An interpretive review of data related to nutritional issues and their intrinsic value in the field of education.

1. Antonella Dagostino The Open University
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EDUCATIONAL ENQUIRY E891
End of Course Assessment (ECA)
IS OBESITY AN EDUCATIONAL ISSUE?
Focus and Rationale
Traditionally, child obesity has always been identified as a health issue,
however recent studies have shown that there is a strong link between
educational outcomes and health. The focus of this paper is to highlight two
aspects of child obesity which are strongly related to educational issues. The
first refers to schools responsibility in promoting healthy eating habits in children
and adolescents. The second, which could be considered as a consequence to
the first, concerns a statistical analysis illustrating that healthier children appear
to perform better at school and have less social and behavioural problems
compared to their overweight peers.
While there is a vast selection of literature available about child obesity mainly
coming from health-related studies, finding articles whose focus revealed a
strong connection with education has been a rather challenging task. For this
reason, I have decided to restrict my review to articles whose claims seemed to
be relevant to support the idea that obesity is indeed an educational issue.
Teaching nutrition as a school subject is not, per se, sufficient to tackle child
obesity; a problem which has reached alarming proportions worldwide (Jenvey,
2007). It is necessary to carefully monitor the food which schools have provided
through cafeterias, canteens and so on, to ensure that the department of
Education proactively contributes to putting a cap on the disastrous
consequences of child obesity which include poor school performance as well
as social behavioural problems.
Reviewing Process Methodology
The present review has been approached from an interpretive perspective as it
seemed the most appropriate choice “to reveal something surprising, startling,
or new...” (Eisenhart, 1998). In fact, as Swandht (1998), eloquently explains
while discussing in favour of the interpretive review “...education is
interpretation, it involves self-understanding and its purpose is to make us more
human”. As a matter of fact, the aim of this review is to interpret data which are
normally associated to health issues and attempt to prove, its intrinsic value in
the field of education. For this reason, other types of reviews have been
discarded as unfit for the purpose.
Articles Selection Process & Rationale
After having read a good deal of literature related to child obesity, my tutor
pointed out to me that perhaps the subject I was interested in was more related
to a health issue rather than an educational one. All of a sudden, I realised that
what was missing in my search was the connection between the two fields. I
then switched my focus towards some articles which could bridge the gap
between health and education in child obesity. The first article that grasped my
attention was Nutrition education: towards a whole-school approach (Rowe et

2. Antonella Dagostino The Open University
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all, 2010). While reading the abstract, I came across a sentence which reported
exactly what I wanted to demonstrate: “The study also illustrates the centrality
of educational leadership in the school context, even in an area typically
identified as a ‘health’ issue” (p.197). The second article was selected based
on its inherent relevance to education: Association of Overweight With
Academic Performance and Social and Behavioral Problems: An Update From
the Early Childhood Longitudinal Study (Judge and Nahns, 2007). From an
interpretive point of view, what has emerged from these articles is that it is
fundamental to involve both students and school staff to prevent child obesity
which, if ignored, has serious consequences in terms of performance and social
and behavioural problems at school. In brief, both articles identified child obesity
as an educational issue and not just as a health one.
IS OBESITY AN EDUCATIONAL ISSUE?
An Interpretive review
According to a recent systematic review conducted in England on the
relationship between childhood obesity and educational attainment, the most
important implication which emerged from the study was that “...obesity should
not be understood solely as a health issue” (Caird et all, p.14, 2011). The
question we should ask ourselves arises spontaneously:
Should we consider obesity as an educational issue? Absolutely yes!
To support this claim, the following is a review of two articles from an
interpretive point of view which have been selected based on their inherent
relevance to the field of education.
The case study presented in the first article titled Nutrition education: towards a
whole-school approach (Rowe et al., 2010), is an extract from a broader
research that assessed “Western Gateway Health Promoting Schools Grant
Scheme” whose aim is to promote health in the school environment by applying
a Health Promoting School (HPS) approach. The study was sponsored by
Queensland Health, a public health agency in Australia which provided financial
support to ten school communities for a period of three years. The school
selected for the study was chosen because of the actualisation of a “Kids Café”
where students were able to prepare, serve and sell nutritious food to other
students (p.199). The study was undertaken in a relatively small primary school
of about 230 students and staff (p.205). The most important fact which emerged
from this research was that the “Kids Café” became so successful in selling
nutritious meal deal items for AU$ 2,00 each that it forced the school tuck shop
to eventually introduce a similar menu as it was starting to lose profits (p.202).
It should be noted that the Kids Café was part of the curriculum hence students
were in charge of promoting the menu, gathering orders, preparing and serving
the food as well as doing the cleaning up chores. The Kids Café had an
“internal champion” identified as a senior teacher who followed its
implementation throughout its development stages. This person demonstrated
that it was possible to include HPS activities in the curriculum because they
could contribute to learning outcomes (p. 203). The meaning of learning
outcomes here is intended in its broader sense. In fact, if we think of
educational outcomes in terms of test results and grades, it may be hard to fully
understand the type of skills that a whole-school approach is likely to provide.
As mentioned earlier, teaching nutrition as a school subject may not be

