This literature review examines strategies to improve nutritional awareness in secondary schools. It discusses tweaking current school food provision, such as naming vegetables used and pre-preparing fruit. Gardening and growing food can increase children's exposure to and familiarity with vegetables. Various educational approaches are also explored, like utilizing cross-curricular lessons and after school activities. The review provides evidence that small, low-cost interventions can help promote healthy eating habits among students.

1. |Thomas Lake|
EXPLORING WAYS TO IMPROVE NUTRITIONAL AWARENESS IN
SECONDARY SCHOOLS: A LITERATURE REVIEW
1st
October 2015

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Contents
Literature Review ......................................................................................................................... 2
Tweaking Current Provision.......................................................................................................3
Gardening/Food Interaction......................................................................................................4
Education.................................................................................................................................5
Interaction/Food Familiarity......................................................................................................6
Conclusion................................................................................................................................ 7
Suggestions:............................................................................................................................. 7
Effectiveness Table....................................................................................................................... 8
Suggestion One – Moving the PSHEE Programme...........................................................................9
Suggestion Two – Extracurricular Activities .................................................................................. 11
 Targeted Children........................................................................................................ 11
 Open Club................................................................................................................... 11
Suggestion Three – Utilising the House Point System for Healthy Eating ........................................ 12
Suggestion Four- A Year 7 Dining Hall Induction........................................................................... 13
Suggestion Five - The creation and maintenance of a school vegetable patch................................. 14
Suggestion Six - Utilise Healthy Eating Week 2016 – or make own one / more themed weeks......... 15
Appendix A – Head Teacher Checklist (School Food Plan).............................................................. 16
Reference List:............................................................................................................................ 18

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Literature Review
This literature review was created in 2015, using a variety of resources published in the
recommended ten year window (Study.com, 2015). It focusses on the area of child
awareness of health and nutrition as opposed to a kitchen-based intervention. All resources
were found in September 2015 over a week-long period of research, using opinions and
facts from websites, blogs, news outlets and television media.
First of all, there is an explicit awareness that some young people aged 5 to 16 display an
alarming lack of nutritional awareness (Burns, 2013) which leads to distorted views on what
a balanced diet actually is. This review does not go into the scientific analysis of what a
balanced diet is; more so analysing education and awareness of optimal nutrition and
exploring strategies to increased knowledge and understanding.
There is a safe-guarding need from everyone involved in working with children to ensure
that children have the appropriate awareness of what a healthy diet can consist of,
particularly when it can form a strand of the OFSTED school examination criteria (OFSTED,
2006, p5). These criteria include working with parents and children in a community-based
manner to ensure that a role is played by everyone connected to improve the nutritional
awareness of children, whilst also acknowledging the significance that media-based
appearance and body issues can impact on teenagers and finding appropriate ways to
circumnavigate these issues.
Although some physical traits such as somatotype and metabolistic disorders are inherited
(Fontana, 2000, p6; Competition, Science Vision, p495) there are other eating pattern
disturbances that are nature-based, or learnt, which can affect the diets of students.
Conditions such as neophobia exist, where individuals consume smaller varieties of food
than others (Gallway et al, 2003, in Robinson, 2006, p7) therefore missing out on key
nutrients. These conditions are likely developed at home, where limited diets or an over-
reliance on smaller food groups by parents or carers can manifest into a more serious issue
where a child is reluctant to try new foods, even though the child may recognise their
nutritional value. Despite neophobia often being associated with a reluctance to eat fresh
fruit and vegetables, in some instances it can be beneficial; those who rarely eat junk food

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at home may be less aroused by much-publicised junk food which offers some prevention to
the habits of eating badly when away from the home environment. This environment can
also be defined as an ‘obesogenic environment’ (Upton and Thirlaway, 2009) where there is
a lack of nutritional promotion and lack of positives choices regarding dietary intake.
There is also evidence that a change needs to be made in education as a whole in the United
Kingdom, which ranked last in a study by UNICEF (2007, in Vogt-Vincent, 2015) based on
children’s wellbeing in school. Whilst this is an umbrella study which makes judgement from
a wide variety of criteria, the new era of terminal exams (Donnelly, 2013; Watkin, 2015)
places students under more pressure with more demanding course content, placing a
greater importance on the food they fuel themselves with.
More recently, the School Food Plan (Children’s Food Trust, 2013a) was created following
research and engagement with schools across the country, with two main messages. The
first was a policy to provide all children in Year Reception, One and Two to be provided a
free school lunch, which was rolled out in 2014. The second policy was a resource bank of
ideas and recommendations for Primary and Secondary Schools, including the
‘Headteacher’s Checklist’ (Children’s Food Trust, 2013b and Appendix A) which offers a
range of ideas to affect health promotion in young people.
Despite the negative connotations associated with school food and eating patterns, there is
evidence to suggest that small adaptations have been made in some schools in the United
Kingdom, and that interventions to improve student’s nutritional understanding do not have
to be as didactic as the approach seen by Caen school (Gussin, 2014) where food deemed
unhealthy was removed from children’s lunchboxes.
Tweaking Current Provision
Evidence suggests that interventions do not have to be on a large scale in order to try to
promote a healthier lifestyle. A 2014 study by Doctor Andrew Hanks (Journal of Education
and Behaviour, 2014, p178) in New York State discovered three effective methods which
reduced canteen food waste at schools, improving the nutritional intake of students and
from an economic point of view saving the canteen and school money due to a reduction in
food waste. These three methods were:

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1. Naming vegetables used – Hanks found that by naming the vegetables in obscure or
less-recognisable dishes and having the vegetables listed in the dish on display
presented a greater take up, as opposed to students trying and subsequently
wasting food which they do not like. Simply by labelling a lasagne with its ingredients
it provides a comfort zone for the students without the shock of a mystery
vegetable, which could further increase neophobia of new foods. This intervention
resulted in a saving of 6c per serving, which with a 200 person dinner would save
around $12 a day, and therefore $60 per week.
2. Moving fruit next to the cash register – In a fashion similar to where supermarkets
and stores leave small goods such as chewing gums and sweets near tills in an
attempt to entice shoppers into a last minute additional item. By moving these
foods, there was less food wastage when the fruits were placed in obscure places
and then were deemed unsellable due to their short shelf life. This intervention
saved 3c per serving, a more moderate saving however there is no data available to
suggest if this increased sales.
3. Slicing fruit and pre-preparing – Hanks found that by taking the extra time to
prepare the fruit by either slicing, separating, peeling or drying fruit helped again to
reduce food waste, saving 4c (33% ROI) per serving and making it easier for children
to access fruit. Some fruits, such as pineapple and kiwi are not easily prepare-able to
active children on the go, so preparing food in advance helped both to make fruit
more accessible and reduce waste.
Gardening/Food Interaction
More recently, schools have started to look at varying degrees of self-sufficiency in terms of
dedicating areas of the school as gardens, and in some cases growing their own fruit and
vegetables, either for profit to raise money for the school or to provide the canteen with
fresh fruit and vegetables.
As well as understanding food nutrition in the technology area of the National Curriculum,
the use of additional cross-curricular nutritional information can help to aid children to
make better nutritional choices both in and out of school. Ritz, (in Jenkin 2014) began the
curation of edible walls in schools in deprived areas of the Bronx in New York where outside
space was either too dangerous or space too restricted. These walls were maintained by

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some students in the school, who were responsible for the watering and care of the plants
and vegetables whilst on the walls inside the school. This responsibility both educated and
aided the children’s exposure to vegetables, but also had remarkable curricular benefits,
with attendance leaping from 43-93% in a short space of time, much owing to the added
responsibility the children had. It also provided better food options to a traditionally under-
nourished area of New York, giving children easier access to important micronutrients.
An example of the edible walls in schools in the Bronx, New York City
This approach was also replicated in England, with companies such as Poppies and Parsnips
linking with projects like The Mead Academy Trust to create viable growing solutions
(Marsh, 2015) such as using growing vegetables in items such discarded wellington boots,
buckets and containers, with inter-class competitions on who can grow the best vegetables.
These ideas are more feasible than similar ideas such as that of Jacobs (2015, in Marsh,
2015) who proposed reducing sports or active areas to allow the development of gardens,
which seems a move which spites the face of the school, with open spaces integral to the
health and wellbeing of young people.
Education
The idea of a link between what the students learn about in class and what they eat in the
dining hall is not a new concept; the Department of Education in Northern Ireland (2013,
p28) advocate a clear ‘consistent message between learning in the classroom and eating in
the dining hall’, promoting links between classroom activities and what the children then
eat afterwards in unstructured time.

