the community-based intervention. Parents completed pre and post focus group discussions that were analyzed using Thematic Analysis. Pre and post surveys were used to investigate children's perceived cooking competence and analyzed with paired-samples t-tests and Cohen's d. Children's perceived cooking competence significantly increased after the intervention (P < 0.001, effect size -0.92). Parental fears around children performing certain skills, such as chopping and cutting, were reduced. Additionally, both children and parents found it an enjoyable experience, and appreciated the time spent together, which may be an indicator for positive wellbeing. Parents reported that children have been more actively involved in cooking since the intervention. Further, parents felt strongly that children should be cooking from as young as possible and that Home Economics should be introduced in primary school and made compulsory for older students in secondary school. The parent-child format for cooking has shown to be effective for increasing children's perceived cooking competence and reducing parental fears, highlighting it as a promising method for future interventions.

Nutrition across the curriculum: a scoping review exploring the integration of nutrition education within primary schools

Primary schools contribute to promoting healthy eating behaviour and preventing overweight and obesity by providing nutrition education. Research highlights the importance of improving teachers' programme implementation to enhance intervention effectiveness. An integrative approach has been suggested to reduce time barriers that teachers currently experience in teaching nutrition. This scoping review explores use and effectiveness of integrative teaching in primary-school-based nutrition education programmes. Six databases were searched for primary-school-based interventions on nutrition education. Papers reporting on integration of nutrition topics within core curriculum were included. Abstracts and full texts of potentially relevant articles were screened to determine eligibility. Next, data were extracted and tabulated. Findings were collated and summarised to describe intervention characteristics, subject integration and effectiveness of the included programmes. Data describing integration of nutrition into the primary school curriculum were extracted from 39 eligible papers. Nutrition education programmes often involve lessons about food groups and are frequently embedded within the mathematics, science or literacy syllabus. Although articles report on the integration of nutrition, the use of this approach was not commonly described in detail. Only seven papers discussed student outcomes related to the integration of nutrition education within core subjects. The ability to draw strong conclusions about school-based nutrition intervention effectiveness is limited by the current lack of programme description and methodological issues. Hence, more research is warranted to inform evidence on effectiveness of integrative nutrition education for both teacher and student outcomes. Future studies that include greater detail regarding the integrative approach are needed.

Fruit and Vegetable Intake Is Associated with Food Knowledge among Children Aged 9–14 Years in Southwestern Ontario, Canada

Interventions to improve dietary quality and intake of fruits and vegetables (FV) among Canadian children have had modest success, and it has been suggested that food knowledge could be key to improvement. Programs have been criticized for insufficiently connecting food knowledge with food skills and decision making about dietary intake. The objective of this study was to investigate factors associated with FV consumption by elementary school children, aged 9–14 years, in Ontario, Canada, including food knowledge, socioeconomic status, sociodemographic characteristics, and the food environment. In 2017–2019, a cross-sectional survey was administered to 2443 students at 60 elementary schools across Southwestern Ontario (SWO), Canada. A parent survey was used to validate self-reported sociodemographic variables. The mean intake of FV reported by these participants was 2.6 (SD 1.1) and 2.4 (SD 1.2) servings/day, respectively. A FV intake below WHO guidelines was reported by 40.7% of respondents. Knowledge score, child age, and parent employment status significantly predicted higher reported intake of FV. This study shows that FV intake among this population group is low, and increased intake is associated with higher food knowledge. To encourage healthy eating, school-based food and nutrition programs that incorporate multiple components and emphasize food literacy are needed.

What makes interventions aimed at improving dietary behaviours successful in the secondary school environment? A systematic review of systematic reviews

OBJECTIVE

To systematically review evidence from systematic reviews of interventions to improve dietary behaviours and reduce food wastage in secondary school pupils.

DESIGN

CINAHL, Cochrane Reviews, EMBASE, MEDLINE, PsychINFO and Web of Science were searched for systematic reviews of school-based dietary interventions from 2000 to 2020 published in a peer-reviewed journal in English. Articles were reviewed independently by two authors. AMSTAR-2 was used for quality assessment.

SETTING

Secondary school dietary interventions.

PARTICIPANTS

Adolescents (aged 11-18).

