The Food Dudes Healthy Eating Programme Presented by Pauline Milne and Sally Pears Presentation to Selby Conference 19th April 2010 Changing children’s eating habits for life

Changing children’s eating habits for life Programme Aim: To increase consumption of fruit and vegetables in primary school children + Main aim - to increase F&V consumption in primary school aged children.Secondary aim - to maintain that behaviour change both at school and at home. Changing children’s eating habits for life

Why Increase Fruit and Vegetable Intake? Adult recommended daily intake = 400g Average British daily intake = 250g Worldwide obesity crisis We must change eating habits We want our children to become a generation of fruit and vegetable eating adults! Adult rec intake …..CLICK Not just a problem in Britain - this is global. Parents and governments across the world are worried about the food children eat, or DON’T eat. For instance, in Australia, obesity has overtaken smoking as the leading cause of premature death and illness (announcement by President of the Public Health Association last week). In US, the prevalence of overweight & obesity in 6-11 yr olds has quadrupled in the last 3 decades. (California Health Interview Survey, 2005) CLICK Naturally, there are lots of factors involved - inactivity, lifestyle, environment, etc, but one thing is for certain - to tackle obesity, we MUST change behaviour, in this case, eating habits. Changing children’s eating habits for life

Health Benefits of Fruit and Vegetables Help prevent obesity Protect against many cancers Reduce the risk of coronary heart disease Help prevent diabetes Protect against asthma Keep skin, teeth and hair healthy We all know the benefits of eating F&V - and many children do, but this doesn’t necessarily mean they EAT F&V. Visiting schools - ask kids and they know the facts. Putting this into practice is another matter. This is why the Food Dudes Programme was developed - to get over that hurdle between knowing what they should be doing and actually doing it. Changing children’s eating habits for life

Changing children’s eating habits for life The Food Dudes Programme Designed by psychologists Brings about major and long-lasting change CLICK FD was developed by the BFARU at Bangor University. FD is the only programme available worldwide that changes children’s eating habits in just 16 days, increasing F&V consumption and reducing consumption of less healthy foods. Sally will provide evidence for this later in the talk. Changing children’s eating habits for life

Changing children’s eating habits for life The Food Dudes 3 Rs Role Modelling – Food Dudes in battle with General Junk Rewards Repeated Tasting There are 3 main components of this programme. We call them The 3 Rs CLICK Role-Modelling — is established by showing DVD adventures featuring four cool superheroes — the Food Dudes, in battle with General Junk and his Junk Punks. The Food Dudes love fruit and veg and they always win. The episodes are designed to maximise the Brand Power and influence of the Food Dudes. Rewards — such as wristbands, sports bottles and colouring pencils further motivate the children to begin tasting fruit and veg and further strengthen the brand. The Repeated tasting this brings about is crucial because, as a huge amount of research shows, if children or indeed, adults taste a food often enough they will learn to like it. Whole School involved 4-11 including teachers Homepack - FD boxes provided in the 2nd phase for children to bring F&V into school from home. This of course, involves parental input and often allows the child to start making choices about what he or she wants to eat. Changing children’s eating habits for life

Why Does Food Dudes Work? The DVD episodes and rewards encourage children to taste fruit and vegetables repeatedly. Children discover the intrinsically rewarding properties of these foods and develop a taste for them. Children come to see themselves as fruit and vegetable eaters and are proud of it. CLICK The DVD is shown whilst the children are eating the F&V and rewards are given immediately afterwards, so the children relate the reward to the eating behaviour. They tell us they actually like the taste of the new foods! See themselves as F&V eaters The whole school approach means a new culture is created within the schools that promotes healthy eating. Feedback from parents suggests family eating habits change for the better as a result of the FD programme. The Programme creates a culture, both at school and at home, that strongly supports the eating of fruit and vegetables.

Changing children’s eating habits for life Take Up Ireland National Roll-out to all primary schools (3,300 schools in total; 200,000 children have now participated). England- (SFT; DoH; HDC; Worshipful Company of Fruiterers) Wolverhampton : Roll-out to 84 schools; 20,000 children. Bedfordshire: Initial roll-out to 9 schools in 2009; 4 schools in 2010. Selby: small pilot in 2 schools. Other regions: are also interested in piloting the scheme. Ireland - National rollout funded by the Government. CLICK England - supported by …. Wolverhampton, Bedfordshire, Yorkshire and negotiating with other areas Abroad, Sicily, California pilots. Negotiating with Utah, US and Worldwide Pilot projects in Sicily and California, US; negotiations with Utah, US and Sydney, Australia. Changing children’s eating habits for life

The Food Dudes Programme Changing children’s eating habits for life

Changing children’s eating habits for life Phase 1 (16 days) Days 1-4: Children earn a reward by tasting both their fruit and vegetable. Days 5-16: Children earn a reward by tasting by eating a portion of their fruit and a portion of their veg. A portion is roughly the amount that fits into the child’s cupped hand CLICK Days 1-4 …. Days 5-16 Portion - cupped hand Changing children’s eating habits for life

Changing children’s eating habits for life Phase 2 (ongoing) Focus shifts to F&V eaten at school lunchtime. Day 17: - Reward given for home consumption during Phase 1. Homepack 2 (letter and F&V boxes). Ongoing: Children receive handstamps for eating F&V at lunchtime. Teachers record progress on a classroom Wallchart. Rewards given when children achieve targets on the Wallchart. CLICK Phase 2 - ongoing. Focus at lunchtime. Home consumption rewarded and FD boxes given in to all children. Throughout the remainder of the school year and beyond…. Handstamps, wallchart, certificates awarded in Assembly. Changing children’s eating habits for life

