Comprehensive School Health and Nutrition 

Written by Paul Fieldhouse, Nutrition Policy & Research Consultant from Manitoba Health & Healthy Living

Nutrition, health and learning

Over the course of a school year a student may eat up to 200 lunches at school, consume food at numerous parties, dances or cultural events, buy food and beverages from vending machines, attend a breakfast or snack program, receive food as a classroom incentive or reward, and sell food products for fundraising. That adds up to a large number of eating events in schools every day [around 100,000 in Manitoba alone]. Offering and promoting healthy food and drink choices throughout the school day can therefore make a big contribution toward improving the nutritional status and overall health of children.

The importance of eating nutritious and well balanced diets has long been recognized and discussed ¹. The diet of children and youth is an important influence on their current and future health, as poor nutrition can put young people at risk of developing obesity, malnutrition, disordered eating, type 2 diabetes, iron deficiency anaemia and dental cavities.  Poor eating patterns established in childhood commonly persist into adulthood, becoming ever-more resistant to change. Recent research underlines the relationship between nutrition and cognitive development and supports claims that poor nutrition is associated with poorer learning outcomes ^2,3,4.

The role of the school

The school is a key setting for primary socialization of children.  What children learn and practice in school will help to establish lifelong attitudes and behaviours that will serve them well in negotiating the myriad of influences and pressures from commerce, media, friends and family that compete to shape their eating habits.

Ideally schools would:

• Help students to establish a pattern of eating that focuses on balance, variety and moderation.
• Be an institutional role model to students, educators, parents and communities about the importance and value of healthy eating.
• Provide opportunities for learning, practicing and establishing healthy eating habits for a lifetime.

This calls for a comprehensive approach that obeys the dictum that “schools educate by what they do” and that integrates multiple aspects of food in school life through curriculum instruction, programs, environment and policy. Consistency, rather than conflict of pedagogical messages and environmental cues is required to maximize effectiveness in the promotion of healthy eating.  For example, it is contradictory to have a nutrition lesson on healthy eating, but then stock vending machines with low-nutrient, high-calorie foods. One memorable cartoon in my collection shows two distinctly obese youngsters at a front door, selling chocolate bars to raise money for diabetes awareness and insulin injection kits.

A comprehensive approach

Curriculum

Nutrition can be and is often taught throughout the K-12 curriculum in a variety of subjects such as home economics, health and physical education and science. There is no shortage of resources and ideas available for teaching nutrition in a creative way. However, because not all students take home economics classes, it is unwise to rely on this as the sole curriculum vehicle for learning about food. This is particularly the case when it comes to practical cooking skills, which are in decline, and the lack of which drastically affects food practices in the home. One response, from the UK, is to make hands-on practical cooking compulsory for all 11-14 year olds – the first time that cooking has ever been compulsory in schools ⁵.

Programs

School nourishment programs – most commonly breakfast and snacks, originally developed on an ad hoc basis to feed ‘hungry kids’, have evolved into more sophisticated programs adhering to best practice standards that aim to meet nutritional needs in a social setting. A school breakfast club can integrate nutritional, educational and social goals, while fruit and vegetable snack programs have been shown to be successful in increasing children’s fruit and vegetable consumption ⁶. These in-school programs reinforce curriculum learning. The “Cooking Bus” program in the UK, designed to support the national curriculum, teachers' own work objectives, and government health messages is a good example of how a centrally coordinated program can be shared between schools ⁷.

Environment

Changes in how schools organize around food are vital to successful food and nutrition education.  This includes both physical and social environments.  What is served or offered for sale in cafeterias, canteens and vending machines, how much it costs, and where it is eaten should be consistent with pedagogical messages in the taught curriculum.  Aspects of the school food environment can also link to broader issues and activities, such as recycling, school gardens and composting.  The concept of the Edible School Yard provides a wonderful example of this broader framing of food and nutrition education ^8,9.

Policy

The last few years have seen the development of school nutrition policy in most Canadian jurisdictions. These initiatives differ to a lesser or greater degree in scope and nature, but all have the same basic purpose to improve access to and consumption of nutritious food in schools. Different approaches are possible, including banning or restricting particular food products, setting nutritional standards for foods served, or providing guidelines and stipulating desired outcomes, while respecting school-based decision–making.

