Outcome Evaluation on Impact of the Nutrition Intervention among Adolescents: A Feasibility,Randomised Control Study from Myheart Beat (Malaysian Health and Adolescents Longitudinal Research Team—Behavioural Epidemiology and Trial)

A healthy eating environment in the school setting is crucial to nurture the healthy eating pattern for youth. Thus, it helps to combat the obesity issue. However, the impact of healthy school environment on healthy eating habits among Asian adolescents is scarce and less clear. This clustered randomised-control study has two objectives. The first objective was to evaluate the changes in adolescents’ dietary intake after the interventions for all arms (control; healthy cooking training only; subsidization with healthy cooking training). The second objective was to compare the effect of subsidization with healthy cooking training and healthy cooking training only with the control arm on adolescents’ dietary intakes. This study consisted of 340 secondary school students aged 14 years in rural and urban Malaysia. A total of two arms of intervention and one arm of control were included. Intervention one focused on healthy cooking preparation for the canteen and convenience shop operators. Intervention two included subsidization for fruits and vegetables with a healthy cooking preparation training for the canteen and suggestions on providing healthy options to the convenience shop operators. The outcome measured was changes to dietary intake. It was measured using a three-day dietary history pre- and post-intervention. A paired-t test was used to evaluate the outcome of intervention programmes on dietary changes for all arms (control, intervention one and two). An ANCOVA test was used to investigate the effect of providing subsidization and healthy cooking preparation training to the canteen and convenience shop operators on adolescents’ dietary intakes as compared to the control arm. Overall, the reduction in energy and carbohydrates for all arms were observed. Interestingly, fat intake was significantly increased after the four-week intervention programme under healthy cooking intervention but not in the food subsidization group. When comparing between control, healthy cooking training only and subsidization with the healthy cooking training arm, there was no significant changes between arms. A robust intervention to include subsidization of healthy foods for intervention programmes at schools in a larger scale study is needed to confirm this finding.     

‘It’s Hard to Make Good Choices and It Costs More’: Adolescents’ Perception of the External School Food Environment

Research on the impact of school and community food environments on adolescent food choice is heavily reliant on objective rather than subjective measures of food outlets around schools and homes. Gaining the perspective of adolescents and how they perceive and use food environments is needed. The aim of this study was to explore adolescent’s perception and use of the food environment surrounding their schools. Purposive sampling was used to recruit schools. Mapping exercises and discussion groups were facilitated with 95 adolescents from six schools. Thematic analysis showed that adolescents are not loyal to particular shops but are attracted to outlets with price discounts, those with ‘deli’ counters and sweets. Cost, convenience and choice are key factors influencing preference for food outlets and foods. Quality, variety and health were important factors for adolescents but these features, especially affordable healthy food, were hard to find. Social factors such as spending time with friends is also an important feature of food environments that deserves further attention. Adolescents’ perceptions of their food environment provide insights into features that can be manipulated to enable healthy choices.     

Dutch Preadolescents’ Food Consumption at School: Influence of Autonomy,Competence and Parenting Practices

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents’ eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents’ food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents’ food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents’ perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents’ healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents’ healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.     

