Food Dude Healthy Eating Programme

Background

The traditional approach to promoting healthy eating has been to inform children about what they should and shouldn't eat in the hope that they will alter their eating habits accordingly. Unfortunately, research evidence shows that this approach has limited success and children's eating habits have remained unaltered ¹ .Clearly, children's knowing what they should do does not mean that that is what they will do. What they need is not simply to be given information, but help to change their actual eating behaviour.The Food Dude Healthy Eating Programme has been developed on the basis of established psychological principles to encourage and maintain healthy eating habits in children. It is a multifaceted project designed to be rolled out to individual schools through a series of key materials including videos and rewards.

What is the problem you are trying to solve?

The UK has one of the lowest fruit and vegetable intakes in Europe. It also has one of the worst heart disease records in the world, and other diet related health problems such as obesity are on the increase. Children, in particular, avoid eating fruit and vegetables and it is the aim of the present government to increase children’s consumption of these foods.

Many of our attitudes to health and the influences on our lives are set in childhood ² , and research suggests that children's food consumption patterns are established early in life ³ . It is clearly important that any attempts to produce long-term improvements in the nation’s diet should start with children.

What local organisations are involved?

This is a multidisciplinary collaborative project, bringing together the Bangor Food and Activity Research Unit (BFARU), government bodies, voluntary organisations, and fruit and vegetable growers, processors and retailers.

The programme is further supported by the UK Department of Health, Department for Education and Skills, Department of the Environment, Food and Rural Affairs, and Food Standards Agency.

How many people are running this project and who are they?

The programme is continually developed by three academic members of staff at Bangor University.

In order for the programme to be implemented in a school, one or two members of staff would need to be identified as Food Dude in-school coordinators. These coordinators would need to attend a training season run by local Food Dude programme managers. These are personnel based in organisations such as the Local Education Authority (LEA), local health board, city council, or Primary Care Trust. It is envisaged that these local Food Dude programme managers would facilitate and oversee the implementation of the programme in schools in a particular area.

What local population are you targeting?

The Food Dude Programme is based at Bangor University but is designed to be operated within individual primary schools in the UK and Republic of Ireland. It could easily be adapted for use in schools in other countries worldwide.

How many people are you targeting?

Over 450 children, aged two to seven years, participated in early studies conducted by the BFARU.

A total of 15 primary schools in England, Wales and Ireland took part in evaluations of the Food Dude standalone package where the schools implemented the programme themselves while researchers measured the effects.

Since 2001, a total of 232 schools in Scotland and England have participated in scaled down versions of the programme.

The most extensive roll out of the Food Dude programme to date is currently taking place in the Republic of Ireland. Approximately 30,000 children from 150 schools will receive the full programme by 2008. Furthermore, the Irish government recently announced that further funding is in place to extend the programme to all primary schools in Ireland. For further information on the Food Dudes in Ireland project see http://www.fooddudes.ie.

The overall aim is to establish requisite conditions for the programme’s introduction into all primary schools in the UK.

Interventions

What interventions are you using to address the problem?

The programme incorporates two key elements: peer-modelling and rewards. The peer-modelling element revolves around the Food Dudes, a group of fictional peers who frequently eat and extol the virtues of fruit and vegetables. Through a series of video adventures, the Food Dudes prompt children to eat these foods and thus provide social models for them to imitate. In addition, daily rewards, such as Food Dude stickers and pencils, are awarded to children for eating target amounts of fruit and vegetables.

There are also a series of short Food Dude letters which provide important information about the benefits of eating a healthy diet, as well as giving encouragement and praise for the children’s eating efforts. A Food Dude Homepack is used to encourage children to eat more fruit and vegetables at home through a system of self monitoring.

