Nutrition Education in the Australian New South Wales Primary School Curriculum: Knowledge and Attitudes of Students and Parents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedure
2.2. Child Nutrition Knowledge Survey (CNK-AU) Development
2.3. Dietary Pattern Questions
2.4. Sorting Task
2.5. Interviews
2.6. Statistical Analysis
3. Results
3.1. Descriptive Statistics
3.2. CNK-AU Scores
3.3. Dietary Patterns
3.4. Sorting Task Children
3.5. Interviews
3.5.1. Children’s Beliefs about Healthy Eating and Nutrition Knowledge
“Yes, so then we can know what’s healthy and what’s unhealthy. For when you grow up.”—Girl, 10 years old
“Yes, it is good to learn about nutrition. Because at this age you’re at a growing point and if you don’t eat healthy, then you won’t be able to grow that well.”—Girl, 10 years old
3.5.2. Nutrition Education and Health Behaviours at Home
“Sometimes if I go to eat something it’ll be like do you need that sort of thing. I could make a better choice.”—Boy, 11 years old
“Absolutely. Because there’s so much—so many—they get so much different information that’s conflicting […]”—Mother of 11 year-old boy
“Absolutely. I think it’s important to start early so that they make the right choices when they’re older themselves. I can help them make choices now but when they’re older they need to know.”—Mother of 10 year-old girl
“[…] so sort of just teaching a little bit more about investigating. Making up your choice, not just believing what is on the front but digging a bit deeper.”—Mother of 10 year-old boy
“Definitely so they can make the right choices and also understand why as a parent you’re setting particular boundaries and instead of giving them certain things, if they understand why you’re doing it and what purpose they’re more likely to get on board rather than just say why do you keep denying me all these things?”—Mother of 10 year-old girl
“But often we just talk about—you know, like we might be out and some children might be eating some certain foods and my children might want to have it and when things like that come up we would have a bit of a talk about it and why do we believe that we don’t want our children to have it.”—Mother of 10 year-old girl
3.5.3. Parental Involvement and Nutrition Education in the Child’s School
“Whenever the teacher comes around it’s pretty much the exact same thing every time. They go over everything and then just keep reminding you every so often. You’re just hearing the same thing over and over. Boring yeah.”—Boy, 11
“No the only thing I can think of is when they’re starting kindergarten, they do talk about making good choices in lunchboxes and five serves of veggies and two fruit, but then that’s kind of—that’s sort of given to you—well it’s really a couple of months before they start kindergarten. Then there’s not really any follow up on that and. Yeah, lunchboxes are hard because of just time stuff. You’re wanting to rush and it’s easy to make three sandwiches in the morning than make salads.”—Mother of 10 year-old girl
“I even just think more just the science behind healthy eating, so I’d love them to actually in school talk about what is calcium, what are vitamins, what is the diseases in Australia, what food helps eyesight, what food helps bones, what food. So I don’t see a general primary school teacher having time in the curriculum to do that, but I think it should. The only time there’s a little bit of influence in the school is when it comes to her lunchbox, which puts it back on the parent.”—Mother of 10 year-old girl
“Yeah, I think it would be good for everyone knowing it—as well as it being funny we’re also learning about it and learning what’s in the food that they’re making. Maybe a bit more about the diet and what sort of—mum and dad have mentioned before the type of fruit or vegetables, how much you need to eat but maybe it would be better to be reminded.”—Girl, 10
“If they actually taught us different stuff. If it wasn’t boring.”—Boy, 11
“Well yeah, a little bit more because sometimes we have—if we do something good or something in class we get these little Starburst candy they give out.”—Girl, 10
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Nyaradi, A.; Li, J.; Foster, J.K.; Hickling, S.; Jacques, A.; O’Sullivan, T.A.; Oddy, W.H. Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr. Int. J. Paediatr. 2016, 105, e209–e218. [Google Scholar] [CrossRef] [PubMed]
- Correa-Burrows, P.; Burrows, R.; Blanco, E.; Reyes, M.; Gahagan, S. Nutritional quality of diet and academic performance in Chilean students. Bull. World Health Organ. 2016, 94, 185–192. [Google Scholar] [CrossRef] [PubMed]
- Lustig, R.; Weiss, R. Disorders of energy balance. In Pediatric Endocrinology; Elsevier: San Diego, CA, USA, 2008; pp. 788–838. [Google Scholar]
- Lobstein, T.; Baur, L.; Uauy, R. Obesity in children and young people: A crisis in public health. Obes. Rev. 2004, 5 (Suppl. 1), 4–85. [Google Scholar] [CrossRef] [PubMed]
- Craigie, A.M.; Lake, A.A.; Kelly, S.A.; Adamson, A.J.; Mathers, J.C. Tracking of obesity-related behaviours from childhood to adulthood: A systematic review. Maturitas 2011, 70, 266–284. [Google Scholar] [CrossRef] [Green Version]
- NSW Ministry of Health. NSW School Physical Activity and Nutrition Survey (SPANS) 2015; NSW Ministry of Health: St Leonards, Australa, 2017.
