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Childhood obesity and prevention: nutrition, cooking, and gardening learning approach for an educational intervention program to increase fruit and vegetable knowledge, preference, and consumptio...
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Content
CHILDHOOD OBESITY AND PREVENTION: NUTRITION,
COOKING, AND GARDENING LEARNING APPROACH FOR
AN EDUCATIONAL INTERVENTION PROGRAM TO
INCREASE FRUIT AND VEGETABLE KNOWLEDGE,
PREFERENCE, AND CONSUMPTION AMONG
ELEMENTARY CHILDREN.
by
Elizabeth K. Mathew
A Professional Dissertation Presented to the
FACULTY OF THE USC SOL PRICE SCHOOL OF PUBLIC
POLICY
UNIVERSITY OF SOUTHERN CALIFORNIA
In partial Fulfillment of the
Requirements for the Degree
DOCTOR OF POLICY, PLANNING AND DEVELOPMENT
August 2016
Copyright 2016 Elizabeth K. Mathew
2
DEDICATION
This dissertation is dedicated to God Almighty who has given me the
strength and courage to finish this work. This work also dedicated to my
late parents, Mr. & Mrs. Mathunny, who always loved me unconditionally
and whose good examples have taught me to work hard for the things that
I aspire to achieve. Also, I dedicate my dissertation to my husband, Dr.
Nebu John, and our children, Nichol and Noel, who have been a constant
source of support and encouragement during the challenges of school and
life. I am truly thankful for having them in my life. Without their patience,
understanding, and most of all love, the completion of this work would not
have been possible.
3
ACKNOWLEDGEMENTS
With much sincerity I express my profound sense of gratitude to LaVonna
Blair Lewis, Ph.D., MPH, Professor at the USC Sol Price School of Public
Policy, for guidance, and valuable counsel throughout the course of my
field study. I could not have imagined having a better advisor and mentor
for my study.
Besides my advisor, I would like to thank the rest of my dissertation
committee: Dr. Deborah Natoli, and Dr. Joseph Priester. Dr. Natoli’s
passion for teaching and her leadership style have made a positive
change in my life. Dr. Priester who is a faculty member at the Marshall
School of Business, Marketing Department has provided insightful
comments and encouragement throughout this process.
My sincere thanks also goes to Boys & Girls Club at Stanton where I did
my educational intervention for my field project. Special thanks to Joanna
Gurrae, who coordinated the teaching lessons with me and obtained
parental permission for the pre- and post-surveys. She also allowed me to
use their facility to do the cooking and gardening activities.
4
I also want to thank Robert Pyles Elementary School, the Magnolia School
District, and the Anaheim Achieve after School Program where I did my
control group surveys. I would like to give special thanks to Diana Suarez,
the Program Coordinator, who got the parental consents and
administering the pre- and post- surveys.
I would like to give sincere thanks to Dr. Gatto, Director of LA Sprouts
program, who provided permission to use the LA Sprouts Curriculum for
the Nutrition, Cooking and Gardening lessons.
I also want to thank my friends and colleagues at Marshall School of
Business, especially, Dr. Dennis Rook, Dr. Kristin Diehl, Prof. Hank
Wasiak, Prof. Gary Frazier, Prof. Valerie Folks, Mrs. Helen Pitts and Mrs.
Martha Maimone for supporting me during this worthwhile endeavor.
Finally, I acknowledge the entire faculty at the USC Sol Price School of
Public Policy, as they are truly outstanding professors and are making a
positive difference in students’ lives at USC.
5
TABLE OF CONTENTS
DEDICATION 2
ACKNOWLEDGEMENTS 3
LIST OF TABLES 7
LIST OF FIGURES 8
ABSTRACT 9
CHAPTER 1 – INTRODUCTION 11
1.1 Childhood Obesity and Prevention Overview 11
1.2 Research Problem 25
1.3 Research Question 27
1.4 Research Purpose 28
1.5 Research Method 29
CHAPTER 2 – LITERATURE REVIEW 31
2.1 Introduction 31
2.2 Childhood Obesity Prevalence 31
2.3 Factors Contributing to Obesity 33
2.4 Consequences of Obesity 41
2.5 Prevention Approaches 51
2.6 Summary 66
CHAPTER 3 – METHODOLOGY 69
3.1 Parent Survey 69
3.2 Objectives of Childhood Obesity Assessment 70
3.3 Results 71
3.3.1 Demographics 71
3.3.2 Schools in Stanton 73
3.3.3 Overweight/Obesity Prevalence 73
3.3.4 Perceptions of Overweight and Obesity 74
3.3.5 Physical Activity and Sedentary Behaviors 75
3.3.6 Eating Behaviors 75
3.3.7 Parents’ Income 76
6
3.3.8 Parents’ Education 77
3.4 Intervention Study 79
3.5 Methods 81
3.6 Program Design 81
3.7 Results and Discussions 88
CHAPTER 4 - CONCLUSION 99
REFERENCES 105
APPENDICES 113
Appendix 1 - Childhood Obesity: Parent Survey 114
Appendix 2 - Eating Habits Questionnaire 118
Appendix 3 - Nutrition and Cooking Lessons 123
Appendix 4 - Gardening Lessons 177
7
LIST OF TABLES
Table 3.1 Weight Status by Age 74
Table 3.2 Children’s Daily Sedentary Behaviors 75
Table 3.3 Children’s Eating Behaviors 76
Table 3.4 Lessons Overview of the 12-week Intervention 84
Table 3.5 Composite Measures for Behaviors 97
8
LIST OF FIGURES
Figure 2.1 Literature Review Map 68
Figure 3.1 Percentage of Children living in
Stanton and California 72
Figure 3.2 Stanton Demographics 72
Figure 3.4 Children’s Wt. as a function of Parents’ Income 77
Figure 3.5 Children’s Wt. as a function of Parents’ Education 78
Figure 3.6 Picture of Raised Bed Gardening 85
9
ABSTRACT
BACKGROUND: This was an experimental study to determine whether a
garden based nutrition curriculum would influence knowledge, preference,
and fruit and vegetable consumption among elementary children.
METHODS: The study was conducted at the afterschool program at Boys
& Girls Club, City of Stanton and approved by the University of Southern
California Institutional Review Board. The participants for this study were
divided into an experimental group and a control group. Twenty students
participated in the intervention program and completed the 12-week
afterschool program. Meanwhile, twenty, fourth to sixth grade students
from the Anaheim Achieve afterschool program, who were not enrolled in
the intervention program, served as the control group. The Boys & Girls
Club participants received weekly 75 minute, interactive classes for 12
consecutive weeks during January to April 2016. The nutrition, cooking
and gardening curriculum were used from the LA Sprouts web-site with
the permission of Dr. Gatto, the Director of the LA Sprouts. A
questionnaire was used to determine pre-post differences. It consisted of
five subscales assessing participants’ fruit, vegetable consumption per
10
day, dietary assessment, background information, and family eating
habits.
RESULTS: Compared to pre-measures in the experimental group, after
the intervention, the participants of the experimental group ate more fruits
on average day (2.13 vs. 3.17; p=.001); vegetables (2.38 vs. 2.81;
p=.088); spinach (1.29 vs. 1.86; p=.026); wheat bread (1.56 vs. 2.31;
p=.009), and exercised more on average (2.75 vs. 3.42; p=0.039). There
were significant differences between the control and experiment
responses for family eating habits. Participants in the experimental group
had household members encouraging them to eat vegetables less often
than their counterparts in the control group, but ate peas/lima beans more
often and eggs less often per day.
CONCLUSIONS: The results of this study suggest that the garden based
nutrition program resulted in significant positive changes in nutrition
knowledge, preferences, and consumption among elementary children.
Further study needs to be conducted to determine the long-term impact.
11
CHAPTER 1 – INTRODUCTION
1.1 Childhood Obesity and Prevention Overview
Definition of Overweight and Obesity
Obesity can be defined as a Body Mass Index (BMI) of 30 and above.
BMI is a measurement used to determine whether a child is overweight or
obese. The BMI, a key index for relating body weight to height, is a
person’s weight in kilograms (kg) divided by their height in meters (m)
squared. Overweight is determined as a BMI at or above the 85
th
percentile for children of the same age and sex. Obesity is determined as
a BMI at or above 95
th
percentile for children of the same age and sex.
These cutoffs, which were set for a base population surveyed in the early
1970s before obesity began to increase, yield a specific, fixed BMI cutoff
used to define overweight and obesity for boys and girls of each age
(Dietz, 1999). Overweight is defined as having excess body weight for a
particular height from fat, muscle, bone, water, or a combination of these
factors. On the other hand, obesity is defined as having excess body fat.
Overweight and obesity are the result of “caloric imbalance”—too few
calories expended for the amount of calories consumed—and are affected
by various genetic, behavioral, and environmental factors. Childhood
12
obesity has more than doubled in children and tripled in adolescents in the
past 40 years (Krebs, 2007).
Obesity Prevalence among Children
Over the past four decades, the obesity rate has nearly tripled from 5
percent to 14 percent for children ages 2 to 5, increased from 4 percent to
19 percent for children ages 6 to 11, and increased from 5 percent to 17
percent for adolescents ages 12 to 19 (Krebs, 2007). In 1997, the World
Health Organization (WHO) acknowledged that obesity is a major public
health problem. Childhood obesity rates are skyrocketing around the
world. WHO predicts that in 2017, 2.3 billion people will be overweight
and more than 700 million people will be obese (WHO 2011). According
to the World Health Organization, 43 million children younger than 5 years
of age are classified as overweight or obese (WHO 2011).
Childhood obesity in the US: According to National Health and Nutrition
survey, an estimated 17% of children ages 2-19 are obese. The
percentage of children aged 6–11 years in the United States who were
obese increased from 7% in 1980 to nearly 18% in 2010 (Krebs, 2007).
Similarly, the percentage of adolescents aged 12–19 years who were
obese increased from 5% to 18% over the same period. This rate has
13
nearly tripled over the past 4 decades. There are significant disparities in
access to healthy food, affordable food, and access to parks and
recreations in obesity prevalence among US children.
Childhood obesity in California: The California Center for Public Health
Advocacy and the UCLA Center for Health Policy Research examined
geographical variation by city in rates of overweight and obesity among
5th, 7th, and 9th grade school children in California. The studies show
that 38% of 5th, 7th, and 9th grade in California children are obese. 75%
of overweight teens are likely to be obese as adults. 80% of children
diagnosed with type 2 diabetes are overweight. California spends more
public and private money on the health consequences of obesity than any
other area (UCLA, 2010).
Why Focus on Childhood Obesity?
The growing rate of childhood obesity is receiving increasing national
attention and recognition. Childhood obesity has significant health, social,
and financial consequences. Overweight children are at risk for numerous
chronic conditions in adulthood (Krebs, 2007). The increasing prevalence
of childhood obesity puts these children at risk for several diseases and
other associated health problems. Obese children have high blood
14
pressure, undesirable serum lipid levels, insulin resistance, as well as
calcifications in the coronary arteries and the aorta. In the past, it was
generally thought type 2 diabetes was restricted to adults and did not
affect children. However, over the past two decades as childhood obesity
has increased, there has been a tremendous increase in type 2 diabetes
in children and adolescents.
Socially, obese children are often the targets of stigmatization which can
have a significant impact on their emotional well-being. Overweight and
obese children are often teased, called names, and the subject of weight-
related jokes. Obese children and adolescents suffer from social isolation
and associated emotional consequences such as lower self-esteem,
emotional distress, anxiety, depression, and suicidal thoughts and
attempts. Compared to normal weight peers, obese children tend to be
less physically active, withdraw from social situations, and participate in
fewer activities.
In addition to the health impacts of obesity, the economic costs are
substantial. Among children and adolescents, annual hospital costs
related to obesity were nearly 3.5 times higher between 1997 and 1999.
Furthermore, the current estimated range of annual national health
15
expenditures associated to obesity is expected to increase given the
growing rates of childhood obesity and the likelihood of children becoming
obese adults.
Factors Contributing to Obesity
Childhood obesity is a complex health issue and it occurs when energy
intake exceeds energy expenditure. A variety of factors contribute to a
child’s obese state, many of which are preventable through healthy
lifestyle choices, such as balanced eating, and physical activity.
Environmental factors, lifestyle preferences, and cultural environment
seem to play major roles in the rising prevalence of obesity worldwide
(Dehghan, et al., 2005). Children may also be at risk of becoming obese
due to genetics, psychological and socioeconomic factors, and familial
influence (Mayo Clinic, 2008). In a small number of cases, childhood
obesity is due to genes such as leptin deficiency or medical causes such
as hypothyroidism and growth hormone deficiency or side effects due to
drugs (Link K, et al., 2004). Most of the time, however, personal lifestyle
choices and cultural environment significantly influence obesity.
16
Energy or caloric intake, physical activity levels, and sedentary behaviors
are important behavioral factors that may contribute to childhood obesity.
Today’s population of children and adolescents are generally consuming
excess energy in several different forms. Contributing factors of excess
energy intake are: the large portions of food and drink that are offered at
most restaurants, eating meals out of the home, frequent snacking on
energy dense foods, and drinking beverages such as soda pop and
energy drinks with high levels of sugar. There is growing evidence of the
association of consuming excess sugar-sweetened drinks with a high
number of calories and weight gain in youth. In addition to this, liquid
forms of energy are not as filling and can lead to more intake of calories
(CDC, 2009).
Because of technological advances, it is often possible to acquire a variety
of highly palatable foods, in larger portion sizes, and at relatively low cost.
Research has revealed a progressive increase from 1977 to 2008, in the
portion sizes on many types of foods and beverages available; and the
concurrent rise in obesity prevalence has been noted (Nestle, 2009).
Foods eaten outside the home are becoming more important in
determining the nutritional quality of American’s diets, especially for
children. Increased time demands on parents, especially working
17
mothers, have shifted priorities from parental meal preparation toward
greater convenience, and the effects of time pressures are seen in
working mothers’ reduced participation in meal planning, shopping, and
food preparation. Another aspect of this trend toward convenience is an
increased prevalence, across all age groups of children and youth, of
frequent snacking and deriving a large proportion of total daily calories
from energy dense snacks (Jahns, et al., 2009). At the same time, there
has been a documented decline in breakfast consumption among both
boys and girls. There are also indications that children and adolescents
are not meeting the recommended daily minimum of five servings of fruits
and vegetables, which is the amount suggested by the Food Guide
Pyramid (Jahns, et al., 2009).
Physical activity is classified into different types including recreational and
or leisure time. National surveys conducted over the past years suggest
an increase in population-wide physical activity levels among men, women
and children; however, a large proportion of these populations still do not
meet the federal guidelines for recommended levels of total daily physical
activity. The amount of time that adults and children spend walking and
biking as a form of transportation has declined in the past years, largely
because people are driving more (Nestle, 2009). Driving children to and
18
from school via motorized vehicles has increased though this represents a
small proportion of their overall travel. National Household Travel Survey
indicated that less than 15 percent of children aged 5 to 15 years walked
to or from school and 1 percent rode their bicycles. Even children living
very close to school do not walk due to safety concerns.
Genetics may cause an increase in susceptibility in weight gain for youth,
but genetics must exist in combination with environmental and behavioral
factors to have a significant impact on the development of obesity. In
some cases, genetics can play a significant role in causing obesity, but the
outstanding rise cannot primarily be from genetics alone. The populations’
genetic characteristics have not changed as strikingly in the last three
decades yet the prevalence of childhood obesity has climbed to nearly
three times its value thirty years prior. Behavioral and environmental
factors must be examined in addition to the possibility of genetic attribution
(CDC, 2009).
According to CDC, American society has become characterized by
environments that promote increased consumption of less healthy food
and physical activity (CDC 2012). It can be difficult for children to make
healthy food choices and get enough physical activity when they are
19
exposed to environments in their home, school, afterschool program, or
community influenced by –
Advertising of less healthy foods
Foods high in total calories, sugars, salt, and fat, and low in
nutrients are highly advertised and marketed through media
targeted to children and adolescents (IOM, 2005)
No safe and appealing place, in many communities, to play or
be active
Many communities are built in ways that make it difficult or unsafe
to be physically active. For some families, getting to parks and
recreation centers may be difficult, and public transportation may
not be available. For many children, safe routes for walking or
biking to school or play may not exist (CDC, 2012).
Limited access to healthy affordable foods
Some people have less access to stores and supermarkets that sell
healthy, affordable food such as fruits and vegetables, especially in
rural, minority, and lower-income neighborhoods (Larson, et al.,
2009). Choosing healthy foods is difficulty for parents who live in
areas an overabundance of food retailers that tend to sell less
20
healthy food, such as convenience stores and fast food restaurants
(Larson, et al., 2009).
Greater availability of high-energy-dense foods and sugar
High-energy-dense foods are ones that have a lot of calories in
each bite. Sugar sweetened beverages are the largest source of
added sugar and an important contributor of calories in the diets of
children in the United States (Reed, et al., 2010). High
consumption of sugar sweetened beverages, which have few, if
any, nutrients, has been associated with obesity (Vartanian, et al.,
2007). On a typical day, 80% of youth drink sugar sweetened
beverages (Wang, et al., 2008)
Some of the Obesity Prevention Approaches
In order to decrease the prevalence of obesity in children and youth in the
United States, we need to develop a prevention-focused action plan. The
primary emphasis to prevent obesity is on examining the behavioral and
cultural factors, social constructs, and other broad environmental factors
involved in childhood obesity and identifying approaches for preventative
efforts. In order to develop a prevention-focused action plan we need to
include many different segments of society from federal, state, and local
21
governments to industry and media, local communities, schools, parents,
and families. Also, social marketing can play a role in preventing
childhood obesity. Some of the prevention approaches in detail.
1. Healthy Marketplace and Media Environments. Children, youth
and their families are surrounded by a commercial environment
that strongly influences their purchasing and consumption
behaviors (Koplan, et al., 2005). Children’s health related
behaviors are influenced by exposure to media messages
involving foods, beverages, and physical activity. Research has
shown that television advertising can affect children’s food
knowledge, choices, and consumption of particular food
products, as well as their food purchase decision made directly
and indirectly through parents (CDC, 2012).
2. Healthy Communities. Encouraging children and youth to be
physically active involves providing them with places where they
can safely walk, bike, run, skate, play games, or engage in other
activities that require energy expenditure (Koplan, et al., 2005).
Health-care professional, including physicians, nurses, and
other clinicians, have a vital role to play in preventing childhood
22
obesity. As advisors both to children and their parents, they
have the access and influence to discuss the child’s weight
status with the parents and make recommendations on dietary
intake and physical activity throughout the child’s lives (Koplan,
et al., 2005). Many factors in the community setting affect the
health of children and youth. Does the design of the
neighborhood encourage physical activity? Do facilities for
entertainment and recreation exist within the community, are
they affordable, and do they encourage healthful behaviors?
3. Healthy School Environment. Schools are one of the primary
locations for reaching the nation’s children and youth. The
school environment has the potential to affect national obesity
prevention efforts because of the population reach and the
amount of time that students spend at school each day (Koplan,
et al., 2005). Both inside and outside of the classroom, schools
present opportunities for the concepts of energy balance to be
taught and put into practice as students learn about good
nutrition and physical activity, engage in physical education, and
make food choices during school meal times. All foods and
23
beverages sold or served to students in school should be
healthy and meet an accepted nutritional content standard.
4. Healthy Home Environment. Parents have a profound influence
on their children by fostering certain values and attitudes by
rewarding or reinforcing specific behaviors, and by serving as
role models (Koplan et al., 2005). A child’s health and well-
being are thus enhanced by a home environment with engaged
and skillful parenting that models, values, and encourages
healthful eating habits and a physically active lifestyle. Parents
play a fundamental role as household policy makers. They
make daily decisions on recreational opportunities, food
availability at home, and children’s allowances; they determine
the setting for foods eaten at home; and they implement other
rules and policies that influence healthful eating and physical
activity. The family is thus an appropriate and important target
for interventions designed to prevent obesity in children through
increasing physical activity levels and promoting healthful eating
behaviors.