RESULTS

In total, thirteen systematic reviews of dietary interventions in secondary schools met the inclusion criteria. A number of key characteristics of interventions that contributed to improvements in food choices in secondary school pupils were identified. These included the combination of education and environmental restructuring, incorporation of computer-based feedback, media or messaging, peer and/or parent involvement, an increase in the availability of healthy foods and the use of behavioural theory as a basis to the intervention. Intervention components that contributed specifically to a reduction in sugar-sweetened beverage intake or an increase in fruit and vegetable consumption, which are particularly relevant to adolescents, could not be determined. Similarly, evidence for interventions that improve nutritional knowledge and attitudes was limited.

CONCLUSIONS

This systematic review of systematic reviews has identified a number of components of dietary interventions that can be explored to improve dietary behaviours in secondary school environments and, if demonstrated to be effective, be considered for inclusion in policies and strategies to improve the school food environment and promote dietary change.

Der Stellenwert gesundheitsbewusster Ernährungsbildung in der Schule

Einleitung

Übergewicht, auch bei Kindern und Jugendlichen, stellt national wie international ein großes Problem dar, welches stark mit Ernährung verknüpft ist. Ernährungsgewohnheiten werden bereits früh geprägt und können Einfluss auf die Krankheitsentstehung nehmen. Schulen als Lern- und Lebensorte können dabei ausgewogene und nachhaltige Ernährungsgewohnheiten fördern. Ziel der vorliegenden Arbeit war daher die Analyse ausgewählter Lehrpläne zur Ernährungsbildung (EB), um darauf basierend Defizite und Verbesserungsvorschläge für die schulische EB herauszuarbeiten.

Methodik

Untersucht wurden naturwissenschaftliche und hauswirtschaftliche Rahmenlehrpläne weiterführender allgemeinbildender Schulen der neuen Bundesländer in der aktuellsten Version bis 2019 mittels qualitativer Lehrplananalyse. Im Fokus standen Ernährungsthemen sowie deren Vertiefungsmöglichkeiten, praktische Umsetzung und Zeitumfang.

Ergebnisse und Diskussion

Ernährung und Humanbiologie werden vorrangig bis Klasse 8 in allen Lehrplänen unterrichtet, komplexere Themen größtenteils ab Klasse 9. Konkrete alltagsrelevante Lerninhalte zu praktischen Ernährungsweisen, zur Lebensmittelqualität sowie zur Rolle der Ernährung für die Krankheitsprävention können die Ernährungskompetenzen der Schüler:innen maßgeblich verbessern, finden jedoch derzeit zu wenig Beachtung in den Lehrplänen. Die Hauswirtschaftsfächer thematisieren u. a. Verbraucherthemen, werden aber nicht an Gymnasien bzw. nicht in allen Bundesländern angeboten. Wahlbereiche und Leistungskurse können die EB ergänzen, sind aber nicht an allen Schulen Teil des Lehrplans. Der Zeitumfang und die praktische Umsetzung für die EB sind u. a. stark von schulinternen Faktoren abhängig. Es lassen sich teilweise erhebliche Defizite in der EB feststellen.

Schlussfolgerung

Als sinnvoll erachtet werden eine intensivierte EB in höheren Jahrgängen, die Einführung von Hauswirtschaftsfächern in allen Schulformen und eine Vereinheitlichung der Lehrplaninhalte zwischen den einzelnen Bundesländern.

A school-based nutrition education program involving children and their guardians in Japan: facilitation of guardian-child communication and reduction of nutrition knowledge disparity

Background

Since the risk of noncommunicable diseases is closely associated with dietary intake, it is important to establish healthy dietary habits in childhood. Although several dietary education programs for children have been attempted, their implementation at school was often difficult due to overcrowded study curricula. We developed a new program which included homework for children and guardians, and evaluated its effect. Determinants of the effect were also investigated.

Methods

The school-based nutrition education program including a 45-min lecture, a series of homework assignments involving children and guardians, and two handouts was implemented in 14 public primary schools in Japan. Seven schools each underwent the intervention in an alternating manner. Nutrition knowledge (percentage (%) of correct answers in the nutrition knowledge questionnaire) and attitude/behavior toward diet was evaluated three times (May (baseline), October, February) as outcomes. These factors and their changes following the intervention were assessed by linear mixed models to adjust for individual factors, with consideration to clustering of the participants and repeated measurements.

Results

In total, 2227 children aged 10–12 years and their guardians participated. All schools completed the program. Children’s nutrition knowledge level was significantly increased (8.7%, 95% confidence interval [7.7–9.7]) following the intervention. Communication between children and their guardians, which was positively related with nutrition knowledge, was facilitated by the intervention. The increase in nutrition knowledge was greater among children with a lower knowledge level at baseline.

