Nutrition Education

for School-age Children:

Best Practices
By Katherine Hopkins

NSLP & SBP Eligibility

Free 130% at or below poverty
level
~ 29,965 for family of four (2013)

Reduced between 130% 185% of the poverty level

185% is ~ $42,643 for family of four

Students charged no more than

$0.30
Schools set own prices for meals
to non-qualifying students
Though still have to operate food

Changes/reductions beginning in
SY 2013-2014
More whole grains offered
Meals more calorically appropriate
for age groups
Reduction in sodium content, with
mandatory reductions being met by
SY 2014-2015, SY 2017-2018, SY
2022-2023
More fruits offered

US Child
Nutrition
Education
Programs

Grade Level

USDA Curriculum

Kindergarten

Discover MyPlate: Nutrition

Education for Kindergarten

Grades 3 - 4

The Great Garden Detective

Adventures

Grades 5 - 6

Dig In! Standards-based

Nutrition Education from the
Ground Up

Grades 1 - 6

Serving Up MyPlate:
A Yummy Curriculum

Grades 7 - 8

Nutrition Voyage: The Quest to

be Our Best

Grades 9 - 12

SuperTracker Nutrition Lessons

for High School Students

Nutrition Education for Children:

Best Practices
Age and developmentally-appropriate content
Culturally and socioeconomically relevant
content
Support and encouragement for children's
ability to self regulate appetite and intake
Respect for the Division of Responsibilities
Empowerment and involvement of
Parents/Caregivers and teachers
Neutral presentation of foods
Evaluation tools

Age and developmental

appropriateness
Presentation and or curriculum should demonstrate
solid understanding of cognitive capabilities of the
target audience
Piagets Theory of Cognitive Development
Pre-Operational
Concrete Operational
Formal Operations

Teach to youngest/lowest level in mixed group

situations

Interventions designed for Adolescents more effective

when based on relative theory (Dewar et al)

ESs Division of
Responsibility
Parents/Caregivers
decide the WHAT and
WHEN
Children decide IF and
HOW MUCH

Neutral presentation of foods

Helps children develop a healthy
relationship with food
Eliminates shaming, judgments
Prevents foods from becoming
associated with rewards or
punishments

Restriction, Coercion, and

Pressure
Restriction associated with weight gain and over
consumption of restricted foods irrespective of
hunger
Increased pressure from parent or caregiver
associated with increased consumption of high fat,
high energy-dense foods
Children become more interested in restricted
foods
Begin associating foods with feelings
It has been suggested that food insecurity mimics
food restriction. Could there be a link?

Its Biological!
Infant taste preferences are said to be a survival
or protective mechanism
Babies prefer sweet tastes, as sweet foods are
often high in energy
Children are often attracted to salty taste,
which research suggests helps them achieve
their mineral needs.
Children abstain from bitter tastes, as many
toxins and or poisons are bitter
Repeated exposures is best way to weaken innate
avoidance of bitter foods such as vegetables

Try this! Its good for you,

and it tastes good too!
Which situation was more fun?
Did you feel more anxiety or pressure with
one or the other?
Did you feel guilty for not trying what I
offered?
Did you try either item to please me?
This was an example of a creative way to
expose or reintroduce foods in a nonnutritive way, with no pressure

Family
Children develop lifelong eating preferences and
behaviors young, well before age 5
Parental feeding practices often based on childhood
experiences, culturally influenced (Mena et al)
Parental behavior and role modeling as most
important aspect of family influence on child nutrition
Provide tips and tools to empower parents facilitation
of nutrition education to children
Create corresponding intervention for parents and
caregivers is
More successful than child-only interventions
(AND)

Cultural Relevance
Availability and access to nourishing foods like fruits and
vegetables, not education, is largest barrier to making healthy
choices
Children's fruit and vegetable consumptions is directly related to
availability of fruits and vegetables in the home
Neumark-Sztainer D et al found children's fruit and vegetable consumptions is
directly related to availability of fruits and vegetables in the home

RDs should be familiar with what's served at school breakfast and

lunch.
Focus content on these foods
For lower income schools reference tray vs. plate

