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Defining Food Education Standards through Consensus: The Pilot Light Food Education Summit
Abstract
Background:
Consistent with the Whole School, Whole Community, Whole Child Approach, food education encompasses nutritional status, culture, community, environment, and society. Unifying standards are needed to support food education integration in K-12 curricula. Pilot Light, a Chicago-based nonprofit, sought to generate such standards. This study reports a formative evaluation research process that led to the development of Food Education Standards (FES).
Methods:
Nine FES were drafted within the context of the National Health Education Standards. The 2-day Pilot Light Food Education Summit convened 26 experts and community members to review draft FES. A facilitated, consensus-building process generated refined FES and K-12 competencies. Drawing on Summit outcomes and expert feedback, a team of teachers subsequently drafted final FES. Summit participants completed pre- and post-Summit surveys to assess changes in food education priorities.
Results:
The initial 9 FES were refined to 7. Comparison data indicated shifts in endorsed priorities for food education, moving from prioritizing specific knowledge, such as "categorizing food into food groups," toward "students having a conscious decision-making process around food."
Conclusions:
Developed with input from experts across multidisciplinary fields, the evidence-based Pilot Light FES can be feasibly implemented in multiple subjects across all school types and community socio-demographic levels.
... The specific term "nutrition education" is used specifically when diet quality, nutrient intake and other goals related to health are emphasised (Lakka et al., 2019;HLPE, 2018), and the ultimate goal is to improve health and well-being (Contento and Koch, 2020b). Also, some definitions of food education emphasise the promotion of health and well-being alongside knowledge about culture, sustainable lifestyles and food systems (Elsden-Clifton and Futter-Puati, 2015;Sutter et al., 2019). The aim of food education can also be awakening pupils to notice and reflect on food-related phenomena and information from different angles (Contento et al., 1995). ...
... The lack of consistent national definitions, objectives or models for food education in Finnish primary schools is an obvious obstacle both to setting specific objectives and to equalising food education across Finlandor even within any single municipality. The same obstacle to implementing food and nutrition education at school has also been identified internationally (Sutter et al., 2019;Lee and Hong, 2015). ...
... The themes for primary school food education defined in the present study are similar to the themes defined by the Delphi method in an earlier study conducted in the USA (Sutter et al., 2019). The themes identified by the study mentioned above, such as culture, production/ system, food choices, social, media, health, food preparation and environment, also constitute a holistic approach that encompasses health aspects along with the environment, culture and society. ...
Purpose
The importance of food education in primary schools has been globally recognised. However, more detailed definitions of its learning objectives are rarely found. The study aimed to define multisectoral themes and learning objectives for food education in primary education in Finland.
Design/methodology/approach
A descriptive three-round Delphi study was conducted with experts in food education in various organisations. In the first questionnaire, the participants were asked to define possible objectives for food education related to general objectives for basic education. Respondents of the first questionnaire formed a research panel ( n = 22). These panellists were then invited to complete the second ( n = 16) and third questionnaires ( n = 12), where the objectives were further modified. Qualitative content analysis and Bloom's taxonomy were applied in the process of creating the learning objectives.
Findings
In the iterative process, 42 learning objectives for food education in primary schools were defined. Further, “Sustainability and ethics of food systems” was defined as the cross-cutting theme of food education. In addition, 13 subthemes were defined, which fell into three thematic categories: personal (e.g. feelings), practical (e.g. eating) and intangible (e.g. culture) issues.
Originality/value
The defined learning objectives for a holistic food education may be used in advancing primary school curriculum in Finland and perhaps other countries.
... Data emphasised the urgency of a food experiences approach to school food. The interrelation between health and sustainability in school food is further substantiated by the linkage between school meals and food education provision within schools (Sutter et al., 2019). The study reveals that school food strategies enhancing human and environmental health with a focus on experience, such as involving pupils in growing ingredients to incorporate into the school meals, contribute to pupils' enjoyment of school food. ...