- National Health and Medical Research Council Australian Guide to Healthy Eating. Available online: https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating (accessed on 3 October 2019).
- Rangan, A.M.; Randall, D.; Hector, D.J.; Gill, T.P.; Webb, K.L. Consumption of ‘extra’ foods by Australian children: Types, quantities and contribution to energy and nutrient intakes. Eur. J. Clin. Nutr. 2008, 62, 356–364. [Google Scholar] [CrossRef] [Green Version]
- Withrow, D.; Alter, D.A. The economic burden of obesity worldwide: A systematic review of the direct costs of obesity. Obes. Rev. 2011, 12, 131–141. [Google Scholar] [CrossRef]
- Hendrie, G.A.; Coveney, J.; Cox, D. Exploring nutrition knowledge and the demographic variation in knowledge levels in an Australian community sample. Public Health Nutr. 2008, 11, 1365–1371. [Google Scholar] [CrossRef] [Green Version]
- Touyz, L.M.; Wakefield, C.E.; Grech, A.M.; Quinn, V.F.; Costa, D.S.J.; Zhang, F.F.; Cohn, R.J.; Sajeev, M.; Cohen, J. Parent-targeted home-based interventions for increasing fruit and vegetable intake in children: A systematic review and meta-analysis. Nutr. Rev. 2018, 76, 154–173. [Google Scholar] [CrossRef]
- Johnson, B.J.; Zarnowiecki, D.; Hendrie, G.A.; Mauch, C.E.; Golley, R.K. How to reduce parental provision of unhealthy foods to 3- to 8-year-old children in the home environment? A systematic review utilizing the Behaviour Change Wheel framework. Obes. Rev. 2018, 19, 1359–1370. [Google Scholar] [CrossRef]
- Gibson, E.L.; Wardle, J.; Watts, C.J. Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children. Appetite 1998, 31, 205–228. [Google Scholar] [CrossRef] [Green Version]
- Pirouznia, M. The correlation between nutrition knowledge and eating behavior in an American school: The role of ethnicity. Nutr. Health 2000, 14, 89–107. [Google Scholar] [CrossRef] [PubMed]
- Moore, L.; Tapper, K. The impact of school fruit tuck shops and school food policies on children’s fruit consumption: A cluster randomised trial of schools in deprived areas. J. Epidemiol. Community Health 2008, 62, 926–931. [Google Scholar] [CrossRef] [PubMed]
- Van Der Horst, K.; Oenema, A.; Ferreira, I.; Wendel-Vos, W.; Giskes, K.; Van Lenthe, F.; Brug, J. A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ. Res. 2007, 22, 203–226. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Worsley, A. Nutrition knowledge and food consumption: Can nutrition knowledge change food behaviour? Asia Pac. J. Clin. Nutr. 2002, 11 (Suppl. 3), S579–S585. [Google Scholar] [CrossRef] [Green Version]
- Dudley, D.A.; Cotton, W.G.; Peralta, L.R. Teaching approaches and strategies that promote healthy eating in primary school children: A systematic review and meta-analysis. Int. J. Behav. Nutr. Phys. Act. 2015, 12, 28. [Google Scholar] [CrossRef] [Green Version]
- Van Cauwenberghe, E.; Maes, L.; Spittaels, H.; van Lenthe, F.J.; Brug, J.; Oppert, J.-M.; De Bourdeaudhuij, I. Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: Systematic review of published and “grey” literature. Br. J. Nutr. 2010, 103, 781–797. [Google Scholar] [CrossRef]
- Friel, S.; Kelleher, C.; Campbell, P.; Nolan, G. Evaluation of the Nutrition Education at Primary School (NEAPS) programme. Public Heal. Nutr. 1999, 2, 549–555. [Google Scholar] [CrossRef] [Green Version]
- Shannon, B.; Chen, A.N. A three-year school-based nutrition education study. J. Nutr. Educ. 1988, 20, 114–124. [Google Scholar] [CrossRef]
- Pérez-Rodrigo, C.; Aranceta, J. Nutrition education in schools: Experiences and challenges. Eur. J. Clin. Nutr. 2003, 57, S82–S85. [Google Scholar] [CrossRef] [Green Version]
- Story, M. School-based approaches for preventing and treating obesity. Int. J. Obes. 1999, 23, S43–S51. [Google Scholar] [CrossRef]
- Hung, T.T.M.; Chiang, V.C.L.; Dawson, A.; Lee, R.L.T. Understanding of factors that enable health promoters in implementing health-promoting schools: A systematic review and narrative synthesis of qualitative evidence. PLoS ONE 2014, 9, e108284. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Report of the Commission on Ending Childhood Obesity; World Health Organization: Geneva, Switzerland, 2016. [Google Scholar]
- NSW Education Standards Authority PDHPE Syllabus K-10. Available online: https://educationstandards.nsw.edu.au/wps/portal/nesa/k-10/learning-areas/pdhpe/pdhpe-k-10-2018 (accessed on 22 January 2020).
