A school-based intervention to promote dietary change.

PURPOSE: This study examined the effect of 2 school-based interventions on adolescents' consumption and knowledge of fish with the hypothesis that home economics education would enhance the effect of modifications in the school canteen. The school lunch intervention (SL) focused on changes in the school canteen, and the school lunch + home economics intervention (SL + HE) in addition consisted of changes in the home economics syllabus. Pupils in the 8th grade (n = 228) from 3 schools in Göteborg, Sweden, participated (control, n = 83; SL group, n = 58; SL + HE group, n = 87). METHODS: A controlled design was used in which behavior and knowledge were assessed before and after the intervention. In contrast to much previous research of this type, measurement of behavior was based primarily on direct observation as opposed to self-reported intakes. Behavior (fish consumption) was measured individually by structured observations in the school canteen 5 times (once a week) when fish was served. Nutritional knowledge was measured by means of 10 items in a questionnaire. To analyze changes in behavior, a nonparametric statistical method assessing systematic change in paired ordered categoric variables was used. RESULTS: At follow-up evaluation, consumption had increased significantly in the SL + HE group, a change that also differed from the control group. In addition, significant positive changes in knowledge were observed in both intervention groups, but not in controls. CONCLUSIONS: The results suggest that dietary change was achieved by modifying conditions in the school canteen together with changing the home economics syllabus. This study shows the importance of the school in the promotion of dietary change among adolescents.

Relation between breakfast food choices and knowledge of dietary fat and fiber among Swedish schoolchildren.

PURPOSE: To investigate dietary knowledge and beliefs of schoolchildren, in relationship to breakfast choices, with specific attention to fat and fiber content. METHODS: Food choice and perceptions were studied by interviews using the "stacking box methodology". Youth (n = 181) aged 11-15 years were instructed to select food items among photographs of breakfast foods. In addition to choosing their own typical breakfasts, they were asked to exchange foods in hypothetical breakfasts to create meals with less fat and more fiber. The interview also dealt with recent changes in breakfast habits, and perceptions of healthy breakfasts, dietary fat, and foods rich in fiber. Data were analyzed by logistic regression. RESULTS: Knowledge concerning sources and health attributes of dietary fiber was associated with usual consumption of bread and breakfast cereals rich in fiber. In a similar way, a positive attitude toward limited fat intake predicted consumption of reduced-fat milk products. However, no association was observed between food choices and knowledge of a food-packaging symbol indicating low-fat and fiber-enriched foods. CONCLUSION: Lack of awareness of, and knowledge about, healthy eating may be important barriers to the development of health promoting food habits by schoolchildren.