This study addresses the complex challenges of childhood obesity, food poverty and environmental degradation by developing a planetary health framework for school food in education. Drawing on Dewey's experiential learning philosophy, it adopts an integrative approach where school meals and food education converge. Rooted in the planetary health model, the research explores the interdependence of human and environmental health within the context of school food. Employing a convergent mixed‐methods approach, we conduct interviews, a web‐based survey and observations in English primary schools to explore multiple stakeholders' perspectives on sustainable school food. Findings underscore three defining characteristics of sustainable school food: reversion to scratch cooking, prioritising local and agroecological food procurement and promoting plant‐based meals. Findings stress the convergence of health and environmental sustainability within school food, highlighting the need for a planetary health approach to school food where meals and education are integrated into school food experiences. Experiential food education, such as cooking and farm visits, supports sustainable school meals provision and their use as a pedagogical tool, embedding sustainable food practices into pupils' everyday school experiences. The study underscores the role of ethical leadership in allocating scarce resources and empowering often marginalised stakeholders such as catering staff and local producers to mobilise school food partnerships. Such partnerships generate mutual benefits, such as supporting local agroecological food production and challenging the dominance of processed foods in school menus from large corporations.
... They need to evaluate the design and the product" [20] Nutrition Education "any combination of educational strategies accompanied by environmental supports, designed to facilitate voluntary adoption of food choices, and other food and nutrition-related behaviours conducive to health and wellbeing (of individuals, community, planet)" [21] Food and Cooking Skills "a wide range of skills required to feed families, including not only factors involved with the meal preparation . . . but also knowledge of how to plan and budget for food and organise and plan meals that other members of the household will find acceptable" [22] Food Education "Education that supports learning about food, nutrition and the role that food plays in one's life, relationships, culture, communities, environment, and in history and society" [23] Food Literacy "the ability of an individual to understand food in a way that they develop a positive relationship with it, including food skills and practices across the lifespan in order to navigate, engage, and participate within a complex food system. It's the ability to make decisions to support the achievement of personal health and a sustainable FS considering environmental, social, economic, cultural, and political components" [24] Whatever food education is called, analysis of what takes place in the curriculum is limited and devoid of government review. ...
(1) Background: As one of the biggest drivers of health and climate change, the food system has unrealised potential to influence consumption toward affordable, healthy, sustainable diets. A range of policy levers, including mandating food education, are needed. Schools are considered the best place for food education and childhood is a crucial period when eating habits that persist into adulthood are formed. Food education as part of the curriculum is crucial in generating population shifts in food systems improvements. The purpose of this policy analysis was to analyse mandatory curriculums in different countries to explore the ways in which primary school food education addresses food literacy. (2) Methods: This study analyses how food education within primary school education policy, in 11 countries, addresses Food Literacy (FL). It is the first study of this kind. A case study methodology was employed, and curriculum policy content analysis was conducted using a Food Literacy framework. (3) Results: Each country has a curriculum dedicated to food education, supported by food education in non-food curriculums. There is no standardized approach to primary school food education policy, no consensus in primary food education nomenclature or what curriculums constitute. Curriculums focus on cooking and health topics, but significantly less on social-cultural, equity, and sustainability issues. (4) Conclusion: How primary curriculums around the world deliver food education policy to address FL varies enormously. All 11 countries have dedicated food curriculums, supported by non-food curriculums, but there is no consensus as to what food education is called or constitutes. Countries rarely deal with FL comprehensively. The most comprehensive are single, detailed food curriculums, complemented by non-food curriculums where food knowledge and skills progress clearly and are the intended learning outcome.
... Previous research on school-based health promotion interventions have noted the importance of incorporating teacher feedback into the intervention design, as well as the importance of tying nutrition education to other academic standards. 33,34 There were some limitations to the study. While the work built on gardening and healthy research in several communities on the Navajo Nation, this study only included formative research from one small school. ...
Objective:
Navajo children are at increased risk for obesity, in part due to limited access to healthy foods. School garden interventions have been shown to increase access to fresh fruit and vegetables and consumption of healthy foods. Our study describes the development and pilot testing of a school garden intervention for Navajo elementary school children.
Methods:
We reviewed existing school garden interventions and conducted formative research with students, caregivers, and school staff to inform the intervention. The intervention consisted of a garden built at the school and a yearlong curriculum on gardening and healthy eating. We pilot tested the intervention in an elementary school on the Navajo Nation.