Include relevant ethnic foods and practices

Do your research! Demonstrate cultural competence and sensitivity
when involving parents/caregivers

Cultural and familial influence

on feeding practices and habits
Mena, et al found that Hispanic mothers
reported that their own childhood practices
influenced their parental feeding style
Ex. Finishing what's on plate, no waste, rice
& beans
Husbands food preferences as a barrier to
eating healthy
Grandparents often disagreeing with WIC
recommendations
Wrestle with idea that childcare doest
provide enough food to child

Teamwork Makes the

Dream Work
Overwhelming evidence
suggests that childcare
programs and schools are in an
opportunistic position to deliver
nutrition education to both
children and parents, however,
the evidence as to the most
successful way to involve
parents in much less
conclusive.

Topic

Recommendatio
n for Revision

Rationale

Boks Bits Discussion

Points

Portion
Control

Just enough? or Im
stuffed!

Consider a discussion
that explores and
supports the young
childs natural ability to
listen to their bodies, to
eat when hungry and
stop when comfortable.

Young children
understand and are
cognizant of feelings
rather than concepts.

Children ages 2-7 are in

the preoperational stage
of life, and learn
through active
participation rather than
sitting and listening

It can be really upsetting for

Parents or caregivers that
perceive their child may be
under- or overeating. However,
its important to remember that
most all children, especially
young children, are naturally
equipped with an intuitive
appetite, and feed based on
internal hunger and satiety
signals.

When instructing young children

to eat certain amounts, we
unintentionally force children to
stop listening to their own
bodies, which can often lead
them to develop unhealthy
eating habits as adolescents and
adults.

What does it feel like in your body when

youre hungry?

Ex. Finishing ones carrots

becomes task oriented and
causes a child to disconnect
from their internal hunger and
satiety signals. If we request
that children finish their carrots
in order to have dessert, we
again we not only disengage
children from listening to their
own body signals, but we also
cause them to develop habits of
eating sweets when not hungry.

What does full feel like?

How do you know when youve had the right
amount of food?
When do you feel the most hungry?
What happens when you eat too much food?
When this happens do you feel energized or
tired?

Breakfast
Consistent and strong emphasis on consuming
breakfast everyday.
Kids who eat breakfast daily

Are less overweight

Are absent less
Visit school nurse less often
Perform better academically

Elementary School #1 Natick

Observations

Upper class community

Older parent population
Siblings
Parents familiar with one another and with other
children in program
Walk their child to instructor taking attendance
Brought water from home
No subsidized breakfast or lunch
Held inside or out
Principle present
PE teacher runs program

Elementary School #2
Natick
Observations

Middle upper to upper class population

Instructor not familiar with participation in school
breakfast or lunch program
Older parent population
Most students brought water from home
Facilitated Boks Bit

Elementary School #3
Roxbury
Observations

Low socioeconomic community

Starts at 7:00 am
100% free meal program
Less than 80% attendance
Some children escorted by parent, most walk to
school
Did not incorporate Boks Bit into session
Per Instructor/PE teacher, often omit nutrition
portion due to irrelevant content, or to allow students
more time at Breakfast

ACTIVITY TIME!!!
You have 8 to
Create

Team 1: The Bone

Builders
Preschool, Fruits, and
Movement
Create an age and
developmentally-appropriate
activity for preschoolers that
incorporates fruits and
movement

Team 2: The Muscle

Makers
Grades 3 - 4, fruits and
vegetables, and teamwork
Create an age and
developmentally-appropriate
activity for 3rd and 4th graders
that incorporates fruits,
vegetables, and teamwork

Will the real nutrition

experts please stand up?
RDs are more than just nutrition experts and
educators
We have the knowledge and expertise to
facilitate long lasting healthy relationship
between people and food
RDs are essential to the promotion of
healthy eating and prevention and reduction
of obesity and eating disorders in children
through the use of evidence based best
practices to create impactful, fun, and
appropriate nutrition education curriculum
for children

Discussions
1. What were some of the child
nutrition education strategies
discussed throughout this
presentation?
2. Round table discussion topic:
How neutral must we be in the
presentation of foods to children?