|Thomas Lake|

Exploring ways to improve nutritional awareness in secondary schools: a literature review

1st October 2015

ContentsLiterature Review..................................................................................................................................2

Tweaking Current Provision...............................................................................................................3

Gardening/Food Interaction..............................................................................................................4

Education...........................................................................................................................................5

Interaction/Food Familiarity..............................................................................................................6

Conclusion.........................................................................................................................................7

Suggestions:.......................................................................................................................................7

Effectiveness Table................................................................................................................................8

Suggestion One – Moving the PSHEE Programme.................................................................................9

Suggestion Two – Extracurricular Activities.........................................................................................11

Targeted Children................................................................................................................11

Open Club............................................................................................................................11

Suggestion Three – Utilising the House Point System for Healthy Eating............................................12

Suggestion Four - A Year 7 Dining Hall Induction.................................................................................13

Suggestion Five - The creation and maintenance of a school vegetable patch....................................14

Suggestion Six - Utilise Healthy Eating Week 2016 – or make own one / more themed weeks..........15

Appendix A – Head Teacher Checklist (School Food Plan)...................................................................16

Reference List:.....................................................................................................................................18

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Literature ReviewThis literature review was created in 2015, using a variety of resources published in the

recommended ten year window (Study.com, 2015). It focusses on the area of child

awareness of health and nutrition as opposed to a kitchen-based intervention. All resources

were found in September 2015 over a week-long period of research, using opinions and

facts from websites, blogs, news outlets and television media.

First of all, there is an explicit awareness that some young people aged 5 to 16 display an

alarming lack of nutritional awareness (Burns, 2013) which leads to distorted views on what

a balanced diet actually is. This review does not go into the scientific analysis of what a

balanced diet is; more so analysing education and awareness of optimal nutrition and

exploring strategies to increased knowledge and understanding.

There is a safe-guarding need from everyone involved in working with children to ensure

that children have the appropriate awareness of what a healthy diet can consist of,

particularly when it can form a strand of the OFSTED school examination criteria (OFSTED,

2006, p5). These criteria include working with parents and children in a community-based

manner to ensure that a role is played by everyone connected to improve the nutritional

awareness of children, whilst also acknowledging the significance that media-based

appearance and body issues can impact on teenagers and finding appropriate ways to

circumnavigate these issues.

Although some physical traits such as somatotype and metabolistic disorders are inherited

(Fontana, 2000, p6; Competition, Science Vision, p495) there are other eating pattern

disturbances that are nature-based, or learnt, which can affect the diets of students.

Conditions such as neophobia exist, where individuals consume smaller varieties of food

than others (Gallway et al, 2003, in Robinson, 2006, p7) therefore missing out on key

nutrients. These conditions are likely developed at home, where limited diets or an over-

reliance on smaller food groups by parents or carers can manifest into a more serious issue

where a child is reluctant to try new foods, even though the child may recognise their

nutritional value. Despite neophobia often being associated with a reluctance to eat fresh

fruit and vegetables, in some instances it can be beneficial; those who rarely eat junk food

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at home may be less aroused by much-publicised junk food which offers some prevention to

the habits of eating badly when away from the home environment. This environment can

also be defined as an ‘obesogenic environment’ (Upton and Thirlaway, 2009) where there is

a lack of nutritional promotion and lack of positives choices regarding dietary intake.

There is also evidence that a change needs to be made in education as a whole in the United

Kingdom, which ranked last in a study by UNICEF (2007, in Vogt-Vincent, 2015) based on

children’s wellbeing in school. Whilst this is an umbrella study which makes judgement from

a wide variety of criteria, the new era of terminal exams (Donnelly, 2013; Watkin, 2015)

places students under more pressure with more demanding course content, placing a

greater importance on the food they fuel themselves with.

More recently, the School Food Plan (Children’s Food Trust, 2013a) was created following

research and engagement with schools across the country, with two main messages. The

first was a policy to provide all children in Year Reception, One and Two to be provided a

free school lunch, which was rolled out in 2014. The second policy was a resource bank of

ideas and recommendations for Primary and Secondary Schools, including the

‘Headteacher’s Checklist’ (Children’s Food Trust, 2013b and Appendix A) which offers a

range of ideas to affect health promotion in young people.

Despite the negative connotations associated with school food and eating patterns, there is

evidence to suggest that small adaptations have been made in some schools in the United

Kingdom, and that interventions to improve student’s nutritional understanding do not have

to be as didactic as the approach seen by Caen school (Gussin, 2014) where food deemed

unhealthy was removed from children’s lunchboxes.

