EDUCATION INCREASES CONSUMPTION OF VEGETABLES BY CHILDREN Betty B. Alford and Mary H. Tibbets Vegetables have limited popularity with children. However, through an educational program using informal approaches, the consumption of vegetables was increased in a summer camp for diabetics.
The consumption of vegetables is declining in the United States according to the USDA dietary survey of 1965 (1). Breakenridge (2) noted in a study of young children a definite dislike for vegetables. Other studies have found limited consumption and actual dis-taste for vegetables (3) (4). Improvement in nutritional status depends on daily decisions of the individual regarding his eating habits. It is essential that he learn t,o make wise choices from the wide variety of available food. Changing food habits is a slow process. Group feeding is a valuable tool for the improvement of food habits (5). The importance of educational programs also has been emphasized. This study in 1969 evaluated the effectiveness of a nutrition education program concerned with vegetables in a group feeding situation. There is much discussion concerning the value of providing food without additional education. A camp for diabetic children at Gainesville, Tex., was the setting. The maintenance diet of the child with diabetes mellitus is essent,ially the same as an adequate diet for normal children (6). The nutrition of the entire family may be improved by eating a diet similar to that of the diabetic child.
Methods The camp provided an adequate, balanced diet similar to t,he food needed by all young individuals. The camping period was three weeks. The camp staff provided basic instruction for the diabetic. Although diet information was included in lectures by the staff, the low carbohydrate, free exchange vegetables were not emphasized. This provided the opportunity to evaluate ,the effectiveness of the educational program based on low carbohydrate vegetables by comparing the level of vegetable consumption of children in two camping sessions. The children in the first session were the exTHE AUTHORS are, respectively, Assistant Professor, Nutrition and Research, Texas Woman's University, Box 23564, Denton, Tex., and Homemaking Teacher, Gainesville Junior High School, Gainesville, Tex. 76204.
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perimen~al group which received the vegetable education program. The second session campers were the control group with no educational program on vegetables other than being served an adequate diet. The camp popUlations were composed of male and female subjects aged from 6 to 17, from a variety of social, economic, ethnic, and regional backgrounds. Seventy-one children from the first session and 89 children from the second session voluntarily participated in the study. Some samples were rejected due to incomplete responses. A questionnaire based on the vegetables included in the exchange lists used by the camp was administ,ered at the start of the camp session to determine vegetable preferences of both groups. Vegetable consumption was recorded during a mid-day meal and an evening meal in the first week of camp. The recording was repeated in the third week of camp on a day when the same veget,ables were served.
The Education Program Following the initial meal observations, colorful cartoon posters emphasizing vegetables were displayed in the dining hall. Beaty (7) noted the use of cartoons in motivating favorable changes in food habits. The posters were changed frequently and incorporated phrases such as: Happiness is togetherness at camp and eating good vegetables. My advice is switch now! When
you feel the blanket urge, go get a carrot to eat. Vegetable snacks clean your teeth. Who ever heard of vegetables for a hobo? Even a hobo likes something fancy once in a while. How about the "crunch, crunch" of people eating fresh vegetables? That might be a new symphony idea. A tasting demonstration involved all the campers in the first, session. It Was conducted to introduce the campers to the uses of low carbohydrate vegetables in the diet. The emphasis was on the use of raw vegetables as snacks. Sufficient quantities of each food were prepared ahead of lime to have samples for each child to taste. The demonstrations of simple preparations included the following: Free vegetables added to gelatin. Tossed salad using low carbohydrate vegetables. Fancy cut raw vegetables. Raw vegetables served with a low calorie dip. Use of cooked vegetables as snacks. The method of preparation can alter the value of the food and the amount allowed in the diet. This was demonstrated through the use of potatoes as chips, French fries, and baked potato. Charts illustrated the calories in relation to the nutrient content for each method of preparation. Because of the wide age range, a discussion of specific nutrients for the
TA,BLE I Percentage of Children Eating Entire Serving of Vegetables Experimental Serving NOON Mashed potato Broccoli Lettuce-tomato EVENING Potato salad Green beans Lettuce-tomato
95 59 60
98 64 66
+ 3 + 5 + 6
90 62 70
96 56 75
+ 6 -6 + 5
80 70 70
85 84 98 + 5 +14 83 70 72 +13 + 2 79 90 60 -30 + 9 Ch, Square - 19* Ch, Square - 5.603** Px 2 5 15.086=0.01 *Significant difference; **no significant difference SUMMER, 1971
vegetables was avoided. The purpose of the program was to encourage vegetable consumption. As a camp activity, a Hobo Picnic was planned. The menu included marinated vegetables served in individual plastic tubs, raw vegetable relishes in plastic bags, beef and potatoes cooked in foil, bread and fruit for dessert. All food was tied in a colored bandana and individually marked for each camper. The picnic provided the opportunity for a vegetable song in the group singing. A small booklet was given at the end of the camp period to each child as reinforcement of the vegetable program. The materials included were miniatures of the cartoons used in the dining hall, the picnic menu, vegetable recipes, and a Basic Four chart with colorful pictures. These were the child's to take home.