24
5. Social Marketing. The primary goal of social marketing is to
benefit society. Studies have shown that social marketing can
effectively influence behavioral change and should be used in
programs to encourage healthier eating among children. Social
marketing has been used in the context of community-based
obesity prevention programs to promote behaviors such as
increased parent-child communication and improved family
health. For example, nutrition and physical activity messages
promoted by the ‘1% milk’ campaign in California, the Centers
for Disease Control and Prevention’s, ‘VERB: It’s What You Do’
campaign, and ‘5-4-3-2-1 Go!’ campaign in Chicago have
targeted parents in order to encourage them to change the
home health environment, and talk to their children about health
behaviors. Social marketing also can encourage parents to
adopt protective behaviors by depicting positive parental role
models creating a healthy home environment. There are
opportunities to prevent childhood obesity at the family, school,
and community levels.
At the individual-level, promotion and product strategies can
directly reach individuals and nudge them to change nutrition
25
and physical activity habits for the better (e.g., reduce
processed and low-nutrient dense foods). At the family level,
programs can reduce childhood obesity risk factors by changing
parental behavior. Promotions aimed at individual parents can
suggest small changes in food choice, such as buying one less
package of processed snack foods and one more fruit or
vegetable item each shopping trip. Social marketing can also
operate at the school level, and there are many examples of
successful school-based campaigns to change student’s
nutrition and exercise patterns through environmental changes
such as cafeteria and vending interventions as well as
promotional advertising. At the community level, social
marketing has shown evidence of effectiveness in promoting
nutrition and physical activity among parents and children.
1.2 Research Problem
A wide range of genetic, biological, behavior and environmental factors
have contributed to the increase in childhood obesity (Drewnowski,
2004). However, energy imbalance resulting from physical inactivity
and excess energy intake are considered the most important factors.
26
Over the past several decades, major societal changes have affected
physical activity. Children also spend a substantial amount of time
doing sedentary activities such as watching TV, playing video games,
and browsing the Internet.
At the same time, there has been an increase in the marketing,
availability, appeal, affordability and consumption of foods and
beverages that are in low in nutrients but high in fat, sugar, and
calories. For example, fast food restaurants have become a major
source of food. Moreover, foods high in sugar and fat are now made
available to children via vending machines, snack bars; in this way,
other food sources are displacing healthy foods and contributing to
excessive fat intake.
Childhood obesity has significant ramifications for children’s physical
health, both in the immediate and long term, given that obesity is linked
to risks for several chronic diseases. In a population-based sample,
approximately 60 percent of obese children aged 5 to 10 years have at
least one physiological cardiovascular disease risk factor such as
elevated total cholesterol, triglycerides, insulin, or blood pressure and
25 percent have two or more cardiovascular disease risk factors
27
(Freedman, et al., 1999). The increasing incidence of type 2 diabetes
in young children is particularly astonishing. For individuals born in the
United States in 2000, the lifetime risk of being diagnosed with
diabetes at some point in their lives is estimated at 30 percent for boys
and 40 percent for girls if obesity rates level off.
Childhood obesity is a continuously growing problem in today’s society
(Childhood Obesity Facts, 2014). Identified risk factors such as poor
nutrition and inadequate physical activity are important in
understanding the etiology of obesity. Educating children about
healthy eating, the importance of physical activity, and obesity facts is
critical to ending the obesity.
1.3 Research Question
The research question for my topic is, “Can nutrition based education
programs (nutrition, cooking and gardening) help to increase Fruit and
Vegetable knowledge, preference, and consumption among
elementary children?
28
This project aims to help children lose weight, or maintain a healthy
weight; motivate them to eat more fruits and vegetables; and teach
them to prepare and eat healthier meals through 12 weeks of
gardening, nutrition, and cooking lessons.
1.4 Research Purpose
The purpose of this study was to determine the effectiveness of a
garden-based Nutrition intervention program in influencing and
motivating elementary school children in their preference from fruits
and vegetables. The result of this study shows that this educational
intervention program focused on gardening, nutrition, and cooking can
increase fruit and vegetable preference, and consumption among
elementary school children. Therefore, we can use this pilot study as a
model for schools and after school programs. For example, schools
give a certain importance to sports and most of the schools have their
own gym, but no school garden or a nutrition program. Also, we can
promote this study to religious organizations and community centers in
order to teach children on how to live a proper healthy life.
29
1.5 Research Method
Childhood obesity rates have increased, more than tripled, in the last
decade (Childhood Obesity Facts, 2014). Children who are obese
have a 70 percent chance of becoming obese adults. Obesity causes
many health problems and severely affects one’s quality life. This
studied program, taught at the Boys & Girls Club located in the City of
Stanton, demonstrated that a gardening and nutrition intervention
improves dietary intake in children. These intervention classes were
taught during 75-minute sessions once a week for 12 weeks during
Spring 2016. Sessions started with participants receiving a 45-minute
nutrition education lesson taught by myself and a Club staff member or
graduate student trained in nutrition. The nutrition lessons focused on
increasing fruit and vegetable intake. Following the Nutrition lessons,
the participants received a 30-minute gardening lesson. The
gardening curriculum helped the children to learn and participate in
planning, growing, and harvesting fruits and vegetables. The
curriculum was developed with the help of the LA Sprouts. A pre and
post survey method used to assess the effectiveness of the
educational intervention and descriptive statistics was used to interpret
30
the results, in which testing was performed 1 week before and 1 week
after the 12-week intervention.
Educating children about healthy eating, the importance of physical
activity, and obesity facts is critical to ending the obesity epidemic. If
educational intervention is effective in increasing obesity awareness
and educating children about diet and nutrition, then this may prevent
the increasing childhood obesity. In addition to preventing obesity, this
program will not only help children be more knowledgeable about
healthy lifestyles, but will also help them engage in healthy behaviors
which will then not only benefit their own health, but benefit that of their
families, community, and society.
31
CHAPTER 2 – LITERATURE REVIEW
2.1 Introduction
In the review of the literature, current and historical research studies
pertaining to childhood obesity issues are examined. Also, health
consequences and the risk factors for childhood obesity are discussed
in this chapter. This review explores current prevention strategies
within schools and after school programs.
2.2 Childhood Obesity Prevalence
Obesity, especially childhood obesity, is one of the biggest issues
present in U.S. health. Russell (2009) points out that about two-thirds
of American adults and 25 million American children are overweight or
obese, which puts them at an increased risk for diabetes,
hypertension, heart disease, stroke, sleep apnea, respiratory
problems, and some cancers. According to Russell, the fundamental
cause of overweight and obesity is an energy imbalance between
calories consumed through eating and calories expended through
activity. His study also shows that since 1970, the prevalence of
32
overweight among children between the ages of 2-5 years has doubled
and that of children and adolescents between the ages of 6-16 years
has tripled. More than 17% of children and adolescents are now
considered overweight or obese.
One of the recent studies, Ogden, et al. (2014) pointed out that more
than one-third of adults and 17% of youth in the United States are
obese, although the prevalence remained stable between 2003-2004
and 2009-2010. For their study, weight and height or recumbent
length was measured in the 2011-2012 nationally representative
National Health and Nutrition Examination Survey. The purpose of this
study was to provide the most recent estimates of childhood obesity
and analyze trends in childhood obesity between 2003 and 2013.
According to their study, in 2011-2012, the prevalence of obesity in the
United States was 16.9% in youth and 34.9% in adults. They
concluded that the overall prevalence of obesity among youth
remained unchanged compared with that in 2009-2010, and there was
no significant change since 2003-2004. Their study also showed that
between 2008 and 2011, significant decreases were reported among
low-income pre-school aged children participating in federal nutrition
programs in 18 states and the US Virgin Islands. These results show
33
the importance of the nutrition program, which will be relevant to the
field of study.
2.3 Factors Contributing to Obesity
Caprio and Genel (2005) described childhood obesity as the most
widespread and preventable nutritional disorder of the twenty-first century in
the United States. According to the CDC (2007), genetics, behavioral, and
environmental factors influence childhood obesity. The etiology of obesity is
an imbalance between calorie intake and energy expenditure (Hagarty et
al., 2004). Genetic risk factors include high birth weight, maternal diabetes,
familial history of obesity, and early menarche. If one Parent is obese, there
is a 40% chance that the child will be obese in childhood; this risk increases
to 80% if both parents are obese (Hagarty, et al., 2004). These risk factors
can lead to obesity through a cycle of weight gain, which then contributes to
a further decrease in physical activity and other health complications. An
example of this cycle was seen in the longitudinal study 5-year-old Pima
Indian children in Arizona. Salbe, et al. (2002) reported that the percentage
of body fat at 5 years of age was a factor in determining the percentage of
body fat at 10 years of age.
34
Behaviors, such as a regular diet of fast food, can lead to an increase in
caloric intake and childhood obesity. According to Gance-Cleveland and
Bushmiaer (2005), fast foods are more accessible than ever, with many of
these foods being processed, prepackaged, and containing high levels of
sugar and fat. The availability and choice of items such as soft drinks and
processed food from vending machines has become the accepted behavior
of today’s culture. These authors note that meals eaten outside of the home
have been shown to be a barrier in maintaining a healthy diet. The
accessibility of fast food restaurants and the “super-sized” mentality have
allowed for increased portion size and high caloric intake (Gance-Cleveland,
et al., 2005).
Sallis, et al. (2006) believes that sedentary recreational behaviors, such as
watching television and videos, using computers, and playing video games,
are important parts of young people’s daily lives. They are also risk factors
for obesity in children, and reducing such behaviors is another strategy for
preventing childhood obesity. According to Sallis, et al research is
beginning to document connections between the built environment and
sedentary behaviors. For example, without safe places to play near home,
children may spend more time being inactive indoors. Likewise, heavy
35
traffic reduces the likelihood of children’s walking and may thus keep them
indoors, where they remain sedentary.
James, et al. (2004) points out that energy imbalance is the reason for
excessive weight gain, whether the main cause is genetic, endocrinal or
idiopathic. A contributory factor seems to be the consumption of
carbonated drinks sweetened with sugar. These have a high glycemic
index and are energy dense. These authors noted that children who drink
one regular carbonated drink a day average of 10% more overall energy
intake than non-consumers. The objective of their study was to determine
if a school based educational program aimed at reducing consumption of
carbonated drinks actually helped prevent excessive weight gain in
children. Their project, which lasted almost one year, used children aged
7 to 11 years from six elementary schools. The result shows that their
program was effective. At the end of their 12-month study the intervention
group showed a significant increase in consumption of water.
Nestle (2003) believe that the obesity rate had increased because of
lifestyle patterns such as women working outside of the home, and their
longer working hours. She also points out that one result of our
overabundant food supply is an increase in the amounts of food sold and
36
consumed at any one time. Larger portions have more calories, and
people tend to eat more when confronted with large amounts of food. Her
findings clearly showed that portion sizes of many foods increased and,
consequently, increased in calories.
Environments such as homes, childcare centers, schools and
communities are all factors that influence behaviors related to physical
activity, and all have an impact on childhood obesity according to Koplan,
et al. (2005). The increased hour of television viewing, computer usage,
and video-game playing decreases the adolescents’ opportunity for
outside play and other physical activity (Drohan, 2004). According to a
survey conducted by Action for Healthy Kids, fewer than 25% of American
children get at least 30 minutes of any type of physical activity every day.
Within the community, access to physical activity opportunities and access
to affordable and healthy foods also are examples of methods that can be
used to reverse the rising prevalence of childhood obesity (Koplan et al.,
2005). Researchers, Sallis and Glanz, have found many links between
the built environment and children’s physical activity, but they have yet to
find conclusive evidence that verifies that the built environment promotes
obesity. For example, certain development patterns, such as a lack of
sidewalks, long distances to schools, and the need to cross busy streets
37
discourage walking and biking to school. Eliminating such barriers can
increase rates of active commute. Salis and Glanz note that recent
changes in the nutrition environment, including greater reliance on
convenience foods and fast foods, a lack of access to fruits and
vegetables, and larger portion sizes, are also widely believed to contribute
to the epidemic of childhood obesity.
According to Hesketh, et al. (2005) preventive health strategies
incorporating the views of target participants have improved the likelihood
of success. They did a qualitative study aimed to illicit child and parent
views regarding social and environmental barriers to healthy eating,
physical activity and childhood prevention programs. Their first aim was
information and awareness. Children were well informed about the health
value of different foods, could identify the healthy and unhealthy foods,
and were aware of the nutrients contributing to their perception of foods
being more or less healthy. They also conducted a focus group for
parents. A series of questions were used to promote discussion. From the
focus group, the researchers Hesketh, et al. found that parents believed
their children knew which foods were healthy, but suspected they did not
fully comprehend the consequences of eating unhealthy foods. This study
also shows that parents themselves, although generally well informed,
38
requested more parent education on healthy eating for children. Parents
also reported the need for strategies to encourage their children to eat
healthy foods and be more physically active, and strategies to resist the
demands of their children for unhealthy foods. They also point out the
barriers to a healthy lifestyle. Car fumes, pollution, roads that are unsafe
for child cyclists, lack of playground equipment, and general safety
concerns were all nominated as barriers to children being more physically
active in their local community. Children from lower socio-economic
families reported that money is a barrier when it comes to participating in
extracurricular activities and physical activity. Many children suggested
that junk foods, or unhealthy foods, are irresistible, taste better, and are
addictive. Parents similarly recognized that aspects of the local
environment could discourage children’s physical activity and healthy
eating. Safety concerns and the increasing distances between children’s
homes and schools were cited as the main obstacles to physical activity,
in addition to distractions within the home, small backyards, and reduced
time for physical activity at school. Lack of parent time was reported to be
a major barrier to children participating in organized sport. Increasing
numbers of fast food outlets and unhealthy options in school cafeterias
were seen as obstacles to healthy eating. Parents acknowledged child
peer pressure as a major barrier to healthy lifestyle; the difficulty of
39
enforcing healthy eating and limiting sedentary activities when their
children want to conform to what their friends are eating and doing.
Hesketh, et al. also found that parents expect schools to take a role in
setting a good example for children, both through provided educational
messages and general policies and school environment.
According to Kopelman (2006) inherited factors play a major role in the
determination of inter-individual differences in fat mass. The identification
of genetic variants influencing human fat mass is critical to obesity
research. In general, rare cases of mutations have been found in children
with extreme obesity. The genetic influences appear to operate through
susceptibility genes, which may be expressed more frequently in certain
ethnic groups (Kopelman, 2006). Such genes increase the risk of
developing a characteristic but they are not sufficient to explain the
development of a disease. Kopelman also believe that changes in lifestyle
are major contributors to the current epidemic of overweight and obesity.
Energy-dense diets rich in fats and refined sugars promote weight gain,
and high sugar and salt intakes also induce an increase in blood pressure.
He point out that energy density is reduced by higher intake of vegetables
and fruit, which results in lower blood pressure.
40
Trust for America’s Health (TFAH), a nonpartisan, nonprofit organization is
dedicated to saving lives by protecting the health of every community and
working to make disease prevention a national priority. The committee of
TFAH testified on a very serious issue-the declining health of America’s
children, which is linked to the obesity epidemic. According to TFAH, the
physical environment and the nutritious environment are the potential
factors that may be contributing to obesity rates. The committee also
notes that children today are eating more and moving less, which
inevitably leads to an increase in weight. Also, they found that many
American children are consuming more calories, eating less healthful
foods, engaging in less physical activity and instead spending more of
their time engaging in sedentary activities. A U.S. Department of
Agriculture report characterized America’s per capita fruit consumption as
“low” and noted that vegetable consumption tells the same story. In
addition to developing poor dietary habits, many children are becoming
less physically active. Furthermore, according to Center for Disease
Control’s Health Program study, only 3.8 percent of elementary schools,
7.9 percent of middle schools and 2.1 percent of high schools provided
daily physical education or its equivalent.
41
2.4 Consequences of Obesity
As the prevalence and severity of childhood obesity increase, concern
about adverse health outcomes in childhood and adolescence is rising
(Daniels, 2006). For example, obesity can cause great damage to the
cardiovascular system, and being overweight or obese during childhood
can accelerate the development of obesity related cardiovascular disease.
Likewise, obesity is linked with many disorders of the metabolic system.
Daniels points that even when the disorders do not present themselves in
childhood, childhood obesity or overweight increases the risk of disorders
developing in adulthood. He notes that many obesity-related conditions
once thought applicable only to adults are now being seen in children and
with increasing frequency. Examples include high blood pressure, type 2
diabetes, fatty liver disease, and disordered breathing during sleep. He
systematically surveys the body’s systems, showing how obesity in
adulthood can damage each and how childhood obesity exacerbates the
damage. He explains that obesity can harm the cardiovascular system
and that being overweight during childhood can accelerate the
development of heart disease. Daniels shows how much the same
generalization applies to other obesity-related disorders-metabolic,
digestive, respiratory, skeletal, and psychosocial-that are appearing in
42
children either for the first time or with greater severity or prevalence. He
concludes, childhood obesity as an issue of utmost public health concern.
In 2008, Freedman, Dietz, Srinivasan, and Berenson used cut points
derived from several national studies to examine the relation of
overweightness to adverse risk factor levels and risk factor clustering.
They used the Bogalusa (Louisiana) Heart study, which is a community-
based study of cardiovascular disease risk factors in early life. The results
of this study indicate that overweight children and adolescents are at a
substantially increased risk for adverse levels of several cardiovascular
risk factors. The prevalence of overweight and obesity is increasing
among youth and their study results demonstrate that even among 7-to-8
year-olds, overweightness is consistently related to several cardiovascular
risk factors. They conclude that because overweightness is associated
with various risk factors even among young children, it is possible that the
successful prevention and treatment of obesity in children could reduce
the adult incidence of cardiovascular disease.
According to U.S. Department of Health and Human Services (USDHHS),
the health impacts of obesity and physical inactivity are dire and can start
at a young age. For example, physical inactivity is tied to heart disease
43
and stroke risk factors in children and adolescents. A number of studies
have documented how obesity increases a child’s risk for a number of
health problems, including the type 2 diabetes, increased cholesterol and
hypertension among children, and the danger of eating disorders among
obese adolescents (USDHHS, 2001). Some studies have shown that
obesity and overweight in children also negatively affect children’s mental
health and school performance. Obese children and adolescents are at
risk for psychological and social adjustment problems, including lower
perceived competencies than normative samples on social, athletic, and
appearance domains, as well as overall self-worth (Schwimmer et al,
2008). They did a cross-sectional study of 106 children and adolescents
who had been referred to an academic children’s hospital for evaluation of
obesity. Compared with healthy children and adolescents, obese children
and adolescents reported significantly lower health-related quality of life in
all previously mentioned domains. They also found that children and
adolescents with obstructive sleep apnea reported a significantly lower
health-related quality of life than obese children and adolescents without
obstructive sleep apnea. They concluded that severely obese children
and adolescents have a lower health-related quality of life than children
and have a similar quality of life as those diagnosed as having cancer .
44
Franks, et al. (2010) studied the effect of childhood risk factors for
cardiovascular disease (CDV) on adult mortality. The rising rates and
increasingly early onset of other chronic diseases such as type 2 diabetes
may also affect mortality rates (Allon, N. 1979). In one study, 70% of
obese children has at least one CDV risk factor, and 39% had two or more
diseases (CDC, 2010). Moreover, early-onset diabetes has been shown
to raise mortality rates, and the relation between cardiovascular risk
factors during adulthood and early death is well defined (Kaplan et al.,
1986). In this study, they assessed the extent to which obesity, glucose
tolerance, hypertension, and hypercholesterolemia in children with
diabetes predicted premature death in American Indians from Arizona.