- De Vlieger, N.; Riley, N.; Miller, A.; Collins, C.E.; Bucher, T. Nutrition education in the Australian New South Wales primary school curriculum: An exploration of time allocation, translation and attitudes in a sample of teachers. Heal. Promot. J. Aust. 2018, 30, 94–101. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Love, P.; Booth, A.; Margerison, C.; Nowson, C.; Grimes, C. Food and nutrition education opportunities within Australian primary schools. Health Promot. Int. 2020. [Google Scholar] [CrossRef]
- Vereecken, C.; De Pauw, A.; Van Cauwenbergh, S.; Maes, L. Development and test–retest reliability of a nutrition knowledge questionnaire for primary-school children. Public Health Nutr. 2012, 15, 1630–1638. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van der Bend, D.; Bucher, T.; Schumacher, T.; Collins, K.; De Vlieger, N.; Rollo, M.; Burrows, T.; Watson, J.; Collins, C. Trends in Food and Beverage Portion Sizes in Australian Children; a Time-Series Analysis Comparing 2007 and 2011–2012 National Data. Children 2017, 4, 69. [Google Scholar] [CrossRef] [Green Version]
- Williams, A.; de Vlieger, N.; Young, M.; Jensen, M.E.; Burrows, T.L.; Morgan, P.J.; Collins, C.E. Dietary outcomes of overweight fathers and their children in the Healthy Dads, Healthy Kids community randomised controlled trial. J. Hum. Nutr. Diet. 2018, 31, 523–532. [Google Scholar] [CrossRef]
- Bucher, T.; van der Horst, K.; Siegrist, M. The fake food buffet—A new method in nutrition behaviour research. Br. J. Nutr. 2012, 107, 1553–1560. [Google Scholar] [CrossRef] [Green Version]
- NHMRC Australian Dietary Guidelines: Recommended Daily Intakes. Available online: http://www.nutritionaustralia.org/national/resource/australian-dietary-guidelines-recommended-daily-intakes%5Cnhttp://nutritionaustralia.org/national/resource/australian-dietary-guidelines-recommended-daily-intakes (accessed on 26 November 2019).
- Australian Bureau of Statistics (ABS). Socio-Economic Indexes for Areas (SEIFA); ABS: Canberra, Austria, 2011.
- Gower, J.R.; Moyer-Mileur, L.J.; Wilkinson, R.D.; Slater, H.; Jordan, K.C. Validity and Reliability of a Nutrition Knowledge Survey for Assessment in Elementary School Children. J. Am. Diet. Assoc. 2010, 110, 452–456. [Google Scholar] [CrossRef]
- Australian Government, D. of H. About the Australian Dietary Guidelines|Eat for Health. Available online: https://www.eatforhealth.gov.au/guidelines/about-australian-dietary-guidelines (accessed on 2 March 2020).
