Melani W. Duffrin

School-Based Screening of the Dietary Intakes of Third-Graders in Rural Appalachian Ohio

BACKGROUND Children in Appalachia are experiencing high levels of obesity, in large measure because of inferior diets. This study screened the dietary intake of third graders residing in 3 rural Appalachian counties in Ohio and determined whether the Food, Math, and Science Teaching Enhancement Resource Initiative (FoodMASTER) curriculum improved their dietary intake. METHODS Dietary intake was measured for 238 third graders at the beginning of the 2007 to 2008 school year and for 224 third graders at the end of that year. The FoodMASTER curriculum was delivered to 204 students (test group). Intake was measured using the Block Food Frequency Questionnaire 2004. The final analysis included 138 students. RESULTS The FoodMASTER curriculum did not significantly affect the diets of the students in the test group, as no significant differences in intake of macronutrients, specific nutrients, or food groups were found between the test and control groups. Majorities of students did not meet the Recommended Dietary Allowance or Adequate Intakes for fiber, calcium, iron, vitamin A, and vitamin E. The students as a whole did not meet the MyPyramid recommendations for any food group, and nearly one fifth of their calories came from sweets. Significant differences in percentages of kilocalories from protein and sweets and in servings of fats, oils, and sweets were seen between groups of higher and lower socioeconomic status. CONCLUSIONS Energy-dense foods are replacing healthy foods in the diets of Ohio children living in rural Appalachia. The prevalence of poor dietary intake in Appalachia warrants further nutrition interventions involving programming for nutrition, such as future FoodMASTER curricula.

Exploring the Associations among Nutrition, Science, and Mathematics Knowledge for an Integrative, Food-Based Curriculum.

BACKGROUND Explore associations between nutrition, science, and mathematics knowledge to provide evidence that integrating food/nutrition education in the fourth-grade curriculum may support gains in academic knowledge. METHODS Secondary analysis of a quasi-experimental study. Sample included 438 students in 34 fourth-grade classrooms across North Carolina and Ohio; mean age 10 years old; gender (I = 53.2% female; C = 51.6% female). Dependent variable = post-test-nutrition knowledge; independent variables = baseline-nutrition knowledge, and post-test science and mathematics knowledge. Analyses included descriptive statistics and multiple linear regression. RESULTS The hypothesized model predicted post-nutrition knowledge (F(437) = 149.4, p < .001; Adjusted R = .51). All independent variables were significant predictors with positive association. CONCLUSIONS Science and mathematics knowledge were predictive of nutrition knowledge indicating use of an integrative science and mathematics curriculum to improve academic knowledge may also simultaneously improve nutrition knowledge among fourth-grade students. Teachers can benefit from integration by meeting multiple academic standards, efficiently using limited classroom time, and increasing nutrition education provided in the classroom.

Middle school nutrition knowledge tool development and evaluation in North Carolina

Purpose This study aims to develop and empirically assess an instrument for measuring nutrition knowledge aligned to the North Carolina (NC) Healthful Living Essential Standards for teaching nutrition. The instrument was critically evaluated and used to assess nutrition knowledge in Eastern NC students. Design/methodology/approach Researchers evaluated 250 students in 16, eighth-grade classrooms using a 22-question researcher-developed nutrition knowledge questionnaire. Assessment questions were aligned with NC Healthful Living Essential Standards, which suggest students should be able to: apply tools to plan healthy nutrition, create strategies to improve dietary intake, create plans for lifelong health, and evaluate health information and products. Survey reliability and validity (face) were evaluated prior to study implementation. Descriptive statistics for individual items, total and individual standard scores were analyzed. Instrument efficacy was evaluated using item-difficulty and discrimination indexes. Findings The survey displayed appropriate levels of item difficulty with three exceptions: two questions were identified as too difficult, and one as too easy. The majority of items also displayed acceptable (>0.20) or excellent (>0.40) discrimination (17 out of 20). Average total nutrition knowledge score was 11.82-3.26 (53.7 per cent). Within aligned standards, students scored highest in creating plans for lifelong health (79 per cent) and lowest in evaluating health information (37.6 per cent). Originality/value Study findings suggest eighth-grade students may only possess half the nutrition knowledge standards expected in the eighth grade. More instrument development is needed to supply researchers with standard means of assessing nutrition knowledge.