Results:
Formative research revealed the importance of incorporating Diné culture, including traditional growing practices and the preparation of traditional foods into the curriculum. School staff also stressed the value of tying the curriculum to state and Diné educational standards. Students enjoyed opportunities for hands-on activities and snack preparation.
Conclusions:
Schools have a meaningful role to play in addressing childhood obesity disparities among Navajo children. School-based interventions that draw on cultural strengths and include healthy traditional practices can be a promising strategy for increasing fruit and vegetable consumption.
... This may signal a shift in teaching practices toward more constructive approaches, or alternatively may relate to a purposeful recognition that successful asset acquisition requires higher-order FL skills. 78 Importantly, all studies addressing interactive FL also addressed functional FL, and those addressing critical components usually addressed both functional and interactive FL. This finding suggests that teachers or researchers may assume FL competencies must be attained in a stepwise fashion, whereby functional FL must be learned before the higher-order competencies can be attained. ...
BACKGROUND
Childhood is a critical period for developing food-related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools.
METHODS
Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4-12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical).
RESULTS
After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N = 111). All studies addressed functional FL (N = 116), while 77% (N = 89) addressed interactive FL and 28% (N = 32) addressed critical FL.
CONCLUSIONS
This first international review of FL programs in elementary schools found great heterogeneity in school-based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions.
... Ten of these position/ consensus papers addressed specific foods or nutrients of interest, 178,180,182,183,185,187,191,192,194,195 particularly sugar and sugar-sweetened beverages (n ¼ 6). Two position/ consensus papers described interventions at the family and home level, 193,196 5 described position/ consensus statements on school nutrition, 179,184,189,190,197 and 2 described positions or consensus on policies. 181,188 Three position/consensus papers focused on weight or T2DM management and included multiple levels of the social-ecological model (Table 3). ...
Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
BACKGROUND
This paper presents the process taken by a nonprofit educational organization to create authentic evaluation tools for Food Education in K‐12 schools. Development was a collaborative effort between organization staff and teachers during an Evaluation Summit. The program background, development of the Summit, and plans for post‐Summit work continuation are described. The Summit included 14 teacher participants (3‐4 per grade band in preK‐1, 2‐5, 6‐8, 9‐12).
METHODS
The process of tool development was captured via direct observations and analysis of artifacts (eg, participants' brainstorming chart paper, online development documents) to identify themes in successful approaches and challenges. Additional post‐Summit activities were also captured via surveys and artifacts. Outcomes of this work are outlined, including the challenges in carrying out the creation of authentic assessments that accurately reflect the classroom teaching experience, and the value of in‐person community building in the Food Education space.
RESULTS
Key findings relate to the importance of in‐person collaboration amongst teachers, centering students in evaluation, and equity and accessibility in tool development.
CONCLUSIONS
Although outlining challenges and outcomes was not an a priori goal of this work, it provides important information for others working in the education nonprofit space—especially as it pertains to new approaches to classroom evaluation.
Schools are recognized as important locales for education and action to change food-related environmental and health behaviours. Research shows the potential for a whole school systems approach to integrate educational activities, food in school, and wider food-related interactions. However, little attention has been given to how theory is put into practice in terms of reforming school food practices in the everyday routines and commitments of schooling. This study aimed to identify how school practitioners operationalise whole systems approaches. The context was an exchange programme involving schools and national school food non-governmental organisations in England, Denmark, and the Czech Republic. Using case study design, the research involved school practitioner interviews and critical group reflection. Participants adopted perspectives and identified actions to create solutions in real-world practice settings, such as themes around, ‘persistence, passion and belief’; ‘bending the rules’ ‘supportive, respectful, and united teams’; ‘having a holistic vision’, ‘resistance’, and ‘making-do’. Drawing upon a conceptual framework concerned with taking an integrated approach, we suggest that these ‘everyday practices’ have a critical role in food systems reform in schools.
Nutrition literacy and food literacy have become increasingly important concepts in health promotion. Researchers use one or the other term to describe the competencies needed to maintain a healthy diet. This systematic review examines whether these terms are synonymous or if their meanings are substantially different.
We searched major bibliographic databases (Web of Science, PubMed, ScienceDirect, CINAHL, SocIndex and ERIC) for publications that provided an original definition of nutrition or food literacy. Then we used Nutbeam’s tripartite health literacy model as an analytical grid. The definitions we found included specific competencies, which we mapped to the domains of functional, interactive, or critical literacy.