Conclusions

This school-based nutrition education program was effective and feasible. Appropriate teaching materials for homework can reduce the burden on schools and facilitate communication between children and guardians. Public schools can be crucial venues for decreasing disparities in nutrition knowledge.

Trial registration

This study was registered as an intervention study in the UMIN Clinical Trials Registry (trial ID: UMIN000029252) on Sep 22, 2017.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-021-00751-z.

From the pandemic to the pan: the impact of COVID-19 on parental inclusion of children in cooking activities: a cross-continental survey

OBJECTIVE

This study aimed to investigate the impact of COVID-19 on time spent cooking and parental inclusion of children in cooking. The secondary aim was to investigate differences between those who frequently included their children in cooking activities during the COVID-19 pandemic and those who included their children less, on a number of factors such as working from home, parents' diet quality and cooking skills confidence.

DESIGN

Cross-continental survey with Wilcoxon-signed ranks, Independent t tests, Mann-Whitney U, χ2 and a binomial logistic regression used for assessment.

SETTING

Online.

PARTICIPANTS

A convenience sample of parents over 18 years from the island of Ireland (n 180), Great Britain (n 312), the USA (n 120) and New Zealand (n 166).

RESULTS

In three regions, parents' time spent cooking and inclusion of children in everyday cooking activities increased (P < 0·001). Country (OR = 3·6, 95 % CI 1·7, 7·6), education (OR = 1·6, 95 % CI 1·1, 2·4), cooking skills confidence (OR = 1·02, 95 % CI 1·009, 1·032) and a parental higher intake of vegetables (OR = 1·3, 95 % CI 1·1, 1·5) were significant predictors of a more frequent inclusion of children in cooking activities.

CONCLUSIONS

While there a number of key benefits to including children in cooking for the children such as providing life skills and increases in diet quality, this study highlighted a higher intake of vegetables by parents who included children more frequently in cooking activities. With continued lockdowns due to COVID-19 and perhaps more flexibility in working from home in the future, including children in cooking activities should be a key public health message for both children and parents.

Evaluation of a Farm-to-School Intervention to Improve Locally Grown Vegetable Choices of Low-Income, Primary School Students

BACKGROUND

The study objective was to determine impact of a Farm-to-School intervention on low-income, diverse elementary school students' nutrition-related attitudes, self-efficacy, behaviors, and locally grown vegetable choices.

METHODS

Six elementary schools within 1 US school district were equally assigned to 1 of 3 conditions: Local Message, Nutrition Message, or Control. Locally grown vegetables (kale, green beans, zucchini, butternut squash, and beets) were served twice during lunch over 16 weeks. "Local" and "Nutrition" groups also received biweekly nutrition education and a messaging campaign in the cafeteria. Knowledge, attitudes, self-efficacy, and related behaviors were assessed using a validated questionnaire. Vegetable selection was assessed using the food service daily production records. General linear model analysis, analysis of covariance, and t tests were performed.

RESULTS

Students in the "Local" group (N = 81) had significantly improved nutrition-related attitudes (p = .0001), preferences (p = .001), and overall vegetable behavior score (p = .002), compared to control (N = 79). There was no difference in overall locally grown vegetable choices, but local beet choices were higher in the "Local" (p = .005) and "Nutrition" (p = .02) groups compared to control.

CONCLUSIONS

Messages about local foods in school cafeterias may improve students' attitudes, preferences, and selection of certain locally grown vegetables.

Integrating nutrition into the mathematics curriculum in Australian primary schools: protocol for a randomised controlled trial

Background

Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons.

Methods

Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups.

Discussion

This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions.

Trial registration

Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.

