Katie Wilks & Madeline McAndrew

Community Nutrition Assessment

DFM 451
Spring 2016

Introduction
Children can be easily molded and influenced to change their opinions when exposed
early on before habits are established. Over time there has been a change in American culture,
which reduced the amount of time families spent preparing meals and eating at home (Hersch,
Perdue, Ambroz & Boucher, 2014). Many factors play a role in why people are cooking and
eating at home less often. Suggested factors causing this phenomenon are an increase in both
parents entering the work force, parents working longer hours and having time constraints
regarding cooking, and accessibility issues (Hersch et al., 2014). With American culture cooking
less or not at all at home due to time constraints and lack of knowledge and basic cooking skills,
children are eating most meals away from home. This in turn leads to overconsumption without
key nutrients. Restaurants rarely provide meals with fruits and vegetables and are calorie dense
rather than nutrient dense (Hersch et al., 2014). Together these circumstances lead to a poor diet
and many future health problems if this behavior is a regular occurrence. In order to prevent
obesity from shortening the lives of many children in America, school programs are needed to
educate students on the importance of fruits and vegetables, inspire children to be involved in
cooking at home, and demonstrate the importance of sharing meals with the family.
Literature Review
Family meals are an important occasion to develop positive eating habits as well as
provide a strong family bond. Sharing a family connection over meals has a significant impact on
a childs development. Research from Child Trends Data Bank indicates parental presence at
meals is associated with higher intake of fruits, vegetables, and dairy products, in addition to a
lower risk for being overweight (Child Trends, 2012). In addition to the nutritional benefits, there
is also a correlation between frequent family meals and positive behavioral outcomes for both

children and teens (Child Trends, 2012). Children and teens who participate in family meals are
less likely to smoke, drink, and use drugs and are more likely to have later initiation of sexual
activity, and better academic performance (Child Trends, 2012). Eating and preparing meals as a
family provides children with positive encouragement from parents, a sense of family affection
and a closer relationship, in addition to modeling healthy eating behaviors.
Cooking programs have been used to encourage healthful eating among people of all
ages. Promoting the consumption of fruit and vegetables among children is important;
interventions used must captivate children and instill healthy eating habits enthusiastically.
Through involvement in meal preparation children have been more receptive to learning about
healthy eating habits. In The Impact of Cooking Classes on Food-Related Preferences,
Attitudes, and Behaviors of School-Aged Children: A Systematic Review of the Evidence, 2003
2014, studies conclude children were more willing to try new foods after cooking involvement
and were more willing to try new foods if they had cooked or had grown it (Hersch et al., 2014).
Studies also found significant increases from baseline in both fruit and vegetable consumption
after cooking education programs (Hersch et al., 2014). Educational cooking programs are a
promising tool for inspiring positive changes in childrens food-related preferences, attitudes,
and behaviors.
Plate waste is a perpetual obstacle in school cafeterias, raising both nutrition and
economic concerns. The Food Assistance & Nutrition Research Program released a report
(Buzby & Guthrie, 2002) in regards to the National School Lunch Program (NSLP) in March
2002. The report analyzed the level of plate waste, the factors that contribute to plate waste, and
methods to reduce plate waste by analyzing literature on plate waste in the NSLP over the past
15 years. The report defines plate waste as the quantity of edible portions of food served

through USDA school nutrition programsthat students discard each year (Buzby & Guthrie,
2002). However, a more prominent and pressing way to think about plate waste is as nutrient
waste. The report notes fruit, vegetables, and salad as the majority of plate waste. This suggests
that many children participating in the NSLP are not ingesting essential nutrients found within
fruit and vegetables.
In regards to plate waste prevention, the report focused on evidence-based methods such
as the offer vs. serve (OVS) provision and rescheduling lunchtime. Additional methods focused
on the effect of improving quality and acceptance of NSLP food, nutrition education, and
modifying portion sizes to coincide with appetites and needs. These methods proved to be
inconclusive because they were supported by limited evidence. It is valid that allowing children
to take only what they desire can decrease plate waste. However, this does not address the root of
the problem, which is the aversion and unwillingness towards fruit and vegetables.
Given the influential role schools have in supporting the wellness of children and
addressing childhood obesity, it is imperative to assess the effect of child nutrition education
programs. The Healthy, Hunger-Free Kids Act of 2010 introduced many changes to the NSLP,
including more rigorous school meal nutrition standards for the 2012-2013 school year (Bergman
et al., 2014). A 2014 study was conducted to assess food waste in an elementary school nutrition
program after implementation of the new NSLP guidelines. Plate waste was collected, separated,
and measured at the end of each lunch period for five consecutive days at one elementary school.
Pre-kindergartener and kindergartener students were selected based on their recent exposure to
the new guidelines. This variable allowed for greater accuracy in determining the effectiveness
of the present strategies to improve consumption and food waste. Out of the 304 meals examined
(4,988 oz.), 45.3% of the food and beverages served was wasted (2,261 oz.). Vegetables were the