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sufficient to promote healthy eating habits in children and adolescents. As a
matter of fact, as reported in the case study, the implementation of a Kids Café
provided students with the opportunity to have a concrete experience in dealing
with their own food choice. The learning outcomes which are expected to be
achieved in this case can be identified, for instance, as becoming responsible,
developing organisational skills, cooperating with peers and gaining self-
respect. Such skills are not commonly assessed in standard school tests and
this could explain why so far, obesity has been considered as a mere health
issue. As a consequence, to demonstrate that obesity is indeed an educational
issue even in its traditional sense, some researchers have attempted to prove
its relationship to educational outcomes beyond any doubts.
The second article, Association of Overweight With Academic Performance and
Social and Behavioural Problems: Un Update From the Early Childhood
Longitudinal Study (Judge and Jahns, 2007), is a statistical study on a sample
of 13,680 third grade children designed and performed by the US Department of
Education. According to the study, math and reading test scores achieved by
overweight children were significantly lower than non-overweight children
(p.672). It should be noted though, that after introducing variables such as
socioeconomics, for instance, only overweight girls appeared to confirm similar
results while differences among boys became insignificant. However, even if
obesity may not be proven to be strictly related to poor educational attainment,
there are still fundamental negative socio-behavioural aspects which are
connected to child obesity. According to the article, overweight children are
potentially more likely to become victims of bullying behaviours as well as
experiencing social isolation and stigmatisation compared to their normal-weight
peers (p.673). In addition, the study illustrated that overweight children were
more likely to have mothers with less than a high school diploma (p.675). In this
case too we can assume that education does matter when discussing child
obesity. In the conclusion, the authors point out that the way educators deal
with children’s overweight in school may have implications for the educational
consequences of a significant proportion of children (p.677).
Why is the school crucial in dealing with child obesity?
As illustrated in a recent study about obesity prevention in schools, Bucher
Della Torre et al. concluded that school participants unanimously agreed that
schools are a crucial environment to carry out child obesity prevention
strategies (p.233, 2010). The study was based on the responses of school
stakeholders such as school staff members, adolescent students and their
parents. It appears rather plausible to think that nobody, children included,
wants to be obese. Adopting a whole-school approach as suggested earlier in
this paper, is not only a good idea but rather a necessity. As Lee et al.,
emphasise, the school is an ideal environment for the promotion of health for
the purpose of relieving the increasing burdens caused by unhealthy lifestyles
(p.49, 2010). In the first article selected for this review, there is a reference to
some activities which are suggested to improve availability, affordability and
accessibility of nutritious food in the school settings (p.205). Such initiatives are
likely to be linked to school curricula, in particular, the authors refer to school-
based food gardens which, according to McAleese and Rankin (2007) have
demonstrated to improve children eating habits. Making connections between
the curriculum and learning imperatives in the school settings is at the core of a

4. Antonella Dagostino The Open University
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socio-ecological, whole-school approach, as highlighted in the case of the
primary school in Queensland (p.206).
From what we have read so far, it can easily be assumed that the function of
schools should not be confined to just teaching a series of instructions out of
their contexts. To maximize learning outcomes, it is necessary to link theoretical
learning with practical skills such as those developed by the children involved in
the implementation of the Kids Café. In general, people think that obesity is
associated to countries whose local culinary culture may not be particularly
popular (i.e.: the U.K.). However, recent studies have shown that obesity is
becoming a serious problem even in countries such as Italy and China. In a
survey published in Italy by the International Association for the Study of
Obesity (www.iaso.org/) between 2001-2002, it resulted that the percentage of
children considered overweight or obese has reached an alarming proportion:
32.4% for boys and 30.9% for girls. Such figures should help us comprehend to
which extent the cost of obesity weighs on governments’ budgets. Just to
mention an example, an estimate indicated that the direct and indirect cost of
obesity in the US in 2003 was about $139 billion (Finkelstein et al., 2005). Of
course, we cannot expect schools to be held solely responsible for
implementing preventative measures to develop healthy eating habits in
children. Promoting healthier lifestyles to adults and banning the targeting of
children in unhealthy food advertising would obviously contribute to achieve
better results. But in order to discourage harmful eating habits in children, it is
fundamental to intervene as early as possible and schools are the place where
children spend most of their time. It is for this reason that schools should be
considered crucial for the development of a successful obesity preventative
scheme.
Discussion
The idea that schools play a crucial role in preventing child obesity is not a
startling one as we have seen from the various studies illustrated in this paper.
What is surprising though is that despite the sound evidence demonstrating
successful projects such as the Kids Café in Queensland, child obesity is still
treated as a health issue. So far, schools have failed to integrate curricula with
initiatives aimed at encouraging healthy eating habits in children which in turn,
contribute to improve social and behavioural integration. According to what has
been illustrated in the articles presented here, it can be assumed that traditional
subjects which are normally included in standard school curricula to promote
health such as physical education, for instance, are not enough to tackle an
issue of such proportion and gravity. The whole-school approach vision
proposed by Rowe et al. (2010) is an outstanding example of how a school with
a relatively small budget could contribute to effectively tackle the issue of
obesity in a small community by implementing projects such as the Kids Café.
The successfulness of such a project is supported by the fact that it seems
easily replicable on a vast scale. The positive aspects which a whole-school
approach is likely to provide range from health to educational attainments even
if the existence of a link between obesity and educational outcomes is still a
controversial issue as clearly stated in the report conducted by Caird et al.
(p.10, 2011). Yet, there are some functional outcomes such as becoming
responsible (self-reliant), developing organisational abilities, cooperating with
peers and enhancing self-esteem which are hardly ever assessed in standard
tests. Perhaps the first step which each school should follow, once