Obesity Prevention Opinions of School Stakeholders: A Qualitative Study

BACKGROUND: In general, schools are an important setting to implement current recommendations for obesity prevention in children because the vast majority of children attend school. This study investigated the opinions of different school stakeholders on the feasibility and acceptability of current obesity prevention strategies that could be implemented in Swiss schools. METHODS: Research methods were comprised of a qualitative study which included school directors, physical education teachers, catering staff, school nurses and health educators, parents of young adolescents, and young adolescents interviewed (N = 40) categorized into 6 focus groups. Open-ended questions were used to determine the participants' opinion regarding current obesity prevention recommendations, and healthy eating and physical activity promotion strategies. RESULTS: All participants approved the implementation of nutritional standards for food and drinks sold in schools, but thought that increasing the attractiveness of healthy options was the best strategy to improve eating habits. Enjoying participation in physical activity classes or after-school activities was stressed. Participants suggested offering classes for all students with poor physical condition, independent of weight status. Stakeholders called for governmental support and global coordination of interventions balanced with providing schools with enough autonomy to adapt programs relevant to their individual circumstances. They recommended integrating all school stakeholders in obesity prevention initiatives, with special attention to students and local authorities. CONCLUSIONS: Participants agreed that schools are a crucial setting to implement childhood obesity prevention strategies. They called on school stakeholders to join efforts aiming to encourage healthy behaviors and to support and reinforce parents' efforts by spreading consistent and coherent health messages.     

Caregivers’ Role in the Effectiveness of Two Dutch School-Based Nutrition Education Programmes for Children Aged 7–12 Years Old

Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.     

Obesity treatment—more than food and exercise: a qualitative study exploring obese adolescents' and their parents' views on the former's obesity

The aim of this study was to explore obese adolescents’ and their parents’ views on the former''s obesity; especially to gain knowledge about barriers and motivational factors that influence obese adolescents’ ability to lose weight. This is a qualitative study involving field observation and semi-structured interviews with obese adolescents and their parents. The analysis takes a phenomenological–hermeneutic approach. Fifteen obese adolescents aged 13–16 years and their parents/grandparents participated in this study (one father, seven mothers, five sets of parents and two sets of grandparents). The results showed that obese adolescents’ are aware that they have unhealthy eating habits and they wish they were able to attain to a healthier diet. Although in poor physical shape, obese adolescents perceive their daily level of exercise as moderate. Obese adolescents blame themselves for being obese and blame their parents for an unhealthy diet, and for being unsupportive regarding exercise. Parents blame their obese child of lacking will power to change eating and exercise habits. As a consequence, the homely atmosphere is often characterised by quarrels and negative feelings. The conclusion is that despite obese adolescents’ intention of reducing weight, underlying issues interfere with this goal. This is particularly related to quarrels with parents, self-blame and misguided understanding of eating and exercising habits. These matters need to be addressed when treating obesity among adolescents.     

Nutrition education for adolescents: principals' views

This study aimed to examine school principals' perceptions of the school environment in Hong Kong as a context for the dissemination of food knowledge and inculcation of healthy eating habits. A questionnaire survey was administered in secondary schools in Hong Kong to survey Principals' views of students' food choices, operation of the school tuck shop, and promotion of healthy eating at school. Questionnaires were disseminated to all the secondary schools offering Home Economics (300 out of 466), and 188 schools responded, making up a response rate of 63%. Collected data were analyzed using SPSS. Most of the schools (82%) claimed to have a food policy to monitor the operation of the school canteen, and about half (52%) asserted there were insufficient resources to promote healthy eating at school. Principals (88%) generally considered it not acceptable for the school tuck shop to sell junk food; however, 45% thought that banning junk food at school would not help students develop good eating habits. Only 4% of the principals believed nutrition education influenced eating habits; whereas the majority (94%) felt that even with acquisition of food knowledge, students may not be able to put theory into practice. Cooking skills were considered important but principals (92%) considered transmission of cooking skills the responsibility of the students' families. Most of the principals (94%) believed that school-family collaboration is important in promoting healthy eating. Further efforts should be made to enhance the effectiveness of school food policies and to construct healthy school environments in secondary schools.     