tables as eaten often were classified as liking vegetables. These children were evaluated for the amounts actually consumed. Only 25% of these children ate all or part of the vegetables served at camp. Therefore, the checklist indicating these children's preferences and pract,ices was not a predictive factor of actual consumption. However, methods of preparation and other factors could have been involved. Summary
To compare the effectiveness of a vegetable education program with the service of an adequate diet incorporating
vegetables, a study was conduct,ed in a camp for diabetic children. In the first camp session, 71 children (experimental group) were observed for vegetable eating practices and given an educational program on vegetables. The consumption was recorded. During the second camp session, 89 children (control group) were not given the educational program and consumption was recorded. Veget,able consumption increased significantly in the experimental group and did not in the control group. For these children, education was an important factor in the vegetable consumption
Results Of a list of 34 vegetables, those liked most by the children were corn, white potatoes, and lettuce. The children of both the experimental and control groups were unfamiliar with many vegetables, usually Brussels sprouts, eggplant, mushrooms, summer yellow squash, greens, and sauerkraut. Figure 1 illustrates the close relationship between preferences and reported consumption in these children. Lettuce is the only free vegetable with a high frequency of consumption. Celery, green beans, tomatoes, pickles, and spinach were t,he only low carbohydrate vegetables indicated as being moderately well-liked and consumed. The record of vegetable consumption indicated an increased intake of some vegetables from the start to the end of the camping period. Although green bean eating increased in both groups, t,hc increase was greater in the experimental group (See Table 1). Broccoli, lettuce, and tomato consumption increased in the experimental group and declined in the control group. When a chi square was applied to the data, the experimental group had a significant increase in low carbohydrate vegetable consumption between the first and final week of camp. There was not a significant increase in the control group. These data indicate that education in addition to the provision of food was an important factor in the vegetable consumption practices of the children. Individual vegetable preferences of the entire group studied were compared with eating practices. A count was made of the number of vegetables children marked as eating often. Arbitrarily, the campers who marked 20 or more vegeSUMMER. 1971
Sum mer sq uash
.! ~ >~
Sour pickles Dill pickles
Brussels sprouts Broccoli
'OoOo • • •
-Eat often Fig. I-Preferences of Children JOURNAL OF NUTRITION EDUCATION / 13
practices even with the servIng of an adequate diet.. ACKNOWLEDGEMENT The authors thank the directors and staff of Camp Sweeney, Gainesville, Tex., for permission to carry out the study and their assistance in it. REFERENCES 1. Dietary Levels of Households in the
United States, Spring 1965, Agricultural Research Service, USDA, Washington, D.C., Jan. 1968. 2. Breakenridge, M. E., "Food attitude of 5-12 year old children," J. Amer. Diet. Assn., 35:704-709, 1959. 3. Pilgrim, F. J., "What foods do people accept or reject?," J. Amer. Diet. Assn., 38:439-443,1961. 4. Hunt, F. E., Patton, M. B. and Carver, A. F., "Plate waste in a school lunch," J. Amer. Diet. Assn., 34:810-813, 1958.