highest food waste category at 51.4% of the total waste. Schools are offering more fruit and
vegetables to meet the USDA standards (USDA Food and Nutrition Service, 2015) but many
students are still not eating the recommended amounts. This trend implies that additional
methods need to be contemplated in order to achieve increased fruit and vegetable intake by
children to meet nutritional standards.
Student wellness and academic success are positively affected by an increase in nutritious
foods at school but providing healthier options in the cafeteria is only part of the solution. A
recent case study identified key strategies for improving school nutrition by observing three
innovative school nutrition programs, each with common elements within a successful approach
(Sacheck et el., 2012). The scope of the study focused on agriculture, economics, nutrition, and
sustainability. It is important to note the case studys primary goal of find program initiatives that
provided replicability for other school districts. The three school districts met eligibility based on
their revenue-neutral improvements in healthful food. Each school district demonstrated steps to
successful change by: utilizing a kids first approach to create clear goals and diminish barriers,
incorporating gradual change by slowing introducing new foods through activities like taste
test days to increase acceptability, applying smarter cafeteria economics by increasing
participation rates for reimbursed meals, reducing waste by adopting special portion control
plates, capitalizing on grant opportunities, and most importantly building strong relationships
between the school nutrition director, district, and community at large (Sacheck et el., 2012). If
an increase in exposure to activities on basic cooking skills and nutrition education positively
effects students food-related behavior, then coordinated in-classroom nutrition education using
cooking demonstrations and taste-testing activities on basic kitchen skills and fruit and vegetable
acceptance will lead to an increase in cooking self-efficacy and healthful eating.

Project Design Overview

Our program is directed towards fourth grade students attending Cabrillo Elementary
School in Pacifica California, a school within the Pacifica School District. We plan to educate
children on the importance of fruits and vegetables through cooking a recipe in the classroom.
Through our demonstration of preparing a meal and having the students try it; we will encourage
children to be confident in their abilities in the kitchen, engage in family meal prep and eating,
and promote healthy eating habits. Initially we will be collecting our qualitative data through key
informants such as the students teacher, our review of literature, and Lisa Kern, the director of
nutrition of the Pacifica School District. Collection of quantitative data will be done through our
pre-assessment, which will be given to the students two weeks before our one session
informative work-shop.
After educating the entire class as a group we will survey them to analyze our impact. We
will test our students knowledge with a casual survey at the end of our lesson by a show of
hands after asking closed ended questions. A homework assignment will be provided to assess
their comprehension of the lesson. The assignment will be a vocabulary matching activity, which
will have terms, and definitions that were presented during the lecture and demonstration.
Comparing the results of the pre and post assessments will complete the programs evaluation
and analysis. Through comparing the students pre and post assessments we will compare our
program results to those in our review of literature and correlate our findings with previous
trends set by the prior programs. We will provide our finding to Lisa Kern, the director of
nutrition, in the hopes of promoting, and implementing nutritional changes in the school district.
Potential Outcomes
Our program works collaboratively with elementary schools to educate and enlighten children on
the joys of cooking, encourage healthful choices, and implement long-term wellness.
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Our goals and objectives are as follows:

Goal #1: Promote healthful eating in elementary-aged children by demonstrating proper cooking
techniques and kitchen etiquette

Increase willingness to try new foods by 20% by improving student acceptability of the
featured vegetable through a pre and post assessment
Increase food-literacy by exposing children to culinary vocabulary through a cooking
demonstration and correct scores on a take-home assignment
Increase self-efficacy towards food and cooking by the end of the cooking demonstration
by 20% through an increase in motivation to cook in student who previously reported
unwilling

Goal #2: Promote long-term wellness by educating elementary-aged children on the importance
of fresh produce and the joys of cooking

Increase the number of students by 20% who are motivated to engage in meal preparation
at home through a pre and post assessment
Increase vegetable consumption and decrease plate waste in the cafeteria and at home by
increasing knowledge of vegetable nutrients and positive attitude towards vegetables by
post assessment questions and observing behavior after demonstration
Improve vegetable acceptance by 20% using nutritional information, guides, and tools by
asking pre and post questions to assess changes in attitude towards featured vegetable