Sustained Benefit Over Four-Year Follow-Up of Michigan’s Project Healthy Schools

Objectives. We determined the sustainability of effects of a school-based intervention to improve health behaviors and cardiovascular risk factors among middle school children.Methods. We administered a questionnaire and health screenings to 5 schools in Ann Arbor and 2 schools in Ypsilanti, Michigan. We assessed demographics, physiological factors, diet, physical activity, and sedentary behaviors from 1126 students who received a health curriculum (Project Healthy Schools) in the fall of sixth grade in 2005, 2006, and 2007. We administered the questionnaire and screening again in the spring and each subsequent spring through ninth grade to all available, consenting students.Results. In the 4 years following the school-based intervention, total cholesterol, low-density lipoprotein cholesterol, and triglycerides improved, and for most years systolic and diastolic blood pressure improved. Serum glucose and body mass index did not change. Physical activity increased and sedentary behaviors diminished.Conclusions. Project Healthy Schools is associated with sustainable improvements in both cardiovascular parameters and healthy behaviors.The rate of childhood obesity in the United States has more than tripled in the past 30 years. As of 2012, almost one third of children and adolescents were overweight or obese.1 Obesity sets the stage for a host of potential health problems, including cardiovascular disease, diabetes, cancer, kidney disease, osteoarthritis, and depression.2 Being obese as a child increases the risk of being obese as an adult, leading to increases in cardiovascular risk.3 Consequently, sustainable community-based interventions that improve wellness among children and adolescents have significant public health implications. However, data on long-term changes in health behaviors after such interventions are limited.Project Healthy Schools (PHS) is a collaboration between the University of Michigan and local community organizations, including public schools. It is designed to increase physical activity and promote healthier choices to reduce childhood obesity and the associated long-term cardiovascular risks. PHS has collected data on long-term changes after the implementation of a school-based wellness curriculum, which offers a unique opportunity to examine the sustained effects of a school-based intervention in communities with varying demographics and resources. We examined changes in health behaviors and physiological parameters from baseline to 4 years postintervention among students who had received the PHS curriculum in their middle schools to address the potential long-term benefit of implementing this program.PHS promotes 5 main goals:

1. eating more fruits and vegetables,
2. choosing less sugary foods and beverages,
3. eating less fast and fatty foods,
4. being active every day, and
5. spending less time in front of a screen (i.e., televisions, computers, video games, or mobile devices).

The program has 3 key components: education, environmental change, and measurement. The educational component consists of 10 in-class, hands-on lessons that are taught to sixth-grade students by a PHS health educator, a program staff member working in the schools, or a teacher from the school. The lessons are presented in the homeroom class period or built into the health or science curriculum. Each lesson is approximately 20 minutes, resulting in a total of 3 hours and 20 minutes of health education in the classroom. These learning activities are designed to be fun and interactive for middle school children while emphasizing the program’s 5 goals. PHS targets the middle school population, because during this time students are gaining more independence and are better able to make lifestyle decisions. In addition to the in-class learning activities, a series of larger assemblies are held throughout the year that promote healthy lifestyles, and classroom awards are presented for the practice of healthy habits.The PHS environmental change component incorporates significant modifications in the school cafeteria in cooperation with the school’s food service vendor. Such modifications include adding a salad bar with fresh vegetable choices, adding healthy snack options such as carrots and celery with peanut butter, and replacing high-sugar beverages and fried snacks with healthier alternatives.The effectiveness of the program is measured through an optional health screening and a health behavior questionnaire that assesses dietary, physical activity, and sedentary habits. Full details of the PHS program have been published elsewhere.4,5     

Eating Habits among Adolescents in Rural Southern Appalachia

A survey of 274 adolescents aged 14–16 years in rural Appalachia showed that unhealthy eating habits were prevalent. A few adolescents were teased about weight whereas 20.1% witnessed weight teasing almost everyday. Perception of parents’ healthy eating and better social support for healthy eating were associated with healthier eating habits.     

