Why does a 30-second video called ‘Japanese school lunches puts the rest of the world to shame’ have more than 42 million likes in a few days? What is the project The Grab 5 doing right when they can claim: ‘There definitely has been an improvement in behaviour and children are healthier now than they were a year ago’? Lunch boxes are changing. Lunch time is seen as part of education, not a break from it. Will South African schools join in happier healthier lunch boxes?

Criteria

The World Health Organisation and the Basic Dietary Guidelines recommends that at least five portions of rainbow coloured food are consumed every day as part of a balanced diet. This advice is easy to understand and remember in theory, and psychologically strengthening, because it does not ask us to give something up. But, sadly, this is not happening.

The Diabetes South Africa (DSA) Agents for Change team knows that in the rural areas, most meals consist of brown and white (very little colour). According to a British project, The Grab 5¹, some children do not even have one coloured piece of fruit or vegetable per day.

Agents for Change model

We, at Agents for Change, target health providers, patients and families living with and working with diabetes and share creative ideas for changing habits. At a recent site visit with our international funders, World Diabetes Foundation, their project manager, Hanne Strandgaard, accompanied us to the Red Cross War Memorial Children’s Hospital in Rondebosch, Cape Town. We interacted with parents and children at the diabetes clinic and demonstrated simple effective ways of presenting healthy, economical and enticing food options.

Dr Steve Delport, the consulting endocrinologist, told us that his little patients kept darting in and out of his rooms to fetch another snack. The snacks definitely passed the taste test, especially the green grapes which Hanne placed on tooth picks and called green balloons. Her ‘boiled egg mice’ were also popular.

The fathers were most interested in tasting all snacks and finding out how to make them. Those who took part in this demonstration also had fun choosing from the available variety of tomatoes, cheese blocks, Vienna rounds, grapes, pawpaw, apple slices, and building their own ‘toothpick towers’. They were overjoyed at being given a copy of the booklet Rainbow in my kitchen¹⁴, which contains ideas of how to shop for a basic pantry, and recipes using whatever you have.

Self-feeding vs spoon-feeding

According to recent studies on eating habits of babies, nutritional ‘schooling’ starts long before schoolgoing age. Early healthy nutrition develops healthy balanced thinking processes and develops the subtle sense of knowing when you have had enough to eat.

Recent UK studies show that spoon-fed babies are more likely to become obese children⁶. If someone else shovels in the food (with the best motives), this bypasses this subtle sense. Let the children guide the way to what and how much they want to eat. The study shows that the self-feeders had a lower obesity rate than the spoon-fed children. Allowing them to choose from a selection of finger foods means they learn to regulate the amount they eat and are less likely to become overweight. They are also more likely to opt for healthier options than spoon-fed babies, who tend to favour sweet things.

The study suggests infants weaned through the baby-led approach learn to regulate their food, resulting in lower body mass index and a preference for healthy foods. This has implications for combating the well-documented rise in obesity in society. Tam Fry, from the National Obesity Forum, said, “Babies have this wonderful rapport with their mother when breastfeeding and indicate how much milk they want and when they are ready to go on to solids.” Adding, “It is important they experience all five food groups and experiment with variety as much as possible. If half of it finishes on the floor, so be it – the value of experimentation in the early months of nutrition is incalculable and babies won’t willingly starve themselves.”

The study comprised 92 children who had been weaned on finger foods and 63 who were traditionally spoon-fed. Parents filled in questionnaires on how their children had been weaned, including how often they ate certain foods when they were aged six months and six years.

The Grab 5 project research

Aiming for a holistic approach to school lunches and healthy tuck shop, they found:

• Well-fed pupils are calmer and concentrate better.
• Well-fed pupils have fewer days off due to illness.
• School food activities, such as tasting events and playground markets, are good ways to involve parents and community groups in school life.
• School food activities, such as cooking, growing and tasting, are often good ways to engage children that are otherwise reluctant to get involved in school life.
• Serving meals and snacks increases school revenue and children develop a positive attitude towards what they eat.
• Curriculum links with food projects and events bring subjects alive and are responsible for healthier more socialised children¹.

How can we change the school food environment?

• Free fresh fruit and vegetable food tasting tables offered to pupils at the tuckshop. This would be a gradual means of finding out what they like and introducing them to new foods textures, colours and combinations.
• Integrating talks on nutrition about all food groups and their service to the body – energy foods (carbohydrates), protection foods (vegetables and fruit), nutrients (milk products), building foods (meat and other protein) and food that protects our nerves (fats)⁴. Tasting tables prepared by children in the classroom.
• A visit to a fruit and veg shop or food farmer.
• Introducing practical demonstrations of how to put food together in balanced, fun healthy and economical combinations. This could be done in the form of fund raising projects, and help to wean children off the unhealthy options offered in tuck shops.

• Introducing all aspects of food into the curriculum in each age group. This would involve maths – budgeting, ordering and invoicing, being able to apply the concept of a planned balanced meal; science – cooking, processes of heating and freezing; biology – learning the various components of hygiene, digesting and nutrition, portion sizes etc.; life-skills – co-operation through supervised preparation of and cooking of simple dishes and clearing up; geography – cultural differences in serving and eating; horticulture – encouraging children to ‘grow their own’ simple bean or spinach plants and to demonstrate sprouting of various pulses and seeds for immediate micro-nutrients.
• Developing new standards for the tuck shop stock e.g. practical fruit and vegetables options, bread sticks, plain popcorn or sprinkled with healthy herb salts, crumpets with honey, natural yoghurt with chopped fruit and toasted snacks^{5,6,7,8,9,10.}.
• The more children taste different kinds of fruit and vegetables, prepared in different kinds of ways, the more they will learn to like them. It is a learning curve for children to try new foods. Exploring new tastes is an educational adventure in itself.

A working model for schools

In Japan, children’s lunch time is part of the curriculum, where fresh simple meals are made from scratch by pupils in rotation for less than $2,50 (roughly R35) per day. They study the menu and cultural history, and assess the nutritional value. The children prepare, cook and serve the meal and then clear up. This teaches cooperation and manners. They harvest from their own gardens where possible. It is no wonder that they have one of the lowest obesity rates in the world.

As the first verse of the song The Greatest Love of All says:

I believe the children are our future
Teach them well and let them lead the way
Show them all the beauty they possess inside
Give them a sense of pride to make it easier
Let the children’s laughter remind us how we used to be

References:

1. https://www.sustainweb.org/g5cp/index1.htm
2. https://www.who.int
3. @ATTN: life (Japanese lunches
4. The Diabetes Toolkit by Buyelwa Majikela – Dlangamandla
5. Gardening is Child’s Play and Sprouting Kit by Noy Pullen
6. http://www.mirror.co.uk/news/uk-news/spoon-fed-children-more-likely-to-be-obese-675605
7. http://www.superhealthykids.com/14-fruit-party-platters/
8. https://za.pinterest.com/clpage13/veggiefruit-tray-display-ideas/?lp=true
9. https://za.pinterest.com/explore/toothpick-appetizers/?lp=true
10. http://childhood101.com/2015/08/simple-kids-snack-idea
11. http://www.jamiesfoodrevolution.org/
12. http://divinefoods.co.za/snoepie-spyskaart.html
13. https://www.worlddiabetesfoundation.org
14. Rainbow in my Kitchen – doing what you can with what you have where you are.