Comprehensive School Physical Activity Programming and Health Behavior Knowledge

No study to date has examined the effect of a multicomponent school-based physical activity program on health behavior knowledge in a large sample of low-income children from the US. The purpose of this study was to explore the change in physical activity and nutrition knowledge during a Comprehensive School Physical Activity Program (CSPAP) in children. Participants were a convenience sample of 789 children recruited from the 4th to 6th grades from five low-income Title I schools located within the Mountain West Region of the US. Students completed two questionnaires consisting of a physical activity and a nutrition knowledge assessment. Questionnaires were administered at baseline before the commencement of CSPAP and at a 36-week follow-up. Data were analyzed using a 3 × 2 × 2 doubly MANOVA test. Physical activity knowledge scores significantly improved from pretest to posttest during the intervention (p = 0.045, Cohen's d = 0.18). Grade level modified the time effects, with older children in grades 5 and 6 displaying greater improvements in physical activity knowledge than younger children in grade 4 (p = 0.044, Cohen's d = 0.33). There were no significant improvements in nutrition knowledge scores during the CSPAP (p = 0.150). These findings demonstrate that improvements in physical activity knowledge can occur during a multicomponent school-based intervention. Improvements in physical activity knowledge may translate to improvements in habitual physical activity behaviors and positively influence children's health outcomes, especially in older children.

Start-Up and Sustaining 20 Years of STEM Outreach Research and Programming: The Food, Mathematics, and Science Teaching Enhancement Resource (FoodMASTER) Initiative

Science and mathematics literacy are fundamental to the basic understanding of food and health and/or the pursuit of science-based careers. In 1999, the FoodMASTER Initiative (FMI) was created to provide an opportunity for youth to experience authentic, real-world health science activities in K-12 learning environments. FMI administrative locations have included Ohio University 1999-2005, East Carolina University 2006-2018 and Northern Illinois University 2018-current. The key programmatic elements for the FMI include: 1) curricular hands-on activities developed with teacher input, 2) free online access, 3) rigorous evaluation of program materials, and 4) robust partnerships with organizations that promote mathematics and science education. The purpose of this manuscript will be to 1) provide a rationale for the FMI programming, 2) share the curriculum and the process for developing curriculum and summarize the quantitative and qualitative findings of the 19 peer-reviewed articles, 3) discuss funding that was secured, 4) discuss strategies that lead to program sustainability, 5) discuss the mission and vision, and 6) summarize programmatic component sustainability.

Practice Paper of the Academy of Nutrition and Dietetics: Comprehensive Nutrition Programs and Services in Schools

It is the position of the Academy of Nutrition and Dietetics, School Nutrition Association (SNA), and Society for Nutrition Education and Behavior (SNEB) that comprehensive, integrated nutrition programs in preschool through high school are essential to improve the health, nutritional status, and academic performance of our nation's children. To maximize impact, the Academy, SNA, and SNEB recommend specific strategies in the following key areas: food and nutrition services available throughout the school campus, nutrition initiatives such as Farm to School and school gardens, wellness policies, nutrition education and promotion, and consideration of roles and responsibilities. This paper supports the joint position paper of the Academy of Nutrition and Dietetics, SNA, and SNEB published in the May 2018 Journal of Academy of Nutrition and Dietetics. In alignment with the joint position paper, this practice paper provides registered dietitian nutritionists and nutrition and dietetics technicians, registered with an overview of current school nutrition services and opportunities for professional careers in school settings. The Academy of Nutrition and Dietetics has several position papers related to youth preschool through adolescence that cover specific nutrition needs in more detail at www.eatright.org.

Health Related Nutritional Knowledge and Dietary Behavior Regarding Caffeine Intake among High School Students in Yongin Region

Objectives

We aimed to examine health-related nutritional knowledge and dietary behavior related to caffeine intake among high school students (n = 310) in the Yongin region of Korea.

Methods

Data were collected using a face-to-face survey, and analyzed using chi-square test, t- test, and logistic regression analysis.

Results

The level of caffeine intake in respondents was divided into low (< 30 mg/d; n = 208) and high caffeine intake groups (> 30 mg/d; n = 102). Total nutritional knowledge related to bone disease was higher in the low intake group (score 2.75) than the high intake group (score 2.39; p < 0.05). The high intake group had lower scores for nutritional knowledge (score 0.70; p < 0.05) related to how caffeinated beverages affect sleep and for dietary behavior (score 3.25; p < 0.001), based on “I avoid caffeinated foods before sleep,” than the low intake group (nutritional knowledge score, 0.80; dietary behavior score, 3.76).

Conclusion

In the overall analysis, the low caffeine intake group had better nutritional knowledge related to bone and sleep health, and healthier dietary behavior related to sleep health compared with the high intake group.