Initially, children are introduced to the Food Dudes who, via the videos, letters and rewards, encourage them to venture regular tastings of fruit and vegetables. This introduction provides sufficient opportunities for children to repeatedly sample fruit and vegetables, and, in the process, develop a liking for them. Once the Food Dude Programme has established a culture of healthy eating, schools are then helped to support the children’s increased consumption of fruit and vegetables and move towards a self sustaining system through in-house reward schemes.

Is the project design based on evidence? If so, please state reference.

The programme is the result of scientifically rigorous research conducted by psychologists at the Bangor Food and Activity Research Unit (BFARU).

The results of these studies are extensively published in peer-reviewed journals and edited books. ^{4 5 6 7 8}

Outcome

What outcomes or planned outcomes are you measuring?

The key outcome measure is children’s consumption of fruit and vegetables. This is assessed either by directly observing what children eat or by weighing foods before and after consumption. The programme has been evaluated in schools throughout the UK and Ireland – these range from small rural schools to large inner city multi-ethnic schools situated in areas of high social deprivation.

Do you have any outcomes or results yet? If so, what are they?

Research conducted by the BFARU shows that the Food Dude Healthy Eating Programme greatly increases the quantity and range of fruit and vegetables that children will consume as part of their regular diet.

It has been shown to double and even triple children's consumption of fruit and vegetables. In one study for example, children were consuming 21% of lunchtime fruit at baseline but this rose to 73% consumption during the intervention. Vegetable consumption rose from 24% to 69% consumption during the intervention ⁸ .

Such increases are not just restricted to a few favourite foods, they extend across a wide range of fruit and vegetable varieties. Moreover, the changes in eating habits have been shown to be long-lasting and parents report that their children eat more fruit and vegetables at home. Detailed analysis of our data has also revealed a key finding - that the greatest gains, in terms of quantities of fruit and vegetables consumed, are made by the children who ate the least at the outset. These are the very children who, from a nutritional standpoint, need them most.

The Food Dude programme has wide ranging impacts on the diets of both boys and girls across the economic spectrum, including those who, for reasons related to family income, too often suffer social exclusion from improvements in the nation's life conditions. This then, is one of the central aims of the present project - to demonstrate how the fruit and vegetable consumption of children can, at relatively little cost, be greatly increased regardless of their social background, age or gender.

Is your project relevant to a government target or guideline?

N/A

Feedback

What obstacles did you have to overcome to set up this project?

Securing funding to enable a UK-wide roll out of the Food Dude programme has been a barrier to further progress.

What have you learned about the project so far?

The roll out in Ireland demonstrates that it is possible to implement the programme on a very large scale.

What would you do differently?

Work closely with governments from the outset.

References:

1. Gatherer A, Parfit J, Porter E, Vessey M. Is health education effective?: an overview of evaluated studies. London: Health Education Council; 1979.
2. Department of Health. Our Healthier Nation - A Contract for Health. A Consultation Paper. Command Paper Cm3852. London: Stationery Office; 1998.
3. Gifft H, Washbon M, Harrosin G. Nutrition, behaviour and change. New Jersey: Prentice-Hall, 1972.
4. Horne PJ, Lowe CF, Bowdery M, Egerton C. The way to healthy eating for children. Br Food J 1998;100:133-140.
5. Horne PJ, Lowe CF, Fleming PFJ, Dowey AJ. An effective procedure for changing food preferences in 5-year- old to 7-year-old children. Proc Nutr Soc 1995;54:441-452.
6. Horne PJ, Tapper K, Lowe CF, Hardman CA, Jackson MC, Woolner J. Increasing children's fruit and vegetable consumption: a peer- modelling and rewards-based intervention. Eur J Clin Nutr 2004;58:1649-1660.
7. Lowe CF, Dowey AJ, Horne PJ. Changing what children eat. In A. Murcott (Ed.), The nation's diet: The social science of food choice (pp. 57-80). London: Longman; 1998.
8. Lowe CF, Horne PJ, Tapper K, Bowdery M, Egerton C. Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children. Eur J Clin Nutr 2004;58:510-522.