In the 173 full-text publications we screened, we found six original definitions of nutrition literacy, and 13 original definitions of food literacy. Seven food literacy definitions were integrated into a conceptual framework. Analysing their structure revealed that nutrition literacy and food literacy are seen as specific forms of health literacy, and represent distinct but complementary concepts. Definitions of nutrition literacy mainly described the abilities necessary to obtain and understand nutrition information. Definitions of food literacy incorporated a broader spectrum of theoretical and practical knowledge and skills. To be food literate also means to apply information on food choices and critically reflect on the effect of food choice on personal health and on society. Since food literacy is based on a more comprehensive understanding of health behaviours, it is the more viable term to use in health promotion interventions. For the practical implication, a harmonization of the different definitions is desirable.
BACKGROUND
Students are the heart of the Whole School, Whole Community, Whole Child (WSCC) model. Students are the recipients of programs and services to ensure that they are healthy, safe, engaged, supported, and challenged and also serve as partners in the implementation and dissemination of the WSCC model.
METHODS
A review of the number of students nationwide enjoying the 5 Whole Child tenets reveals severe deficiencies while a review of student-centered approaches, including student engagement and student voice, appears to be one way to remedy these deficiencies.
RESULTS
Research in both education and health reveals that giving students a voice and engaging students as partners benefits them by fostering development of skills, improvement in competence, and exertion of control over their lives while simultaneously improving outcomes for their peers and the entire school/organization.
CONCLUSIONS
Creating meaningful roles for students as allies, decision makers, planners, and consumers shows a commitment to prepare them for the challenges of today and the possibilities of tomorrow.
BACKGROUND
While it is a national priority to support the health and education of students, these sectors must better align, integrate, and collaborate to achieve this priority. This article summarizes the literature on the connection between health and academic achievement using the Whole School, Whole Community, and Whole Child (WSCC) framework as a way to address health-related barriers to learning.METHODSA literature review was conducted on the association between student health and academic achievement.RESULTSMost of the evidence examined the association between student health behaviors and academic achievement, with physical activity having the most published studies and consistent findings. The evidence supports the need for school health services by demonstrating the association between chronic conditions and decreased achievement. Safe and positive school environments were associated with improved health behaviors and achievement. Engaging families and community members in schools also had a positive effect on students' health and achievement.CONCLUSIONS
Schools can improve the health and learning of students by supporting opportunities to learn about and practice healthy behaviors, providing school health services, creating safe and positive school environments, and engaging families and community. This evidence supports WSCC as a potential framework for achieving national educational and health goals.
BACKGROUND: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education.
METHODS: The existing literature, including scientific articles and key publications from national agencies and organizations, was reviewed and synthesized to describe (1) the historical context for CSH and a whole child approach, and (2) lessons learned from the implementation and evaluation of these approaches.
RESULTS: The literature revealed that interventions conducted in the context of CSH can improve health-related and academic outcomes, as well as policies, programs, or partnerships. Several structural elements and processes have proved useful for implementing CSH and a whole child approach in schools, including use of school health coordinators, school- and district-level councils or teams; systematic assessment and planning; strong leadership and administrative support, particularly from school principals; integration of health-related goals into school improvement plans; and strong community collaborations.
CONCLUSIONS: Lessons learned from years of experience with CSH and the whole child approaches have applicability for developing a better understanding of the WSCC model as well as maximizing and documenting its potential for impacting both health and education outcomes.
Background:
The Whole Child approach and the coordinated school health (CSH) approach both address the physical and emotional needs of students. However, a unified approach acceptable to both the health and education communities is needed to assure that students are healthy and ready to learn.
Methods:
During spring 2013, the ASCD (formerly known as the Association for Supervision and Curriculum Development) and the US Centers for Disease Control and Prevention (CDC) convened experts from the field of education and health to discuss lessons learned from implementation of the CSH and Whole Child approaches and to explore the development of a new model that would incorporate the knowledge gained through implementation to date.
Results:
As a result of multiple discussions and review, the Whole School, Whole Community, Whole Child (WSCC) approach was developed. The WSCC approach builds upon the traditional CSH model and ASCD's Whole Child approach to learning and promotes greater alignment between health and educational outcomes.
