Entrevista con el Dr. Hansjürg Leu

According to Bronfenbrenner (1986), the nature and strength of connections existing between the family and the various other settings which the family participates in are major influences on development during the first years of life. In modern industrialised societies the development of the child is likely to be heavily affected by influences on family

functioning that are exerted in three exosystems: the parents’ workplace, the parents’ social networks and the community. In Malta, for example, if a mother’s employer allows for flexi- time working hours, this may determine whether she will be home to prepare a meal for her young children when they return from school at 2.30 p.m. Another example is that if many of the mother’s friends are members of a weight-loss club and the conversation often evolves around healthy eating it could be that the mother will be more nutritionally conscious as to what she is feeding her child. A third example is that if the family lives in a tourist resort area, this may influence access to foreign foodstuffs. Although, the different exosystems are influential in various manners and to varying degrees on a child’s food intake, it is beyond the scope of this review to discuss them separately in depth.

One system I shall discuss briefly, however, is the school; specifically the European Network of Health Promoting Schools (ENHPS). The role of the school in promoting and facilitating healthy food choices among children is indisputable. In general, countries which have embraced the philosophy and vision of the ENHPS have focused on policy development, curriculum development and the school environment. These components require attention in order to fulfil the WHO’s (2003b) criteria for a Health Promoting School. (See Appendix 2.2). The dynamic interplay of various factors in creating schools which will promote healthier behaviours amongst children has been acknowledged within the different models adopted (Bruun Jensen & Simovska, 2002). One of these models is the Ecological Model Of The Health Promoting School (Parsons, Stears & Thomas, 1996), which demonstrates the relationship between factors that influence the structures and development of schools as health promoting settings. Some of these factors are external to the school, such as local health campaigns and education programmes. Others are internally generated, such as the formal and informal health education curriculum and routes for home-school liaison.

A comprehensive report by the International Planning Committee of the ENHPS (Dixey et al., 1999) highlighted what should be the targets for a holistic nutrition education in a health promoting school. (See Table 14). The overall aim should be to adopt a child-centred approach, minimising contradictory messages between what is taught in the classroom and

TABLE 14

Nutrition Education Targets For A Health Promoting School

• Have nutrition teaching that is provided adequate resources • Develop a statement of policy about nutrition education • Focus on the enjoyment of food

• Promote training for staff – teachers, caterers and cleaners – in healthy eating • Provide comfortable surroundings in which children and staff can enjoy eating • Enable healthy choices if food is provided at the school

• Involve parents and the wider community

• Be explicitly concerned that no child is hungry while at school and that poor nutrition does not affect learning

• Coordinate all aspects of nutrition education to ensure efficient use of resources and to minimize contradictory messages

• Ensure that all staff are committed to the goals of the health-promoting school and be explicitly concerned about the health and wellbeing of both pupils and staff (Adapted from Dixey et al., 1999, p. 10)

what is experienced in the school, home and community environment. According to Dixey et al (1999), “Child-centred means starting with what children and young people know and how they see the world” (p. 9). Based on these key principles, the report also proposes a set of minimum requirements for nutrition education to be effective. (See Table 15).

TABLE 15

Criteria For Effective Nutrition Education

• Be personally relevant • Be clearly understandable

• Use foods rather than nutrients as a basis • Be consistent in its dietary messages

• Take into account people’s perception of relative risks • Emphasise the benefits of change

• Address the barriers to making dietary changes

(Adapted from Stockley, L. (1993). The promotion of healthier eating: A basis for action. London: Health Education Authority. Cited in Dixey et al., 1999, p.7)

The role of the primary school teacher in enabling young pupils to make informed choices in relation to nutrition, diet and food has been spelt out recently by the British Department of Health (DOH) and the Ministry of Agriculture, Fisheries and Food (MAFF) in their document for guidance on inclusion of food and nutrition information in primary teacher training (British DOH/MAFF, 1998). The document explains how food and nutrition education needs to be

incorporated into initial teacher training and professional development courses so that teachers are equipped to integrate food and nutrition education across the curriculum and as part of a whole school approach. The knowledge, understanding and skills which primary schoolteachers should be trained to impart are outlined in Table 16.

TABLE 16

Food And Nutrition Learning Outcomes for Primary School Pupils

Primary school teachers should be trained to teach young pupils to:

• Recognise that food is a basic requirement of life and should be enjoyed • Understand that food must be edible and safe to eat

• Develop an understanding of the underlying scientific principles upon which current issues and advice about human nutrition are based

• Know about methods of food production and food processing in domestic and commercial situations

• Demonstrate an awareness of social, economic and cultural aspects of food choice • Demonstrate and apply appropriate and relevant skills and knowledge when

planning, preparing and making choices related to food.

(Adapted from British DOH/MAFF, 1998. p.5)

Based on the above reports and documents it is clear that education in food and nutrition should be integral to a child’s learning experiences whilst attending primary school. Being able to make informed choices will foster enjoyment of food and sound dietary practices that help to reduce or eliminate various health risks.