According to the Health Education Population Survey (HEPS 1996-2003), there is substantial evidence of the effectiveness of healthy eating campaigns put in place over the last eight years. The proportion of people aware of the recommended daily consumption of at least five fresh fruit and vegetables portions rose significantly from 19% in 1996 to 59% in 2003 (NHS Scotland, p.3). However, four in ten adults are still not aware of the 5-a-day recommendation and this reflects on children who need to be made aware of the importance of healthy food choices. The Scottish Health Survey (2003) revealed that children aged 5-15 consumed just an average of 2.6 portions a day. Only 12% achieved the recommended daily amount and, sadly, 12% consumed none at all (The Food and Health Strategy Group, 2008, p. 30). These results suggest there is still considerable scope for further research and improvement.
Research (The Scottish Office, 1996, sec. 6.27) into schools show that, although pupils have a fair understanding of healthy eating, they are ineffective in applying the knowledge in practice. Advertising, fads, peers and role models easily influence children. Easy access to unhealthy products high in fat, salt and sugar such as school vending machines and tuck shops deter children from making healthy choices.
According to new research carried out by Dairy Farmers of Britain, one in ten children think tomato ketchup counts as one of their 5-a-day fruit and veg portions (DFB 2007, p.1). This succinct example of how children today perceive healthy eating provides the basis for this research. The number of children eating ready meals, take aways and unhealthy packed lunches have laid the foundation for an alarmingly obese UK population and recent years have seen the trusted school dinners come under close scrutiny for their unhealthy content. The insufficient consumption of fruit and vegetables is thought to contribute to 31% of
ischaemic heart diseases and 11% of strokes. With such serious health risks awaiting the young generation there is now much being done in Scotland and the UK to completely revise how children eat both at home and at school.
The striking results obtained by the survey carried out by the Dairy Farmers of Britain in June 2007 has shown the reality of children’s eating habits as well as how they actually see their food. Their campaign, called “Grass is Greener”, includes a thorough look into children’s understanding of healthy eating and the survey consisted of a sample of over 1,000 children aged between 8 and 15 who were asked what they thought could be included in a 5-a-day. They revealed a concerning lack of knowledge about what goes into 5-a-day, but their eating habits were also seen to be linked to where they lived. The key findings of the survey were as follows (DFB 2007, p.2):
• Almost one in four (22%) did not include fruit smoothies
• One in five (18%) failed to recognise frozen peas as a healthy vegetable
• One in three (31%) did not think tinned tomatoes could count in 5-a-day
Starchy foods caused the most confusion:
• Almost one in three chidren (31%) counted roast potatoes as one of the 5-a-day
• More than one in ten (12%) thought pasta could be counted as a vegetable
• More than one in twenty (6%) included bread
The results presented a significant difference between children living in the city and those living in the countryside which suggested that a rural upbringing teaches children more about healthy eating habits. When asked about the obvious fruit – an apple – four percent of children from the city did not think that it counted as a 5-a-day portion compared to only two percent of children living elsewhere. The worst region in the survey was the East Midlands, where:
· Nearly one in five (18%) children thought ketchup could be included
· Almost one in two (44%) thought tinned tomatoes were not part of 5-a-day
However, Scottish children were close on the heels of the Midlands kids with one in 10 thinking low fat crisps were part of 5-a-day, almost one in 5 counting tomato ketchup and 13 percent believing that sliced bread could also be counted as one of 5-a-day (DFB 2007, p.3).
In conclusion, the survey showed that while almost all of the children (99%) had some idea of what a 5-a-day meant, still many were confused as to which foods could be counted as 5-a-day portions.
Over the past few years the NHS, local education authorities and councils are taking part in many campaigns to promote healthy diets in children and much of these campaigns are aimed directly at the children to increase their awareness of the food they consume.
