When evaluating our new third grade program, Shaping Up My Choices  I had the privilege to observe students going through some of the nutrition education lessons. Dairy Council of California staff observed about 90 classroom lessons throughout the state in an effort to document program fidelity, student engagement and concept mastery.

During one classroom observation, I brought my camera to capture a health lesson in action. Lesson 7 in Shaping Up My Choices is “Get Ready, Get Set, Get Moving”. Why does a nutrition curriculum have a lesson on physical activity? The answer is simple; students need to understand the importance of physical activity in addition to healthful eating.

Mrs. Potter followed the lesson closely; she engaged students by asking what physical activities they participated in and challenged those who said they played video games to think about movement.

After completing the vocabulary which differentiates low, moderate and vigorous activity, it was time for students to get up and move with a game of charades.  Playing on the computer is not active…

This student is doing swimmingly in her charade action…

This student is moving so fast shooting baskets with his imaginary basketball my camera can’t keep up. That’s moderate-vigorous activity. His classmates are super engaged watching and raising their hands to participate.

The floors rumbled as students stood up for activities that got their heart moving or sat down for activities that were low levels of movement. Could these students be having any more fun dancing while learning?

After completing the lesson, Mrs. Potter goes over the answers using the teacher guide answer key. Students tear out the family homework on activities they do at home and what they can do as a family.

The lesson closes with a request that students bring in a sample food label from home for the next lesson, "Label Language". Mrs. Potter puts out a challenge to the class as they prepare to go out for afternoon recess. “Now that we’ve talked about physical activity and being active, let’s see if you can all walk as fast as me when we go outside.” That’s putting a lesson into action right away. I’d say these students are well on their way to Shaping Up My Choices!

Trina Robertson

Registered Dietitian

In August, I spoke at the Association of Nutrition Service Agencies annual conference in San Diego. My presentation, Developing Nutrition Education Programs That Target Behavior Change, focused on how to create programs that really work for the intended audience. I started the presentation with a quick overview of the key messages in Dairy Council of California programs: eat nutrient-rich foods, include 30-60 minutes of physical activity most days of the week, all foods can fit in a healthy diet, and convenience, taste and family/cultural traditions must all be considered when planning daily food choices.

Armed with this understanding of the our nutrition philosophy, attendees learned about our behavior change model. 

1. The model begins with identifying choices that increase risks and the benefits of better choices which can improve outcome expectancies.
2. The next phase is to engage the user in the content to help them identify potential changes through reflection.
3. To facilitate behavior change clients must increase self-efficacy, improve decisional balance, set goals and increase intrinsic motivators (external motivators and rewards have not been demonstrated as effective).
4. The final phases are the adoption and maintenance of behavior change. Critical is encouraging social support, relapse prevention and addressing setbacks that do occur.

The principles of the behavior change model were illustrated using our new Shaping Up My Choices third grade program and our newly revised Activity & Eating program. These examples allowed the attendees to visualize how the steps were incorporated in the program development process.

The third and final portion of the presentation stressed the importance of including health literacy techniques. Most health education materials are written at or above a tenth grade reading level when they should be written at the sixth grade level. To achieve behavior change, users must understand the information and how to use it. Attendees broke into small groups and identified how to improve a program to achieve the principles of the behavior change model.

ANSA conference attendees come from across the country and from various agencies- and serve a wide range of populations- so the feedback received was from multiple viewpoints. The group found this interactive presentation beneficial, particularly the focus on readability and use of plain language during program development. It was reassuring that the feedback so closely match the changes made to Activity & Eating. One attendee mentioned he was very fond of the previous edition of Activity & Eating and could not imagine liking the new one better. After seeing the updates, he was even more thrilled about having this new resource available. As attendees asked for copies of the booklet to share with their health educators, I knew we had created a very usable booklet that can improve food and activity choices.

Trina Robertson, MS, RD

Project Manager

March is National Nutrition Month ®, when the American Dietetic Association reminds us about the importance of healthy eating. This year’s theme is “Improving your nutrition from the ground up”. Now is the time to go back to the basics and build a healthy diet that includes healthy foods from all food groups.  

Despite the variety of nutrition messages over what not to eat plastered all over the media, Internet and from family and friends, many people still don’t have a clear idea of what foods they should be eating. By focusing on the positive components of foods you can help your clients develop a healthful approach to eating that will lead to a well-balanced and sensible diet.  