Adolescent Knowledge,Attitudes and Practices of Healthy Eating: Findings of Qualitative Interviews among Hong Kong Families

To tackle unhealthy eating among adolescents, it is crucial to understand the dietary knowledge, attitudes, and practices (KAP) on which adolescent eating habits are based. This qualitative study identifies the gaps in KAP by exploring what Chinese adolescents know, perceive, and practice regarding healthy eating to better inform targeted interventions for this important health problem. Parent–adolescent dyads were purposively sampled based on, for example, the dietary intake, age, and gender of the adolescent and household income, and each completed a 30 to 60 min interview. Twelve themes were synthesized: knowledge: (1) dietary recommendations, (2) health outcomes of healthy eating, (3) nutrition content in food, and (4) access to healthy meals; attitudes: (5) outcome expectation for healthy eating, (6) food preferences, and (7) self-efficacy regarding adopting healthy eating; and practices: (8) going grocery shopping for healthy food, (9) eating home-prepared meals. (10) eating out in restaurants or consuming takeaway food, (11) fruit and vegetable consumption, and (12) snacking, perceived unhealthy eating to be low risk, made unhealthy choices regarding snacking and eating out, and had insufficient fruit and vegetable intake. Programs should emphasize the positive short-term health outcomes of healthy eating and empower adolescents to acquire food preparation skills to sustain healthy eating habits.     

How Does the Family Influence Adolescent Eating Habits in Terms of Knowledge,Attitudes and Practices? A Global Systematic Review of Qualitative Studies

Promoting healthy eating habits can prevent adolescent obesity in which family may play a significant role. This review synthesized findings from qualitative studies to identify family barriers and facilitators of adolescent healthy eating in terms of knowledge, attitudes, and practices (KAP). A literature search of four databases was completed on 31 July 2020; qualitative studies that explored family factors of adolescent (aged 10 to 19 years) eating habits were included. A total of 48 studies were identified, with the majority being from North America and sampled from a single source. Ten themes on how family influences adolescent dietary KAP were found: Knowledge—(1) parental education, (2) parenting style, and (3) family illness experience; Attitudes—(4) family health, (5) cultivation of preference, and (6) family motivation; Practices—(7) home meals and food availability, (8) time and cost, (9) parenting style, and (10) parental practical knowledge and attitudes. This review highlights five parental characteristics underlying food parenting practices which affect adolescents’ KAP on healthy eating. Adolescents with working parents and who are living in low-income families are more vulnerable to unhealthy eating. There is a need to explore cultural-specific family influences on adolescents’ KAP, especially regarding attitudes and food choices in Asian families.     

Impacts of a School-Based Intervention That Incorporates Nutrition Education and a Supportive Healthy School Canteen Environment among Primary School Children in Malaysia

In this study, a school nutrition program (SNP) that incorporates nutrition education and a healthy school canteen environment was developed to improve nutrition knowledge among intervention respondents and provide a healthier environment for them to practice healthy eating. In the current study, we evaluated the impacts of the SNP on eating behaviors, physical activity, body mass index-for-age (BAZ), and cognitive performance at pre-intervention, post-intervention, and 3-month follow-up points between intervention and comparison groups. This intervention study involved 523 primary school children (7–11 years old) from six selected schools in Batu Pahat District, Malaysia. Each respondent completed anthropometric and cognitive performance assessments and a set of standardized questionnaire at pre-intervention, post-intervention, and 3-month follow-up points. Multiple linear mixed model analysis was performed to determine the impacts of that SNP after being adjusted for covariates. After the program, the intervention group increased their frequency of breakfast, lunch, and dinner consumption and morning tea snacking and showed more frequent physical activity and better cognitive performance as compared to the comparison group overtime (p < 0.05). At 3-month follow-up, the intervention group showed lower BAZ scores than their comparison counterparts (p < 0.05). The SNP showed positive effects on eating behaviors, physical activity, BAZ, and cognitive performance in school children. Hence, the SNP is highly recommended for all primary school children.     