- Engell, D.; Bordi, P.; Borja, M.; Lambert, C.; Rolls, B. Effects of information about fat content on food preferences in pre-adolescent children. Appetite 1998, 30, 269–282. [Google Scholar] [CrossRef]
- Hart, K.H.; Bishop, J.A.; Truby, H. An investigation into school children’s knowledge and awareness of food and nutrition. J. Hum. Nutr. Diet. 2002, 15, 129–140. [Google Scholar] [CrossRef] [Green Version]
- De Vlieger, N.M.; Collins, C.; Bucher, T. What is a nutritious snack? Level of processing and macronutrient content in fl uences young adults’ perceptions. Appetite 2017, 114, 55–63. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Follong, B.; Prieto-Rodriguez, E.; Miller, A.; Collins, C.; Bucher, T. An exploratory survey on teaching practices integrating nutrition and mathematics in Australian primary schools. Int. J. Res. Educ. Sci. 2020, 6, 14–33. [Google Scholar]
- Yabancı, N.; Kısaç, İ.; Karakuş, S.Ş. The Effects of Mother’s Nutritional Knowledge on Attitudes and Behaviors of Children about Nutrition. Procedia Soc. Behav. Sci. 2014, 116, 4477–4481. [Google Scholar] [CrossRef] [Green Version]
- Al-Shookri, A.; Al-Shukaily, L.; Hassan, F.; Al-Sheraji, S.; Al-Tobi, S. Effect of mothers nutritional knowledge and attitudes on Omani children’s dietary intake. Oman Med. J. 2011, 26, 253–257. [Google Scholar] [CrossRef]
- Vereecken, C.; Maes, L. Young children’s dietary habits and associations with the mothers’ nutritional knowledge and attitudes. Appetite 2010, 54, 44–51. [Google Scholar] [CrossRef]
- Perry, C.L.; Luepker, R.V.; Murray, D.M.; Kurth, C.; Mullis, R.; Crockett, S.; Jacobs, D.R. Parent involvement with children’s health promotion: The Minnesota home team. Am. J. Public Health 1988, 78, 1156–1160. [Google Scholar] [CrossRef] [Green Version]
- Pigeyre, M.; Rousseaux, J.; Trouiller, P.; Dumont, J.; Goumidi, L.; Bonte, D.; Dumont, M.P.; Chmielewski, A.; Duhamel, A.; Amouyel, P.; et al. How obesity relates to socio-economic status: Identification of eating behavior mediators. Int. J. Obes. 2016, 40, 1794–1801. [Google Scholar] [CrossRef]
- Smith, R.; Kelly, B.; Yeatman, H.; Boyland, E. Food marketing influences children’s attitudes, preferences and consumption: A systematic critical review. Nutrients 2019, 11, 875. [Google Scholar] [CrossRef] [Green Version]
Food Item | Correct Box | Based on |
---|---|---|
Water * | healthy | The Australian Dietary Guideline advice to drink plenty of water. |
Plain yoghurt | healthy | Guideline 2: Enjoy a wide variety of nutritious foods from the food group consisting of milk, yoghurt, cheese, and/or their alternatives, mostly reduced fat. |
Mixed nuts * | healthy | Guideline 2: Enjoy a wide variety of lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans. |
Wholemeal bread slice * | healthy | Guideline 2: Enjoy a wide variety of nutritious foods from grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa, and barley. |
Banana * | healthy | Guideline 2: Enjoy a wide variety of nutritious foods from the fruit food group. |
Carrot | healthy | Guideline 2: Consume plenty of vegetables, including different types and colours, and legumes/beans. |
Egg * | healthy | Guideline 2: Enjoy a wide variety of lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans. |
Strawberry milk | neutral | Guideline 3a: limit foods high in saturated fat and added sugars. Guideline 2: Enjoy a wide variety of nutritious foods from the food group consisting of milk, yoghurt, cheese, and/or their alternatives, mostly reduced fat. |
Orange juice | neutral | According to guideline two of the Australian Dietary Guidelines, people should enjoy a wide variety of fruits. ½ cup of fruit juice (with no added sugar) can only occasionally be considered a standard serve of fruit. Therefore, orange juice is placed in the neutral group. |
Straw. yoghurt | neutral | Guideline 3a: limit foods high in saturated fat and added sugars. Guideline 2: Enjoy a wide variety of nutritious foods from the food group consisting of milk, yoghurt, cheese, and/or their alternatives, mostly reduced fat. |