Results
Thirty fourth-grade students from Cabrillo Elementary School in Pacifica, California
participated in the nutrition education lesson. All thirty students completed an anonymous preassessment survey, which consisted of six closed-ended questions and three open-ended
questions. Results of the pre-assessment survey (table 1) showed that 63.3% of the students can
name all of the food groups and 63.3% of the students are interested in cooking. 83.3% of the
students said their family cooks meals regularly at home, out of which 43.3% of students stated
they are involved in the cooking process at home and 33.3% of students stated they are not
involved in the cooking process at home. When asked if they would like to be involved in the
cooking process 56.7% said yes, 16.7% said no, and 23.3% said not sure. The open-ended
questions allowed the students to provide subjective answers, which enabled us to gauge their
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knowledge of nutrition. While most of the answers are unquantifiable, they showed that a
significant amount of students are aware of the presence of vitamins and minerals in fruits and
vegetables, as well as various categories of fruits and vegetables (see Appendix for completed
pre-assessment surveys). This helped structure the nutrition education lesson because it provided
insight into the students level of education.
At the beginning of the lesson the students were asked four questions. Answers were
collected by a show of hands. The first question was, who knows what cabbage is? All 30
students raised their hands, indicating that 100% of the students knew what cabbage was. The
second question was, who likes to eat cabbage? Twelve students raised their hands, indicating
that an initial 40% of the students like to eat cabbage. The third question was, who thinks
cabbage is healthy? Twenty-eight students raised their hands, indicating that 93.3% of the
students think cabbage is healthy. The fourth question was can anyone tell me why cabbage is
healthy? One student raised his hand and responded by stating, Because it has vitamins. We
then proceeded to ask the same student if he knew which vitamins were in cabbage, which he
was unsure of. A brief lesson on the health benefits of cabbage was then given to the students.
After the lesson and cooking demonstration and during the product tasting, a post-assessment
survey was conducted. The students were asked again if anyone knew what makes cabbage
healthy. All thirty students raised their hands, and several students shouted-out the correct
answers. The students were also asked if they would like to make the recipe at home with their
family. All thirty students raised their hand, indicating 100% of the students would like to be
involved in the cooking process at home.

Table 1. Pre-assessment survey responses from 4th grade students at Cabrillo Elementary
School in Pacifica, California (N=30)
Question
Can you name all the
food groups?
Are you interested in
cooking?
Does your family
cook meals regularly
for dinner?
If yes, are you
involved in the
preparation or
cooking process?
If no, would you like
your family to cook at
home?
Would you like to be
involved in the
process?

Yes
19

No
4

Not Sure
7

19

25

13

10

12

17

Discussion
The premise of our project was directed at educating elementary aged students on the
importance of nutrition, specifically fruits and vegetables. We set up our lesson plan to involve
cooking in the hopes that through learning about nutrition while participating in cooking a meal,
the students would be more willing to eat healthfully and to accept fruits and vegetables as well
as and be more willing to help cook at home and eat with their family. Encouraging the students
to eat with their family was a goal of ours because parental presence at meals is associated with
higher intake of fruits, vegetables in addition to a lower risk for being overweight (Child Trends,
2012). As stated in The Impact of Cooking Classes on Food-Related Preferences, Attitudes, and
Behaviors of School-Aged Children: A Systematic Review of the Evidence, 20032014 children
are more willing to try new foods after cooking involvement and were more willing to try new
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foods if they had cooked or had grown it which was reflected through our nutrition education and
cooking session at Cabrillo Elementary School (Hersch et al., 2014).
When the students were asked if they would like to be involved in the cooking process 16.7%
said no and 23.3% said they were not sure. This indicates a need for an increase in food literacy
and education of the cooking process. An increase in food literacy and knowledge of cooking
may lead to an increase in self-efficacy in the kitchen. Studies have found that cooking programs
can positively influence childrens food-related preferences, attitudes, and behaviors
(Vaitkeviciute, Ball & Harris, 2014). Children may then be more inclined to gravitate towards
participating in the cooking process and engaging in healthful eating habits.
Katie Cavuto, Registered Dietitian, explains different approaches to having children connect with
healthy food in her article Encouraging Your Child to Appreciate Food. She claims cooking a
meal with family is an amazing way to spend time together, to learn about ingredients and
flavors, and to encourage experimentation with new foods. It is a well-known fact that children
are more enthusiastic to try a new food if they are involved in the preparation (Cavuto, 2014).
During our brief nutrition class we were able to observe the students change their opinions after
taking part in meal preparation.
While presenting about cabbage a few facts regarding nutrients were shared to the class.
We declare the benefits of cabbage using a colorful poster as a visual. We explained cabbage has
vitamin C, which supports immune health, and cabbage also contains vitamin K, which promotes
bones strength. At the end of the class we asked what vitamins were in cabbage and the class as a
whole discussed the nutritive properties behind vitamins C and K. The response to the question
regarding nutrients in cabbage exhibits how involvement in meal preparation in the kitchen
during nutrition education aids the students in learning the information as well as implementing