Tweaking Current ProvisionEvidence suggests that interventions do not have to be on a large scale in order to try to

promote a healthier lifestyle. A 2014 study by Doctor Andrew Hanks (Journal of Education

and Behaviour, 2014, p178) in New York State discovered three effective methods which

reduced canteen food waste at schools, improving the nutritional intake of students and

from an economic point of view saving the canteen and school money due to a reduction in

food waste. These three methods were:

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1. Naming vegetables used – Hanks found that by naming the vegetables in obscure or

less-recognisable dishes and having the vegetables listed in the dish on display

presented a greater take up, as opposed to students trying and subsequently

wasting food which they do not like. Simply by labelling a lasagne with its ingredients

it provides a comfort zone for the students without the shock of a mystery

vegetable, which could further increase neophobia of new foods. This intervention

resulted in a saving of 6c per serving, which with a 200 person dinner would save

around $12 a day, and therefore $60 per week.

2. Moving fruit next to the cash register – In a fashion similar to where supermarkets

and stores leave small goods such as chewing gums and sweets near tills in an

attempt to entice shoppers into a last minute additional item. By moving these

foods, there was less food wastage when the fruits were placed in obscure places

and then were deemed unsellable due to their short shelf life. This intervention

saved 3c per serving, a more moderate saving however there is no data available to

suggest if this increased sales.

3. Slicing fruit and pre-preparing – Hanks found that by taking the extra time to

prepare the fruit by either slicing, separating, peeling or drying fruit helped again to

reduce food waste, saving 4c (33% ROI) per serving and making it easier for children

to access fruit. Some fruits, such as pineapple and kiwi are not easily prepare-able to

active children on the go, so preparing food in advance helped both to make fruit

more accessible and reduce waste.

Gardening/Food InteractionMore recently, schools have started to look at varying degrees of self-sufficiency in terms of

dedicating areas of the school as gardens, and in some cases growing their own fruit and

vegetables, either for profit to raise money for the school or to provide the canteen with

fresh fruit and vegetables.

As well as understanding food nutrition in the technology area of the National Curriculum,

the use of additional cross-curricular nutritional information can help to aid children to

make better nutritional choices both in and out of school. Ritz, (in Jenkin 2014) began the

curation of edible walls in schools in deprived areas of the Bronx in New York where outside

space was either too dangerous or space too restricted. These walls were maintained by

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some students in the school, who were responsible for the watering and care of the plants

and vegetables whilst on the walls inside the school. This responsibility both educated and

aided the children’s exposure to vegetables, but also had remarkable curricular benefits,

with attendance leaping from 43-93% in a short space of time, much owing to the added

responsibility the children had. It also provided better food options to a traditionally under-

nourished area of New York, giving children easier access to important micronutrients.

An example of the edible walls in schools in the Bronx, New York City

This approach was also replicated in England, with companies such as Poppies and Parsnips

linking with projects like The Mead Academy Trust to create viable growing solutions

(Marsh, 2015) such as using growing vegetables in items such discarded wellington boots,

buckets and containers, with inter-class competitions on who can grow the best vegetables.

These ideas are more feasible than similar ideas such as that of Jacobs (2015, in Marsh,

2015) who proposed reducing sports or active areas to allow the development of gardens,

which seems a move which spites the face of the school, with open spaces integral to the

health and wellbeing of young people.

EducationThe idea of a link between what the students learn about in class and what they eat in the

dining hall is not a new concept; the Department of Education in Northern Ireland (2013,

p28) advocate a clear ‘consistent message between learning in the classroom and eating in

the dining hall’, promoting links between classroom activities and what the children then

eat afterwards in unstructured time.

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There are several angles to this message from the Department of Education in Northern

Ireland; simple interventions include education on food nutrition earlier in the curriculum

(currently in the Park School PSHEE programme – earliest it is seen is Spring Term Year 8) all

the way to offering alternative education options such as the single award BTEC

qualifications (Edexcel, 2010, in Oliver, 2010) which allow students to further study the idea

of health and nutrition with the tangible reward of additional qualifications at the end of the

course. These types of options inevitably cause financial, logistical and educational issues

which need to be addressed prior to any commencement, so easier, more viable options

should be looked at to try to make a difference to the nutritional understanding of young

people.