Conclusion:
By focusing on children and youth as students, addressing critical education and health outcomes, organizing collaborative actions and initiatives that support students, and strongly engaging community resources, the WSCC approach offers important opportunities that will improve educational attainment and healthy development for students.
To determine the effectiveness of school-based strategies for obesity prevention and control using methods of systematic review and meta-analysis.
Peer-reviewed studies published between 1966 and October 2004 were considered for review. Studies meeting eligibility criteria were published in English, targeted children aged 3-18 in a school setting, reported weight-related outcomes, included a control measurement and had at least a 6-month follow-up period. Studies employed interventions related to nutrition, physical activity, reduction in television viewing or combinations thereof. Weight related data were analyzed using RevMan software.
Sixty-four studies were considered for inclusion. Fourteen did not meet inclusion criteria; 29 were excluded due to poor methodological quality. Twenty-one papers describing 19 studies were included in the systematic review and 8 of these were included in the meta-analysis. Nutrition and physical activity interventions resulted in significant reductions in body weight compared with control ((standardized mean difference, SMD=-0.29, 95% confidence interval (CI)=-0.45 to -0.14), random effects model). Parental or family involvement of nutrition and physical activity interventions also induced weight reduction ((SMD=-0.20, 95%CI=-0.41 to 0.00), random effects model).
Combination nutrition and physical activity interventions are effective at achieving weight reduction in school settings. Several promising strategies for addressing obesity in the school setting are suggested, and warrant replication and further testing.
The Delphi technique is a method of collecting opinion on a particular research question. It is based on the premise that pooled intelligence enhances individual judgement and captures the collective opinion of a group of experts without being physically assembled. The conventional Delphi uses a series of questionnaires to generate expert opinion in an anonymous fashion and takes place over a series of rounds. The technique is becoming a popular strategy that straddles both quantitative and qualitative realms. Issues that are critical to its validity are the development of the questionnaire; definition of consensus and how to interpret non-consensus; criteria for and selection of the expert panel; sample size; and data analysis. The authors used the Delphi technique to assist with making recommendations regarding education and training for medical practitioners working in district hospitals in South Africa. The objective of this Delphi was to obtain consensus opinion on content and methods relating to the maintenance of competence of these doctors. They believe the experience gained from their work may be useful for other health science education researchers wishing to use the Delphi method.
BACKGROUND
Elementary teachers have the potential to influence children's eating habits. This study examined teacher views and practices regarding nutrition education.
METHODS
An online survey was administered to K‐6 teachers (N = 628) in 55 public elementary schools in a large city in the western United States. Three indices were created based on responses. Indices included: (1) attitudes and beliefs about nutrition education; (2) self‐efficacy regarding nutrition education; and (3) personal health behaviors. Relationships between indices, classroom practices, and teacher characteristics were tested. Teacher comments were categorized into themes.
RESULTS
Most teachers agreed they can make a difference in the eating behaviors of their students (68%). Correlations between hours of nutrition taught and teachers' attitudes and beliefs (r = .37, p < .01), nutrition self‐efficacy (r = .38, p < .01), and personal health practices (r = .15, p < .01) were weak, yet statistically significant. Number of years teaching was inversely related to frequency of food rewards (r = −119, p < .01). Few teachers (21%) agreed they have support to teach nutrition in the classroom.
CONCLUSION
Teachers understand the importance of nutrition education but provision is limited by competing demands. Teachers suggest tailored nutrition materials, qualified nutrition personnel, and school stakeholder support to promote nutrition education.
BACKGROUND
Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs.
METHODS
For this cross‐sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD.
RESULTS
No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02).
CONCLUSIONS
These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.
BACKGROUND
Obesity is a complex health problem affecting more than one‐third of school‐aged youth. The increasing obesity rates in Kansas and Missouri has been particularly concerning, with efforts being made to improve student health through the implementation of school wellness policies (SWPs). The primary purpose of this study was to conduct a rigorous assessment of SWPs in the bi‐state region.
METHODS
SWPs were collected from 46 school districts. The Wellness School Assessment Tool (WellSAT) was used to assess comprehensiveness and strength. Additionally, focus group discussions and an online survey were conducted with school personnel to identify barriers and supports needed.