One way to help your clients make healthy choices is by encouraging them to include nutrient-rich foods into their daily eating pattern. Nutrient-rich foods have large amounts of key nutrients for fewer calories. These foods provide essential vitamins and minerals that the body needs to promote healthy growth, fight illness, increase energy levels and prevent chronic disease. Plus, being lower in calories helps individuals achieve maximum nutrition while still maintaining a healthy weight. Some nutrient-rich foods to focus on are:

• Whole grains, which are high in dietary fiber, B vitamins, iron and magnesium
• Fruits and vegetables, which are a great source of potassium, dietary fiber, folate and vitamins A,C and E
• Low-fat milk and milk products, which provide calcium, vitamin D, protein and potassium
• Lean meats, beans, nuts and seeds which supply protein, iron, zinc, B vitamins, vitamin E and magnesium

The “nutrition from the ground up” theme conjures up images of a backyard vegetable garden which certainly can be an element in a healthy lifestyle. However, you don't have to be a gardener to have a healthy diet. Fruits and vegetables are plentiful in your local grocery store or a farmer's market. Frozen, canned and dried produce provides greater variety and easier storage of foods particularly in winter when availability and access are limited. We can feel good about eating a wide range and variety of fruits and vegetables. 

This March take a new approach to purchasing, preparing and eating foods for a healthier you. For more information on National Nutrition Month, visit www.eatright.org and peruse Dairy Council of California’s downloadable handouts for information you can share with adults and children. 

Trina Robertson, M.S, R.D.

Project Manager

The start of the year marks resolutions that often include food. There are a variety of factors we take into consideration when purchasing food such as taste, cost, preparation and nutrition value. Newer on the list and rising in popularity is eating a "green" or sustainable diet. It is apparent that implementing a sustainable diet varies broadly and is very personal. I think of it as a continuum with the most devoted growing their own food, composting and purchasing local, seasonal foods. Others dabble in “going green” by recycling plastic bottles and periodically bringing reusable shopping bags to the market.
 
Here are a few simple ideas to consider as you and your clients think about sustainable eating practices: 

• Cook at home. Eating out less often reduces your calorie intake and you can better control food quality. 
• Eat fresh produce in season. Another good option, eat canned or frozen fruits and vegetables which are nutrient-dense since they are processed immediately after harvest. 
• Reduce food waste. Forty percent of food waste is at the consumer level. Plan your meals so you cook the food you buy. Store and preserve food properly. For people who are further in the going green process, compost rather than throw out inedible parts of food. 
• Ditch prepackaged foods. Bite into a piece of fruit rather than a fruit-filled granola bar or crunch on veggies rather than potato chips. 
• Eat less, or eat appropriate portion sizes. Your waist and wallet will thank you. 

Individuals may choose to be more proactive in their quest to be green. With a huge potential list of green options it is useful to think about what is simple to implement and has the largest impact. As a newly emerging field, researchers are still determining how to accurately measure carbon footprint. Some actions have less impact than one might expect. Consider these ideas carefully before diving in. 

• Organic foods. Organic foods are produced without the use of pesticides, herbicides and synthetic fertilizers. However, the majority of organic production is large scale and may have similar food miles and water/soil conservation practices as conventional agriculture. Foods are defined organic based on the process, not the outcome of the product. For example, organic and conventional milk provide the same nutrient value.  Shoppers should feel confident that foods, organic and conventionally grown, available at their local grocery store are healthy choices. 
• Local farmer markets. While these are a great alternative and can be a fun way to shop; the food can be expensive and the hours may not be convenient. You may also be surprised to learn how far the food vendors have traveled to sell at your local market. We should not feel guilty buying produce from your local grocery store. 
• Grow your own food. With time, attention and the right climate you can successfully grow fruits and vegetables. This can be a fun activity that includes the whole family. I live in a very warm and dry climate and wonder whether the amount of water needed to grow a handful of tomatoes each summer is a good use of this precious resource.

Ultimately how to overlay sustainability with the other food and nutrition priorities of individuals and families is a personal choice. It is important however to not eliminate an entire food group from your diet, since each food group provides essential nutrients. All foods can fit in a healthy diet when eaten in the proper quantity. For more information on sustainability and how to advise your patients, read our Health Connections newsletter. Helping your clients think through these issues can help them identify reasonable steps leading to better food choices.
 
Trina Robertson, M.S., R.D.
Project Manager