One such example of positive steps taken in this direction is the Health Promoting School Profiling Project commissioned by the Dumfries and Galloway Education Department. Carried out between from July 2002 to August 2002 and with a funding of £10,000 the objective of the project was to conduct research at school level in order to identify health needs and develop a health profile of the schools within the NCS (New Community Schools) cluster. Pupils from Primary 6, 7 and Secondary 1-3 completed questionnaires as well as participating in group discussions. Headteachers were given an Healthy Schools assessment tool to complete and all of the findings were disseminated to the partner agencies for evaluation and monitoring purposes, and to inform future development of the Health Promoting School throughout Dumfries and Galloway (The Food and Health Strategy Group, 2008).
An interactive campaign for children to help increase their awareness of 5-a-day are The
Bash Street Kids cartoon characters which have been introduced to inject fun into learning. The school project is funded by the Food Standards Agency and began in 1999 with 500
pupils in two primary schools in Dundee, Scotland (464 children in two further schools
acted as controls). Implemented throughout the UK, The Bash Street Kids material is aimed at 7 to 11 year old primary school pupils and can be used in many ways to support the promotion of the 5-a-day message. Primary school teachers have access to a number of materials and tools which can fit in with the school curriculum (Food Standards Agency, 2008).
The aims of 5-a-day the Bash Street way are to:
encourage children to eat more fruit and vegetables each day
help them to feel more positive about fruit and vegetables, which can genuinely promote their good health
help establish the 5-a-day habit for a lifetime.
As well as the rest of the UK, many people in Scotland face serious health risks due to poor diet and lack of exercise. More than 150,000 of the Scottish population have diabetes and this is likely to double over the next 10-15 years. During school year 2004-05, 21.5% of children in Primary 1 (aged 4-5 years) were identified as being overweight, 9.0% obese and 4.4% severely obese. Older children had higher levels of obesity. Of those aged 11-12 years, 34.1% were overweight, 19.4% were obese and more than one in 10 (11.2%) were severely obese. According to the Scottish Government Consultations, the Scottish Executive’s health improvement policy, based on WHO’s advice, aims to promote the 5-a-day campaign on a nationwide basis (Scottish Executive 2006, p.3). Acknowledging the importance of healthy lifestyles in children which can be carried into adulthood and ultimately passed onto their own
children, the proposed Bill will ensure that all local authority schools are health promoting environments and healthy food and drinks are supplied. The campaign aims to:
place a duty on local authorities to ensure that food and drinks supplied in local authority schools meet defined nutrient standards. It is proposed that children attending independent schools where their places are arranged, or funded, by a local authority are supplied with food and drinks which meet the same defined nutrient standards as they would receive were they attending a school managed by the local authority;
place a duty on local authorities to promote uptake of school meals, in particular free school meals, and a duty to ensure that those receiving free school meals can do so anonymously, as far as is practicable;
within defined nutrient standards, give local authorities the power to provide children, either free of charge or with a charge, with drinks, fruit, vegetables, bread or cereal based snacks, at any time of the day;
place a duty on Scottish Ministers and local authorities to endeavour to ensure that all local authority schools are health promoting environments (Scottish Executive 2006, p. 12).
This introduction serves to outline the fact that a good diet in childhood is essential to growth, development and wellbeing and contributes to the prevention of disease in later life. In particular low consumption of fruit and vegetables has been identified as a key risk factor in chronic disease, thus continuing extensive research into the promotion of the daily intake of 5 fresh fruit and vegetable portions is required for establishing a healthy future generation.
NHS Scotland, 11 November 2004, Health Education Populat?on Survey
(HEPS) 1996-2003, NHS Health Scotland, pp 1-8.
Dairy Farmers of Britain, 22 June 2007, kids failing to ‘ketch-up’ with 5-a-day News
Release, pp. 1-4.
The Food and Health Strategy Group, February 2008, A Food and Health Strategy and
Action Plan for Dumfries and Galloway 2008-2013, pp. 1-67.
Food Standards Agency, April 2008, 5-a-day The Bash Street Way, viewed 03 April 2008,
The Scottish Office, July 1996, Eating for Health: A Diet Action Plan for Scotland.
Nutrition and Health Promotion Consultation, May 2006, Bill for Improving the Health and
Nutrition of Scotland’s Children: Consultation on the Schools, Scottish Executive,
Edinburgh, part 2, pp. 1-32.