RESULTS
Assessment of the SWPs indicated that most school districts failed to provide strong and specific language. Due to these deficiencies, districts reported lack of enforcement of policies. Several barriers to implementing the policies were reported by school personnel; supports needed for effective implementation were identified.
CONCLUSIONS
To promote a healthful school environment, significant improvements are warranted in the strength and comprehensiveness of the SWPs. The focus group discussions provided insight as to where we need to bridge the gap between the current state of policies and the desired beneficial practices to support a healthy school environment.
Obesity prevalence has been increasing since the 1980s among adults, but among youth, prevalence plateaued between 2005-2006 and 2013-2014.¹,2 We analyzed trends in obesity prevalence among US youth and adults between 2007-2008 and 2015-2016 in order to determine recent changes.
Objective:
An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy.
Design:
A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand.
Results:
The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between 'healthy' and 'unhealthy' foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one's capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model.
Conclusions:
The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.
Importance
Previous analyses of obesity trends among children and adolescents showed an increase between 1988-1994 and 1999-2000, but no change between 2003-2004 and 2011-2012, except for a significant decline among children aged 2 to 5 years.
Objectives
To provide estimates of obesity and extreme obesity prevalence for children and adolescents for 2011-2014 and investigate trends by age between 1988-1994 and 2013-2014.
Design, Setting, and Participants
Children and adolescents aged 2 to 19 years with measured weight and height in the 1988-1994 through 2013-2014 National Health and Nutrition Examination Surveys.
Exposures
Survey period.
Main Outcomes and Measures
Obesity was defined as a body mass index (BMI) at or above the sex-specific 95th percentile on the US Centers for Disease Control and Prevention (CDC) BMI-for-age growth charts. Extreme obesity was defined as a BMI at or above 120% of the sex-specific 95th percentile on the CDC BMI-for-age growth charts. Detailed estimates are presented for 2011-2014. The analyses of linear and quadratic trends in prevalence were conducted using 9 survey periods. Trend analyses between 2005-2006 and 2013-2014 also were conducted.
Results
Measurements from 40 780 children and adolescents (mean age, 11.0 years; 48.8% female) between 1988-1994 and 2013-2014 were analyzed. Among children and adolescents aged 2 to 19 years, the prevalence of obesity in 2011-2014 was 17.0% (95% CI, 15.5%-18.6%) and extreme obesity was 5.8% (95% CI, 4.9%-6.8%). Among children aged 2 to 5 years, obesity increased from 7.2% (95% CI, 5.8%-8.8%) in 1988-1994 to 13.9% (95% CI, 10.7%-17.7%) (P < .001) in 2003-2004 and then decreased to 9.4% (95% CI, 6.8%-12.6%) (P = .03) in 2013-2014. Among children aged 6 to 11 years, obesity increased from 11.3% (95% CI, 9.4%-13.4%) in 1988-1994 to 19.6% (95% CI, 17.1%-22.4%) (P < .001) in 2007-2008, and then did not change (2013-2014: 17.4% [95% CI, 13.8%-21.4%]; P = .44). Obesity increased among adolescents aged 12 to 19 years between 1988-1994 (10.5% [95% CI, 8.8%-12.5%]) and 2013-2014 (20.6% [95% CI, 16.2%-25.6%]; P < .001) as did extreme obesity among children aged 6 to 11 years (3.6% [95% CI, 2.5%-5.0%] in 1988-1994 to 4.3% [95% CI, 3.0%-6.1%] in 2013-2014; P = .02) and adolescents aged 12 to 19 years (2.6% [95% CI, 1.7%-3.9%] in 1988-1994 to 9.1% [95% CI, 7.0%-11.5%] in 2013-2014; P < .001). No significant trends were observed between 2005-2006 and 2013-2014 (P value range, .09-.87).
Conclusions and Relevance
In this nationally representative study of US children and adolescents aged 2 to 19 years, the prevalence of obesity in 2011-2014 was 17.0% and extreme obesity was 5.8%. Between 1988-1994 and 2013-2014, the prevalence of obesity increased until 2003-2004 and then decreased in children aged 2 to 5 years, increased until 2007-2008 and then leveled off in children aged 6 to 11 years, and increased among adolescents aged 12 to 19 years.