Interaction/Food FamiliarityPrimary schools offer a range of educational activities that link into nutritional awareness, all

of which can be altered and moulded to suit the needs and demands of Secondary School

children. Pondhu Primary School, located in Cornwall, used pre-identified days such as sugar

detective days (Blake, 2015) where students used a wide range of methods to discover the

amount of hidden sugar in foods, in a quantitative and hands-on manner. These activities

were also extended to the parent’s forum in the evening, demonstrating the link that Ganz

(2015) advocates between parent/carer nutritional awareness and subsequently more

educated food choices at home.

Other successful ideas included the creation of after-school cooking clubs, run as part of an

initiative of the Children’s Food Trust (2015) to get more children to both experience food

and understand how to make basic dishes, which hopefully has the opportunity to manifest

into a passion for cooking and enjoying food. These types of interventions do not require

much expense or start-up costs, rather just facilities which the school already has and

willingness for students to participate and attend regularly.

The National Governor’s Association (2007, p26) also recommend the use of additional

interventions in schools that can engage children, without the limits of after-school

transport issues or extra costs involved for ingredients for after school clubs. These ideas

include staggered lunchtimes so that children have time to sit, eat and digest their meals

before running off into unstructured time, which could be the rationale as to why they are

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choosing fast food as it is quicker to eat and dispose of. It also recommends the idea of

using electronic technology to monitor food patterns, and when a series of ‘inappropriate’

food choices are made the data can be fed home to parents or carers to show what their

child is eating on a daily basis.

The environment is also mentioned by the report as a considerate in the aim of promoting

healthy eating, with queuing systems, space and pupil-student staff relations all playing their

part in the successful promotion of healthy living.

ConclusionHaving experienced being both a student and a member of staff at the school, the food and

nutritional awareness the school offers has undoubtedly got better, from the days of the

turkey twizzler to the current scenario of salad buffets and pasta bowls. What has also

changed in our world however is the ability to ‘disguise’ foods and over-exaggerate benefits,

as seen by the withdrawal of the Lucozade advert which [falsely] claimed it can hydrate

better than water (Shaikh, 2014) showing how easy it is to manipulate minds and influence

dietary decisions.

Foods packed with artificial flavourings, added sugar and salt are commonly cheaper than

natural foods, which adds an economic reasoning to the difficulty of sustaining a more

nutritious diet and in some cases the nutritional awareness is there, yet the availability of

more nutritious foods is limited due to the reasons of X, Y or Z.

From this literature review and taking into account socio-economic justifications, I have

proposed six suggestions which may help to achieve a greater nutritional understanding for

students at The Park Community School.

Suggestions: Moving the PHSEE Healthy Eating module from Year 8 to Year 7

Re-start the after school clubs

Utilising the House point system to include healthy eating

A Year 7 Dining Hall induction

The creation and maintenance of a school vegetable patch

Utilise Healthy Eating Week 2016 – or make own one / more themed weeks

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Effectiveness TableThe below table suggests the effectiveness and feasibility of each suggestion, signified by a traffic-light based system which subjectively evaluates the cost, difficulty, time investment and the educational exposure to the students.

Cost Difficulty Investment of Time

Educational Exposure

Suggestion 1 – Moving

PSHEESuggestion 2

– After School ClubsSuggestion 3

– House Point SystemSuggestion 4

– Dining Induction

Suggestion 5 – School Garden

Suggestion 6 – Healthy

Eating Week

Low Medium High

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Suggestion One – Moving the PSHEE ProgrammeThis is the easiest intervention, with no cost or additional resources required, rather just a

re-jig of the current PSHEE provision. A search on the Google Drive – Resources folder shows

the programme for Year 7, with no mention of healthy eating.

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A further search suggests that spring half term in Year 8 is the first time that the children

encounter a module on diet and exercise, barring the Food and Nutrition technology

module they would have had in Year 7. Adding this into the Food and Nutrition module

places additional pressure on classroom teachers to deliver this plus their necessary

elements of their module. The easier option seems to be to move the PSHEE module to Year

7 so at least there is a small window of time that children are able to learn about what they

are eating and what constitutes a balanced diet.

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Suggestion Two – Extracurricular ActivitiesThe school already offers a fantastic array of extra-curricular activities in both lunchtimes

and after school, which undoubtedly increases participation in sports, arts and crafts and

academic sessions such as drop-in revision clubs and homework clubs.

There are obvious physical benefits to extra-curricular exercise, however there is also an

understanding that not every child likes or enjoys exercise.