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There are several angles to this message from the Department of Education in Northern
Ireland; simple interventions include education on food nutrition earlier in the curriculum
(currently in the Park School PSHEE programme – earliest it is seen is Spring Term Year 8) all
the way to offering alternative education options such as the single award BTEC
qualifications (Edexcel, 2010, in Oliver, 2010) which allow students to further study the idea
of health and nutrition with the tangible reward of additional qualifications at the end of the
course. These types of options inevitably cause financial, logistical and educational issues
which need to be addressed prior to any commencement, so easier, more viable options
should be looked at to try to make a difference to the nutritional understanding of young
people.
Interaction/Food Familiarity
Primary schools offer a range of educational activities that link into nutritional awareness,
all of which can be altered and moulded to suit the needs and demands of Secondary School
children. Pondhu Primary School, located in Cornwall, used pre-identified days such as sugar
detective days (Blake, 2015) where students used a wide range of methods to discover the
amount of hidden sugar in foods, in a quantitative and hands-on manner. These activities
were also extended to the parent’s forum in the evening, demonstrating the link that Ganz
(2015) advocates between parent/carer nutritional awareness and subsequently more
educated food choices at home.
Other successful ideas included the creation of after-school cooking clubs, run as part of an
initiative of the Children’s Food Trust (2015) to get more children to both experience food
and understand how to make basic dishes, which hopefully has the opportunity to manifest
into a passion for cooking and enjoying food. These types of interventions do not require
much expense or start-up costs, rather just facilities which the school already has and
willingness for students to participate and attend regularly.
The National Governor’s Association (2007, p26) also recommend the use of additional
interventions in schools that can engage children, without the limits of after-school
transport issues or extra costs involved for ingredients for after school clubs. These ideas
include staggered lunchtimes so that children have time to sit, eat and digest their meals
before running off into unstructured time, which could be the rationale as to why they are

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choosing fast food as it is quicker to eat and dispose of. It also recommends the idea of
using electronic technology to monitor food patterns, and when a series of ‘inappropriate’
food choices are made the data can be fed home to parents or carers to show what their
child is eating on a daily basis.
The environment is also mentioned by the report as a considerate in the aim of promoting
healthy eating, with queuing systems, space and pupil-student staff relations all playing
their part in the successful promotion of healthy living.
Conclusion
Having experienced being both a student and a member of staff at the school, the food and
nutritional awareness the school offers has undoubtedly got better, from the days of the
turkey twizzler to the current scenario of salad buffets and pasta bowls. What has also
changed in our world however is the ability to ‘disguise’ foods and over-exaggerate benefits,
as seen by the withdrawal of the Lucozade advert which [falsely] claimed it can hydrate
better than water (Shaikh, 2014) showing how easy it is to manipulate minds and influence
dietary decisions.
Foods packed with artificial flavourings, added sugar and salt are commonly cheaper than
natural foods, which adds an economic reasoning to the difficulty of sustaining a more
nutritious diet and in some cases the nutritional awareness is there, yet the availability of
more nutritious foods is limited due to the reasons of X, Y or Z.
From this literature review and taking into account socio-economic justifications, I have
proposed six suggestions which may help to achieve a greater nutritional understanding for
students at The Park Community School.
Suggestions:
 Moving the PHSEE Healthy Eating module from Year 8 to Year 7
 Re-start the after school clubs
 Utilising the House point system to include healthy eating
 A Year 7 Dining Hall induction
 The creation and maintenance of a school vegetable patch
 Utilise Healthy Eating Week 2016 – or make own one / more themed weeks

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Effectiveness Table
The below table suggests the effectiveness and feasibility of each suggestion, signified by a
traffic-light based system which subjectively evaluates the cost, difficulty, time investment
and the educational exposure to the students.
Cost Difficulty
Investment
of Time
Educational
Exposure
Suggestion 1
– Moving
PSHEE
Suggestion 2
– After
School Clubs
Suggestion 3
– House
Point System
Suggestion 4
– Dining
Induction
Suggestion 5
– School
Garden
Suggestion 6
– Healthy
Eating Week
Low Medium High

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Suggestion One – Moving the PSHEE
Programme
This is the easiest intervention, with no cost or additional resources required, rather just a
re-jig of the current PSHEE provision. A search on the Google Drive – Resources folder shows
the programme for Year 7, with no mention of healthy eating.

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A further search suggests that spring half term in Year 8 is the first time that the children
encounter a module on diet and exercise, barring the Food and Nutrition technology
module they would have had in Year 7. Adding this into the Food and Nutrition module
places additional pressure on classroomteachers to deliver this plus their necessary
elements of their module. The easier option seems to be to move the PSHEE module to Year
7 so at least there is a small window of time that children are able to learn about what they
are eating and what constitutes a balanced diet.