Award Winning Programme Changing children’s eating habits for life World Health Organisation - combating obesity Caroline Walker Trust - changing children’s diets Social Marketing Centre - Showcase Award FD programme has won several awards WHO, Caroline Walker Trust, NSMC Exemplar Study Changing children’s eating habits for life

Changing children’s eating habits for life Fun and Effective Huge appeal for parents and teachers - 99% approval. Meets needs of Governments, Health Organisations and Industry. Recommended Programme in the 2010 Conservative Green Paper – “A Healthier Nation”. FD is enjoyable and effective. CLICK Kids love it. Parents love. Politicians have discovered the programme and realised it’s effectiveness - hence Tory Green Paper recommends the FD programme. I WILL NOW HAND OVER TO SALLY, WHO WILL PRESENT SOME OF THE EVIDENCE OF THIS EFFECTIVENESS IN STUDIES CONDUCTED TO DATE …. Changing children’s eating habits for life

Changing children’s eating habits for life Evidence From schools in Ireland, London and Wolverhampton Changing children’s eating habits for life

Fruit and Vegetable PROVISION Fruit and Vegetable CONSUMPTION Ireland Fruit and Vegetable PROVISION (in packed lunches) Fruit and Vegetable CONSUMPTION (from packed lunches) 20 40 60 80 100 120 140 Before 131 10 20 30 40 50 60 70 80 90 100 93 42 After 12 months grammes provided grammes consumed 68 63 49 34 63 Irish Experimental Evaluation (packed-lunches only, no school meal system). Food Dudes school got the Programme, the Control School got 16 days of F&V First graph shows grams of F&V provided by parents Second graph shows grams of F&V consumed by children At baseline (before FD) provision is about 60-70g 12 months after FD provision increases to 131g (nearly doubles), but remains the same in the control school Same pattern of results seen for consumption Programme is very effective at not only increasing children’s consumption of F&V but also increasing parental provision of these foods Food Dudes School Control School Food Dudes School Control School Horne et al. (2009) Increasing parental provision and children's consumption of lunchbox fruit and vegetables in Ireland: the Food Dudes intervention. Eur. J. Clin. Nutr. 63, p613-618.

London Poorest Eaters Food Dudes School Control School 68 48 70 Fruit Vegetables 60 48 43 50 % consumed 40 30 20 2 Schools in Brixton, London - 80% non-british attended 700 children 1 Food Dudes 1 Control F & V + DVDs and Rewards F & V % consumed@ LUNCHTIME - school canteen Red - fruit Green - veg POOREST EATERS - those who ate under 20% or less of provided F & V FD School: BASELINE - F & V for 2 weeks INTERVENTION - 16 DAYS DVD & Rewards Follow-up - 4 months About a third in the Experimental School who ate just 4% of fruit and 11% of veg. But when the intervention was introduced there was a massive increase and at follow-up there was still a 12-fold increase in fruit and a 400% increase in vegetable consumption compared to baseline. The control group data are fascinating because again they show that simply giving fruit and vegetables to these kids has no real impact on their consumption which stays at an appallingly low 5-7%. These results show that simply making fruit and vegetables available to kids without the support of a programme like the Food Dudes, is a waste of resources. 11 5 7 2 7 4 10 4 Before After 16 Days After 4 Months Before After 16 Days After 4 Months Before After 16 Days After 4 Months Before After 16 Days After 4 Months NB. Average daily portion weight presented = 83g of fruit or 60g of vegetables

Changing children’s eating habits for life Wolverhampton 6 Experimental Schools. 24 hour food diary (DIET24) recorded consumption at different eating occasions throughout the day, both at home and at school. Number of portions of fruit and veg consumed. Results show large significant increases in both fruit and vegetable consumption, particularly in the Poorest Eaters. Changing children’s eating habits for life

* * * Wolverhampton Daily Fruit & Veg Consumption (at Home and School) Whole School Poorest Eaters (<2portions per day) 1.92 * Fruit 0.0 0.4 0.8 1.2 1.6 2.0 * 1.10 1.61 Vegetables 1.37 * 0.87 1.30 Portions Consumed POST = approx. 4months after Phase 1 Whole School 0.5 portion increase in fruit consumption 0.6 portion increase in veg consumption 1.0 portion increase Poorest Eaters 1.0 portion increase in fruit consumption 1.0 portion increase in veg consumption 2.0 portion increase 0.24 0.41 PRE POST PRE POST PRE POST PRE POST

Displacement of ‘Unhealthy’ Snacks As F&V consumption increased, ‘unhealthy’ snack food consumption decreased. Suggests that F&V displaced other snack food in children’s diets. Changing children’s eating habits for life

Unhealthy Snack Consumption (in School) Wolverhampton Unhealthy Snack Consumption (in School) 0.3 0.4 0.5 0.6 0.7 0.8 0.9 0.63 * 20% reduction 0.79 Portions Consumed 0.16 portion decrease PRE POST

Changing children’s eating habits for life Contact: Pauline Milne National Food Dudes Co-ordinator School of Psychology, Bangor University Tel: 01248 388534 Mob: 07767003036 Email: p.a.milne@bangor.ac.uk www.fooddudes.co.uk Changing children’s eating habits for life

Changing children’s eating habits for life Some testimonials from parents…… ‘He has increased the variety of fruit he eats and is keen to select when shopping…. Excellent.’ ‘Food Dudes should be introduced into every Primary School.’ ‘The children ate more fruit and veg and asked for less chocolate and crisps!’ ‘I found I was buying more fruit than usual’. ‘I think it was beneficial, it has helped and encouraged all the family to eat healthy. My son is trying to encourage other family members to eat healthy. Changing children’s eating habits for life