The creation of an after-school project such as a cooking club or nutritional programme

could further engage students, of whom existing clubs are not suitable for, into a positive

change. Previous schools I have worked in up in Derby offered sessions on two types of

basis:

Targeted Children – Identifying a group of children for whom there might be

known cases of malnutrition, or children who the school think may benefit from

additional nutritional knowledge and offering places to them which are subsidised or

free (I do not know about funding, finances or anything like this sorry!)

Open Club – Offering the club to the whole school with a predefined number of

students. Reduce costs by creating simple recipes with inexpensive ingredients – e.g.

vegetarian dishes or ‘healthier’ versions of baking.

If possible, engaging the local community could also be an option, such as walking down to

the butchers in Town to see how meat is cut, or inviting farmers or local tradespeople in to

school to talk or run workshops based on food. This may add extra appeal to prospective

parents if they become aware of inter-community links between local food producers and

the school, emphasising the community-based school we are achieving.

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Suggestion Three – Utilising the House Point System for Healthy EatingThe House Point system was previously, and still to an extent, is a very sports-orientated

system where Houses score points based on inter-House sporting achievements. More

recently, this has started to include the Accelerated Reader program in the School Library

where House Points are available for the amount of reading and difficulty of the books over

a period of time.

This suggestion could involve a week or pre-defined amount of time where points are given

for the amount of fruit or vegetables eaten per week, in the form of a sticker system given

by MTA’s or the Canteen Staff or by reading data from the Smart Card system. This would

create extra emphasis on the importance of healthy eating in the weeks before in the form

of assemblies and morning registration sessions, hopefully leaving a legacy afterwards with

children choosing more positive options. This again has a minimal cost of the stickers but all

other infrastructure is in place.

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Suggestion Four - A Year 7 Dining Hall InductionThe Year 7’s who arrive at their first day at Secondary School come from a structured school

eating environment where set meals are provided, to an environment where children have

free reign what they spend their money on.

Without restricting food choices, a simple exercise could be done in the morning of the first

day or second day where some sort of Food Presentation is shown, followed by a fairly

simple quiz to demonstrate understanding of basic macro and micronutrients and what, in

an ideal world, we should be aiming to eat daily. This could be certified to add more appeal

to the children, with the ethical knowledge that at least the students have a basic

knowledge of what they are going to buy at lunchtime. This again is an activity where

knowledge is passed across with little cost apart from the reprographic costs of creating and

printing certificates and making a presentation.

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Suggestion Five - The creation and maintenance of a school vegetable patchThis is the costliest suggestion, but could have the greatest impact on the lives of the young

people we work with daily.

The school garden we already have is underused, underpublicized and possibly damaged

due to the erection of the Sports Hall roof, with [as far as I am aware] no curricular use for

subjects. There are obvious scientific and food technology benefits to using the garden, as

well as linking into other subjects such as Art and Geography.

The Garden could be revived and used more, however another option could be to use an

area of the Year 7 quad (which is used sparingly by Year 7’s) and transform it into a small

vegetable patch, with its proximity to the Food Technology rooms an obvious bonus. This

could be maintained by a group of children with the eventual aim of having vegetables

which can either be used in Food Technology or sold to staff to create revenue for the

school.

I am unsure of the costs of such a project, but it could develop into an ongoing project

where possibly the canteen could even benefit from home grown vegetables which could

save the canteen and the school money.

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Suggestion Six - Utilise Healthy Eating Week 2016 – or make own one / more themed weeksHealthy Eating Week 2016 (Food, a Fact For Life, 2015) is a nationwide initiative which

reaches over ‘7,500 nurseries, schools and academies’ and promotes healthy eating during

the week of June 13-17, 2016.

Activities recommended during Healthy Eating Week include:

considering guests you could invite into school to provide talks and run workshops

based on healthy eating, cooking and food provenance;

thinking about trips and visits for the pupils, e.g. to a local farm, supermarket, food

factory, restaurant;

Talking to your canteen about special dishes and events for the week.

Other ideas can include cross-curricular links, non-school uniform days and special clubs

during the week to add additional exposure to the Healthy Eating Week.

In our school we already run successful themed weeks in the Dining Hall, including from last

year a Chinese week and an American week, plus more. This could easily be extended to

incorporate the Health Promotion theme, either during the designated week or at a time

the school decides is suitable.