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Suggestion Two – Extracurricular Activities
The school already offers a fantastic array of extra-curricular activities in both lunchtimes
and after school, which undoubtedly increases participation in sports, arts and crafts and
academic sessions such as drop-in revision clubs and homework clubs.
There are obvious physical benefits to extra-curricular exercise, however there is also an
understanding that not every child likes or enjoys exercise.
The creation of an after-school project such as a cooking club or nutritional programme
could further engage students, of whom existing clubs are not suitable for, into a positive
change. Previous schools I have worked in up in Derby offered sessions on two types of
basis:
 Targeted Children – Identifying a group of children for whom there might be
known cases of malnutrition, or children who the school think may benefit from
additional nutritional knowledge and offering places to them which are subsidised or
free (I do not know about funding, finances or anything like this sorry!)
 Open Club – Offering the club to the whole school with a predefined number of
students. Reduce costs by creating simple recipes with inexpensive ingredients – e.g.
vegetarian dishes or ‘healthier’ versions of baking.
If possible, engaging the local community could also be an option, such as walking down to
the butchers in Town to see how meat is cut, or inviting farmers or local tradespeople in to
school to talk or run workshops based on food. This may add extra appeal to prospective
parents if they become aware of inter-community links between local food producers and
the school, emphasising the community-based school we are achieving.

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Suggestion Three – Utilising the House
Point System for Healthy Eating
The House Point system was previously, and still to an extent, is a very sports-orientated
system where Houses score points based on inter-House sporting achievements. More
recently, this has started to include the Accelerated Reader program in the School Library
where House Points are available for the amount of reading and difficulty of the books over
a period of time.
This suggestion could involve a week or pre-defined amount of time where points are given
for the amount of fruit or vegetables eaten per week, in the form of a sticker system given
by MTA’s or the Canteen Staff or by reading data from the Smart Card system. This would
create extra emphasis on the importance of healthy eating in the weeks before in the form
of assemblies and morning registration sessions, hopefully leaving a legacy afterwards with
children choosing more positive options. This again has a minimal cost of the stickers but all
other infrastructure is in place.

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Suggestion Four - A Year 7 Dining Hall
Induction
The Year 7’s who arrive at their first day at Secondary School come from a structured school
eating environment where set meals are provided, to an environment where children have
free reign what they spend their money on.
Without restricting food choices, a simple exercise could be done in the morning of the first
day or second day where some sort of Food Presentation is shown, followed by a fairly
simple quiz to demonstrate understanding of basic macro and micronutrients and what, in
an ideal world, we should be aiming to eat daily. This could be certified to add more appeal
to the children, with the ethical knowledge that at least the students have a basic
knowledge of what they are going to buy at lunchtime. This again is an activity where
knowledge is passed across with little cost apart from the reprographic costs of creating and
printing certificates and making a presentation.

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Suggestion Five - The creation and
maintenance of a school vegetable patch
This is the costliest suggestion, but could have the greatest impact on the lives of the young
people we work with daily.
The school garden we already have is underused, underpublicized and possibly damaged
due to the erection of the Sports Hall roof, with [as far as I am aware] no curricular use for
subjects. There are obvious scientific and food technology benefits to using the garden, as
well as linking into other subjects such as Art and Geography.
The Garden could be revived and used more, however another option could be to use an
area of the Year 7 quad (which is used sparingly by Year 7’s) and transform it into a small
vegetable patch, with its proximity to the Food Technology rooms an obvious bonus. This
could be maintained by a group of children with the eventual aim of having vegetables
which can either be used in Food Technology or sold to staff to create revenue for the
school.
I am unsure of the costs of such a project, but it could develop into an ongoing project
where possibly the canteen could even benefit from home grown vegetables which could
save the canteen and the school money.

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Suggestion Six - Utilise Healthy Eating
Week 2016 – or make own one / more
themed weeks
Healthy Eating Week 2016 (Food, a Fact For Life, 2015) is a nationwide initiative which
reaches over ‘7,500 nurseries, schools and academies’ and promotes healthy eating during
the week of June 13-17, 2016.
Activities recommended during Healthy Eating Week include:
 considering guests you could invite into school to provide talks and run workshops
based on healthy eating, cooking and food provenance;
 thinking about trips and visits for the pupils, e.g. to a local farm, supermarket, food
factory, restaurant;
 Talking to your canteen about special dishes and events for the week.
Other ideas can include cross-curricular links, non-school uniform days and special clubs
during the week to add additional exposure to the Healthy Eating Week.
In our school we already run successful themed weeks in the Dining Hall, including from last
year a Chinese week and an American week, plus more. This could easily be extended to
incorporate the Health Promotion theme, either during the designated week or at a time
the school decides is suitable.