Risk factors were standardized according to sex and age. Their study
shows that rates of death from endogenous causes among children in the
highest quartile of BMI were more than double those among children in
the lowest BMI quartile. They concluded that obesity, glucose intolerance,
and hypertension in childhood were strongly associated with increased
rates of premature death from endogenous cause in American Indian
population.
Strauss, R. (2000) studied the relationship between childhood obesity and
self-esteem. His study shows that obese white and Hispanic girls
45
demonstrated significantly lower levels of self-esteem by 13 to 14 years of
age compared with healthy, non- obese white and Hispanic girls. In this
study, obese white and Hispanic girls had similar changes in self-esteem.
Unfortunately, no other study has documented the effects of obesity on
self-esteem in Hispanic children. However, data from the Youth Risk
Behavior Survey indicated that 37% of white and Hispanic girls consider
themselves too fat, compared with only 25% of black girls (Strauss, 2000).
His findings demonstrate significant social consequences of decreasing
levels of self-esteem in obese children. Strauss also points out that obese
children with falling self-esteem are also more likely to engage in high risk
behaviors. Although his study demonstrates an association between the
presence of childhood obesity and lower levels of self-esteem in early
adolescence, the relationship remains speculative. Other factors
associated with obesity, such as decreased levels of physical activity,
increased levels of depression, or poorer home environments, may
contribute to lower self-esteem in obese adolescents. Strauss’ study
concluded that obese adolescents with decreasing self-esteem are likely
to report increased levels of loneliness, and, sadness.
Sturm, R. (2002) studied the effects of obesity, smoking, and drinking on
medical problems and costs. Many behavioral risk factors, such as
46
smoking, heavy drinking, and obesity, are known causes of chronic health
conditions. Chronic health conditions, like cancer, diabetes, or heart
disease are primary drivers of health care spending, disability, and death.
Sturm’s paper compares the associations of smoking, problem drinking,
and obesity with health care and chronic conditions. All three factors are
prevalent, although only obesity has dramatically increased over the past
years. He used the data from Healthcare for Communities, a national
household telephone survey with 10000 respondents. Sturm’s study
results show that the effects of obesity on the number of chronic
conditions are significantly larger than the effects of the current or past
smoking or drinking problem. He believes that obesity appears to have a
stronger association with the occurrence of chronic medical conditions,
reduced health-related quality of life, and increased health care and
medication spending than either smoking or drinking. According to
Sturm’s study there are no similar comparisons across these health risks,
but the estimated cost effects of obesity are consistent with recent studies.
This results shows that risk behavior precedes health and spending
impacts.
Reilly, et al. (2003) study shows the short and long-term consequences of
obesity. The aim of their study was to provide a critically appraised,
47
evidence based, summary of the consequences of childhood obesity in
the short term (for the child) and longer term (in adulthood). For the short
term consequences, the results show that obese children are more likely
to experience psychological or psychiatric problems than non-obese
children, which girls are greater risk than boys, and that risk of
psychological morbidity increases with age, low self-esteem and
behavioral problems were particularly associated with obesity (Reilly,
2003). For the long-term consequences, the results show that obesity in
adolescence has adverse effects on social and economic outcomes in
young adulthood. A large body of high quality evidence has shown that
childhood obesity is strongly associated with the presence and clustering
of cardiovascular risk factors in childhood. Obesity in childhood tends to
persist into adulthood. Cardiovascular effects of obesity in childhood
persist and this predicts a strong link between childhood obesity and
morbidity in adulthood; this should be reflected in an increase in future
cardiovascular morbidity as the current generation of obese children
become adults. This evidence makes a strong case for greater efforts
directed at the prevention and treatment of childhood obesity.
Of all the economic issues related to obesity, perhaps the most important
is the cost of its associated health problems. According to the Department
48
of Health and Human Services, obese and overweight adults cost the
United States anywhere from $69 billion to $117 billion per year.
According to Sturm (2002), obese adults’ medical expenses are 36
percent higher than of non-obese adults. Evaluating the costs of
overweight and obesity in childhood and adolescents is difficult because of
a paucity of data. Dietz, et al used hospital discharge diagnoses to
estimate the cost of obesity-related disorders in childhood. They used the
most frequent principal diagnoses where obesity was listed as a
secondary diagnosis and then compared hospital diagnoses. They found
increases in obesity related diagnoses. The results show that asthma
associated with obesity increased from 6 to 8 percent; diabetes associated
with obesity, from 1.4 to 2.4 percent. They also found that time spent as
an inpatient was longer for children with obesity and estimated that
obesity-related inpatient costs were about 1.7 percent of total annual U.S.
hospital costs. Better understanding of childhood obesity costs will help
the health care system determine the best approach in preventing and
treating childhood obesity.
Other obesity-related economic issues may begin in childhood and carry
over into adulthood. The implications of negative stereotyping in
childhood carry into the experience of obese individuals as they enter
49
adulthood. Women who are obese as adolescents are more likely to have
less education, lower earning power, a higher likelihood of poverty, and
lower likelihood of marriage when they become adults. Obese individuals
have more difficulty gaining admission to college, and obese adults may
also experience discrimination in renting apartments and houses. There is
growing evidence documenting the association between obesity and poor
mental health. Adults currently or previously diagnosed with depression
were found to be 60% more likely to be obese, and those with anxiety
disorders were 30% more likely to be obese than their non-anxiety
counterparts (Daniels, S. 2006). Adults with depression or anxiety were
also less likely to engage in regular physical activity.
The poor health of Americans of all ages is putting the nations’ economic
security in jeopardy. Health care cost of obese workers are higher than
non-obese workers. Obese and physically inactive workers also suffer
from lower worker productivity, increased absenteeism, and higher
compensation claims. To maintain our economic competitiveness and our
general health and wellbeing, we must improve the health of America’s
next generation. To do that, we must prevent obesity.
50
Psychosocial issues are other issues related to obesity. These issues
involve psychological health and the ability to relate to family members
and peers. Childhood obesity is also linked with various psychosocial
problems, the best Study of which is depression. According to Daniels, S.
(2014) depression is a common mental health problem in adolescents. In
a long-term study, E. Stice and several colleagues found that body
dissatisfaction, dietary restraint, and symptoms of bulimia are linked to
depression (Stice, E. 2000). Weight issues often cause body
dissatisfaction, but they may affect girls of various ethnic groups
differently. Other studies have documented that obese adolescents
seeking treatment for their obesity have more depressive symptoms than
community-based obese or non-obese control groups.
Depression itself is often associated with abnormal patterns of eating and
physical activity that could result in future obesity; however, obesity may
also result in psychosocial problems that can produce depression. It
appears that obese children and adolescents have difficulties with peer
relationships. Overweight children, for example, tend to have fewer
friends than their non-overweight peers. Mapping childhood social
networks demonstrates that normal-weight children have more social
relationships with a central network, whereas overweight children have
51
more peripheral and isolated relationships in the network. An important
psychosocial issue for overweight children and adolescents is quality of
life. J. S. Schwimmer and colleagues found that obese children and
adolescents reported significantly lower health-related quality of life than
their normal-weight counterparts, and they were five times more likely to
have impaired quality of life. And obese children and adolescents with
obstructive sleep apnea reported even lower quality of life than those
without it, perhaps because of their increased daytime sleepiness.
2.5 Prevention Approaches
Obesity is a chronic disorder that has multiple causes. Dehghan, et al.
(2005) believe that overweight and obesity in childhood have significant
impact on both physical and psychological health. They also believe that
psychological disorders such as depression occur with increased
frequency in obese children. Over-weight children are more likely to have
cardiovascular and digestive diseases in adulthood as compared with
those who are lean. It is believed that both over-consumption of calories
and reduced physical activity are the main factors leading to childhood
obesity. Apparently, prevention strategies seem to be more effective in
children than in adults. A number of potential effective plans can be
52
implemented to target the built environment, physical activity, and diet.
These strategies can be initiated at home, schools or after-school
programs as a natural setting for influencing the diet and physical activity.
Almost all researchers agree that prevention could be the key strategy for
controlling the current epidemic of obesity. Prevention may include
primary prevention of overweight or obesity, secondary prevention or
prevention of regaining weight following weight loss, and avoidance of a
weight increase in obese persons unable to lose weight. The studies
show that most preventative efforts have focused on changing the
behavior of individuals through diet and exercise. For adults who are
overweight and obese, it is difficult to reduce excessive weight once a
certain lifestyle has become established. Therefore, children should be
considered as the population of focus for intervention strategies.
Prevention may be achieved through different intervention approaches
targeting diet and exercise. All in all, there is an urgent need to initiate
prevention and treatment of obesity in children.
According to Lobstein, T. (2010) a rise in the prevalence of overweight
and obesity among children and adolescents occurred in the last half of
the twentieth century in virtually every country of the world. He believes
that the prevention of obesity in children is considered important for two
53
reasons. First, patterns of behavior are learned at an early age, and
unhealthy behavior patterns can lead to a lifetime of increased risk of ill-
health. Second, the pathological effects of obesity are in many cases a
product of the duration and severity of obesity, which varies for each
individual. Lobstein believes that interventions that can maintain or
improve healthy behavior from an early age and prevent long-term obesity
are far more likely to be cost-effective over a longer period than treating
obesity and its related diseases after they have developed. According to
the author, evidence for the effects of different approaches to preventing
child and adolescent obesity and developing dietary and physical activity
patterns is growing rapidly. Also, the author believes that obesity
prevention, like other health promotion strategies, can be approached
using an investment paradigm, in which prevention initiatives are
considered speculative activates. The author concluded that public health
interventions are also considered particularly relevant in the case of
children because children are generally not held responsible for their own
health behavior; their risk of obesity may be determined by prenatal and
child-care influences. In addition, their subsequent health behavior can be
influenced by their family and community environment. For example,
children can be more easily targeted in preschool, school and afterschool
program settings.
54
Evans, et al. (2010) proved that social marketing is another preventive
strategy used to prevent childhood obesity. Their study shows that an
ecological approach to nutrition, along with physical activity promotion has
become widespread in community-based obesity prevention programs.
One aspect of such approaches has been incorporation of social
marketing messages. According to Evans, et al social marketing has
been used in the context of community-based obesity prevention
programs to promote behaviors such as increased parent-child
communication and improved family health. Many social marketing
efforts-such as nutrition and physical activity messages promoted by the
1% milk campaign in California, the Centers for Disease Control and
Prevention (CDC) VERB: It’s What You Do campaign, and the 5-4-3-2-1
Go! Campaign in Chicago-have targeted parents in order to encourage
them to change the home health environment, and talk to their children
about health behaviors. The authors discussed how the social marketing
can encourage parents to adopt protective behaviors by depicting positive
parental role models creating a healthy home environment. They also
discussed how social marketing could be used to promote engagement
and positive role modeling from residents, community leaders such as
religious leaders, nor-profit sectors, and local health and healthcare
55
organizations. They found that social marketing is effective through use of
multiple “P” strategies in changing behaviors.
Behavioral or lifestyle approaches are currently recommended for the
treatment of mild to moderate obesity. These approaches are designed to
help obese individuals modify their eating and exercise behaviors in order
to change energy balance. According to Wing, Rena (2010), most
behavioral programs have common format and content. This type of
program is offered as a series of lessons, and the entire group of
participants receives lessons each week. Research during the period of
1990-2000 was designed to evaluate new strategies that might increase
the magnitude of weight loss achieved in behavioral programs.
Interestingly, years 1990-1995 focused mainly on diet, whereas 1996-
2000 stressed physical activity. Although the continuous study of
approaches to diet and physical activity are done, trials reported between
2000 and 2010 have focused more on maintaining the weight loss over
time and disseminating treatments in a cost-effective manner. The author
points out that one of the important recent achievements has been the
demonstration that the magnitude of weight loss produced by behavioral
weight control interventions is sufficient to produce marked improvements
in health. The author concluded that behavioral treatment programs focus
56
on teaching participants to change their diet and exercise behaviors.
Currently, strong behavioral programs have resulted in weight loss. This
weight loss diminishes cardiovascular risk factors and reduces the
incidence of diabetes. Efforts to improve weight loss results have focused
on strengthening the diet and exercise components of weight loss
programs.
Ozer, E. (2007) studied the effects of school gardens on students and
schools. According to Ozer there are thousands of school gardens in the
United States, and there is evidence that school garden programs can
enhance students’ learning in academic, social, and health-related
domains. Because of the current obesity crisis in the United States and
the potential of school gardens and farm-to-school programs to promote
healthier eating, these models are likely to receive greater attention. The
author points out that the school garden programs provide potential direct
effects on Academic Performance. According to Ozer, some school
garden programs are focused on providing hand-on inquiry to promote
learning about scientific and other concepts consistent with state-
mandated learning objectives. For example, to understand decomposition
of matter, they study scavengers and identify the actions of decomposers
(California Department of Education, 2002). There are also multiple
57
indirect pathways by which school garden programs could affect students’
general academic behavior and performance. School garden programs
could also potentially affect academic achievement and behavior through
other indirect pathways, such as student nutrition and parental
involvement. Prior research indicates that children’s level of attention and
academic performance are affected by their nutritional intake, particularly
at breakfast (Pollitt, et al., 1998). The author concluded that in school
garden programs that grow edible produce, students generally learn
science and nutrition concepts relevant to growing food while they work
the garden. Students harvest the vegetables and, in some programs,
learn to cook nutritious meals from the harvest.
Wang, et al. (2009) show that exposure to a one year school intervention
increases vegetable consumption. The authors believe that the school
has been identified as a key setting for implementing nutrition-related
obesity prevention program in the United States. Because fruits and
vegetables are low-energy dense foods that are high in essential
micronutrients and can be expected to reduce obesity risk, such programs
often aim to increase fruit and vegetable intake. The success of these
programs varies widely; some children have increased knowledge, several
have increased preference for fruits and/or vegetables, and a few have
58
increased consumption of fruit and/or vegetables. Their findings support
the hypothesis that garden- and cooking-based education, along with
changes to the school food environment, has a positive behavioral impact
on a child’s fruit and vegetable consumption. Their findings strongly
suggest that a comprehensive school intervention that includes regular
attendance and hands-on learning in garden and cooking classrooms, in
conjunction with a changed school meal program matched to nutrition,
environment, gardening, and cooking lessons, can be effective in
increasing preference for a variety of fresh produce and fruit and
vegetable consumption among 4
th
to 6
th
grade children in public schools.
They also believe that schools can play an important role in promoting
healthy eating behaviors and preventing obesity; the high societal costs of
obesity, in terms of increased morbidity and mortality, and decreased
economic productivity provide a compelling reason to involve schools in
the fight against obesity.
Koch, et al. (2006) shows the effect of a summer program on the
nutritional knowledge, attitude and behaviors of children. One objective of
this research study was to evaluate the effect of a nutritional education
program, on nutritional knowledge of children, specifically knowledge
about the benefits of eating fruit and vegetables. Additional objectives of
59
the study included evaluating the effect of the nutritional education
program on nutritional attitudes and eating behaviors of children as they
related to fruit and vegetables. The authors believe that nutrition plays a
critical role in the life of a child because of the impact it can have on
growth, development, and the ability to learn. Proper childhood nutrition
not only contributes to mental, physical, and emotional health, but also to
the level of health a person has an adult. Koch, et al. concluded that
children participating in activities from Health and Nutrition programs not
only had improved knowledge concerning the benefits of eating fruits and
vegetables, but also demonstrated an increase in healthier snack
consumption after the study. Their study shows that children’s
preferences toward fruit and vegetables did not significantly improve
during or after participating in the program. But small changes in
knowledge and consumption of children participating in the program may
be important to note since poor dietary behaviors have been associated
with many physical problems, including, anemia obesity, and high blood
cholesterol. In addition, poor dietary practices have been shown to affect
mental growth, academic performance, physical growth, and social
development. Most personal food and exercise habits that continue
throughout life are established by the age of 15 years, and adults who
reported eating five servings for fruit and vegetables daily generally stated
60
that these habits were established in childhood. Since eating habits and
patterns are formed early in life, children are an important target for
interventions to change nutrition behavior.
Hermann, et al. (2006) believe that after-school programs incorporating
gardening provide opportunities for hands-on food, nutrition and physical
activity education for children. For their study, they did a survey of fourth
grade teachers at schools reported to have gardens; 47% reported they
taught nutrition along with the use of gardening and 43% reported they
perceived the garden to be somewhat to very effective at enhancing
children’s eating habits. Another study reported fourth grade children’s
preference for some vegetables improved when in-school gardening was
combined with nutrition education. The purpose of the Hermann et.al
study was to evaluate the impact of after-school education and gardening
program on reported vegetable intake and physical activity among children
in 3
rd
through 8
th
grade. The after-school education and gardening
program was evaluated using two pre/post questions “I eat vegetables
every day” and “I am physically active every day” with a three category
“yes,” “sometimes,” and “no” response scale. The results shows that forty-
three children completed the pre and post evaluation questions, forty-
seven percent were male and fifty-three percent were female. There was
61
a significant increase in the proportion of children reporting “I eat
vegetables every day” and “I am physically active every day” after the
education and gardening program. The authors concluded that
incorporating gardening along with food preparation into nutrition and
physical activity education was an effective way to improve children’s
reported vegetable intake and physical activity in an after-school setting.
Manger, et al. (2012) did a pilot study for obesity prevention in young
school children. They hypothesized that instilling a healthy lifestyle in
school-aged children will favorably impact prevention of excess weight
gain. They adapted the Values Initiative Teaching About Lifestyle (VITAL)
program developed by the National Hypertension Association. The VITAL
program consists of 8 different weekly lessons that teach young children
healthy eating and appropriate physical activity. They observed that
students and teachers readily accepted the VITAL program. The authors
believe that one of the most effective ways of combating excessive weight
gain, obesity, and their complications is prevention in young children,
since changing ingrained lifestyle habits in older children and in adults is
often extremely difficult, if not impossible. It is noteworthy that a
community-based effort to prevent overweight children in France by
promoting healthy eating and increased physical activity was effective-
62
after 5 years, overweight in children has fallen to 8.8%, whereas it had
risen to 17.8% in neighboring communities where no effort had been
made to prevent weight gain (Romon, 2009). Community intervention for
1 year in children in several Massachusetts schools increased healthy
eating and physical activity and prevented excess weight gain (Economos,
2007). Manger, et.al believe that the success of the VITAL program in
preventing excess weight gain by promoting healthy eating and
appropriate physical activity was primarily due to the young age of children
participating in the program. According to the authors the VITAL program
showed promise in improving the lifestyle of children. It is a relatively
inexpensive program, easy to implement, and enthusiastically accepted by
children, parents, teachers, and school administrators.
Castro, et al. (2013) describes a pilot study to evaluate a community
intervention, known as the Growing Healthy Kids Program (GHK), to
prevent childhood obesity among low-income families in a southern state.
The intervention included a weekly gardening session, cooking and
nutrition workshop, and social events for parents and children. According
to the authors, this pilot study evaluates a community-based initiative,
participation in the program was open to all families in the community.
Families were recruited through outreach activities at local schools,
63
childcare centers, the public health department, word of mouth, and
referral. The authors focus attention on the role that community gardens
can play as strategy to prevent childhood obesity, in particular, among
low-income families. Their study results suggest the children who
participated in the GHK community gardening program had an increased
availability of fruits and vegetables they consumed. A recent review of
literature concluded that community gardens seem to be a promising
intervention strategy to increase availability of fruits and vegetables,
especially among low-income families, and thus help reduce childhood
obesity and improve overall health (Johnson, 2006). The authors
concluded that findings from this pilot study are consistent with previous
studies reporting an increase in availability and consumption of fruits and
vegetables among families participating in community gardens.
