A study to evaluate the nutritional habits of year 6 children, before and after a nutrition-based intervention: The CHANGE! (Children's Health, Activity, and Nutrition: Get Educated!) Project.

Poor nutrition and impaired dietary intakes are associated with certain chronic disease states such as obesity, cardiovascular disease and diabetes. There have been a number of school-based, nutrition-focused interventions which have been used to measure and determine healthy eating behaviours in UK school children but with varying degrees of success. The main aim of this thesis was to develop, pilot and evaluate the Children’s Health, Activity and Nutrition: Get Educated! (CHANGE!), a healthy eating curriculum for year 6 children. A formative study, unique in this type of intervention study, was carried out to investigate the behaviours, habits and attitudes to food of the children and the data collected used to inform the design of the intervention teaching curriculum. It revealed the diversity of the food and eating environments to which the children were exposed. Some of their perceptions about health and food, food choices and eating behaviours were inter-related. The key health messages included in the teaching curriculum were developed from these findings. At baseline, the participants’ food intakes, knowledge about food and nutrition and their attitudes to eating were measured using questionnaires. Additionally anthropometric measurements were taken and the children’s postcodes used to assess the socio-economic status of the children. The results showed that the control and intervention groups were alike at baseline. At post-intervention, the results indicated that there were some positive changes to food intakes, with a slight decrease in the consumption of negative marker foods. There was an increase in the total mean food knowledge scores, with children from the areas of lower deprivation scoring highest. There was no significant difference between control and intervention groups. The children’s eating attitudes displayed some trends with cues to eating. There was a significant increase in height in all children but this did not alter the body mass index status of the overweight or obese children. The importance of the use of CHANGE! as an intervention at the school-level is demonstrated by some of the more important findings from the study, such as the increased self-assessed ability to make certain foods, and that there was an increase in total food knowledge scores from the children who lived in areas of lower deprivation. These results could potentially be the starting point for some children to start questioning the types of food they are habitually eating and maybe looking to make some adjustments to their behaviours, as even small changes can be nutritionally significant in the longer-term for the future health of the children. Furthermore, the sustainability and long-term effects of CHANGE! need additional assessment and evaluation