Association between Food Preferences and Food Habits in a Polish Adolescents’ COVID-19 Experience (PLACE-19) Study

Food preferences are among the most influential factors of food habits in the vulnerable period of adolescence; in addition, gender-dependent differences in food preferences are also observed. The aim of the present study was to analyze differences in food habits between individuals stratified based on their food preferences in a population-based sample of adolescents aged 15–20. The study was conducted within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population in a group of 2419 secondary school students who were randomly chosen to participate in the study using a random quota sampling procedure. The food preferences were determined on the basis of a validated Food Preference Questionnaire (FPQ) (which enables assessing preference of vegetables, fruit, meat/fish, dairy, snacks, and starches), whereas food habits were determined on the basis of the Adolescents’ Food Habits Checklist (AFHC) (which enables assessing food purchase, preparation, and consumption habits). The analysis involved three homogenous clusters (‘low-preferring’, ‘hedonists’, and ‘high-preferring’), which were identified using the k-means algorithm. It was found that for a number of the assessed food purchase, preparation, and consumption habits, there were statistically significant differences between the ‘low-preferring’, ‘hedonists’, and ‘high-preferring’ clusters. Within food purchase habits, the food preference influenced frequency of buying pastries/cakes and frequency of eating takeaway meals for all the respondents, while for female respondents, it influenced also choice of desserts in restaurants, and for male respondents, it influenced choosing a low-fat lunch away from home (p < 0.05). Within food preparation habits, the food preference influenced the fat content in desserts at home, the frequency of eating at least one serving of vegetables/salad with an evening meal, the frequency of spreading butter/margarine on bread thinly, and the frequency of having cream on desserts for all the respondents; meanwhile, for female respondents, it also influenced the frequency of avoiding fried foods and the frequency of including chocolate/biscuits in their packed lunch (p < 0.05). Within food consumption habits, the food preference influenced the frequency of eating a dessert/pudding, eating at least one serving of fruit a day, eating at least one serving of vegetables/salad a day, avoiding sausages/burgers, trying to ensure they eat plenty of fruit and vegetables, and frequency of choosing fruit as a snack for all the respondents; meanwhile, for male respondents, it also influenced the frequency of eating sweet snacks and eating at least three servings of fruit most days (p < 0.05). Taking into account that some improper food habits may be typical for the specific clusters, there is an urgent need to analyze and address them for the purposes of public health and to bear in mind that some of those habits are gender-dependent.     

Social Inequalities in Changes in Diet in Adolescents during Confinement Due to COVID-19 in Spain: The DESKcohort Project

Adolescence is a critical period in the consolidation of healthy lifestyles that can last into adulthood. To analyze changes in food consumption and eating behaviors in high-school adolescents during the first confinement, a cross-sectional study was conducted at the end of confinement in Spain. Changes in the frequency or quantity of consumption of different types of food and food-related behaviors were analyzed. Socioeconomic and health-related variables were also considered. To determine whether dietary changes were related to socioeconomic position (SEP), Poisson regression models with robust variance were estimated. Overall, there were some changes towards a healthier diet such as an increase in fruit consumption (38.9%) and a decrease in the consumption of soft drinks (49.8%), sweets and pastries (39.3%), and convenience foods (49.2%). Some changes, however, were related to less healthy behaviors, such as a more irregular pattern of meal distribution (39.9%) or an increase in snacking between meals (56.4%). Changes towards less healthy eating were also related to students’ SEP. The risk of worsening the diet was found to be 21% higher in adolescents from a more disadvantaged SEP. Future public policies could be adapted to avoid increasing nutritional and health inequalities.     