Studies have shown that eating patterns are developed at an early age
and can be traced into and through adulthood (Sandeno et al., 2000).
Proper adolescent nutrition can reduce overweight and obesity and can
reduce risk factors for diet-related diseases later in life (Odea, 2005). As
results, experts suggest developing interventions and effective nutrition
programming early in a child’s life as a tool for increasing healthful dietary
patterns and reducing the risk of chronic disease later in life (Domel,
64
1993). School based programs represent an important venue for nutrition
behavior change. There is great potential for affecting behaviors and
health risks that persist into adulthood, such as food choices and obesity
(Story, et al., 1996). A study of California teachers found that school
gardens were perceived as an effective tool for promoting healthful eating
habits (Graham et al., 2005). Morris and Zidenberg-Cherr (2005) found
that garden-enhanced nutrition education was effective in improving
nutrition knowledge and vegetable preferences of fourth-grade students.
McAlesse, et al. (2007) study was designed to measure the effects of
garden-based education on fruit and vegetable consumption. The results
from this study illustrate the efficacy of using garden-based nutrition
education when attempting to increase adolescents’ consumption of fruits
and vegetables.
Diet quality in children and adolescents has declined increasingly in the
last few decades and this occurrence has a profound effect on the rise of
childhood obesity. In 2008, Fahlman, Dake, McCaughtry, and Martin
tested the effectiveness of the Michigan Model (MM) Nutrition Curriculum
on nutrition knowledge and eating behaviors in middle school students.
This study used a pre-test, post-test and quasi-experimental design. The
instrument developed consisted of 33 questions, assessing the students
65
eating patterns and knowledge of nutrition facts. The intervention was
conducted by teachers trained in the MM curriculum, and was taught over
a period of one month. The post-test was administered two weeks after
the end of the intervention. Statistical analysis was used to determine
effectiveness by comparing pre/post-tests. The results indicated that
middle school students who were taught the educational lessons not only
increased their nutrition knowledge, but also were more likely to make
healthy changes in their diet. This study is an example of a successful
educational program focusing on prevention of childhood obesity.
In 2010, Thomas and Perera studied school-based programs for
preventing smoking. The primary objective of this study was to assess the
effectiveness of school-based programs in preventing children and
adolescents from smoking. A secondary objective was to assess which
program elements were associated with effectiveness. These researchers
have used five types of interventions in schools, each based on a different
theoretical orientation of the prevention programs such as an information-
giving curriculum, social competence curriculum, social influence
approaches, and multi-model programs.
66
For the information-giving curriculum, participants were presented with
information about smoking, including health risks of tobacco use, and the
prevalence and incidence of smoking. For the influence approaches,
based on McGuire’s persuasive communication theory and Evan’s theory
of psychological inoculation, normative education methods and anti-
tobacco resistance skills training were used. These include correcting
adolescents’ overestimates of the smoking rates of adults and
adolescents; recognizing high-risk situations; increasing awareness of
media, peer, and family influences; teaching and practicing refusal skills;
and making public commitments not to smoke. The high quality study on
information-giving alone reported a significant effect of the intervention.
2.6 Summary
The review of the literature explored the different risk factors that
contribute to obesity, obesity prevalence, consequences of obesity, and
prevention strategies of childhood obesity. The review is strong with
literature pertaining to this study’s primary factors; nutrition, cooking,
garden, and education intervention strategies. The review showed some
positive effects on nutrition knowledge and behavior. However, empirical
evidence is minimal concerning the link between nutrition, cooking,
67
gardening and dietary behavior. Therefore, this study sought to elucidate
the effects of after school program on children’s fruit and vegetable
knowledge, preference, and consumption.
68
Figure 2.1 Literature Review Map
Childhood Obesity Prevention
Obesity
Reilly, J.J. 2010
Risk Factors
Reilly et al 2005
Home
Hesketh et al
2005
Environmental
Kopelman, O.
2007
Diet
Nestle, M.
2003
School
Nauta et al 2009
Maternal
diabetes
Daniels, S.
2006
Familial
History
Obesity
Hart, K.H., &
Bishop, J.
2002
Behavioral
Ogden et al
2014
Genetic
Hagarty et al 2004
Prevention
Dehghan et al 2005
Physical
Activity
Kopelman, P.
2007
Cost
Sturm, R. 2002
Economic
Wang. G, &
dietz, W. 2002
Diabetes
Narayan
et al 2003
Cardiovascul
ar
Freedmal et
al 2008
Health
Reilly et al 2003
Psychosocial
issues
Wight et al 2005
Curriculum
Health
Promotion
Naylor, P. 2008
Health
Awareness
Fahlman et al
2008
Educational
interventions
Veugelers, P.J. 2005
Needs to study: Effects of educational
intervention on children’s knowledge of
fruit and vegetable, preference and
consumption
69
CHAPTER 3 – METHODOLOGY
3.1 Parent Survey
A survey was conducted to identify children’s eating habits and physical
activities related to childhood obesity in the City of Stanton. The
permission was from the Magnolia School District to conduct the survey at
the Robert M. Pyles Elementary School, which is one of the elementary
schools in Stanton. The survey was distributed to the parents of the 5
th
and 6
th
grade students. A survey was also distributed to 200 adults who
have a child attending at the Robert M. Pyles Elementary School. The
survey included 23 questions on the child’s height and weight, the child’s
physical activity and eating behaviors, parents’ education and income, and
the living environment.
Seventy four families responded each with an average of 2-3 children.
The respondents were predominately Hispanic (68%) and females (78%).
A total of 6 percent of the respondents completed college or
graduate/professional school and almost half reported a household
income (46%) less than $20,000.
70
3.2 Objectives of Childhood Obesity Assessment
1. Obtain data on the prevalence of childhood obesity and overweight
2. Assess opportunities for physical activity available to children
3. Assess the availability of healthy food choices for children
4. Obtain input from parents on their perceptions of childhood obesity,
opportunities and barriers to physical activity and healthy food
choices
Additional Data Collection
Additional pre-existing data was gathered from the Parks and Recreation
Department, including information on:
City of Stanton’s parks/playgrounds
Community Health Programs
Physical education, and other activities offered by the City
Limitations
Several limitations must be considered. It took more than six weeks to get
the permission to distribute the survey to the parents of the students.
When I contacted the Principal of the school, she told me I had to get the
School District’s permission. When I contacted the School District, they
transferred my calls to different Personnel, and finally, I got the permission
71
to distribute the surveys after six weeks. The survey was distributed to
200 people, the sample included individuals who have a child attending
this particular elementary school. These individuals may not truly
represent the population of City of Stanton. More than half of (55%)
parents didn’t return their surveys. About 45% returned their surveys,
while they provided valuable information, some of the information such as
child’s age, weight, and or height was not completed. Omitted such
surveys from the analysis.
3.3 Results
3.3.1Demographics
Stanton is a city located in western Orange County, California. According
to the 2010 US Census there are approximately 38,186 people, 10,825
households, and the population density was 12,122 people per square
mile. Among the 10,825 households, 46.3% have children under the age
of 18 living with them (Figure 3.1). The racial makeup of Stanton was
20,142 (51.8%) Hispanic, 9,547 (24.6%) Asian, 7,492 (19.3%) White, 857
(2.2%) African American, 39 (0.1%) American Indian, and 7 (0.02%)
Pacific Islander (Figure 3.2). The median household income was
approximately $49,555.
72
Figure 3.1 Percentage of Children Living in Stanton and California
Figure 3.2 Stanton Demographics
Source: http://www.city-data.com/city/Stanton-California.html
7.9
27.7
6.8
25
0 5 10 15 20 25 30
Population under
5 years
Persons under 18
years
California Stanton
73
3.3.2 Schools in Stanton
Residents of Stanton are served by four public school districts, and one
private school. The public school districts are Garden Grove, Savanna,
Magnolia and Anaheim school district. There is one private school; Saint
Polycarp School (K-8) is a Catholic School which is located in Stanton.
Robert M. Pyles Elementary School’s (Magnolia School District) 5
th
and 6
th
grade students’ parents participated in the survey.
3.3.3 Overweight/Obesity Prevalence
Body mass index (BMI) was calculated by dividing weight in kilograms by
height in meters squared. For children of the same age and sex between
the ages of 2 and 20, overweight is defined as a BMI between 85
th
and
94
th
percentile and obesity is defined at or above the 95
th
percentile.
In the survey, parents were asked to report their child’s height and weight.
Using the height and weight provided by parents, approximately 19
percent of children are underweight, 34 percent healthy weight, 25 percent
overweight, and 22 percent obese. Table 2 provides weight status by age.
74
Table 3. 1 Weight Status by Age
Age Underweight
(%)
Healthy
Weight (%)
Overweight
(%)
Obese
(%)
4 50.0 0.0 0.0 50.0
5 50.0 50.0 0.0 0.0
6 66.6 0.0 16.7 16.7
7 25.0 0.0 25.0 50.0
8 100.0 0.0 0.0 0.0
9 35.0 30.0 26.0 26.0
10 13.2 34.8 26.0 26.0
11 10.0 40.0 36.7 13.3
12 25.0 75.0 0.0 0.0
13 20.0 60.0 20.0 0.0
14 0.0 33.3 16.7 50.0
15 16.7 50.0 16.7 0.0
16 0.0 100 0.0 0.0
17 0.0 33.3 0.0 66.7
Based on information provided by parents (n=106)
3.3.4 Perceptions of Overweight and Obesity
Perceptions of the children’s level of overweight and obesity were
obtained from parents. After providing their child’s height and weight,
parents were asked how they perceived their child’s weight status.
Among the children that were actually classified as overweight, 37 percent
of parents perceived their child as overweight. Almost 12 percent of
parents considered their child to be underweight and 51 percent classified
their child to be at a healthy weight. Parents of obese children also
misclassified their child’s weight status. 15.5 percent perceived their child
to be at healthy weight and 4.6 classified their child as overweight.
75
3.3.5 Physical Activity and Sedentary Behaviors
Parents were asked to report on their child’s physical activity and
sedentary behaviors. 14 percent of parents (n=106) said their child gets at
least 20 or more minutes of physical activity 5 or more times per week; 34
percent (n=106) said 3-4 days per week; 44 percent said 1-2 times per
week and 8 percent said never or rarely.
Parents were asked to report on their child’s daily sedentary behaviors,
including watching TV, using computer, and playing video games.
Table 3.2 Children’s Daily Sedentary Behaviors
Less than 1
hour/day
1-2
hours/day
3-4
hours/day
5-4
hours/day
Watch TV,
Use the
computer,
and playing
video games
32.07
50.9
15.09
1.94
3.3.6 Eating Behaviors
Parents were asked to report on their child’s eating habits including fruits
and vegetables intake, fast food and soda consumption. 11 percent of
parents said their child eats fruit 4 or more times per day; 41.9 percent
76
said 2-to-3 times per day, 41.5 percent said 1 time per day, and 6.6 said
never or rarely.
For the vegetables intake, 3 percent of parents said their child eats
vegetables 4 or more times per day; 35 percent said 2-to-3 times per day,
52.8 said 1 time per day, and 9.4 percent said never or rarely.
For eating fast food, less than 1 percent of parents said their child eats
fast food 4 or more times per day; 6.6 percent said 2-to-3 times per day,
50 percent said 1 time per day, and 44 percent said never or rarely.
For the soda consumption, 2.8 percent of parents said their child drink
soda 4 or more times per day; 3.3 percent said 2-to-3 times per day, 30
percent said 1 time per day, and 63.9 percent said never or rarely.
Table 3.3 Children’s Eating Behaviors
Food Choice Never or
rarely
1 time/day 2-3
times/day
4 or more
times/day
Fruits 6.6 41.5 41.9 11
Vegetables 9.4 52.8 35 3
Fast food 44 50 6.6 Less than 1
Soda 63.9 30 3.3 2.8
3.3.7 Parents’ Income
Parents were asked to report their approximate household income. 46
percent of parents said their income less than $20,000; 26 percent
77
reported their income is in between $20,000 and $39,000; 12 percent said
their income is in between $40,000 and $59,000 and 7 percent said their
income is greater than $60,000.
Figure 3.4 Children’s Wt. as a function of Parents’ Income
This graph shows that dependent variable (children’s weight) as a function
of independent variable (parents’ income).
3.3.8 Parents’ Education
Parents were asked to report their highest level of education. Thirty four
percent of parents reported they have less than high school education; 34
0.00
10,000.00
20,000.00
30,000.00
40,000.00
50,000.00
60,000.00
70,000.00
Income
Weight
Weight vs. Income
Male
Female
78
percent said they have completed high school, 18 percent reported that
they have completed college or vocational training, and 2 percent said
they completed graduate or professional school.
Figure 3.5 Children’s Wt. as a function of Parents’ Education
The graph shows that the dependent variable (children’s weight) as a
function of independent variable (parents’ education)
0
50
100
150
200
250
300
0 1 2 3 4 5 6
WEIGHT
EDUCATION
Weight vs. Weight
Male
Females
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3.4 Intervention Study
Nutrition, Cooking, and Gardening Learning Approach for an Educational
Intervention Program to Increase Fruit and Vegetable Knowledge,
Preference, and Consumption among Elementary School Children, City of
Stanton, Orange County.
Introduction
Over the past two decades obesity rates among children in the United
States have reached alarming levels (Ogden, et al., 2010). In the United
States, the percentage of children ages 6-11 who were obese increased
from 7% in 1980 to nearly 18% in 2012 (Alexander, 2005) Comparably,
the percentage of obese adolescents ages 12–19 increased from 5% to
nearly 21% over the same period (Childhood Obesity Facts, 2014).
Obesity rate in City of Stanton, Orange County is an important issue
because children and adolescents who are obese are more likely to be
obese as adults, and are therefore more at risk for adult health problems
such as heart disease, type-2 diabetes, stroke, several types of cancer,
and osteoarthritis. According to the CDC, “One study showed that
children who became obese as early as age 2 were more likely to be
obese as adults” (Childhood Obesity Facts, 2014). In addition, the Orange
80
County Health Needs Assessment found that “overweight or obese adults
in Orange County were 12% more likely to be diagnosed with 3 or more
major diseases than adults with normal weight” (Alexander, 2005).
Nutrition plays a critical role in the life of a child because of the impact it
can have on growth, development, and the ability to learn (Byrd-
Bredbenner, et. al., 1993). Proper childhood nutrition not only contributes
to mental, physical, and emotional health, but also to the level of health a
person has as an adult (Fahlman, et al., 2008). School-based and
afterschool programs are the best venue to implement a nutrition program.
Initial studies show some positive effects on nutrition knowledge and
behavior. However, empirical evidence is minimal concerning the link
between nutrition, cooking, gardening and dietary behavior. Therefore,
this pilot study sought to elucidate the effects of after school program on
children’s fruit and vegetable knowledge, preference, and consumption.
A 12-week nutrition, gardening, and cooking intervention program
conducted at the Boys & Girls Club in Stanton, California. The objective of
the study were to examine the effect of an educational intervention on
behavior associated with dietary intake.
81
3.5 Methods
Participants
This study was conducted at the afterschool program at Boys & Girls Club,
City of Stanton. All fourth to sixth grade afterschool program students
were invited to participate in this pilot study, and a total of 35 students had
agreed to enroll in the study. Twenty students participated in the program
and completed the 12-week afterschool program. Meanwhile, twenty,
fourth to sixth grade students from the Anaheim Achieve afterschool
program, who were not enrolled in the intervention program, served as the
control group. The Magnolia School District, Boys & Girls Club, and the
Institutional Review Board of the University of Southern California
approved this study. Permission to work with the students was granted by
the Boys & Girls Club Director, the principal, and Robert M. Pyles
Elementary School. In addition, parental consent letters from parents of
both the experimental and control groups were collected before the start of
the intervention program. I have used the nutrition, cooking and gardening
curriculum from the LA Sprouts web-site with the permission of Dr. Gatto,
the Director of the LA Sprouts.
3.6 Program Design
Experimental Group
82
The Boys & Girls Club intervention program was taught during a 75-
minute session once a week for 12 weeks at the Stanton Boys & Girls
Club during January to April 2016. Sessions began with 45-minute
interactive nutrition and cooking education lessons taught by trained staff
and held within the club space, which was equipped with seating, tables
and a kitchen for the cooking classes. Nutrition lessons were adapted
from an existing curriculum developed by La Sprouts and focused on
vegetables, fruits, fiber, whole grains, and low-sugar beverages. During
the cooking class, children got a chance to read the recipes and make
their own snacks; they sat together at a table and ate the food in a family-
style manner that demonstrated positive effects of such practices on
behavioral outcomes.
After the cooking and nutrition lessons, students received a 30-minute
gardening lesson which was taught by a botanist. Two large, raised
garden bed plots measuring 4 feet by 4 feet were used for the cultivation
of vegetables for the program. The gardening lessons were also adapted
from an existing curriculum developed by LA Sprouts. The gardening
curriculum also used a hands-on approach in which children participated
directly in planning, growing, maintaining, and harvesting organic
vegetables.
83
The experimental participants’ received in-class gardening lessons along
with the hands-on gardening experience. Gardening in-class lessons
included lessons on identifying vegetables plants, seasonal crops,
transplanting, recycling, composting, irrigation, and mulching. These
participants planted cabbage, kale, collards and butter lettuce, all while
maintaining the garden (watering, weeding, and pest management) with
adult supervision. Students engaged in gardening successes by watching
the emergence of the first head of cabbage, as well as gardening
challenges such as dealing with the fungi growth on cabbage leaves. At
the end of the intervention, the students prepared a Salad from the Butter
Lettuce they had grown.
Control group
The students at the Robert Pyles Elementary School who were not
enrolled in Boys & Girls Club served as the control group. Control group
participants did not receive any nutrition, cooking, or gardening lessons
between pre- and post- testing.
84
Table 3.4: Lessons Overview of the 12 –week intervention
a
Lessons Nutrition topics Cooking Recipe Gardening topics
Wk#1 Introduction
Kitchen and knife safety
Winter garden
salad
Materials needed
for gardening
Wk#2 Types of fruits
Fruit health benefits and
serving size
Fruit rainbows Introduction to
documenting
garden progress
Wk#3 Types of vegetables
Vegetable health benefits
and serving size
Quinoa Salad Sowing seeds
Wk#4 Real food vs packaged
food
Reading ingredient lists
Vegetable
quesadillas with
salsa
Transplanting
Wk#5 Healthy family dining
habits
Healthy chips
with salsa
Using recycled
materials for
gardening
Wk#6 Health benefits of fiber
Sources of fiber and
serving size
Whole-grain
pasta with
vegetables
Composting
Wk#7 Natural vs added sugar
Finding sugar on a
nutrition label
Apples and
bananas with
peanut butter
Garden
maintenance
Wk#8 Role of vitamins A and C
in the body
Sources of vitamins A
and C
Beet, carrot,
and avocado
salad
Composting
Wk#9 Importance of eating
breakfast and Ways to
eat a healthier breakfast
Yogurt Parfait Identifying fruit
and vegetable
plants
Wk#10 Importance of a healthy
lunch and Selecting a
healthy school lunch
Sandwich Watering
Wk#11 Choosing healthy options
at holidays and parties
Corn and bean
dip with pita
chips
Garden
maintenance
Wk#12 Review of topics Strawberry
salad
Harvesting
vegetables
a
This curriculum is adopted from the LA Sprouts lesson plan with their
permission
85
Figure 3.6 Picture of Raised Bed Gardening
86
Testing
Testing was performed on all consenting fourth to sixth grade students.