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Appendix A – Head Teacher Checklist
(School Food Plan)

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Reference List:
Blake, R. (2015) ‘Learning about healthy eating at Pondhu School’ [online] Available from:
http://www.cornishguardian.co.uk/Learning-healthy-eating-Pondhu-School/story-
27862807-detail/story.html (Accessed 29th September 2015)
Burns, J. (2013) ‘'Cheese is from plants' - study reveals child confusion’ [online] Available
from: http://www.bbc.co.uk/news/education-22730613 (Accessed 25th September 2015)
Children’s Food Trust (2013a) ‘School Food Trust’ [online] Available from:
http://www.childrensfoodtrust.org.uk/childrens-food-trust/schools/school-food-plan/
(Accessed 30th September 2015)
Children’s Food Trust (2013b) ‘Checklist for Head Teachers’ [online] Available from:
http://www.schoolfoodplan.com/headteacher-checklist/ (Accessed 27th September 2015)
Children’s Food Trust (2015) ‘Let’s get cooking – setting up a club’ [online] Available from:
http://www.childrensfoodtrust.org.uk/lets-get-cooking/set-up-a-club/ (Accessed 24th
September 2015)
Department of Education in Northern Ireland (2013) ‘Healthy food for healthy outcomes
september 2013 food in schools policy’ Belfast, Government of the United Kingdom, p28
Donnelly, K. (2013) ‘New era for schools in radical overhaul of exams’ [online] Available
from: http://www.independent.ie/irish-news/new-era-for-schools-in-radical-overhaul-of-
exams-29705050.html (Accessed 29th September 2015)
Fontana, D. (2000) ‘Personality in the workplace’, London, United Kingdom, Macmillan
Press, p6
Food, A Fact For Life (2015) ‘Healthy Eating Week 2016’ [online] Available from:
http://www.foodafactoflife.org.uk/section.aspx?sectionId=114 (Accessed 1st October 2015)
Ganz, S. (2015) ‘Fresh from the garden patch: healthy food options for students in Richmond
Public Schools’ [online] Available from: http://rvanews.com/features/fresh-from-the-
garden-patch-healthy-food-options-for-students-in-richmond-public-schools/129429
(Accessed 29th September 2015)

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Gussin, T. (2014) ‘Staff remove ‘unhealthy’ food from pupils’ lunchboxes at Braunton primary
school’ [online] Available from:
http://www.northdevongazette.co.uk/news/staff_remove_unhealthy_food_from_pupils_lu
nchboxes_at_braunton_primary_school_1_3785580 (Accessed 31st March 2015)
Hanks, A. S. (2014) ‘Smarter lunchrooms equal deeper pockets’ in ‘Journal of Nutrition
Education and Behavior’, Volume 46, Issue 4S, p178
Jain, M. (2008) ‘Competition, science, vision’ Year 11, Issue 124, p495
Marsh, S. (2015) ‘Green-fingered teachers: how to grow fruit and vegetables in school’
[online] Available from: http://www.theguardian.com/teacher-network/2015/jun/29/green-
fingered-teachers-how-to-grow-fruit-and-vegetables-in-school (Accessed 29th September
2015)
OFSTED (2006) ‘Healthy eating in schools’ [online] Available from:
http://webarchive.nationalarchives.gov.uk/20130401151715/http://www.education.gov.uk
/publications/eOrderingDownload/4167.pdf (Accessed 24th September 2015)
Oliver, J. (2010) ‘Jamie’s Cooking Skills’ [online] Available from:
http://www.jamieshomecookingskills.com/about.php (Accessed 20th September 2015)
Robinson, S. (2006) ‘Healthy eating in primary schools’, London, SAGE Publishing, p7
Shaikh, T. (2014) ‘Lucozade Sport ad campaign banned for claiming drink hydrates better
than water’ [online] Available from:
http://www.independent.co.uk/news/media/advertising/lucozade-sport-ad-campaign-
banned-for-claiming-drink-hydrates-better-than-water-9047437.html (Accessed 29th
September 2015)
Study.com (2015) ‘Assessing the reliability and validity of sources’ [online] Available from:
http://study.com/academy/lesson/assessing-the-reliability-and-validity-of-sources.html
(Accessed 25th September 2015)

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Vogt-Vincent, O. (2015) ‘I am 16 and the education system is destroying my health’ [online]
Available from: http://www.theguardian.com/teacher-network/2015/aug/16/i-am-16-and-
the-education-system-is-destroying-my-health (Accessed 24th September 2015)
Watkin, B. (2015) ‘Reformed GCSEs and A-levels: an overview’, London, SSAT (The Schools
Network)