Adolescents from low‐income families in Hong Kong and unhealthy eating behaviours: Implications for health and social care practitioners

The development of dietary preferences of adolescents involves a complex interplay of individual behaviours and environmental factors. Interpersonal factors—such as peer influences and unpleasant school experiences—and institutional factors—such as school rules and policies—are closely associated with unhealthy eating of adolescents. Family support and guidance are also crucial in influencing adolescents’ eating habits. However, the low social status, low educational levels, and low household incomes of disadvantaged parents can markedly prevent their children from establishing healthy eating habits. Therefore, adolescents from low‐income families are more likely to engage in unhealthy dietary behaviours and hence to be more susceptible to diet‐related health problems. However, few studies have addressed the difficulties associated with inculcating healthy eating habits among adolescents from low‐income families. Therefore, to investigate the barriers to adopting healthy eating habits, this study adopted a qualitative research approach and conducted five focus‐group semistructured interviews with 30 junior‐ and senior‐form students of a secondary school in Hong Kong, all of whom were from low‐income families. The results revealed skipping meals because of poverty, following irregular meal patterns on school holidays, receiving poor guidance from family and peers, perceiving healthy eating as expensive and unappealing, and geographical inaccessibility to healthy food all prevented these students from healthy eating. These mutually reinforcing factors were interlocking with the economic strain that was experienced by the participants and their families. In particular, the stereotype of “healthful food is expensive” was strong. Therefore, we suggest students from low‐income families should be enabled to understand that healthy eating is not necessarily expensive. The participants’ stereotypes about healthy food was handed down by their parents. Such stereotypes, together with the low health literacy, influence the food preparation habits of the parents. Therefore, parents should be made to aware that healthful food can also be affordable.     

‘It's very hard to find what to put in the kid's lunch’: What Perth parents think about food for school lunch boxes

Aim: To describe the factors affecting school food selection by parents of young children attending low socioeconomic schools in Perth and recommend the features of resources parents need to make healthier choices. Methods: Nine focus groups of parents of young children attending low socioeconomic status schools in Perth were conducted where parents were asked about the food their children ate at school and their opinions of school food resources. Results: Focus group discussion centred on the themes of the challenge of being a good parent by providing healthy lunch box food; making compromises in what their children eat at school and the barriers to healthy eating in the school environment. Parents were concerned about what their children were eating at school but the barriers of convenience, child preference, cost and food safety prevented them from including healthier food in the lunch box. The amount of time allowed for eating and lack of refrigeration were school‐based barriers that impacted on the type and amount of food selected. Parents liked colourful, practical school food resources with recipes and nutrition information aimed at children. Conclusions: Parents want help with selecting lunch box food/drinks that are nutritious, convenient, inexpensive and appealing for children to eat. Schools need to be supported to introduce healthy eating programs and should review the time given for young children to eat at school. Dietitians need to consider the home food environment and what motivates parents to make food choices for their children.     

Social and Institutional issues in the Adoption of School-based Technology-aided Sexual Health Education Program

Objective: School-based sexual health education interventions can reach young people of diverse backgrounds and equip them with knowledge and skills for protecting themselves against HIV/AIDS, unwanted pregnancies, and live healthy and responsible lives. However, given that school-based sexual health education intervention are health projects implemented in educational settings, variety of social and institutional issues can present challenges. This study aimed to obtain rich insights into the facilitating or inhibiting mediators for the implementation of a school-based sexual health education intervention in Uganda.Method: This study conducted 16 qualitative interviews to investigate the mediators for the implementation of the school-based sexual health education intervention based on experiences of two Ugandan schools: the school which successfully completed the implementation of the intervention, and the school which abandoned the intervention half-way the implementation.Results: Rather than the technological aspects, results indicate that the implementation was strongly influenced by interplay of social and institutional mediators, which were more favourable in the “successful” school than in the “failure school”. These mediators were: perceived students’ vulnerability to HIV and unwanted pregnancies; teachers’ skills and willingness to deliver the intervention, management support; match with routine workflow, social-cultural and religious compatibility, and stakeholder involvement.Conclusion: Rather than focusing exclusively on technological aspects, experiences from this evaluation suggest the urgent need to also create social, institutional, and religious climate which are supportive of school-based computer-assisted sexual health education. Evidence-based recommendations are provided, which can guide potential replications, improvements, and policy formulation in subsequent school-based sexual health education interventions.Key words: sexual health education, school health education, adolescents’ sexual health, teacher-student sex education, informatics     