The tests were administered by after school program staff members and
coordinators one week before and one week after the 12-week
intervention at the Boys & Girls Club and Robert M. Pyles Elementary
School. The details of the instrumentation is described below.
Instrumentation
The instrument used for this study consists for four segments. These
segments assessed participants’ fruit, vegetable consumption per day,
dietary assessment, family eating habits, cooking and gardening activities,
and the personal background information. All these evaluations were
conducted by the primary investigator (myself) as both pre- and post-
assessments immediately prior to and following the intervention. The first
segment of the instrument was 7 multiple-choice questions. These
questions dealt with family eating habits questions such as how often a
family member encouraged the children to eat vegetables and fruits, how
many times the children ate fruits and vegetables per day, how many
times per day they ate fast foods, how many times they exercised per
week, and how many hours they watched TV on an average.
87
The second segment of the research was a personal dietary assessment
for these children. These questions dealt with how often, on average, per
day they used dairy foods, fruits, vegetables, meat, sweets, baked goods,
and beverages. Children observed a listing of common fruit and
vegetables by name and rated whether they ate those particular fruits and
vegetables or not. The four possible responses to each dietary
assessment and the points associated with each response included: 0 =
never eat, 1 = 1 per day, 2 = 2-3 per day, 3 = 4-5 per day.
The third segment of the instrument consisted of eight questions related to
the cooking and gardening activities. The first four questions evaluated
children’s interest for cooking and gardening. The two possible responses
to each cooking and gardening activities and the points associated with
each response included: 1 = yes, 2 = no.
The fourth segment of the instrument gathered demographic information,
including gender, grade, age, height, weight, ethnicity, name, and
language. The name of the student was used only to correctly match pre-
test and post-test at the end of the study.
88
Statistical Analysis
The data collected were analyzed using SPSS (SPSS for Windows 22.0)
Statistical procedures included general factorial tests of comparison and t-
tests. Statistical significance was set at P≤ .05. Descriptive statistics
were used to summarize demographic data. To determine the effects of
the intervention, a 2 (pre vs post) X 2 (intervention vs control) repeated
measures analysis of variance was run on each set of subscales.
3.7 Results and Discussions
There were 25 participants had agreed to participate in the educational
intervention, and 20 completed the 12-week intervention, attending at
least 10 of the 12 sessions and completed the surveys. Of the 50
students invited, 25 agreed to participate in the surveys, and 20 completed
the control group surveys.
Background Analysis: Control Group versus Experimental Group (Pre-
Measures)
Before performing any analyses with the post-measures, I first analyzed
the pre-measures between the experiment and control groups to see if
any differences existed between the two groups prior to the intervention.
89
To determine this, I performed a t-test for each question with more than
two answers (i.e. not a “yes/no” question). I assumed equal variances
between the two groups, since the study participants came from one total
population and were not assigned to the groups based on any
predetermined characteristics.
After performing the fifty-six t-tests corresponding to the fifty-six survey
questions, I found significant differences between the control and
experiment responses for six questions (note each question had a scaled
response, not an absolute quantitative response, so participants were not
asked for exact amount of fruits, vegetables, etc. they ate):
How often does a family member bring fruit home for you to try?
o Average response, control group: 1.69
o Average response, experimental group: 2.41
o t-statistic = -2.29, p-value = 0.029
How often do you eat fruits on an average day?
o Average response, control group: 3.13
o Average response, experimental group: 2.13
o t-statistic = 3.55, p-value = 0.01
About how many hours do you sit and watch TV or videos on an
average school day?
o Average response, control group: 1.73
o Average response, experimental group: 2.50
o t-statistic = -2.24, p-value = 0.033
How often on average do you eat carrots per day?
o Average response, control group: 1.53
90
o Average response, experimental group: 2.19
o t-statistic = -2.29, p-value = 0.029
How often on average do you eat chicken per day?
o Average response, control group: 1.87
o Average response, experimental group: 2.38
o t-statistic = -2.38, p-value = 0.024
How often on average do you eat pie (ready-made) per day?
o Average response, control group: 1.00
o Average response, experimental group: 1.44
o t-statistic = -3.39, p-value = 0.002
According to these results, the control group ate more fruits on average
than the experimental group before the intervention, but the experimental
group had fruit brought home more often, watched more videos/TV, and
ate more carrots, chicken, and ready-made pies.
Results like these are expected with so many survey questions where
participants could only select from one of four answers. Since each group
had at maximum 17 participants, even slight variations in question
responses can have a large effect on the t-test results. Because it is
impossible to say whether these differences are true differences or not, I
perform the comparison t-tests for the post-measures between the control
and experimental groups with an ANCOVA procedure to control for the
pre-measures. (Note that based on the results of a chi-squared test, no
91
significant differences existed between the two groups in the responses to
the eight “yes/no” questions on cooking and gardening.)
Background Analysis: Demographic Analysis
To determine if significant differences existed in the demographic makeup
of the two groups, I performed t-tests on the three numerical demographic
variables (age, height, and weight of the participants) and chi-squared
tests on the two qualitative demographic variables (gender and ethnicity,
where ethnicity was Hispanic or not). All three numerical demographic
variables and both qualitative variables had p-values above 0.05,
indicating no significant difference between the groups.
Result Analysis: Control Group versus Experimental Group (Post-
Measures)
After performing an ANCOVA procedure to ensure any existing
differences in the pre-measures did not affect the analysis of the post-
measures, I again performed tests for all fifty-six questions without a
“yes/no” response (and another chi-squared analysis for the eight “yes/no”
questions). This time we examined the responses to the same survey
questions both before and at the conclusion of the study. After controlling
92
for the pre-measures, the F-test analysis showed significant differences
between the control group and the experimental group on three questions:
How often does a member of your household encourage you to eat
vegetables a day?
o Average response, control group: 1.88
5 participants reported a decrease, 7 participants
reported the same value, and 4 participants reported
an increase
o Average response, experimental group: 1.24
8 participants reported a decrease, 8 participants
reported the same value, and 1 participant reported
an increase
o F-statistic = 5.14, p-value = 0.031
How often on average do you eat peas or lima beans per day?
o Average response, control group: 1.29
6 participants reported a decrease, 7 participants
reported the same value, and 1 participant reported
an increase
o Average response, experimental group: 1.75
2 participants reported a decrease, 9 participants
reported the same value, and 5 participants reported
an increase
o F-statistic = 4.41, p-value = 0.045
How often on average do you eat eggs per day?
o Average response, control group: 2.31
1 participant reported a decrease, 8 participants
reported the same value, and 7 participants reported
an increase
o Average response, experimental group: 1.81
7 participants reported a decrease, 7 participants
reported the same value, and 2 participants reported
an increase
93
o F-statistic = 4.91, p-value = 0.035
According to these results, participants in the experimental group had
household members encouraging them to eat vegetables less often than
their counterparts in the control group, but ate peas/lima beans more often
and eggs less often per day. It is important to note that of these three
questions, only the encouragement to eat vegetables question showed a
significant difference before controlling for the pre-measures, though
neither the peas/lima beans or eggs question showed significant
differences in the pre-measure analysis above. This could be a result of
the small sample size in each group. In addition, the chi-squared analysis
showed a significant difference in the responses to the question, “Food
that I cook is healthier than food that I buy” (chi-squared = 4.08, p-value =
0.043).
Result Analysis: Pre-Measures versus Post-Measures (Experimental
Group)
To measure the results of the intervention on the experimental group, I
conducted t-tests for each question to test for differences in responses
between the pre-measures and post-measures in the experimental group.
I found six questions for which a significant difference existed:
94
How often does a member of your household encourage you to eat
vegetables a day?
o Average response, pre-measure: 1.82
o Average response, post-measure: 1.24
o t-statistic = -2.79, p-value = 0.013
8 participants reported a decrease, 8 participants
reported the same value, and 1 participant reported
an increase
How often do you eat fruits on an average day?
o Average response, pre-measure: 2.13
o Average response, post-measure: 3.07
o t-statistic = 4.09, p-value = 0.001
2 participants reported a decrease, 4 participants
reported the same value, and 11 participants reported
an increase
How often do you eat vegetables on an average day?
o Average response, pre-measure: 2.38
o Average response, post-measure: 2.88
o t-statistic = 1.83, p-value = 0.088
3 participants reported a decrease, 6 participants
reported the same value, and 8 participants reported
an increase
How many times per week you exercise enough to make sweat and
breathe hard for 20 or more minutes?
o Average response, pre-measure: 2.75
o Average response, post-measure: 3.42
o t-statistic = 2.34, p-value = 0.039
4 participants reported a decrease, 5 participants
reported the same value, and 8 participants reported
an increase
How often on average do you eat spinach per day?
o Average response, pre-measure: 1.29
95
o Average response, post-measure: 1.86
o t-statistic = 2.51, p-value = 0.026
0 participants reported a decrease, 9 participants
reported the same value, and 5 participants reported
an increase
How often on average do you eat wheat bread per day?
o Average response, pre-measure: 1.56
o Average response, post-measure: 2.31
o t-statistic = 3.00, p-value = 0.009
1 participant reported a decrease, 7 participants
reported the same value, and 8 participants reported
an increase
Aside from how often participants were encouraged by someone in their
household to eat vegetables, all questions showed an increase between
the pre-measures and the post-measures. That is, participants ate more
fruits, vegetables, spinach, and wheat bread and exercised more on
average after the intervention than before the intervention.
Result Analysis: Pre-Measures versus Post-Measures (Control Group)
For completeness, I also conducted t-tests for each question to test for
differences in responses between the pre-measures and post-measures in
the control group. I found six questions for which a significant difference
existed:
About how many hours do you sit and watch TV or videos on an
average school day?
o Average response, pre-measure: 1.73
o Average response, post-measure: 2.40
96
o t-statistic = 2.00, p-value = 0.032
How often on average do you eat eggs per day?
o Average response, pre-measure: 1.81
o Average response, post-measure: 2.31
o t-statistic = 2.45, p-value = 0.027
How often on average do you eat pie (homemade) per day?
o Average response, pre-measure: 1.06
o Average response, post-measure: 1.75
o t-statistic = 2.42, p-value = 0.029
How often on average do you eat pie (ready-made) per day?
o Average response, pre-measure: 1.00
o Average response, post-measure: 1.81
o t-statistic = 3.10, p-value = 0.007
How often on average do you eat cake per day?
o Average response, pre-measure: 1.31
o Average response, post-measure: 1.88
o t-statistic = 2.18, p-value = 0.045
How often on average do you eat wheat bread per day?
o Average response, pre-measure: 1.19
o Average response, post-measure: 1.81
o t-statistic = 2.82, p-value = 0.013
For the control group, all six of these variables tended to increase
between the pre-measures and the post-measures. That is, participants
watched more TV and ate more eggs, pie (both ready-made and
homemade), cake, and wheat bread per day. As noted previously, it is not
surprising to find some changes in responses even with the control group,
97
specifically because some answers were missing in the control group for
the post-measures. This reduced the sample size even further, meaning
small changes in responses ultimately affected the t-test more severely.
Table 3.5 Composite Measures for Behaviors
Table 3.5 shows the composite measures for health positive- behaviors
such as fruits, vegetables, white bread intake and daily exercises and the
negative- behaviors including the intake of fast food, hot dog, potato chips,
and fries. The difference between experimental and control group for the
difference between pre- and post-test result shows that the participants in
the experimental group had increased their positive behavior than their
counterparts in the control group (0.7125 vs. -0.0525) and also the
Positive Behavior
Pre Post Diff t-test Sig Pre Post Diff t-test Sig
Fruits 2.17 3.07 0.93 4.09 0.001 3.13 2.87 -0.27 -0.94 0.369
Vegetables 2.38 2.88 0.5 1.83 0.088 3.79 3.29 -0.5 -0.32 0.754
Exercises 2.75 3.42 0.67 2.34 0.039 2.87 2.8 -0.07 -0.16 0.876
Wheat Bread 1.56 2.31 0.75 3 0.009 1.19 1.81 0.63 2.82 0.13
Average 0.7125 -0.0525
Negative Behavior
Fast Food 2.33 2.27 -0.07 -1.47 0.067 2.21 2.07 -0.14 -0.43 0.671
Hot Dog 2.14 1.79 -0.36 -1.59 0.13 1.6 1.93 0.33 0.96 0.353
Pototo Chips 2.19 2.06 -0.13 -0.62 0.54 1.88 1.81 -0.06 -0.32 0.751
Fries 2.33 2.27 -0.07 -0.43 0.067 2 2.56 0.56 0.94 0.356
Average -0.1575 0.1725
Experiment Control
Experimental Vs. Control (Composite)
98
participants in the experimental group decreased their negative behavior
compared to the control group (-0.1575 vs. 0.1725).
99
CHAPTER 4 – CONCLUSION
This study did demonstrate some significant findings, particularly in the
differences between the experimental group’s responses before and after
the study. The experimental group ate significantly more fruits, vegetables,
spinach, and wheat bread after the intervention than before, while the
control group ate significantly more eggs, cake, pie (both homemade and
ready-made), and wheat bread after the study. In addition, the
experimental group exercised more on average after the study and also
reported a decrease in the number of times people in their household
encouraged them to eat vegetables.
It is not surprising, then, that the analysis showed a significant difference
between the post-measures of the control and experimental groups on
both the eggs and encouragement of vegetables questions. In addition,
though, the experimental group demonstrated more of a tendency to eat
peas/lima beans than the control group at the end of the study. Since the
experimental group did not show a significant increase between the
beginning of the study and the end of the study, we can conclude this was
likely not a result of the study itself but rather a characteristic of the
experimental group.
100
However, the study does show some limitations which might affect the
interpretation of these results. The most significant limitation is the small
sample size for both the control and experimental groups. For some tests,
we had a sample size of only 13, which can cause instability in the
analyses. This can be seen particularly in the comparisons of the pre-
measures and the post-measures for the control group, since we applied
no experimental condition to these participants but the results still showed
significant differences in six of the questions. Since some surveys were
incomplete, or participants answered questions in the pre-survey but not in
the post-survey, the incomplete questionnaires further limit sample size.
The results seen here may not be repeatable with a different group (or a
larger group), since the results of small sample sizes are naturally highly
variable.
Additionally, t-test analysis on survey results can have significant
variability even outside small sample sizes. This occurs because
respondents are limited to one response on a scale. Studies have shown
this can have an incalculable effect on results, especially when surveys
necessarily require responses not on a Likert Scale (typically a five- or
seven-response scale to accommodate respondents’ tendency to cluster
at a middle value). The survey also had a high number of questions,
101
meaning it is likely some results will be found significant even if they are
not. The Bonferroni correction could be used to ameliorate this, but I
deemed this unnecessary since I would rather set a higher threshold for
including significant results and have more avenues for additional study.
Contribution to Practice
The results of this study suggest that the garden based nutrition program
resulted in significant positive changes in nutrition knowledge,
preferences, and consumption among elementary children. Based on the
results, this study needs to promote to all schools within Magnolia School
District and all the Parent Teacher Association (PTA) to educate the
parents of these students as well.
The good nutrition is fundamental for children’s current and future health.
The benefits of developing healthy dietary and lifestyle patterns from an
early age onwards can positively impact on people’s nutrition and health
throughout their adult lives. Nutrition education is an important element in
an overall strategy to improve children’s knowledge for fruit and vegetable
intake. Schools are ideal settings for promoting lifelong healthy eating
habits and lifestyles for several reasons (CDC, 2001):
Schools can reach almost all children.
102
Schools can teach students how to resist social pressures.
Skilled personnel are available. After appropriate training, teachers
can use their instructional skills to promote healthy eating habits.
Schools provide opportunities to practice healthy eating. Study
shows that more than one-half of youths in the United States eat
one of their three major meals in school.
Nutrition education is not integrated into school curricula in most of the
schools. In the school environment, classroom lessons alone might not be
enough to effect changes in children’s eating behaviors; children also
need access to healthy food and the support of persons around them
(CDC, 2001). Each school has to adopt a school nutrition policy that
promotes healthy eating through classroom lessons and a supportive
school environment. A coordinated nutrition policy that ensures that
students receive nutrition education messages that are reinforced
throughout the school environment. The school environment can
powerfully influence students’ attitudes, preferences, and behaviors
related to food (Contento, et al., 1995). A school nutrition policy should be
a brief document that incorporates input from all relevant constituents of
school community. The policy should meet local needs and be adapted to
the health concerns. To ensure a healthy future of our children, school-
103
based nutrition education programs must become a national priority.
These programs should be part of school health programs and reach
students from preschool through high school. School leaders, community
leaders, and parents must commit to implementing and sustaining nutrition
education programs within the schools (CDC 2001). The written policy
should describe the importance of the nutrition component within the
comprehensive school health program.
The Magnolia School District of Orange County needs to get the
administrators to continuously support the initiative to give healthy lunches
to elementary students of all economic backgrounds. Allowing students
from impoverished areas to access the same fresh produce as those
people who live better off will help fight the obesity epidemic. The
Magnolia School District administration can do this by continuing to
partner with the National School Lunch Program. According to the fact
sheet provided by the United States Department of Agriculture, “The
National School Lunch Program is a federally assisted meal program
operating in over 100,000 public and non-profit private schools and
residential child care institutions. It provided nutritionally balanced, low-
cost or free lunches to more than 31 million children each school day in
2012” (NSLP, 2015). By continuing to participate in this program, the
104
Magnolia School Districts will get cash subsidies and USDA foods for
each meal that serve.
Schools play an important role in the promotion and maintenance of their
student’s health. But schools can’t do it alone. Parents are the other
crucial half of the equation to provide the healthy start that children need
to thrive in the classroom and in life. Health-promoting schools should
closely collaborate with parents so that children are less likely to
experience inconsistencies between suggestions and practices at home
and at school. Parents play an important role in their child’s life in their
roles as teacher, disciplinarian, role model and supervisor since parents
control most of the food choices available at home. Therefore, it is
essential that they understand and reinforce what the Health-Promoting
School seeks to achieve. Also, improving parents’ eating habits may be
one of the most effective ways to promote healthy eating for their children.
At the school level, involving parents in nutrition-related learning
experiences, is effective in enhancing the eating behaviors of both
children and parents (CDC, 2001).
105
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APPENDICES
114
Appendix 1 – Childhood Obesity: Parent Survey
This set of questions is about your children’s eating habits and physical
activity. Your participation in this survey is voluntary and all answers will
be kept confidential.
1. How many school-age children do you have (K-12
th
grade)
1 2 3 4+
Please answer the following questions for each of your children:
Child 1 Child 2 Child 3 Child 4
2. Sex
Male
Female
Male
Female
Male
Female
Male
Female
3. Age
______
years old
______
years old
______
years old
______
years old
4. Height
(in ft & in)
_____ ft
_____ in
_____ ft
_____ in
_____ ft
_____ in
_____ ft
_____ in
5. Weight
(in pounds)
____ ____
____ lbs
____ ____
____ lbs
____ ____
____ lbs
____ ____
____ lbs
Please check one box per child:
6. How often does your children ages 2 and over eat fruit on an
average day?
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t
know/ not
sure
Child 1
Child 2
Child 3
Child 4
115
7. How often does your children ages 2 and over eat vegetables on an
average day? (Includes vegetable salad)
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t
know/ not
sure
Child 1
Child 2
Child 3
Child 4
8. How many times a day does each child eat fast food (McDonalds,
Wendy’s, Taco Bell, etc.)
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t
know/ not
sure
Child 1
Child 2
Child 3
Child 4
9. How many sodas per day does each child drink?
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t
know/ not
sure
Child 1
Child 2
Child 3
Child 4
10. How many times per week does each child play or exercise enough
to make him/her sweat and breathe hard for 20 or more minutes?