Food literacy has emerged as a term to describe the everyday practicalities associated with healthy eating. The term is increasingly used in policy, practice, research and by the public; however, there is no shared understanding of its meaning. The purpose of this research was to develop a definition of food literacy which was informed by the identification of its components. This was considered from two perspectives; that of food experts which aimed to reflect the intention of existing policy and investment, and that of individuals, who could be considered experts in the everyday practicalities of food provisioning and consumption. Given that food literacy is likely to be highly contextual, this second study focused on disadvantaged young people living in an urban area who were responsible for feeding themselves. The Expert Study used a Delphi methodology (round one n=43). The Young People's Study used semi-structured, life-course interviews (n=37). Constructivist Grounded Theory was used to analyse results. This included constant comparison of data within and between studies. From this, eleven components of food literacy were identified which fell into the domains of: planning and management; selection; preparation; and eating. These were used to develop a definition for the term "food literacy".
The Delphi method is well suited to the research needed to inform health education and health promotion campaigns. This paper measures the current interest in the method by way of a literature review. It then describes how the method has evolved from its inception in the 1950s, to its current form. The focus is on a Delphi variant that is particularly relevant to health education – the Policy Delphi. The benefits of the method for the developer of health education and health promotion campaigns are then discussed. The main benefits relate to the gaining of expert opinions without the time and geographical restraints involved in alternative methods. The anonymity that is central to the Delphi method also has benefits for the researcher. The last section of the paper deals with potential pitfalls in the Delphi method that might undermine the successful application of the method, and recommends steps the practitioner can take to address these pitfalls.
To outline the key concepts and principles of the Delphi technique.
Reference is made to a selection of studies that illustrate a variety of methodological interpretations. Drawing on Heshusius's concept of 'goodness criteria', particular emphasis is given to the question of scientific merit and means of evaluation.
Although the technique should be used with caution, it appears to be an established method of harnessing the opinions of an often diverse group of experts on practice-related problems.
There is growing recognition of the need to increase consumption of currently suboptimal levels of fruit and vegetables by children, given their known beneficial effects for health. There is, however, a need for a synthesis of the evidence on interventions that might achieve this policy goal.
A systematic review of published and unpublished studies was carried out by searching 14 publication databases and contacting experts in the fields. All papers in eight languages were considered if they described individual- and population-based interventions and promotion programmes that encouraged the consumption of a diet relatively higher in fruit and/or vegetables in free-living, not acutely ill children of both genders, with follow-up periods of at least 3 months, measurement of change in intake and a control group.
Fifteen studies focusing on children met the criteria for inclusion in the systematic review. None of the studies reviewed had a detrimental effect on fruit and vegetable consumption. Ten studies had a significant effect, ranging from +0.3 to +0.99 servings/day.
More research is needed to examine in more depth, for longer follow-up periods, the effectiveness of interventions promoting fruit and vegetable consumption. The evidence is strongest in favor of multi-component interventions to increase fruit and vegetable consumption in children.
The increase in obesity and chronic diseases such as diabetes and heart disease worldwide reflects the complex interactions of biology, personal behaviour and environment. Consequently there has been a greater recognition of the importance of nutrition education. An analysis of the evidence from 300+ studies shows that nutrition education is more likely to be effective when it focuses on behaviour/ action (rather than knowledge only) and systematically links theory, research and practice. There are three essential components to nutrition education: 1. A motivational component, where the goal is to increase awareness and enhance motivation by addressing beliefs, attitudes through effective communication strategies. 2. An action component, where the goal is to facilitate people's ability to take action through goal setting and cognitive self-regulation skills. 3. An environmental component, where nutrition educators work with policymakers and others to promote environmental supports for action. Each component needs to be based on appropriate theory and research. The procedure for program design can use the logic model: Inputs are the resources needed as well as the needs analysis process. The outputs are the activities within the three components of nutrition education described above. Here the behavioural focus is selected and theory and research are used to design appropriate educational strategies to achieve the targeted behaviours. The outcomes are the short, medium or long-term impacts of the nutrition program. These are evaluated through the use of appropriate designs and instruments. Nutrition education programs that link research, theory, and practice are more likely to be effective.
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