The power of policy is that it is an intentional statement of commitment. It provides both impetus and a framework for change, but it also supports and enables change where there is resistance. The existence of a written policy that is developed by and shared with the broader school community is in itself an educational tool that strengthens understanding and empowers action.  Many successful policies are predicated on full involvement of administrators, teachers, student, parents, food service providers and other ancillary staff. Realistic action plans should start where success is most likely to be achieved. Changes should be monitored and shared so that everyone can see how it is making a difference; and successes should be recognized and celebrated (with healthy food of course!).

Food is more than nutrition

Health has physical, social, mental and spiritual dimensions but when it comes to food we seem to focus almost exclusively on the physical side, and may be in danger of reducing food to a collection of nutrients or, worse still, to mere fuel. As adults we know that food plays a central role in daily life: it is part of social interaction such as family meals or dinner with friends; it affects, and is responsive to, our moods and feelings of well-being; it is part of being human.

Why should that be different for children at school?  Through food children learn about security and affection, friendship and love, peer acceptance, prestige and status, punishment and reward, hospitality and sharing. What would the food experience at school look like if we paid more attention to these other dimensions? 

The Japanese concept of Shoku-iku is an example of an attempt to embrace this wider approach to food and nutrition education. Not only does it aim to give children the knowledge and ability to choose food and prepare healthy, nutritionally balanced meals on a regular basis, but also incorporates teaching respect for food from the earth to the plate, aesthetic appreciation of food presentation, and social interaction around food from personal manners to sharing and consideration for others ¹⁰.

Desired outcomes – a healthy relationship to food

There is a modern tendency to over-emphasize the importance of individual foods – either by demonizing them or investing them with miraculous powers. The age old message of healthy eating is balance, variety and moderation; although operationalizing this message has always been a major challenge for nutrition education. While teaching dietary prudence, we must avoid a guilt-producing, unhealthy preoccupation with food that may exacerbate the very problems that we are trying to address. Most importantly we need to imbue children with a sense of connection to food as the source of life and celebration. A thoughtful, comprehensive approach to food and nutrition at school provides this opportunity.

References

1- Birch, H.G. & Gussow, J.D. (1970) Disadvantaged Children: Health, Nutrition and School Failure. Harcourt, Brace & World: New York.

2- Florence, M.D., Asbridge, M., & Veugelers, P.J. (2008) Diet quality and academic performance. J. School Health. 78: 209-215.

3- Bellisle, F. (2004) Effects of diet on behaviour and cognition in children, British  Journal of Nutrition. Suppl. 2: S227-S232.

4- Sorhaindo, A.. &  Feinstein, L. (2006) What is the relationship between child nutrition and school outcomes? Centre for Research on the Wider Benefits of Learning. Institute of Education,  London, UK.

5- Department of Children, Schools and Families. Compulsory Cooking Lessons for All Young People. http://www.dcsf.gov.uk

6- He, M. et al (2007) Northern Fruit and Vegetable Pilot Program: Final Report. London, Ontario: Middlesex-London Health Unit.

7- Food Standards Agency. The Cooking Bus. http://www.food.gov.uk/healthiereating/nutritionschools/

8- The Edible Schoolyard [Berkeley] http://www.edibleschoolyard.org/

9- The Edible School Yard [Nova Scotia] http://slowfoodns.blogspot.com/2008/03/coming-in-may-2008-edible-schoolyard.html

10- Ministry of Agriculture, Forestry and Fisheries, Japan. What is Shoku-iku? http://www.maff.go.jp/e/topics/pdf/shokuiku.pdf

Dr. Paul Fieldhouse
Nutrition Policy & Research Consultant
Manitoba Health & Healthy Living
300 Carlton St.
Winnipeg, Manitoba R3B 3M9

Ph 204-786-7350
Fax 204-948-2366
Email  Paul.Fieldhouse@gov.mb.ca

Please note that this is a modified version of the article. The full article is published as part of the Canadian Association of Principals (CAP) Journal which can be accessed through the following link: www.jcsh-cces.ca/upload/spring%202009%20issue_CAP%20Journal%20reduced%20file%20size.pdf