Senior Secondary School Food Literacy Education: Importance, Challenges, and Ways of Improving

Food literacy education at senior secondary school can provide both immediate and long-term benefits for adolescents. The exploration of multiple stakeholder groups’ opinions regarding the importance, roles, and challenges of school food literacy education, and their suggestions for its improvement, will help the design and execution of future food literacy-related curricula and programmes. This study explored a broad range of Australian and international food, health, and education professionals’ opinions regarding senior secondary school food literacy education through an online survey. One hundred and fifty-five food, health, and education professionals completed this survey between April and October 2017. Overall, the respondents strongly supported the need for food literacy education for senior secondary school students. Their suggestions for improving this form of education included: incorporation of relevant and up-to-date content, the presence of strong practical components, offering food literacy as compulsory subjects or the incorporation of food literacy concepts into compulsory core subjects. Moreover, they proposed the active contribution of both internal and external stakeholders in the planning and delivery of this education to upgrade its quality and relevance. Overall, the findings suggest that a wide range of food, health, and education professionals are highly supportive of senior secondary school food literacy education and their constructive suggestions should be considered in school food literacy education enhancement efforts. Education authorities should seek ways of involving different stakeholders, including food-related professionals, in the design and delivery of food literacy education, and future studies should explore the best mechanisms for such involvement.

Exploring the Associations Among Nutrition, Science, and Mathematics Knowledge for an Integrative, Food-Based Curriculum

BACKGROUND

Explore associations between nutrition, science, and mathematics knowledge to provide evidence that integrating food/nutrition education in the fourth-grade curriculum may support gains in academic knowledge.

METHODS

Secondary analysis of a quasi-experimental study. Sample included 438 students in 34 fourth-grade classrooms across North Carolina and Ohio; mean age 10 years old; gender (I = 53.2% female; C = 51.6% female). Dependent variable = post-test-nutrition knowledge; independent variables = baseline-nutrition knowledge, and post-test science and mathematics knowledge. Analyses included descriptive statistics and multiple linear regression.

RESULTS

The hypothesized model predicted post-nutrition knowledge (F(437) = 149.4, p < .001; Adjusted R = .51). All independent variables were significant predictors with positive association.

CONCLUSIONS

Science and mathematics knowledge were predictive of nutrition knowledge indicating use of an integrative science and mathematics curriculum to improve academic knowledge may also simultaneously improve nutrition knowledge among fourth-grade students. Teachers can benefit from integration by meeting multiple academic standards, efficiently using limited classroom time, and increasing nutrition education provided in the classroom.

What Should Be Taught in Secondary Schools' Nutrition and Food Systems Education? Views from Prominent Food-Related Professionals in Australia

Education can help young people to attain the knowledge and the skills that they need to make proper food choices and develop lifelong healthy eating patterns. This study explored the perspectives of prominent food-related professionals in Australia regarding essential nutrition and food systems (N&FS) education programs for adolescents during formal education. Semi-structured interviews were conducted with 21 prominent food-related professionals in Australia. Interview transcripts were analysed thematically. Four essential areas for N&FS education programs were identified. (1) Key nutrition messages to a healthy lifestyle; (2) Skill development programs to enhance health and wellbeing; (3) Ethical food-related lessons to support environmental sustainability, farm animal welfare, local producers, and food security; and, (4) Introductory lessons about foods from farm to plate to facilitate more informed food choices. Findings of this study may provide new insights for curriculum developers in Australia for further assessment of the current gaps in N&FS components of secondary school curriculum. Integration of these four areas into secondary school curricula has the potential to enhance adolescents’ knowledge of important scientific and ethical issues in a range of N&FS fields, and enable them to develop fundamental food-related life skills that are supportive of health and wellbeing.

Process Evaluation of FoodMASTER Middle Grades: An Integrative Approach to Nutrition Education in the Science Classroom

OBJECTIVE

Considering current adolescent obesity rates and the lack of previous intervention effects, our purpose was to utilize process evaluation techniques to help researchers identify intervention limitations for targeted programming.

METHODS

During the 2013-2014 academic year, 9 8th grade science teachers implemented the FoodMASTER Middle Grades (FMM) science curriculum. Researchers used classroom observations, formative and summative written feedback, and structured interviews to inform the fidelity, dose received, dose delivered, and context of curricular implementation.

RESULTS

Teachers reported that class size and time restraints were primary barriers to implementation. Primary facilitators included student enjoyment, standard alignment, ease of instructions, and professional development training experience.

CONCLUSIONS

Overall, FMM was feasible for implementation in middle school science classrooms as an integrated science curriculum.