5. Antonella Dagostino The Open University
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acknowledged that obesity is indeed an educational issue, is to upgrade the
current curriculum by including activities and assessment tests based on the
implementation of a whole-school approach. What is implied here, is that the
creation of school-based food gardens, Kids Cafés or similar practical projects
are likely to greatly contribute to the creation of a new culture which places
health, in its holistic sense, as one of its main priorities.
The importance of recognising schools as ideal environments to implement
obesity prevention schemes is highlighted by Lee and Hooker who
straightforwardly assert that “fighting childhood obesity should be a school-wide
campaign” (p.7, 2010). They stress the crucial role of teachers in both public
and private schools for the promotion of healthy lifestyles through innovative
curriculum developments. In addition, they believe that teachers should also set
a good example for children by following a proper diet and doing regular
physical exercise themselves. Policy makers and school management are also
mentioned as key figures to implement a strategic obesity prevention plan but
most importantly, Lee and Hooker emphasise the essential combined efforts of
schools, families and communities to reverse obesity trends.
Conclusion
In educational research, each study is normally assessed according to two main
factors: validity and relevance. Validity is determined by measuring how
accurately and truthfully a phenomena can be represented (Study Guide,
p.192). Relevance, on the other hand, establishes to which extent the topic is
considered relevant to issue of public concern or interest (Study Guide, p.194).
The purpose of this review was attempting to explain that obesity, particularly
child obesity, is undoubtedly an issue of public concern which is directly linked
to scholastic education. The level of validity provided to support this idea mainly
comes from the two articles selected for the purpose which include both
quantitative and qualitative data. As proving validity is normally more
challenging than other tasks in educational enquiry, other research papers have
been used to supplement this review with the aim of supporting the growing
idea that obesity is indeed an educational issue. As implied earlier, fighting child
obesity concerns the upgrading of schools curriculum with the inclusion of
initiatives strictly related to improving healthy eating habits in children and
adolescents. Public schools in particular, should implement what has been
referred to as a whole-school approach to ensure that today’s children will be
less likely to become obese and consequently develop social behavioural
problems. It has been suggested that perhaps, traditional testing systems may
need to be adapted to emerging school trends to assess abilities which have
not been given appropriate consideration in test scores so far despite their
positive appraisal in adult society (i.e.: organisational skills). As it has been
illustrated, the role of teachers and school staff members in general, is
fundamental to set an example for the children thus it must be based on their
own behaviour and awareness of the subject. For this reason, the creation of a
successful whole-school approach needs the support of all of the people
involved in school policy and practice and ideally, also that of parents and
community members.
Another relevant aspect which should be taken into consideration is the cost
that the implementation of a whole-school approach may have. The project in
the Australian primary school was supported by a grant of AU$ 28,000 given
over a period of three years by a public health agency (p.199). As mentioned

6. Antonella Dagostino The Open University
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earlier, the annual cost of obesity amount to billions of dollars in the US so it
can easily be assumed that by investing in obesity prevention schemes at
school today, governments will save a huge amount of money tomorrow.
To conclude, it should be reiterated the importance of considering obesity as an
educational issue because, as long as we envision the role of the school as a
mere place where children can learn sets of instructions which may prove useful
later on in their working life, we are missing its crucial role as a fertile ground to
seed fundamental values which will provide our children with the necessary
tools to have a healthier and happier lifestyle.

7. Antonella Dagostino The Open University
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