5. Pattison, M., Barbour, H., and Eppright, E. S., Teaching Nutrition, 2nd Ed., Iowa State College Press, Ames, Iowa. 1963, p. 89. 6. Jackson, R. L., "Nutrition management of children with diabetes mellitus," J. Amer. Med. Assn., 168:42-46, Sept. 6, 1958. 7. Beaty, L., "Use of communication media to influence change," Nutrition Education Conference Proceedings, USDA, Washington, D.C., 1967, pp. 25-26.
FOOD AND NUTRITION EDUCATION FOR MENTALLY DISTURBED WOMEN Margaret Wilkinson, Elinor Kerrey, Ruth Ganshorn and Constance Kies An evaluation of teaching nutrition/meal management classes for emotionally disturbed women in a day care center is presented. Such classes, may be of therapeutic as well as practical value.
Classes in nutrition and meal management perhaps can be an important part of a rehabilitation program for mentally disturbed women. The Food and Nutrition Department, College of Home Economics, University of Nebraska, sponsored a series of such classes for women who were patients in a day care program at the Lincoln Regional Center at the request of this agency. The classes were suggested by staff psychiatrists as possibly offering opportunities for social interaction and for strengthening of selfesteem, two important factors in the treatment of mental illness (1, 2). In addition, it was thought the classes might offer opportunities for the women to become more effective homemakers by increasing their knowledge and understanding of nutrition and meal management. Most of the classes were held in a foods laboratory at the university because experiences and trips ·away from the hospital environment. were of therapeutic value to the women. Also, it was thought that the women would gain some personal prestige and self-esteem by being able to say that they were attending classes at the university. Twenty-four classes were held (3) with attendance per class ranging from 4 to II patients. Close supervision of the patients was possible at. all times because they were accompanied to the classes by a nurse, an aide, and a recreational therapist. Although instructors of the class THE A UTHORS are, respectively, Instructor, Instructor, Associate Professor, and Professor, Dept. of Food and Nutrition, University of Nebraska, Lincoln, Neb. 68503.
had no formal training in working with mentally disturbed individuals, all had had some formal classes in psychology. Hence, communicat,ion between the hospital and university staff members was greatly eased and much informal training occurred during the course of the project. Professionally trained individuals must complement and supplement their respective competencies. Most of the patients suffered from chronic mental illness and were in varying stages of the illness. The degree of illness was likely to change from week to week. Sometimes t.he woman exhibited symptoms of their illness or of the effects of medication at the time classes were held. However, the classes proceeded with few unusual incidents. Ages of the women varied from 27 to 62 years. Nearly all were married with families. Enrollment in the program was encouraged by the rehabilitation staff of the institution. Educational achievement and intelligence levels varied considerably. Of the 14 women who attended classes at least five times, four were college graduates, two had attended college, six were high school graduates, two had attended high school for only two years, and one had an eighth grade education. All of the women belonged to the low or low-middle economic class. Each lesson began with a short discussion of the particular food group being studied that day (3). This was followed or accompanied by a food preparation demonstration. Then the women, in small groups, prepared foods using recipes which pertained tp the day's lesson. As part of each lesson, a complete meal containing food from each of the four
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food groups was planned, prepared, and served. While the meal was teacher pre-planned, processes involved in planning were presented. When the foods prepared by each group were added to the buffet table, a complete luncheon resulted. In this manner, the women experienced preparation of food and saw how these foods could be incorporated into meals acceptable to the cultural values of this society. No pressure was placed upon the patients to learn facts. The primary objectives of the classes were to foster selfconfidence and encourage social interaction. However, since it would be difficult to measure the effectiveness of the classes in regard to the latter factors, short tests over the subject matter were administered. After determining that short tests did not seem to cause anxiety in the patients, pre-tests and post-tests were administered over some of the lessons in order to obtain information for evaluative purposes. Test scores indicated that the women had gained some understanding of the principles of nutrition and meal management (3). To provide additional opportunities for actual experience and application of knowledge, groups of four women were asked to plan, prepare, and serve a meal to the entire group. Accordingly, on two occasions meals were prepared and served in the day care area at the hospital. On one occasion the meal was prepared and served by the patients in the home of an instructor to provide a more realistic experience. Since food is a topic of universal interest and in itself encourages conversation, the lessons contributed to social SUMMER, 1971