Professionals' Recommended Strategies to Improve Australian Adolescents' Knowledge of Nutrition and Food Systems

Background: Education and policy measures within schools are valuable strategies to promote health. This study explored views of experienced food-related educators, researchers and policy-makers regarding their recommended strategies to improve Australian adolescents’ knowledge of nutrition and food systems (N&FS). Methods: Semi-structured interviews were conducted with twenty-one experienced food-related experts from across Australia. Interviews were conducted either by telephone or face-to-face. Recorded interviews were transcribed verbatim and analyzed thematically. Results: Five central themes and five sub-themes were identified from food professionals’ suggestions for best strategies to improve adolescents’ knowledge of N&FS. The central themes included: (1) specific improvements in schools’ core curricula; (2) pre-service and in-service training of school teachers about N&FS; (3) training students to develop a critical mind about N&FS issues; (4) multidisciplinary collaborations to improve school-based N&FS education; and (5) a supportive N&FS education environment for students. Conclusion and implication: These findings provide a guide for curriculum developers, educational policy developers, and food educators to incorporate the suggested N&FS strategies into Australian education programs in order to improve Australian adolescents’ knowledge and skills of N&FS issues. The results of this investigation also may assist the development of international N&FS curricula guides.

Experts' views regarding Australian school-leavers' knowledge of nutrition and food systems

OBJECTIVE

To explore Australian experts' views regarding strengths and gaps in school-leavers' knowledge of nutrition and food systems ( N&FS) and factors that influence that knowledge.

METHOD

Semi-structured interviews were conducted with 21 highly experienced food-related experts in Australia. Qualitative data were analysed thematically using Attride-Stirling's thematic network framework.

RESULTS

Two global themes and several organising themes were identified. The first global theme, 'structural curriculum-based problems', emerged from three organising themes of: inconsistencies in provided food education programs at schools in Australia; insufficient coverage of food-related skills and food systems topics in school curricula; and the lack of trained school teachers. The second global theme, 'insufficient levels of school-leavers knowledge of N&FS ', was generated from four organising themes, which together described Australian school-leavers' poor knowledge of N&FS more broadly and knowledge translation problem for everyday practices.

CONCLUSION

Study findings identified key problems relating to current school-based N&FS education programs in Australia and reported knowledge gaps in relation to N&FS among Australian school-leavers.

IMPLICATIONS

These findings provide important guidance for N&FS curriculum development, to clearly articulate broadly-based N&FS knowledge acquisition in curriculum policy and education documents for Australian schools.

Essential Nutrition and Food Systems Components for School Curricula: Views from Experts in Iran

BACKGROUND

This study aimed to investigate food experts' views on important nutrition and food systems knowledge issues for education purposes at schools in Iran.

METHODS

In 2012, semi-structured, face-to-face or telephone interviews were conducted with twenty-eight acknowledged Iranian experts in food and nutrition fields. Participants were selected from four major provinces in Iran (Tehran, Isfahan, Fars and Gilan). Open-ended interview questions were used to identify nutrition and food systems knowledge issues, which experts considered as important to be included in school education programs. Qualitative interviews were analyzed thematically using NVivo.

RESULTS

A framework of knowledge that would assist Iranian students and school-leavers to make informed decisions in food-related areas was developed, comprising five major clusters and several sub-clusters. Major knowledge clusters included nutrition basics; food production; every day food-related practices; prevalent nutritional health problems in Iran and improvement of students' ethical attitudes in the food domain.

CONCLUSION

These findings provide a guide to curriculum developers and policy makers to assess current education curricula in order to optimize students' knowledge of nutrition and food systems.

Relationship between nutrition knowledge and dietary intake among primary school children in Japan: Combined effect of children's and their guardians' knowledge

Background

Improving the dietary habits of children is important to decrease the future burden of noncommunicable diseases. While various food education programs have been implemented worldwide, evaluation of nutrition knowledge is difficult, even at baseline. Further, the relationship between nutrition knowledge and dietary intake has not been clarified in non-western countries.

Methods

After developing nutrition knowledge questionnaires for Japanese primary school children and adults, we examined whether higher nutrition knowledge of children and their guardians was associated with better dietary intake in children. A total of 1210 children in four public primary schools and 319 guardians were included in this cross-sectional study.