Never or
rarely
1-2 times 3-4 times 5 or more
times
Don’t know/
not sure
Child 1
Child 2
Child 3
Child 4
116
11. About how many hours do you estimate each of your children sit
and watch TV or videos on an average school day?
Less than 1
hour
1-2 hours 3-4 hours 5 or more
hours
Don’t know
Child 1
Child 2
Child 3
Child 4
12. How would you describe each child’s weight?
Very
underweight
Slightly
underweight
About the
right weight
Slightly
overweight
Very
overweight
Child 1
Child 2
Child 3
Child 4
13. Has your Doctor ever told you that your child was overweight?
Yes No Don’t Know
Child 1
Child 2
Child 3
Child 4
14. How important are the following items when you are buying food for
your household?
Very important
Important
Somewhat
Important
Not important
Price
Convenience
Nutritional Value
Taste
15. How difficult is it for you to get to a grocery store that sells fresh
produce like fruits and vegetables?
Very difficult Difficult Somewhat difficult Not difficult
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16. Does your neighborhood have sidewalks?
Yes No Don’t know
17. How safe is your neighborhood?
Very safe Safe Somewhat safe Not safe
GENERAL QUESTIONS
This section asks general questions about you.
18. Gender
Male
Female
19. Are you Hispanic, or Latin American descent?
Yes No Don’t know
20. What is your race?
Caucasian African American Asian
Native American Other (please specify)
21. What is your highest level of education?
Less than high school
Completed high school
Some college or vocational training
Completed college or university
Completed graduate or professional school
22. What is your approximate household income?
Less than $20,000
$20,000 - $39,999
$40,000 - $59,999
$60,000 - $89,999
Greater than $90,000
23. How many people, including yourself, live in your household?
1 2 3 4 5 6 or more
Thank you for completing this survey.
118
Appendix 2 – Eating Habits Questionnaire
Name: ___________________
This set of questions is about your eating habits. Your participation
in this survey is voluntary and all answers will be kept confidential.
FAMILY EATING HABITS
1. How often does a member of your household?
a. Encourage you to eat vegetables?
O Often O Sometimes O Seldom O Never
b. Encourage you to eat fruit?
O Often O Sometimes O Seldom O Never
c. Talk about food nutrition with you?
O Often O Sometimes O Seldom O Never
d. Bring healthy food home for you to try?
O Often O Sometimes O Seldom O Never
e. Bring fruit home for you to try?
O Often O Sometimes O Seldom O Never
f. Bring vegetables home for you to try?
O Often O Sometimes O Seldom O Never
2. How often you eat fruits on an average day?
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t know/
not sure
3. How often you eat vegetables on an average day? (Includes
vegetable salad)
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t know/
not sure
4. How many times a day you eat fast food (McDonalds, Wendy’s,
Taco Bell, etc.)
Never or
rarely
1 time 2-3 times 4 or more
times
Don’t know/
not sure
119
5. How many times per week you exercise enough to make sweat
and breathe hard for 20 or more minutes?
Never or
rarely
1-2 times 3-4 times 5 or more
times
Don’t
know/ not
sure
6. About how many hours you sit and watch TV or videos on an
average
school day?
Less than 1
hour
1-2 hours 3-4 hours 5 or more
hours
Don’t know
PERSONAL DIETARY ASSESMENT
7. For each food listed, fill in the oval indicating how often on average per
day you have used
DAIRY FOODS Never 1 2-3 4-5
per per per
day day day
Skim or low fat milk (8 oz. glass) O O O O
Whole milk (8 oz. glass) O O O O
Yogurt (1 cup) O O O O
Ice cream (1/2 cup) O O O O
Cheese, e.g., American, Cheddar O O O O
Butter (pat), added to food or bread O O O O
FRUITS
Fresh apples or pears (1) O O O O
Oranges (1) O O O O
Orange juice or grapefruit juice O O O O
Peaches, apricots or plums O O O O
Bananas (1) O O O O
Other fruits, fresh, frozen, O O O O
or canned (1/2 cup)
VEGETABLES
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Tomatoes (1) or O O O O
tomato juice (small glass)
String beans (1/2 cup) O O O O
Broccoli (1/2 cup) O O O O
Cabbage, or cauliflower O O O O
Carrots (1/2 carrot or 2-4 sticks O O O O
Corn (½ cup fresh or canned) O O O O
Peas or Lime beans O O O O
(1/2 cup fresh, frozen, canned)
Yams or sweet potatoes (1/2 cup) O O O O
Spinach or collard greens, cooked O O O O
Beans or lentils, baked or dried O O O O
MEAT, SWEETS, BAKED GOODS, MISC.
Eggs(1) O O O O
Chicken or Turkey O O O O
Bacon (2 slices) O O O O
Hot dogs (1) O O O O
Processed Meat, e.g., sausage, salami, O O O O
Hamburger(1 patty) O O O O
Fish(3-5 oz.) O O O O
BEVERAGES
Coffee O O O O
Tea O O O O
Coke, Pepsi, or 7-up O O O O
Punch, lemonade, or other fruit drinks O O O O
Chocolate c (1 oz.) O O O O
Candy without chocolate (1 oz.) O O O O
Pie, homemade (slice) O O O O
Pie ready made (slice) O O O O
Cake (slice) O O O O
Cookies (1) O O O O
White bread (slice), including pita bread O O O O
Wheat bread (slice) O O O O
French fries, potatoes (4 oz.) O O O O
Rice or pasta, spaghetti, etc. (1cup) O O O O
Potato chips or corn chips O O O O
(small bag or 1 oz.)
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COOKING
8. Cooking is fun
O Yes
O No
9. Cooking is easy
O Yes
O No
10. I can cook at my home
O Yes
O No
11. Food that I cook is healthier than food I buy
O Yes
O No
GARDENING
12. Gardening is fun
O Yes
O No
13. Gardening is easy
O Yes
O No
14. I can grow a vegetable at my home
O Yes
O No
15. Vegetables from the garden taste better than vegetables from the
store
O Yes
O No
PERSONAL BACKGROUND INFORMATION
16. Are you O Male O Female
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17. How old are you? ______
18. How tall are you? ____ Feet ____ Inches
19. How much do you weigh? ______ Pounds
20. Are you of Hispanic/Latino origin such as Mexican American,
Central American, Puerto Rican, Cuban, or Dominican?
O Yes
O No
21. Which of the following categories best describes your racial
background? Are you:
O White
O Black
O Asian or Pacific Islander
O American Indian/Native American
O Other: Please Specify _____________________
22. What language do you usually speak at home?
O English
O Spanish
O Farsi
O Mandarin
O Tagalog
O Cantonese
O Vietnamese
O Other: Please Specify _____________________
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Appendix 3 - Nutrition and Cooking Lessons
WEEK1
1
:
INTRODUCTION
In this lesson you will learn:
1. Class information
2. How to properly wash hands.
3. Kitchen safety.
4. Knife safety
1
All lessons are adopted from LA Sprouts Curriculum with their permission
124
WELCOME TO
CLASS!
There are three parts to this class: nutrition, cooking and
gardening. Each week, there will be 30 minutes of nutrition and
cooking lessons, and 30 minutes of gardening lessons.
• In nutrition lessons, you’ll learn health benefits of
eating fruits and vegetables.
• In cooking activities, you’ll learn how to prepare/cook
healthy meals with fruits and vegetables.
• In gardening activities, you’ll learn how to plant, grow
and harvest fruits and vegetables.
Why is eating healthy important?
• It helps you feel better and have more energy.
• It can reduce obesity and other related disorders.
• It improves school performance.
• It improves physical fitness.
What are some healthy eating topics we’ll discuss in
Classes?
• How to eat more fruits and vegetables in your daily meals.
• How to eat less added sugar in foods.
• How to drink less sugary beverages.
• Background about the culture and history of fruits and
vegetables.
• Why different fruits and vegetables grow during different
seasons.
• Which fruits and vegetables are grown locally.
• Be nice and courteous to your classmates and teachers,
• Ask lots of questions-- there is no such thing as a stupid
question!
125
• No “yuck” statements, tell us why you like or don’t like a
food rather than just saying you don’t like it.
• Make sure you have enough room during activities
and be kind to your neighbor.
• Remember to have FUN!
HAND WASHING
2
• Always wash your hands before and after food preparation.
• Always wash your hands before
and after eating, after using the
bathroom, and after working in
the garden.
• How to properly wash your hands:
1. Wet your hands under running warm water.
2. Apply soap to your hands and lather well.
3. Rub hands together and scrub ALL surfaces for at least
20 seconds (or sing the “Happy
Birthday” song twice).
4. Rinse your hands under running warm water.
5. Dry your hands using a clean towel.
2
Adapted from CDC website: http://www.cdc.gov/
126
KITCHEN SAFETY
• Always clean counter tops and
tables before and after cooking.
• Wipe up any spills immediately.
• When using the stove or the
burner, turn the pot handles in so
they do not hang over the edge of
the stove.
• Always use a potholder when picking up a pot
or pan.
KNIFE SAFETY
• Remember a knife is not a toy.
• Never run with a knife.
• Always keep your eye on the knife when cutting.
• Always cut on a cutting board.
• Always hold a knife by its handle, not its blade.
• Never try to catch a falling knife.
• When cutting fruits and vegetables, first cut a flat
side or a base so it lays flat on the cutting board
and does not wobble or rock.
• While chopping or slicing, tuck in your fingers
on the hand you are holding the fruit or
vegetable with.
127
Ingredients Time: 20 minutes
Makes 4-6 servings
2 bunches
1/2 bunch
2
1/4 cup
1/3 cup
1/3 cup
1/4 cup
1
1/4 tsp
1/8 tsp
Seasonal greens, such as kale, Swiss
chard, spinach or lettuce
Radishes
Apples, or other fruit, such as oranges or
pears
Cilantro
Nuts or seeds, such as walnuts,
almonds, sunflower seeds or
pepitas
Crumbled queso cotija or feta cheese
(optional)
Dressing:
Olive oil
Lemon, or 2 limes
Salt
Pepper
Directions
1. Wash all fruits and vegetables.
2. Chop all greens into bit-size pieces or ribbons and place in a large mixing bowl.
3. Thinly slice radishes and fruit, and add them to the bowl.
4. Add cilantro leaves and nuts to the bowl.
5. Squeeze lemon juice over vegetables, and add olive oil, salt and pepper to the bowl.
6. Toss everything together, and top with cheese (if desired).
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WEEK 2
REAL FOOD
In this lesson you will learn:
1. The difference between real food and processed food.
2. Where you can find real food.
3. Why real food is healthier than processed food.
4. How to identify real food and incorporate it into your diet.
What is real food?
• Real food doesn’t come in a package.
• Real food doesn’t need an ingredient list.
• Real food is not processed.
• Real food does not have preservatives added to it.
• Real food is naturally flavorful, and doesn’t require
sweeteners or artificial flavors.
What are some of the differences between real and
processed food?
129
Real Food Packaged Food
• Real food is simple, fresh, and
tasty.
• It doesn’t require artificial
ingredients or flavors.
• Real food has more nutrients per
serving.
• Packaged food contains a lot of
unnecessary ingredients that were
added to increase the flavor of
food and make it last longer.
Food type quiz
Which of these foods are real foods and which are processed foods?
Circle the ones that you think are real foods.
130
Where can you find real food?
• Growing in a garden.
• At the farmer’s market.
• At the grocery store. Grocery stores have both real food
and processed food.
Real food is usually on the outside edges of the store
or in the produce section.
Tip: avoid the middle aisles where there is
mostly processed food.
What am I eating?
What are some of the ingredients in this bag of Flamin Hot Cheetos?
131
Ingredients:
Enriched corn meal (corn meal, ferrous sulfate, niacin, thiamin
mononitrate, riboflavin, and folic acid), vegetable oil (contains one or
more of the following: corn, soybean, or sunflower oil), salt,
maltodextrin, sugar, monosodium glutamate, autolyzed yeast extract,
citric acid, artificial color (including red 40 lake, yellow 6 lake, yellow
6, yellow 5), corn syrup solids, partially hydrogenated soybean and
cottonseed oil, hydrolyzed soy protein, cheddar cheese (cultured milk,
salt, enzymes), whey, onion powder, whey protein concentrate, corn
syrup solids, natural flavor, buttermilk solids, garlic powder, disodium
phosphate, sodium diacetate, sodium caseinate, lactic acid, disodium
inosinate, disodium guanylate, nonfat milk solids, sodium citrate, and
carrageenan.
• How many ingredients are there in this food?
• You probably haven’t heard of many of these ingredients. Circle
the ones you don’t know.
• Try to choose foods that have few ingredients. If they
have fewer ingredients, they will be less processed. Do
you know how many ingredients are in these foods?
- An apple?
o 1 ingredient: Apple
132
- A snack of celery and natural peanut butter?
o 3 ingredients: Celery, peanuts and salt
- A snack of strawberries and plain yogurt?
o 3 ingredients: Strawberries, low fat milk and live cultures
What are some other snacks you can eat that don’t
have many ingredients?
VEGGIES WITH YOGURT DIP
Ingredients Time: 10 minutes
Makes 4 servings
4 cups
8 oz
½
½
1
2 Tbsp
Fresh seasonal vegetables (like
tomatoes, celery, carrots, broccoli,
zucchini, green beans, peppers,
cucumbers)
Dip:
Plain low fat (or nonfat) yogurt
Lime (or lemon), juiced
Clove garlic, pressed. Or, .5 tsp
garlic powder
Green onion, sliced thinly
(optional- green stems only)
Cilantro (optional)
Salt and pepper to taste
Directions
1. Wash all vegetables.
2. Cut all vegetables (except chives or green onions) into dipping-size pieces.
3. Mix all dip ingredients together in a bowl.
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WEEK 3
SUGAR
In this lesson you will learn:
1. The difference between natural and added sugar.
2. Why it is important to limit added sugar.
3. About added sugar in sodas.
4. How to calculate the teaspoons of sugar in processed
foods and beverages.
5. How to make naturally sweetened, low-sugar drinks.
Natural vs. Added Sugar
• Natural sugars come from foods that are naturally
sweet, such as fruits
Foods with natural sugar:
Fruit, milk, plain yogurt, raisins, frozen fruit
• Added sugar is the sugar or sugary syrups that is often
added to foods to make them sweeter. Theses sugars
contain calories, but no vitamins or minerals.
Foods with added sugar:
Chocolate milk, fruit drinks, sports drinks, soda, fruit snacks,
candy, canned fruit, ice cream
Liquid Candy
Have you ever thought of soda as liquid candy? Really, that’s all it
is!
• It is hard to think of sodas as candy because we drink them,
but they give us just as much sugar, if not more.
134
Nutrition Facts
Serving Size: 100 g • 3.53 oz
Amount Per Serving
Calories 490 Calories from Fat
225
%DV
Total Fat 25 g
Saturated Fat 14 g
Cholesterol 35 mg
Sodium 70 mg
Total Carbohydrate 70 g
Dietary Fiber 0 g
Sugars 63 g
Protein 7 g
Vitamin A 0% • Vitamin C
0% Calcium 0% • Iron
0%
• Drinking soda adds extra calories to your diet without
adding any beneficial nutrients like vitamins or
minerals.
• When you drink soda, you usually don’t have room
for healthier drinks.
• Drinking soda can often end up making you feel
more thirsty.
How much sugar is
in our drinks?
M&Ms candy
When
you
divide 63
g of
sugar by
4 = 16
teaspoon
s of
sugar in
1 regular
bag of
M&Ms
4 grams of Sugar = 1 teaspoon of sugar
You should try to eat less than 50 g of added sugar per day.
Calculating Teaspoons of Sugar
Coca Cola
12 oz (355 ml) Can
Sugar: 39g
135
Total grams of sugar (multiply grams by servings per container):
Teaspoons of sugar (take the total grams of sugar above and
divide by 4):
Coca Cola
20 oz (590 ml) Bottle
Sugars: 65g
Total grams of sugar (multiply grams by servings per container):
Teaspoons of sugar (take the total grams of sugar above and
divide by 4):
Arizona Lemon Ice Tea
24 oz Can
Sugar: 72g
Total grams of sugar (multiply grams by servings per
container):
Teaspoons of sugar (take the total grams of sugar above
and divide by 4):
7-Eleven Super Big Gulp
Total grams of sugar (multiply grams by servings per
container):
Teaspoons of sugar (take the total grams of sugar above
and divide by 4):
Facts about fruit drinks
136
It’s not just soda that can be bad for you; juice and
fruit drinks can be unhealthy too.
• Juice does not contain the fiber that whole
fruits and vegetables have.
• A lot of juice can provide excessive amounts
of calories and may cause weight gain. A lot
of juice is also bad for your teeth.
• Most fruit drinks only contain 5-10% fruit juice.
• Watch amount of juice you drink- too much can be bad!
A ½ cup (4 ounces) of fruit juice
equals one serving from the fruit or
vegetable group.
Beverage Taste
Homemade aguas frescas are better than 100% fruit juice, and
both of
these are better than fruit drinks. 100% juice is the juice of fruit or
vegetable without the added sugar, but it still has a lot of natural
sugars, so it is still
not a good choice.
You can also add water to 100% fruit juice or fruit drinks to
water them down and make them better for you.
137
APPLES WITH PEANUT BUTTER
Ingredients Time: 10 minutes
Servings: 1
½ Apple (sliced)
1 Tbsp Peanut Butter
Directions
1. Slice apples and cut out the core.
2. Spread peanut butter on apple slices to taste (approximately 1
Tbsp).
CUCUMBER LEMON WATER
Ingredients Time: 10 minutes
Servings: Class size
Filtered water
1 Cucumber
2 Lemons
Directions
1. Cut cucumber in half crosswise and then slice it lengthwise into 4 sections.
2. Wash the lemons and cut them into thin slices.
3. Put the lemon and cucumber into a pitcher and fill the pitcher with water. Put
the pitcher in the refrigerator to chill.
4. To serve, pour the water into glasses, leaving the lemon and
Cucumber in the pitcher. You can refill the pitcher and reuse the lemon and
cucumber a few times. They will stay fresh for about 2 days if kept cold.
138
WEEK 4
ALL ABOUT FIBER
In this lesson you will learn:
1. The benefits of eating fiber.
2. Different sources of fiber.
3. How to find fiber on the nutrition label.
4. How much fiber is needed each day.
5. Ways to eat more fiber every day.
What is fiber?
Fiber is found in the plants we eat. It is the part of plant that
we cannot digest. It is important to have a high fiber diet to
maintain good health.
Fiber helps lower blood cholesterol and blood sugar levels. It also
improves digestion. Eating more fiber helps you feel full, so you
don’t overeat.
Whole fruits have fiber, but juice does not.
The skin and pulp of the fruit contains a lot of fiber and many
other important nutrients. Juicing removes the skin and pulp
from the whole fruit, removing most of the fiber and many of the
nutrients.
What do you think is healthier: A whole orange or orange
juice?
139
• Which has more fiber, the juice or the orange?
• When an orange is squeezed, what part of the orange is
left behind?
• About how many medium oranges do you need to
make 1 cup of juice?
• Which has more sugar?
• What is better to have, orange juice or an orange?
Where else can you find fiber?
• 100% whole-grain breads, cereals, and tortillas.
• Vegetables like green peas and broccoli.
• Legumes and nuts, like beans, split peas and almonds.
Why do whole grains have fiber, but refined grains don’t?
• A whole grain has three layers: the bran, endosperm, and
germ.
• Whole grains, like brown rice, have all parts of the grain.
• Refined grains, like white bread, have some parts of
the grain removed (the bran and germ), which also
removes the fiber.
• The bran is the outer layer where the fiber is.