White bread slice * | neutral | Guideline 2: Enjoy a wide variety of nutritious foods from grain (cereal) foods, mostly wholegrain, and/or high cereal fibre varieties. |
Cola | unhealthy | Considered unhealthy as the Australian Dietary Guidelines state to limit intake of foods and drinks containing added sugars such as sugar-sweetened soft drinks. |
Chips * | unhealthy | Guideline 3a: Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps, and other savoury snacks. |
Muffin * | unhealthy | Guideline 3a: limit foods high in saturated fat and added sugars. |
Timtam *† | unhealthy | Guideline 3a: limit foods high in saturated fat and added sugars. |
Pork sausage * | unhealthy | Guideline 3a: limit intake of foods high in saturated fats such as meats. |
Muesli bar | unhealthy | Guideline 3a: limit foods high in saturated fat and added sugars. |
Children | Parents | |
---|---|---|
Number of participants | 21 | 21 |
Mean age (years) | 10.3 (SD 0.6) | 43.1 (SD 4.6) |
Gender | ||
Male | 5 (23.8%) | 2 (9.5%) |
Female | 16 (76.2%) | 19 (90.5%) |
Year of school | ||
Year 5 | 18 (85.7%) | N/A |
Year 6 | 3 (14.3%) | |
Number of other children in the home | 2.4 (SD 0.8) | |
Type of school | Government: 17 (81%) | |
Catholic: 3 (14.3%) | ||
Independent: 1 (4.8%) | ||
Average SEIFA * per postcode | 7.7 |
Score Possible | Score Mean ± SD | Δ Score Children-Parents | Correlation (p Value) | ||
---|---|---|---|---|---|
Children | Parents | ||||
Healthy choices | 12 | 8.24 (0.86) | 9.20 (1.44) | −0.95 | 0.084 |
Serves & portions | 11 | 4.05 (1.77) | 5.67 (1.49) | −1.62 | 0.001 * |
Nutritional values | 11 | 5.67 (2.03) | 9.86 (0.96) | −4.19 | <0.001 * |
Food groups | 6 | 4.33 (0.86) | 5.33 (0.80) | −1.00 | 0.001 * |
Total score | 40 | 22.3 (4.22) | 31.00 (2.85) | −8.71 | <0.001 * |
Food/Beverage | Unhealthy | Neutral | Healthy | % Correct |
---|---|---|---|---|
Banana | 0 (0%) | 0 (0%) | 21 (100%) * | 100 |
Carrot | 0 (0%) | 0 (0%) | 21 (100%) * | 100 |
Chips | 17 (81%) * | 4 (19%) | 0 (0%) | 81 |
Cola | 21 (100%) * | 0 (0%) | 0 (0%) | 100 |
Egg | 0 (0%) | 4 (19%) | 17 (81%) * | 81 |
Mixed nuts | 0 (0%) | 8 (38%) | 13 (62%) * | 62 |
Muesli bar | 3 (14%) * | 16 (76%) | 2 (10%) | 14 |
Muffin | 19 (90%) * | 2 (10%) | 0 (0%) | 90 |
Orange juice | 9 (43%) | 11 (52%) * | 1 (5%) | 52 |
Plain yoghurt | 0 (0%) | 15 (71%) | 6 (29%) * | 29 |
Pork sausage | 3 (14%) * | 17 (81%) | 1 (5%) | 14 |
Straw. yoghurt | 5 (24%) | 14 (67%) * | 2 (10%) | 67 |
Strawberry milk | 15 (71%) | 6 (29%) * | 0 (0%) | 29 |
Timtam | 20 (95%) * | 1 (5%) | 0 (0%) | 95 |
Water | 0 (0%) | 0 (0%) | 21 (100%) * | 100 |
White bread slice | 2 (10%) | 16 (76%) * | 3 (14%) | 76 |
Wholemeal bread slice | 0 (0%) | 6 (29%) | 15 (71%) * | 71 |
Healthy Criteria Mentioned | Neutral Criteria Mentioned | Unhealthy Criteria Mentioned | |||
---|---|---|---|---|---|
Fruit and/or vegetables | 19 | Neutral | 16 | Sugar | 51 |
Healthy | 10 | Sometimes | 5 | Contains chocolate | 14 |
Natural (sugar) | 7 | Not healthy/unhealthy | 4 | Unhealthy | 13 |
Grains | 5 | Salt | 4 | ||
Protein | 5 | Processed | 3 | ||
Good for you | 4 | ||||
Vitamins | 2 |
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de Vlieger, N.; van Rossum, J.; Riley, N.; Miller, A.; Collins, C.; Bucher, T. Nutrition Education in the Australian New South Wales Primary School Curriculum: Knowledge and Attitudes of Students and Parents. Children 2020, 7, 24. https://doi.org/10.3390/children7040024
de Vlieger N, van Rossum J, Riley N, Miller A, Collins C, Bucher T. Nutrition Education in the Australian New South Wales Primary School Curriculum: Knowledge and Attitudes of Students and Parents. Children. 2020; 7(4):24. https://doi.org/10.3390/children7040024
Chicago/Turabian Stylede Vlieger, Nienke, Jolien van Rossum, Nicholas Riley, Andrew Miller, Clare Collins, and Tamara Bucher. 2020. "Nutrition Education in the Australian New South Wales Primary School Curriculum: Knowledge and Attitudes of Students and Parents" Children 7, no. 4: 24. https://doi.org/10.3390/children7040024