Results

Nutrition knowledge questionnaires were developed for children in lower and higher grades and adults. Higher nutrition knowledge of the children was significantly associated with higher vegetable intake (p for trend = 0.024 for boys and <0.0001 for girls in lower grades, <0.0001 for boys and 0.020 for girls in higher grades). Higher nutrition knowledge of the guardians was also associated with higher vegetable intake, except for boys in higher grades. The relationship between guardians' nutrition knowledge and intake of staple foods and fruits in children differed by children's sex.

Conclusions

We developed nutrition knowledge questionnaires for Japanese children and adults and identified a relationship between higher nutrition knowledge and healthier dietary habits. The child's own nutrition knowledge of dietary intake might be as important as that of the guardian for some foods. Sex differences in the effect of nutrition knowledge should receive greater attention in food education.

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Nutrition knowledge questionnaires were developed for Japanese children and adults.

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Higher nutrition knowledge was associated with healthier dietary habits in children.

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Both children's and guardians' nutrition knowledge affected food intakes in children.

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Sex differences in the effect of nutrition knowledge were suggested.

Middle school nutrition knowledge tool development and evaluation in North Carolina

PURPOSE –

This study aims to develop and empirically assess an instrument for measuring nutrition knowledge aligned to the North Carolina (NC) Healthful Living Essential Standards for teaching nutrition. The instrument was critically evaluated and used to assess nutrition knowledge in Eastern NC students.

DESIGN/METHODOLOGY/APPROACH –

Researchers evaluated 250 students in 16, eighth-grade classrooms using a 22-question researcher-developed nutrition knowledge questionnaire. Assessment questions were aligned with NC Healthful Living Essential Standards, which suggest students should be able to: apply tools to plan healthy nutrition, create strategies to improve dietary intake, create plans for lifelong health, and evaluate health information and products. Survey reliability and validity (face) were evaluated prior to study implementation. Descriptive statistics for individual items, total and individual standard scores were analyzed. Instrument efficacy was evaluated using item-difficulty and discrimination indexes.

FINDINGS –

The survey displayed appropriate levels of item difficulty with three exceptions: two questions were identified as too difficult, and one as too easy. The majority of items also displayed acceptable (>0.20) or excellent (>0.40) discrimination (17 out of 20). Average total nutrition knowledge score was 11.82-3.26 (53.7 per cent). Within aligned standards, students scored highest in creating plans for lifelong health (79 per cent) and lowest in evaluating health information (37.6 per cent).

ORIGINALITY/VALUE –

Study findings suggest eighth-grade students may only possess half the nutrition knowledge standards expected in the eighth grade. More instrument development is needed to supply researchers with standard means of assessing nutrition knowledge.

Best Strategies to Improve School-leavers' Knowledge of Nutrition and Food Systems: Views from Experts in Iran

Background:

The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts’ views of the best strategies to improve school-leavers’ knowledge of nutrition and food systems.

Methods:

In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo.

Results:

The experts’ suggested strategies to improve Iranian school-leavers’ knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge.

Conclusions:

Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely.

Implementation of a Food-Based Science Curriculum Improves Fourth-Grade Educators' Self-efficacy for Teaching Nutrition

BACKGROUND

Teacher self-efficacy can positively impact student dietary behaviors; however, limited curricular resources and professional development can serve as barriers to the provision of nutrition education in the classroom. The purpose of this study was to assess the impact of a food-based, integrative science curriculum on 4th grade teachers' self-efficacy toward teaching nutrition.

METHODS

Researchers used a quasi-experimental design to implement the FoodMASTER Intermediate (FMI) curriculum in 19 4th-grade classrooms across Ohio and North Carolina. The Nutrition Teaching Self-Efficacy Scale was used to assess baseline and post-test teacher self-efficacy using a 4-point Likert-scale (1=not confident at all; 4=very confident). ANCOVA and Wilcoxon-Signed Rank Test were used for statistical analysis.

RESULTS

Teachers in the intervention group displayed significantly higher post-efficacy expectation scores (mean=3.52; sd=0.41) than comparison group teachers (mean=2.86; sd=0.55). Overall, the intervention group showed significant improvement in self-efficacy on 15 of the 18 items.

DISCUSSION

The results suggest providing training and integrative resources to teachers can significantly improve self-efficacy toward teaching nutrition. Future research should focus on determining the amount of training needed to improve the quality of teacher-delivered nutrition education.

TRANSLATION TO HEALTH EDUCATION PRACTICE

Health educators can use the findings to inform the development of teacher trainings in nutrition and health.