Nutrition Comparison
Fresh-squeezed Orange
Juice (1 cup)
Medium Orange
Calories 112 80
Sugar 25g 14g
Fiber Less than 1g 7g
140
• This information is on the nutrition label (if its packaged).
• Fiber is listed under total carbohydrates.
How much fiber do you need?
• It is important to have about 25-30 grams of fiber per day.
• Good fiber foods have about 3-5 grams per serving.
• High fiber foods have 5 grams or more per serving.
Here are some examples of the amount of fiber
in foods:
• ½ cup of cooked green peas
o This has about 4 grams of fiber.
• 1 apple with skin
o This has about 3 grams of fiber.
• ½ cup of baked beans
o This has about 6 grams of fiber.
Adding fiber to your diet is easy:
• Have a bowl of oatmeal or other high fiber cereal for
breakfast
• Try whole grains, like brown rice instead of white rice
• Use 100% whole grain bread for your sandwiches
• Eat more fruits, like raspberries or apples as a healthy
snack
• Add more vegetables, like broccoli or peas, to your meal
• What are some other ways to add fiber to your diet?
We are going try a variety of whole grain foods. Next to each item
will be the nutrition label. Go ahead and taste each item. On a
scale of 1 to 5 (with
5 being the best) rate how much you like the foods by circling
the number on the scale. Then, read the label and find out how
much fiber is in that food. Write this number down too. Do you
like these whole grain foods?
141
Dislike Like
1) Whole wheat pasta. 1 2 3 4 5
Grams of fiber per serving:
2) Brown rice. 1 2 3 4 5
Grams of fiber per serving:
3) Whole wheat bread. 1 2 3 4 5
Grams of fiber per serving:
4) Crunchy Corn Bran cereal. 1 2 3 4 5
Grams of fiber per serving:
5) Quaker Oat Squares cereal. 1 2 3 4 5
Grams of fiber per serving:
6) Quinoa. 1 2 3 4 5
Grams of fiber per serving:
7) Barley. 1 2 3 4 5
Grams of fiber per serving: ____________
142
Ingredients Time: 20 minutes
Makes 4 servings
1 cup
2 cups
1
1-2 tsp
2 cups
¼ cup
1 stem
Whole wheat pasta, uncooked
Fresh tomatoes, chopped (if tomatoes
are not in season, use 1 cup
canned whole tomatoes)
Clove garlic
Olive oil
Vegetables such as zucchini,
eggplant, spinach, peppers
Parmesan cheese
Fresh basil or oregano, chopped
(dried is ok if you don’t have fresh
herbs)
Salt and pepper to taste
Directions
1. Cook pasta according to package directions.
2. To make tomato sauce, sauté garlic in 1 tsp olive oil over medium heat for about 30
seconds, until you can smell it. Add in tomatoes and bring to a simmer. Let cook
for about 5 minutes, breaking up tomato chucks with a spoon, if necessary.
Season with salt and pepper
3. Cut all other vegetables into bite-sized pieces. Cook vegetables by
steaming (or sautéing in 1 tsp olive oil). Season with salt and pepper.
4. Toss pasta, vegetables, and sauce together.
5. Top with herbs and cheese, if desired.
143
WEEK 5
ALL ABOUT FRUITS
In this lesson you will learn:
1. The benefits of eating fruits.
2. Different categories of fruit.
3. To eat 2-3 servings of fruit a day.
4. Ways to eat more fruit every day.
144
A fruit is a part of a plant that you can eat.
Fruits come from the flower of the plant
and contain seeds. All seeds eventually
grow into new plants. Fruits have vitamins
and minerals that are important to maintain
a healthy body. Can you name some fruits
that you like to eat?
Why is fruit good for you?
Fruits also contain vitamins, fiber, and other important nutrients.
They give you energy to play and nutrients to stay strong. It is
important to eat a
variety of colorful fruits every day. And remember, the brighter
the color, the more nutrients the fruit has!
Different categories of fruit
Did you know that there are many different categories of fruit?
Here are some examples of the different groups:
• Berries are small, juicy, fruits like strawberries and
blackberries.
• Stone fruits have a pit in the middle, like a plum. Can you
name three more stone fruits?
• Citrus fruits are acidic, like oranges, grapefruits and lemons.
How much fruit do I need?
It is important to eat 2-3 servings of fruit every day.
• One serving of fruit is one cup of fruit.
• 1 cup of fruit is 1 whole fruit, like an apple or a banana, or
two cupped handfuls, like two handfuls of blueberries.
145
There are many benefits to eating the skin on your fruit. Try to
keep skin on when you eat fruits, if it is edible. For example, you
can eat skin on apples, peaches, and grapes.
• Vitamins and minerals are contained in the skin.
• Fruit skin is rich in fiber.
• The skin also contains anti-oxidants.
Adding Fruit to Your Diet
What are some ways that you can add fruit
to your diet?
• Add berries or bananas to your cereal or oatmeal in the
morning.
• Fresh fruit, like apples, bananas, or oranges make a great
“on the go”
snack.
• Make fruit smoothies! Just put your favorite fruit in a
blender with yogurt and ice.
• Eat fresh fruit for dessert, like mango, watermelon or
berries.
• Make fruit kebobs with chunks of your favorite fruit!
• Eat an apple with peanut butter for a
delicious snack. Can you name some more
ways to add fruit to your diet?
You are going to receive a Mystery Bags with certain fruit in it.
Can you guess what fruit you are feeling? Without peeking,
describe what each fruit feels like, and take your best guess!
Mystery Bag 1: What is it?
146
If you don’t know what it is, what does the fruit feel like?
Mystery Bag 2: What is it?
If you don’t know what it is, what does the fruit feel like?
Mystery Bag 3: What is it?
If you don’t know what it is, what does the fruit feel like?
Mystery Bag 4: What is it?
If you don’t know what it is, what does the fruit feel like?
Mystery Bag 5: What is it?
If you don’t know what it is, what does the fruit feel like?
147
FRUIT RAINBOWS
Now it’s your turn to make a delicious fruit rainbows! In front
of you are several kinds of fruits. Place the fruits in color
order, like a rainbow. Use the yogurt (or cottage cheese) as
clouds!
Ingredients Time: 10 minutes
Makes 3-4
servings
½ cup Purple fruit (like figs or red grapes)
½ cup Blue fruit (like blueberries)
½ cup Green fruit (like kiwi, honeydew melon)
½ cup Orange fruit (like oranges or mango)
½ cup Yellow fruit (like pineapple or banana)
½ cup Red fruit (like watermelon or strawberries)
1 cup Plain, low-fat vanilla yogurt or cottage cheese
Directions
1. Wash all fruits.
2. Cut the larger fruit into cubes.
3. Place the fruit into rows, according to rainbow color order.
4. Use the yogurt or cottage cheese as clouds.
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WEEK 6
GARDEN TO TABLE
This week you will learn:
1. The importance of seasonality.
2. Where our food comes from.
3. Where to get fresh grown fruits and vegetables.
SEASONALITY
Some fruits and vegetables grow better at different times
throughout the year. In Southern California, for example,
watermelon grows better in the summer, and pumpkins grow
better in the fall. We say that fruits and vegetables are “in
season” when they are grown and harvested during their
appropriate time of year.
Why is it important to choose fruits and vegetables in
season?
• They are less expensive.
• They are fresher and taste better.
• They are easier to find.
• You’ll eat a variety of fruits and vegetables over the
year. This helps to make sure you’re getting all
beneficial vitamins and minerals.
Every fruit and vegetable requires a special climate to grow.
Some fruits and vegetables grow better in the summertime,
when it is warm and sunny, while others grow better in the
winter. Fruits that are grown locally, and eaten in their prime,
are the most delicious and healthy.
Here are some examples of growing seasons for fruits in
Southern
California.
• What fruits do you think grow best in the summer?
• What fruits do you think grow best in the winter?
149
Here are some examples of growing season for vegetables.
• What vegetables do you think grow best in the summer?
• What vegetables do you think grow best in the winter?
WHERE DOES OUR FOOD COME FROM?
There are different ways to tell where our food comes from.
Here are some of the ways:
• You can read the labels to find out where they came
from. You can look at the sticker on the fruit or
vegetable, or read the signs in the grocery store.
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Apples * * * * *
Grapefruit * * * * * * * * * * *
Grapes * * * * * * *
Oranges * * * * * * * * * * * *
Peaches * * * * *
Strawberries * * * * * * *
Watermelon * * * * * *
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Asparagus * * * *
Spinach * * * * *
* * *
Beets * * * * *
* * *
Cauliflower
* * * *
Daikon
radish
* * * *
* * * *
Turnip * * *
* * * *
Kale * *
* * *
Broccoli * * *
* * * *
Carrots * * * * * * * * * * * *
150
• You can buy fruit and vegetables that are grown locally.
You can do this by visiting local farmers markets, or getting
a CSA box. CSA stands for Community Supported
Agriculture, and farmers send boxes directly to your home
with fresh fruits and vegetables in season.
• You can grow your own fruits and vegetables! You can
grow these at community gardens, home (in pots,
planters, or in the yard), school, churches, and
community centers.
It is good to buy locally grown fruits and vegetables
This is important for many reasons:
• It helps to provide jobs to workers in our state.
• It helps the environment, since we do not have to
ship fruits and vegetables on a truck or airplane, and
don’t use up fuel.
• Local fruits and vegetables taste better!
151
BEET, CARROT AND AVOCADO SALAD
Ingredients Time: 45-60 minutes
Servings: 8
4 Beets
4 Carrots
2 Avocados, sliced
6 Small limes (or 3 large)
½ cup Onion, chopped
½ cup Cilantro, chopped
2 TBSP Olive oil (or other vegetable oil) Salt
(to taste)
Directions
1. Wash beets well. Cut their stems off but do not peel them.
2. Put the beets into a pot and cover with water. Bring the water to a boil over
high heat, then reduce heat and simmer until tender, about 30-45 minutes.
3. Meanwhile, peel carrots, cut them in half lengthwise, and slice into 1/2
inch pieces. In a separate small pot or in the microwave, steam the
carrots until they are tender.
4. Once the beets are done, carefully drain the cooking water, and rinse them
under cold water. Their skins should slip off easily. Once peeled, slice the
beets into 1/2 inch pieces.
5. Chop onion and cilantro
6. Put the beets and carrots into a medium bowl, add the chopped onion and
cilantro and mix well.
7. Squeeze the limes into the bowl, add the oil, and mix again.
Add salt to taste.
8. Transfer the salad onto a plate and place the sliced avocados around the
edges. Serve with extra lime slices, if desired.
152
WEEK 7:
ALL ABOUT VEGETABLES
In this lesson you will learn:
1. The benefits of eating vegetables.
2. Different groups of vegetables.
3. To eat 2-3 cups of vegetables a day.
4. Ways to eat more vegetables every day.
What is a vegetable?
A vegetable is a part of a plant that you can eat. Vegetables
come in different sizes, shapes and colors. Vegetables also
contain vitamins, potassium, fiber, and other important
nutrients. Like fruits, they give you energy to play and
nutrients to stay strong.
What parts of the vegetable can you eat?
There are many different parts of plants that you can eat. Here
are some examples:
• Roots, like carrot and beet
• Stems or stalks, like celery and asparagus
• Leaves, like kale and spinach
• Seeds like lima beans and peas
It is important to eat a variety of colorful vegetables every day.
Dark leafy greens and bright red, yellow, and orange
vegetables have the most nutrients!
Dark Green Vegetables (like bok choy, spinach, broccoli, kale):
153
• Contain great sources of vitamin C, K, E, and B, as well as
iron, calcium, and fiber. The darker the color, the more
nutrients there are.
• Are great for our skin, hair, and nails
• Contain anti-oxidants, which boost our immune system
and prevent cancer
Bright Vegetables (like peppers, butternut squash, carrot):
• Contain an antioxidant known as beta carotene
• Have minerals like folate and potassium
• Are high in vitamins A and C
Starchy vegetables, like corn and potatoes, should not be
chosen as often. They have more calories and less vitamins and
minerals, compared to other vegetables.
It is important to eat 2-3 servings of vegetables every day. One
serving of vegetable equals:
• 1 cup of raw or cooked vegetables
• 2 cups of raw leafy greens
o These are less dense so you need more to get the same
nutrients
Adding vegetables to your diet:
Vegetables may be eaten raw or cooked. What are some
ways that you can add vegetables to your diet?
• Add broccoli, asparagus, or peppers to breakfast eggs
• Add vegetables to a casserole, pasta, or soup
• Eat a colorful salad as a main dish
• Eat carrots, celery, broccoli, or other raw vegetables for a
healthy snack
154
• Put vegetables on pizza, like spinach or peppers
• Add spinach, lettuce or other vegetables to your sandwiches
• Add vegetables as a side dish for dinner
Can you name some more ways to add vegetables to your diet?
You are going to receive Mystery Bags with certain vegetables in
each bag. Without peeking, can you guess what vegetables you
are feeling?
Describe what each vegetable feels like, and take your best
guess!
Mystery Bag 1:
Describe the vegetable:
What is it?
Mystery Bag 2:
Describe the vegetable:
155
What is it?
Mystery Bag 3:
Describe the vegetable:
What is it?
Mystery Bag 4:
Describe the vegetable:
What is it?
Mystery Bag 5:
Describe the vegetable:
What is it?
156
Ingredients Time: 15 minutes
Makes 1 serving
1 Corn tortilla (8 inches)
1 oz Cheese, such as cheddar or
mozzarella
¼ cup Vegetables (such as cauliflower, onion,
broccoli, bell peppers, spinach),
diced
Salsa
1 Tomato, diced
¼ Onion, diced
½ Jalapeno, minced
½ Lime, juiced
2 sprigs Cilantro
Salt and pepper to taste
Directions
1. Heat both sides of the tortilla on the stove.
2. Add cheese and vegetables to ½ of the tortilla.
3. Fold the tortilla in half, and cook on both sides until the cheese has melted.
4. Mix all ingredients for the salsa together in a bowl.
157
WEEK 8
FOOD AND FAMILY
In this lesson you will learn:
1. The importance of family eating.
2. Different family dining habits.
3. Ideas for dinner discussion at home.
What is a family dinner?
A family dinner takes place when:
• Some or all members of
the family eat together.
• Eating that takes place
at a dining table or in a
common area with
everyone facing each
other.
• Conversations happen during this time.
• Family dinners usually
last at least ½ hour
(30 minutes), but they
can be longer or
shorter.
Why are family dinners a good thing?
• They help you to connect with your family.
• They give you the chance to talk about your day.
• You can learn more about members in your family.
• They help you to enjoy your meal more.
• You may also eat more slowly.
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• You may be more likely to eat healthy foods
when you eat with your family at the table.
Are the following examples considered a family dinner?
o Having a McDonald’s meal in the car on your way to the
mall.
o Eating at a restaurant with some or all of your family, and
talking
about your day.
o Eating dinner with just your brothers or sisters in
front of the TV.
o Eating dinner with just your brothers or sisters at
the dinner table.
o Having leftovers in your room alone while you
finish homework.
o Eating a small dinner when everyone comes
home and quickly talks about his or her day.
159
Here are some questions about
your family dining habits. Answer
these questions, and compare
your answers with your
classmates.
1. How many nights a week do you
eat dinner with your family at a table?
2. Who eats dinner with you? Brother/sisters? Parents?
Grandparents?
3. What time do you normally eat dinner on weeknights?
4. How long does your dinner last?
5. Do you sometimes eat dinner alone?
6. Do you ever eat in front of the TV?
7. What can you do to help start more family dinners?
8. Do you eat different kinds of food when you eat
with your family, compared to when you don’t eat
with them?
• What is your parent’s favorite childhood memory?
• What are your family members’ favorite meals?
• If your family could invite
any famous person for
dinner, who would it be
and why?
• If you could travel to
any country in the
world, where would
you go? Why?
160
• What is something that you
have always wanted to do
but have not done yet?
• Can you remember one of the times you have laughed the
hardest?
Tell the story of what made you laugh.
• What is your earliest memory? Can you
remember when you were 3 years old? 4 years
old? What comes to mind?
• What is your favorite vegetable?
• If you were stranded on a desert island and could
only have 2 single foods, what would you
choose?
• Can you think of a food that you have never tried but would
like to try?
• If you were to write a book, what would it be about?
• What is your favorite smell?
• If you were a fruit, which one would you be and why?
What are other topics you can talk about at dinner with your
family?
161
Breakfast Taco
(That you can eat any time of day)
Ingredients Time: 20 minutes
Makes 4 servings
2 cups Vegetables, like zucchini, kale,
spinach, asparagus, peppers
4 Eggs
4 Corn tortillas
2 tsp Olive oil
Salsa
1 cup Tomato, diced
¼ Onion, diced
½ Lime, juiced
¼ Jalapeño, diced
2 Tbsp Cilantro, or to taste
Salt and pepper to taste
Directions
1. Mix all ingredients for salsa.
2. Chop vegetables and sauté with 1 tsp olive oil in a large pan over medium
heat, until soft (about 5 minutes). Season with salt
and pepper and set aside.
3. Crack eggs into a bowl and whisk with a fork to scramble.
4. Heat 1 tsp olive oil in a sauté pan over medium heat and add eggs. Stir
eggs occasionally as they cook, about 3-5 minutes.
5. Warm the tortillas, and spoon the vegetables and eggs into them.
6. Top with salsa.
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WEEK 9
BREAKFAST
In this lesson you will learn:
1. The benefits of eating breakfast.
2. Ways to make a healthy breakfast.
3. How to make time for breakfast.
4. How to choose a healthy breakfast at school.
BREAKFAST
Breakfast is the most important meal of the day. Eating breakfast
gives you energy for the whole day. Skipping breakfast causes
you to be really
hungry in the morning and can lead you to make unhealthy
choices during lunch. It is important to eat a healthy breakfast
every morning.
Why is eating breakfast important?
• It gives you more energy to be physically active and to do well in
sports.
• It makes you less grumpy and tired in the morning.
• It makes you healthier and helps you
miss less days of school.
• It helps you maintain your weight.
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o It does this by turning on
your metabolism first thing
in the morning.
o Breakfast also helps you avoid
overeating or snacking on
unhealthy foods later.
• It allows you to concentrate, giving you better grades in school.
Can you name some other reasons why eating breakfast is important?
What is a healthy breakfast?
Breakfast needs to be well balanced. It should be low in sugar
and high in fiber. Fruits, vegetables, and whole grain products
are healthy additions to breakfast meals. Try not to eat store
bought cereal bars, toaster pastries and donuts. These have a
lot added sugar in them.
Here are some healthy meals you can make for breakfast:
• Oatmeal with blueberries or other fruit
• Whole grain cereal with strawberries or bananas
• Breakfast burrito with a whole grain tortilla,
eggs, salsa, and spinach
• Low-fat yogurt with granola and berries
• Whole grain English muffin with peanut butter
What are some other foods you can make for a healthy breakfast?
Mornings are always busy and we always seem to run out
of time for breakfast. This activity will help us make sure
that we are still getting a healthy breakfast, even when we
are running late. Being prepared for breakfast will make
busy mornings a lot easier.
In this activity, you will be given a series of scenarios that often
happens in the morning. You are going to solve these scenarios
by thinking of ways to make a healthy breakfast. So, let’s make
breakfast!
164
Are both healthy and taste good. Sometimes it is tempting to
choose breakfast foods that are high in sugar, but these won’t
give you energy for the whole day.
Here are some tips on how to make your school breakfast
healthier:
• Choose the whole fruit, if is offered.
• Stay away from syrup and jelly.
• Choose white milk instead of juice.
• Or, you can bring your own breakfast to school.
You want to prepare breakfast the night
before because you know you will not
have time in the morning. What do you
want to make for breakfast? What can
you do to prepare ahead of time?