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it when they cook. The answer to the post-assessment question indicates a positive impact on the
skill-based knowledge and nutrition related attitudes and motivation provided during the
nutrition education lesson and cooking demonstration. In the formal pre-assessment, 16.7% of
students said they would not like to be involved in the cooking process and 23.3% stated they
were unsure. During the post-assessment, 100% of the students indicated they would like to
make this recipe at home with their family, indicating a 70.5% increase in positive motivation
towards cooking.
Through educating elementary age students our findings indicate that cooking education
programs may be a promising tool for promoting positive changes in childrens food-related
preferences, attitudes, and behaviors. The pre-assessment survey was used as a tool to assess the
population need. Comparing our pre and post assessments illustrated how much the students
learned from a short presentation. Components which are necessary for an effective program
concerning nutrition and cooking education is still unclear, but through our nutrition cooking
session it was demonstrated that students who interacted with the food by smelling, tasting,
touching and preparing it did increase their acceptance to the food itself. The ideal number of
exposures to a lesson plan is unknown. It has not been found whether nutrition education should
be paired with cooking lessons, the role of parent involvement, or the usefulness of tastings and
gardening activities (Hersch et al., 2014). In terms of program outcomes, more evidence is
needed to determine whether changes in food choices are occurring as a result of cooking
interventions and whether changes are sustained through childhood and adolescence (Hersch et
al., 2014). It would be ideal if nutrition education took place in various environments such as
schools, community centers, and the home to exhibit the differences in locations and the benefits
attributed to the children from different exposures.

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Conclusion
Studies indicate schools have been making some progress in improving the school food and
physical activity environments, but that much more work is needed. Improved policies are
needed to provide healthier meals to students at schools in addition to motivating children to
choose healthier foods, increase willingness to accept new foods, and bring new attitudes
towards food. There is a need for more programs that offer hands on interaction with food and
cooking. Factors to consider in program innovation include: the ideal number of exposures, the
role of parent involvement, whether nutrition education should be paired with cooking lessons,
cafeteria economics, and the usefulness of tastings and gardening activities. Future studies need
to address gaps through controlled trials, which measure both quantitative and qualitative effects.
It would be ideal if the trials were conducted in various environments such as schools,
community centers, and the home. Further research will help us identify what program initiatives
will successfully educate and encourage involvement in meal preparation and an increase the
consumption of fruit and vegetables.

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Reference List
Bergman, E.A., Englund, T., Taylor, K.W., Watkins, T., Schepman, S., & Rushing, K. (2014).
School lunch before and after implementation of the healthy hunger-free kids act. The
Journal of Child Nutrition & Management. Retrieved from
https://schoolnutrition.org/uploadedFiles/5_News_and_Publications/4_The_Journal_of_
Child_Nutrition_and_Management/Fall_2014/SchoolLunchBeforeandAfterImplementati
onHealthyHungerFreeKidsAct.pdf
Buzby, J.C. & Guthrie, J.F. (2002). Plate waste in school nutrition programs: Final report to
congress. Electronic Research Service. Retrieved from
http://162.79.45.209/media/887982/efan02009.pdf
Cavuto, K. (2014). Encouraging your child to appreciate food. Huffington Post. Retrieved from
http://www.huffingtonpost.com/katie-cavuto-ms-rd/diet-and-nutrition_b_5662797.html
Child Trends. (2012). Family meals. Retrieved from: http://www.childtrends.org/?
indicators=family-meals
Hersch D, Perdue L, Ambroz T, Boucher JL. The Impact of Cooking Classes on Food-Related
Preferences, Attitudes, and Behaviors of School-Aged Children: A Systematic Review of
the Evidence, 20032014. Prev Chronic Dis 2014;11:140267. DOI:
http://dx.doi.org/10.5888/pcd11.140267.
Novick O'Keefe, L. (2016). Heart health - love, happiness, gratitude, and learning. Huffington
Post. Retrieved from http://www.huffingtonpost.com/linda-novick-okeefe/heart-health---love-happiness-gratitude-and-learning_b_9276736.html

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Sacheck, J.M., Morgan, E.H., Wilde, P., Griffin, T., Nahar, E., & Economos, C.D. (2012). Key
strategies for improving school nutrition: A case study of three school nutrition program
innovators. Journal of Child Nutrition & Management. Retrieved from
https://schoolnutrition.org/5--News-and-Publications/4--The-Journal-of-Child-Nutritionand-Management/Spring-2012/Volume-36,-Issue-I,-Spring-2012---Sacheck,-Morgan,Wilde,-Griffin,-Nahar,-Economos/
USDA Food and Nutrition Service. (2015). Team nutrition: Local school wellness policy.
Retrieved from http://www.fns.usda.gov/tn/local-school-wellness-policy
Vaitkeviciute, R., Ball, L.E., & Harris, N. (2014). The relationship between food literacy and
dietary intake in adolescents: a systemic review. Retrieved from
http://www98.griffith.edu.au/dspace/bitstream/handle/10072/65287/99129_1.pdf?
sequence=1

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