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Appendix A – Head Teacher Checklist (School Food Plan)

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Reference List:Blake, R. (2015) ‘Learning about healthy eating at Pondhu School’ [online] Available from:

http://www.cornishguardian.co.uk/Learning-healthy-eating-Pondhu-School/story-

27862807-detail/story.html (Accessed 29th September 2015)

Burns, J. (2013) ‘'Cheese is from plants' - study reveals child confusion’ [online] Available

from: http://www.bbc.co.uk/news/education-22730613 (Accessed 25th September 2015)

Children’s Food Trust (2013a) ‘School Food Trust’ [online] Available from:

http://www.childrensfoodtrust.org.uk/childrens-food-trust/schools/school-food-plan/

(Accessed 30th September 2015)

Children’s Food Trust (2013b) ‘Checklist for Head Teachers’ [online] Available from:

http://www.schoolfoodplan.com/headteacher-checklist/ (Accessed 27th September 2015)

Children’s Food Trust (2015) ‘Let’s get cooking – setting up a club’ [online] Available from:

http://www.childrensfoodtrust.org.uk/lets-get-cooking/set-up-a-club/ (Accessed 24th

September 2015)

Department of Education in Northern Ireland (2013) ‘Healthy food for healthy outcomes

september 2013 food in schools policy’ Belfast, Government of the United Kingdom, p28

Donnelly, K. (2013) ‘New era for schools in radical overhaul of exams’ [online] Available

from: http://www.independent.ie/irish-news/new-era-for-schools-in-radical-overhaul-of-

exams-29705050.html (Accessed 29th September 2015)

Fontana, D. (2000) ‘Personality in the workplace’, London, United Kingdom, Macmillan

Press, p6

Food, A Fact For Life (2015) ‘Healthy Eating Week 2016’ [online] Available from:

http://www.foodafactoflife.org.uk/section.aspx?sectionId=114 (Accessed 1st October 2015)

Ganz, S. (2015) ‘Fresh from the garden patch: healthy food options for students in Richmond

Public Schools’ [online] Available from: http://rvanews.com/features/fresh-from-the-

garden-patch-healthy-food-options-for-students-in-richmond-public-schools/129429

(Accessed 29th September 2015)

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Gussin, T. (2014) ‘Staff remove ‘unhealthy’ food from pupils’ lunchboxes at Braunton primary

school’ [online] Available from:

http://www.northdevongazette.co.uk/news/staff_remove_unhealthy_food_from_pupils_lu

nchboxes_at_braunton_primary_school_1_3785580 (Accessed 31st March 2015)

Hanks, A. S. (2014) ‘Smarter lunchrooms equal deeper pockets’ in ‘Journal of Nutrition

Education and Behavior’, Volume 46, Issue 4S, p178

Jain, M. (2008) ‘Competition, science, vision’ Year 11, Issue 124, p495

Marsh, S. (2015) ‘Green-fingered teachers: how to grow fruit and vegetables in school’

[online] Available from: http://www.theguardian.com/teacher-network/2015/jun/29/green-

fingered-teachers-how-to-grow-fruit-and-vegetables-in-school (Accessed 29th September

2015)

OFSTED (2006) ‘Healthy eating in schools’ [online] Available from:

http://webarchive.nationalarchives.gov.uk/20130401151715/http://www.education.gov.uk

/publications/eOrderingDownload/4167.pdf (Accessed 24th September 2015)

Oliver, J. (2010) ‘Jamie’s Cooking Skills’ [online] Available from:

http://www.jamieshomecookingskills.com/about.php (Accessed 20th September 2015)

Robinson, S. (2006) ‘Healthy eating in primary schools’, London, SAGE Publishing, p7

Shaikh, T. (2014) ‘Lucozade Sport ad campaign banned for claiming drink hydrates better

than water’ [online] Available from:

http://www.independent.co.uk/news/media/advertising/lucozade-sport-ad-campaign-

banned-for-claiming-drink-hydrates-better-than-water-9047437.html (Accessed 29th

September 2015)

Study.com (2015) ‘Assessing the reliability and validity of sources’ [online] Available from:

http://study.com/academy/lesson/assessing-the-reliability-and-validity-of-sources.html

(Accessed 25th September 2015)

Vogt-Vincent, O. (2015) ‘I am 16 and the education system is destroying my health’ [online]

Available from: http://www.theguardian.com/teacher-network/2015/aug/16/i-am-16-and-

the-education-system-is-destroying-my-health (Accessed 24th September 2015)

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Watkin, B. (2015) ‘Reformed GCSEs and A-levels: an overview’, London, SSAT (The Schools

Network)

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