Measuring me: using nutrition education curriculum activities to teach elementary mathematics.

Understanding basic functions of mathematics can greatly improve individuals’ future health risk.1 Numeracy skills help people understand medication prescriptions, nutrition plans, and which treatment option is best for them.2 However, one of the largest obstacles health professionals face is patient compliance to interventions; one reason being, lack of mathematical proficiency among the population.1,2,3, Teachers in K-12 learning environments have the greatest opportunity to lay core foundations in mathematics.5 A mastery of mathematics skills such as addition, subtraction, multiplication, division, proportions, and fractions is important for children to learn early to assist them in addressing health issues later in life.2, 6 School-based health promotion interventions focusing on nutrition and physical activity can also aid children in making connections between mathematics learned in the classroom and healthy living.7 Therefore, the authors developed an introductory activity called Measuring Me for the Food Math and Science Teacher Enhancement Resource (FoodMASTER) Initiative (Figure 1) to be used while collecting pre-study anthropometric data for the FoodMASTER study. The educational and developmentally appropriate interactive activity allows students to apply mathematics while becoming familiar with simple anthropometric measurements in the classroom. Figure 1 Measuring Me activity sheets. Program Description FoodMASTER Intermediate is a 3rd–5th grade curriculum that uses food as a tool to integrate nutrition concepts into the standard course of study for math and science.6 There are 10 units that make-up the FoodMASTER curriculum, each containing two or three activities (24 activities total). It meets national school standards for mathematics and science education and is also easily adaptable to each state’s standards. During the 2009–2010 school year, self-selected teachers in North Carolina (N=18) implemented the Measuring Me activity in their 4th grade classrooms as an introduction to FoodMASTER. Researchers from the program visited each classroom in the fall of 2009 to collect pretest data including students’ heights, weights, waist circumference, and food frequency. Other pretest data included nutrition, science, and mathematics knowledge, attitudes, and self-efficacy. Led by program researchers, Measuring Me was piloted in classrooms to allow children to become familiar with body measurements and connect abstract numbers to concrete applications such as health. Measurement plays an especially crucial role in helping children to identify relationships among objects.5 In using their own height measurement, students are able to identify items that are shorter, taller or the same height as them and make comparisons.5 Independent comparisons about other anthropometric measures, such as weight, can also be applied by students. Connecting comparisons students make about length and mass with nutrition and health concepts can be beneficial to improving students’ long term health literacy as adults.2 In intermediate grades, three core competencies children must learn are standard units of metric and customary measurement; collect, organize, analyze, and report data; and perform standard computations, all of which are included as components of Measuring Me.5 The Lesson Like other FoodMASTER activities, Measuring Me took one class period (30–45 minutes) to complete and is straightforward enough for teachers to pick-up quickly and implement in their classrooms. Eighteen classrooms and 298 students participated in the activity. Measuring Me followed a similar format as other FoodMASTER hands-on lessons. First, elementary student volunteers read a short passage about why health professionals measure height and weight. Next, each student completed the threereading comprehension questions independently and then answers were reviewed as a class. Subsequently, students participated in Height Math, the hands-on component of Measuring Me. A demonstration in how to measure height with yardsticks was shown to the class. The class was then divided into teams of 3–4 students to measure each others’ height using two yard sticks. The first student removed his/her shoes and stood straight. Limited wall space was available in most classrooms, so students estimated using free-standing heights. A second student held the yard sticks, one on top of the other, and the third student read the height in inches. Students switched roles until everyone in the group had been measured. Heights were recorded after each measurement. Students used individual results within teams to order heights from least to greatest; to calculate the sum, difference between the minimum and maximum height, mean, and median; and to perform several measurement conversions. Anonymous class results were used to make conclusions about students’ heights and to determine the class mode for height. The math concepts covered provided teachers with an opportunity to either review topics or introduce the topic for the first time depending on the teacher’s curriculum schedule. It also gives teachers an opportunity to discuss the nutrition concept of energy balance and how it relates to anthropometric measures.