Familiarizing children with healthy food

Between 1982 and 1999, French researchers recorded the food choices of about 400 toddlers who were given lunch at the kindergarten. When they revisited these children in the new millennium — now aged between 4 and 22 — the researchers found their preferences had barely changed. The subjects who had often chosen fruit as toddlers still liked fruit; the ones who had preferred savoury food still did. The food perferences the participants had acquired as little children had stayed with them.

It is not just food preferences that can be traced back to childhood, but other health-related habits too.  Overweight kids are more likely to be overweight as adults. So says Gertrude Zeinstra, an expert in eating behaviour at Wageningen University & Research. She has been researching children’s eating behaviour for 20 years. ‘The latest figures from Statistics Netherlands (CBS) show 11 per cent of children are now overweight. A third of that group, 4 per cent, are obese. There is nothing to indicate that the upward trend is going to stop. That also means increasing risks of diabetes, heart disease and liver problems.’

To turn things around, Zeinstra and her colleagues are developing and studying strategies that help children develop healthy eating habits, often deployed at daycare centers or schools. Those strategies that go further than just a lesson on the importance of vitamins in food. ‘It’s much harder for children that are unfamiliar with healthy products, like fruit and vegetables, to develop healthy eating habits.’ To help children make a habit out of eating healthy, they need more than knowledge. They also need to become familiar with the way healthy food smells, feels and tastes, and gain ‘food skills’ – preferably in a supportive environment.

One of the programmes that does more than just teach the facts is the Taste Classes programme, developed by WUR. By now, schools have now been using it for almost 20 years. The programme is used by 75 per cent of primary schools. ‘It combines lessons with what we call experience-focused activities,’ says Taste Classes project manager Els van Coeverden. ‘Children, for example, get familiar with products, work on reading labels, get their hands dirty in the school garden, or prepare a healthy snack themselves.’ 

‘The content of the lessons differs per school year, but the essence is the same,’ explains Van Coeverden. ‘Children all encounter the same themes: taste, health, food production, consumer skills and cooking.’ Young children learn how to taste with all their senses, with the help of a blindfold, for example. Another lesson is about making apple sauce from scratch and comparing it to apple sauce from a jar. And during the ‘taste feast’ that concludes the series, every school year prepares a dish themselves. ‘The lower years start with a fruit skewer, for example, and the upper secondary kinds make a vegetable burger from legumes.’

‘The cookery lesson is a great way of learning through experience: kids learn about products, get to sample, and are occupied with healthy food in a positive context,’ says Zeinstra. The children develop skills, and that gives them self-confidence in eating healthily. ‘In addition, if you are involved in preparing the fruit and vegetables you eat, you tend to find them tastier. This is termed the IKEA effect in the scientific literature: you appreciate something more if you had to put an effort into it.’

The Taste Classes programme has been included in the ‘Healthy Living Portal’ intervention database created by the National Institute for Public Health and the Environment (RIVM). This is a resource where schools can find tried-and-tested lesson packs and programmes. At present, Zeinstra is carrying out an extensive new study that also looks into the programme’s effectiveness in the long term.

Vegetable gardens can also be an effective form of experience-focused food education, as is shown in a study by Zeinstra and her colleagues. ‘In this study, we looked at the literature and held three sessions with experts with practical experience. Our study revealed a range of beneficial effects.’ Children who grow their own fruit and vegetables in a vegetable garden often have a more positive attitude to those products and learn more about them. They are more prepared to try fruits and vegetables, develop a stronger preference for these products and may even eat more fruit and vegetables. ‘An illustration of the power of the IKEA effect.’

In practice, school vegetable garden projects are quite variable. Working together with professionals and stakeholders, Zeinstra and her colleagues analysed which key elements and criteria are crucial in creating a vegetable garden project that is supported by the scientific evidence. These core criteria formed the basis for the ‘Model Intervention School Gardens’, in which the researchers formulate the framework for the implementation of an effective school garden project. ‘For example, every child needs to work in the garden at least ten times and the class needs to repeatedly try the vegetables they have grown,’ says Zeinstra. According tot the RIVM, the model intervention is ‘well-founded’ and thus, like the Taste Classes, it has been added to the database.

‘So far, I’ve mainly been talking about kids’ knowledge, skills and preferences and how we could help develop them,’ says Zeinstra. ‘But I should also be talking about the environment in which children learn about eating, as that is also very important.’

Take the school or sports club cafeteria. It’s often easy to grab an unhealthy snack there. ‘Research shows that children and teenagers actually like fruit, but fruit can’t compete with chocolate bars and high-fat snacks. So if you want children to choose healthy options, it’s important not to offer those unhealthy competitors during the break at school, for example.’ In other words, make it easy to opt for healthy food. ‘At home too,’ emphasizes Zeinstra.

‘The ten o’clock break — the moment halfway through the morning when children have a small snack — is a thorny issue in primary schools,’ says Zeinstra. Is there a pre-wrapped biscuit or a handful of cucumber slices in that lunch box? ‘We looked at schools that have a snack policy. It turns out requiring parents to give their children something healthy to take to school is very effective. Our research shows that children eat twice as much fruit and vegetables at school if that is the rule. But it only works if the school is prepared to take parents to task if they don’t stick to that rule.’

‘For young children especially, parents are the most important factor in their food environment. Research shows interventions are more effective when parents are involved,’ says Zeinstra. How can a school best approach bringing them in? In their research, Zeinstra and her colleagues looked at various forms of parental involvement to compare how appealing each form was to the parents, schools and teachers, how feasible it was and how many parents it reached. The findings show that each form has its own advantages and disadvantages. ‘The key is to diversify. What doesn’t appeal to some parents, does draw in others.’

Schools that don’t just teach children facts but also give them experiences and new skills, create a healthy food environment and encourage parents to do the same at home are the schools that are most effective in getting children to adopt healthy eating habits. ‘This is termed the “whole school approach”,’ says Zeinstra. It is not limited to a series of lessons; the school seizes every opportunity to encourage healthy eating habits.

‘The whole school approach takes healthy food as a core value and combines different programmes or elements from those programmes.’ That means for example that teachers don’t just teach the lesson pack, they should also set a good example by eating healthily themselves. And no fatty snacks on sports days; instead, bananas are handed out. ‘The key is to make healthy eating an intrinsic part of the school experience. The children at this schools develop their preferences and food skills in an environment where fruit and vegetables are eaten as a matter of course.’

At present, it is still up to the school whether to be so ambitious in working on healthy eating habits. ‘It would help if certain types of food education were to become a compulsory element in education. I know that’s not easy — teachers already have so much to do. But it could make such a difference to growing children.’