Taste Ratings of Healthier Main and Side Dishes among 4-to-8-Year-Old Children in a Quick-Service Restaurant Chain

Restaurants are regular eating environments for many families. Children’s consumption of restaurant foods has been linked with poorer diet quality, prompting emerging research examining strategies to encourage healthier eating among children in restaurants. Although taste is a primary determinant of restaurant meal choices, there is a lack of research considering children’s perspectives on the taste of different healthier kids’ meal options. The current study sought to examine, via objective taste testing, children’s liking of and preference for healthier kids’ meal options at a quick-service restaurant (QSR) and to describe bundled kids’ meals with evidence of both taste acceptability and consistency with nutrition guidelines. Thirty-seven 4-to-8-year-old children completed taste tests of ten healthier main and side dish options. Liking and preference were assessed using standard methods after children tasted each food. Children also reported their ideal kids’ meal. Results show the majority of children liked and preferred three main (turkey sandwich, chicken strips, peanut butter/banana sandwich) and side dishes (yogurt, applesauce, broccoli), with rank order differing slightly by age group. Accepted foods were combined into 11 bundles meeting nutritional criteria. Results highlight healthier kids’ meals with evidence of appeal among children in a QSR. Findings can inform future research and may increase the success of healthy eating interventions in these settings.     

The EIT Food School Network: Integrating solutions to improve eating habits and reduce food wastage in secondary schoolchildren

Most European children and adolescents do not meet dietary guidelines. Therefore, there is a need to develop and implement effective strategies to help young people adopt healthier dietary habits and maintain these into adulthood. The amount of time that children and adolescents spend in the school setting makes this an ideal environment in which to develop interventions that target healthy eating. Schools, however, are complex systems and a whole‐school approach that promotes consistent messages within the school environment and across the curriculum is needed to support positive food choices. Given current concerns about climate change and the environment, it is also important to ensure that any nutrition interventions implemented in the school setting are environmentally friendly and do not increase food wastage. This paper presents the results of stakeholder discussions on the topic of secondary school food in Northern Ireland, conducted as part of the recently developed European Institute for Innovation and Technology (EIT) Food School Network. The Network was established to facilitate the exchange of information within existing national schools programmes and to identify and develop strategies that positively impact on food choice and food wastage in schools across Europe. Improving schools’ adherence to the Food in Schools Policy and engaging pupils and parents to encourage a sense of ‘ownership’ of the school food system were identified as potential ways to positively impact on the dietary habits of children and adolescents.     

A Cross-Sectional Study of the Nutritional Quality of New South Wales High School Student Food and Drink Purchases Made via an Online Canteen Ordering System

Unhealthy dietary patterns in adolescence are associated with an increased risk of future chronic disease. This study aimed to assess online canteen lunch purchases made by high school students to identify: (1) the nutrient composition of purchases (energy, saturated fat, sugar, sodium, percent energy from saturated fat and total sugar); (2) the proportion of items classified as healthier (‘Everyday’) and less healthy (‘Occasional’ or ‘Should not be sold’) according to the New South Wales Healthy Canteen Strategy; (3) the frequency of purchases by product type (e.g., salty snacks), their classification and nutrient composition; and (4) associations between student characteristics and the nutrient composition and classification of purchases. The average order contained 2075 kJ of energy, 6.4 g of saturated fat, 18.4 g of sugar and 795 mg of sodium. Less healthy (‘Occasional’ and ‘Should not be sold’) items combined accounted for 56% of purchases. The most frequently purchased products were burgers and crumbed/coated foods. Students in higher grades purchased a significantly higher mean percent of ‘Everyday’ items, compared to students in grades 7 or 8. The majority of high school student purchases were less healthy (‘Occasional’ or ‘Should not be sold’) items, warranting further investigation of factors influencing online canteen purchasing behaviour in this setting.