You want a bowl of whole grain cereal
and milk for breakfast. What fruit can you
add to make breakfast healthier?
You just woke up and are not hungry yet.
You don’t feel like eating breakfast, but you
know that breakfast is the most important
meal of the day. What can you put in your
backpack so you can eat it on the
bus or before school?
You want to make a healthy breakfast
that includes vegetables. What can you
make with vegetables?
You are running late for school. You only
have 10 minutes to eat breakfast. What
quick and healthy meal can you make and
eat in 10 minutes?
You are very tired this morning and want
to eat something that will provide you
with a lot of energy. What healthy
breakfast meal can you make that will
give you a lot of energy?
165
YOGURT PARFAIT RECIPE
Ingredients Time: 10 minutes
Serving: 4
2 cups Low-fat plain yogurt
1 cup Granola
Fruit, such as berries, peaches,
plums. Try to pick seasonal fruit.
Directions
1. Wash all fruits.
2. Chop large fruits into bit-size pieces and place in a large mixing bowl.
3. Put some yogurt in your bowl.
4. Add some granola on top of the yogurt.
5. Then, add the fruits on top of the yogurt and granola.
166
WEEK 10
SCHOOL LUNCH
In this lesson you will learn:
1. The benefits of eating a healthy lunch.
2. How to make a healthy school lunch.
3. Ways to make healthy food choices at school.
SCHOOL LUNCH
Eating lunch at school can be a great opportunity to eat healthy
and nutritious foods that will give you energy to learn and play in
the afternoon.
Why is eating a healthy lunch important?
• It gives you energy for playing and sports after school.
• It keeps your body healthy.
• It helps you concentrate and do better in school.
• It fills you up, and prevents you from picking unhealthy snacks
later.
• It helps you be more creative and alert.
Can you name some other reasons why eating a
healthy lunch is important?
Choosing a healthy lunch at school
167
It might be difficult to find school lunches that taste good and
are healthy for you. Here are some tips to keep in mind when
you are having lunch at school.
• Try to choose fruit and vegetable options.
• Go for whole grains.
• Colorful meals are better for you, especially with
brightly colored vegetables.
• Try to eat the fruit instead of drinking the fruit juice.
• Choose white milk or water over other beverages.
Sometimes it can be difficult to make healthy food choices when
you are eating in the cafeteria. But there are some healthy
options offered at school.
Circle the healthy foods and beverages below to make a
complete meal. You’ll want to choose one main item, one
side item, and a drink.
168
Main Item Side Item Drink
Grilled Chicken
Sandwich
Baked Potato Wedges Milk- 1%, Fat Free
Beef Burger Slider Fruit Cup Chocolate Milk
Spaghetti & Meatballs Fresh Broccoli & Dip Soda
Vegetable Tamale Carrot Bites Water
Turkey Pita Breadstick/ Bread roll Fruit Juice
169
Making your own lunch:
You can also make sure to get a healthy lunch at school by
bringing your own. Here are some tips for when you pack a
lunch from home:
• Ask your parents for help.
• Sandwiches make a great lunch. Make sure they are on
whole grain bread.
• Bring as many veggies as you can. You can add these to you
sandwich, or bring baby carrots or other cut up vegetables.
• Water is a great drink to keep you hydrated.
• There are lots of other great snacks you can add to your
lunch. Here are some ideas:
o String Cheese
o Fruit
o Hummus and crackers
o Trail mix
THE ULTIMATE SANDWICH
Ingredients Time: 10 minutes
Makes 1 serving
2 slices High-fiber bread
2 slices Turkey breast, or other lean meat
1 slice Cheese, such as pepper jack or
provolone
1 leaf Romaine lettuce
Sliced Tomato, peppers, cucumber, onion
¼ Avocado (optional)
Mustard (optional)
Directions
1. Place the turkey and cheese on the bread. Heat in a toaster oven or
conventional oven to melt the cheese, if desired.
2. Layer on the avocado, lettuce, and other vegetables.
170
WEEK 11
PARTIES AND HOLIDAYS
In this lesson, you will learn:
1. How to choose healthier holiday and party foods
2. How to create healthier meals for holidays and parties.
Holidays and parties are a time when families and friends
gather together to celebrate, and that usually means a lot of
food. The foods that we eat during the holidays and at parties
are not always healthy. Also, sometimes we eat until our
stomach hurts, which is also unhealthy. We celebrate a lot of
holidays and parties over the year, so all that unhealthy eating
adds up!
171
Party food can be:
• High in sugar (like candy, soda and cake)
• Low fiber (like white breads and desserts)
• Highly processed (like chips and candy)
• Non-nutritious (with little vitamins and minerals)
• There can be lots of food and lots of choices, like when
food is served buffet-style.
• We don’t always sit down and eat together at all holidays
and parties, which can mean lots of snacking.
Making party meals healthier
Be creative and think about how to make food healthier at a
party. If you are invited to a family party, you can bring a healthy
snack or side dish to share with everyone, that way you know
you will have something healthy to
eat. Or if you have a birthday party, you can choose to
provide healthier food at your party.
celebrations. What foods are healthier than others? Can you
brainstorm healthy food options to replace the unhealthy ones?
Birthday Party
• Frosted cake
• Pizza
• Soda or juice
• Piñata full of
Holidays
• Tamales
• Turkey or Ham
• Mashed potatoes
• Pies and other
Family Picnic
• Fruit punch
• Aqua frescas
• Carne asada
• Tortillas
candy holiday deserts • Chips and dip
• Chips and dip • Hot chocolate • Cookies
172
• Veggie plate • Salad • Candy
• Water
•
•
• Red apples,
grapes
•
•
•
•
Here are some tips to avoid eating too much:
• Use a smaller plate.
• Chew on sugar free gum or mint. This will leave you with
a clean taste in your mouth and will keep your mouth busy.
• Drink lots of water.
• Eat slowly, and pay attention to when you start to feel full.
• Eat a healthy snack at home before going to a party. This
way you will not be as hungry and won’t be as tempted to
make unhealthy choices.
• Only eat when you are sitting down. This will help you avoid
mindless snacking.
173
BEAN SALAD WITH PITA CHIPS
Ingredients Time: 20 minutes
1 tsp Olive oil
1 Clove garlic, minced
2 cups Cooked black beans, drained
2 Tbsp Water
¼ Red onion, chopped
½ Bell pepper, chopped
½ Jalapeno, minced
¼ cup Cilantro, chopped
Squeeze lime juice (optional) Salt
Whole wheat pitas or tortillas
Makes 4 servings
Directions
To make dip:
1. Heat oil in a medium pan over medium heat. Add the garlic and cook until you
can smell it, about 30 seconds.
2. Add the beans and water and mash until they are smooth.
3. Add all the other dip ingredients and mix.
To toast pitas (optional):
1. Heat the grill/griddle, or heat the oven to 400 degrees.
2. To make the pita chips, cut the whole pitas into 8 wedges.
3. Put the wedges on a baking sheet, or directly onto the grill/griddle, and cook
until crisp and slightly browned, about 5 minutes.
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WEEK 12
REVIEW
In this lesson you will learn:
1. Review what you have learned in the nutrition lessons.
2. Review the importance of healthy eating.
3. Review ways to incorporate healthy habits into every meal and s
nack.
4. Let’s Play Jeopardy!
175
Sugar Fruits &
Veggies
Fiber Family
Dining
Real
Foods
Cooking Meals
100
Which is
better,
drinking
orange juice
or eating an
orange?
100
Name 3
yellow fruits.
100
Name 2
whole grain
foods.
100
What is one
healthy drink
you can have
at a party?
100
T/F:
Processed
food is
better than
real food.
100
Name 3
ingredients
that go into
salsa.
100
Name 1
healthy
breakfast
food with
whole
grains.
200
T/F: Sports
drinks are
low in sugar
and good
for you.
200
Name three
vegetables
that are dark
green.
200
What is one
benefit of
fiber?
200
What are three
questions you
can ask your
family at
dinner?
200
Name 3
real foods.
200
Name
three easy
snacks you
can make
at home.
200
Name 2
lunches
that
include a
leafy
greens.
300
What is the
difference
between
natural &
added
sugar?
300
How many
servings of
fruits and
vegetables
should we eat
each day?
300
How much
fiber should
be eaten
every day?
300
Name 2 things
you can put in
a piñata
instead of
candy?
300
Where can
you find
real food?
300
How long
should you
wash your
hands for?
300
Name a
healthy
breakfast
you could
eat “on the
go”
500
What is
maximum
amount of
sugar we
should eat
in a day?
500
How big is 1
serving of
vegetables?
500
Name one
part of a
whole grain
kernel that is
not found in a
white kernel.
500
What are three
benefits of a
family dinner?
500
What is
one benefit
of real
food?
500
Name a
benefit of
cooking at
home.
500
Name two
reasons
why it is
important
to eat a
healthy
breakfast
176
STRAWBERRY BALSALMIC SALAD
Ingredients Time: 10 minutes
Makes 4 servings
½ Head lettuce, chopped
½ cup Sliced strawberries
¼ cup Chopped walnuts
2 Tbsp Green onions, diced
2 Tbsp Cotija cheese
1 Tbsp Balsamic vinegar
2 Tbsp Olive oil
Salt and pepper to taste
Directions
1. Mix chopped lettuce, strawberries, walnuts, green onions, and cheese in
a bowl.
2. Mix oil and vinegar in a separate bowl.
3. Pour oil and vinegar on salad mixture and serve.
4. Add salt and pepper to taste.
177
Appendix 4 - Gardening Lessons
WEEK 1
3
WELCOME ORGANIC GARDENERS!
What we would like
you to learn:
1. Meet your teacher and get to know your garden group.
2. Tour the garden “before.”
3. Learn the garden rules.
4. Learn about the history of agriculture.
5. Discuss why it is important to grow our own food.
• Break up into groups:
• Meet your group members
• Name five qualities of your group’s vegetable
For example, a red
delicious apple:
Red in color
Sweet tasting
Grows on trees
Has small brown seeds in its core
• Go over Garden Rules
What are some reasons it is important to grow my own food?
Save money – growing my own food is economical
3
Adapted from LA Sprouts Website: http://www.lasprouts.com
178
Better flavor – the fruits and vegetables that I grow taste
better than those I can buy in the store
Health – eating fruits and vegetables is good for my health and
the
health of my family
Being outdoors – being in the garden gets me outdoors in
the sun and breathing fresh air
Good exercise – gardening is a form of exercise and it’s good
for my health
Special crops – I can grow special crops that are important
to my culture and that I can’t find in the stores
Relaxation – gardening and being around green plants helps
me to relax and de-stress
Community – gardening is a way to connect with my
friends and community
Beauty – gardens with vegetable and fruit plants, flowers and
trees are colorful and beautiful; they attract birds and
butterflies
History of agriculture
Humans developed agriculture at least 10,000 years ago. Early
humans started out as “hunter-gatherers” who would follow animals
around to hunt them and gather plants where they found them
growing in the wild.
179
Humans evolved into agricultural societies when they started to plant
crops purposely to eat. Some of the earliest crops that humans
planted include wheat, barley, peas, lentils, figs and flax in the Middle
East. Other early
crops in the Americas include corn, potatoes, tomatoes, peppers,
squash and beans.
During periods of exploration and colonization (1400s-1600s),
agricultural crops were traded. Crops and animals that were
previously unknown were introduced to other parts of the world.
During the Industrial Revolution (1800s-1900s), the invention of
machines took place that made farming easier, faster and on a
larger scale. After World War II, the use of chemical pesticides and
fertilizers became more common. Since the 1970s, there has been
a return to organic farming because of a rising awareness of the
damage agricultural practices and use of chemicals can have on our
environment.
Let’s define the following terms:
Organic: Raised without the use of drugs, hormones, or
synthetic chemicals
Agriculture: the science, art, or practice of cultivating the soil,
producing crops, and raising livestock
Environment: our surroundings; all living and non-living things that
occur naturally on Earth
FUN Fact(s) of the week:
• There are over 500 different varieties of bananas.
• Peaches are the third most popular fruit grown in America.
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• Archeologists have found evidence that humans have
enjoyed eating apples since 6500 B.C. On average, today
each American eats more than 19 pounds of apples
annually.
• It takes 540 peanuts to make one 12 ounce jar of peanut
butter.
Agriculture is everywhere in our lives!
• Products we use in our everyday lives come from plant and
animal products produced by farmers:
o Health Care: Pharmaceuticals, surgical sutures,
ointments, latex gloves, X-ray film, gelatin for capsules
and heart valves.
o Construction: Lumber, paints, brushes, tar paper, tool
handles
o Transportation: Fuel, lubricants, antifreeze, tires,
upholstery
o Manufacturing: Glues, solvents and detergents
o Printing: Paper, ink and film
o Personal Care Products: Shampoo, cosmetics, lotions,
finger nail polish and toothpaste
o Education: Crayons, textbooks, desks, pencils and paper
o Sports: Uniforms, baseball bats, leather equipment and
shoes
Test yourself:
Word Search
Agriculture Cantaloupe Soybeans
Animal Carrots Strawberry
Apple Cauliflower Sugar beets
Asparagus Celery Tomatoes
Barn Cheese Tractor
Beans Cherry Trout
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Beef Pork Turkey
Blueberry Potatoes U-Pick
Butter Safety Vegetables
Cabbage Seed Weather
Sheep Weights
S E L B A T E G E V D N C C R A N B E R R I E S
T G Q F A I R S C A B B A G E P G R A P E S C U
R G F L Y T N U O C E R R R I P T H
K E N E U G A G R I C U L T U R E R
R A S L E U F A R M C A W P E P P
E R S C A F S O I D E M N R C A I U
R B A S E R U S A E M I N T N K C I
P U H B L M B E S E E D A N D L I V
E S T O C K S I E L K B E
R P O T A T O E S L F L O W E R S V T S J B E E
R O C H R I S T M A S T R E E S A
N I M A L R T Y R R E B E U L B R P
X C A N T A L O U P E S S
R K S P E A R S U F E P H A V C H S O N I O N S
R O U N T R O U T G S U O S U E P
L U M S A HT E R G E F E E D T Q T
R R A H L T U R K E Y A U
H G A K A T Z P E I I Y S F O E I C I B E O R N
C A R C L S R Y R D C S E E N R W
F L K L B V A A N A I L O E X E E I E
V T E Y J O L U I S E G W I P H T P
T B H L D L C Y Y W S R T O W P S I
H C S C C M A E T I E P G R C H E
E S E W E T H E B A P Y O W A A S
S A Q I E N C O R N K E L C
A R E D I C D N E F E M O H M A R
K E T M H R I T O M A T O E S W E I
G H T S S M O O R H S M
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On your own:
• Tonight at home or before the next class, think about
someone you know who has a garden and grows their
own food. It could be a member of your family – your
grandmother or grandfather, your mom or dad, one of
your aunts or uncles; maybe a neighbor on your street or
one of your friend’s parents. What does this person grow
in their garden? Can you remember one fruit or
vegetable that this person grows? If you can’t
remember, ask your mom or
dad for help, or better yet, call up this person on the
telephone and ask them what they grow. Take notes
about this in your journal.
• Next, imagine you could grow anything you want in your
garden.
What would you grow? Would you grow your favorite
fruit or vegetable? Would you grow something special
for your mom or
dad to cook for dinner? Maybe you would grow something
special
to share with your friends. In your journal, write about
what you would grow in your garden. Next week we’ll
talk about it in class.
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WEEK 2
PLANNING YOUR
GARDEN
What we would like you to learn:
1. Learn how the sun and shade are important for planting.
2. Learn about the different soil textures.
3. Learn how to test your soil before planting your garden.
Is there enough sun where I want to grow my vegetables?
• Fall and winter vegetables need 4-6 hours of direct sunlight.
• Spring and summer vegetables need 6-8 hours of direct
sunlight.
North, South, East, and West: Which direction is best?
We know that the sun rises in the east and sets in the west. Fruits
and vegetables in your garden will be planted in rows from east to
west, where plants on the eastern side of the garden will absorb the
most sun. You can also plant rows from north to south for even
sunlight. Taller plants such as fruit trees or corn should be planted
in the northern part of your garden. This way they do not block the
sunlight of the smaller plants, such as berries or lettuces.
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Activity: Draw
in your favorite
fruits and
vegetables in
the space
provided to the
right.
Remember that
taller plants
should be
planted in the
northern part of
your garden.
Let’s define some of the following terms:
Sand
Sand is the main particle in soils. You know that soil is sandy by
how it feels when you rub it between your fingers. Sandy soil is a
combination of rock, quartz, or silica. By itself, sandy soil does not
have enough nutrients to grow a healthy garden.
Clay
Clay is also a type of soil. Dry clay is hard and smooth to the touch,
like a clay pot. When wet it is very sticky. Clay is full of nutrients
and is made from small rock particles. Water and air have trouble
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making it through dense clay soils so they are not the best for
growing plants.
Silt
Sandy soil and clay make silt when they are combined. It is powdery
to the touch and does not stick together when it is wet.
Loam
When you mix sand, clay, and silt, you create loam. Loam breaks up
easily when it is in your hand, so air and water can easily pass
through. It is the best type of soil for growing plants.
Testing your garden’s soil
• Just as our bodies need nutrients, plants need nutrients too.
Nutrients for plants are derived from the sun, the soil texture,
and the minerals in the soil.
• It is important to test your soil to see whether it is acidic or
alkaline.
This is done using the pH scale. The pH scale ranges from 1-
14 and allows you to measure whether your soil environment
is alkaline or
acidic.
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• If your soil is either too alkaline or too acidic, your plants
will not be able to absorb the mineral nutrients they need to
grow.
In Class: Using the pH test.
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Acidic soil: Anything ranging from 1 to 6.5 is considered acidic.
Calcium and magnesium are harder for plants to absorb.
Alkaline soil: Anything between 7.5 and 14 is considered
alkaline. Iron zinc and manganese are harder for plants to
absorb.
Neutral: The neutral zone is between 6.5 and 7.5 on the pH scale.
This is best for a healthy garden.
Some examples of fruits and vegetables on the pH scale:
Blueberry: 4.5 Cantaloupe: 7.5 Carrot:
6.0
On your own:
• Write in your journal about different places that could
become a garden. Think about the places around your
home or that you pass on your way to school. What does
the soil look like? Where is the sun? Discuss the steps you
would need to take to plant a garden there. Sketch a
design for a garden.
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WEEK 3
HOW TO START SEEDS AND HOW TO GARDEN SAFELY
What we would like you to learn:
1. Learn how to use tools safely in the garden.
2. Learn how to sow/plant your seeds.
3. Learn how to transplant.
Tool Safety
Tools help us to carry out tasks in the garden and we need to
use them safely. Tools can be sharp, so we have to handle
them with care and awareness. Tools can be heavy, so we
want to carry them carefully. Tools can be dangerous if left out
on the ground. We might trip over them, stub our toe, or fall
over and hurt ourselves. We always want to store tools
carefully to prevent accidents and so that we know where to
find them.
The most important tool we have as gardeners is our hands.
We use our hands for sowing, transplanting, weeding, and for
taking care of our plants. We can keep our hands safe by using
gloves.
We also want to wash our hands thoroughly after gardening
so that we don’t accidentally ingest any of the soil or
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microorganisms that we may touch while gardening.
Sowing Seeds
How do I sow a seed?
Sowing is another word for planting. Seeds should be planted 2-3
times the depth of its own size. We also want to water the soil
where we’ve planted our seeds to help them germinate.
Advanced Tips:
Scarification - Some seeds germinate more easily if they are
scratched beforehand. This is called scarification. Why might this
be?
Soaking seeds overnight – some seeds are faster to germinate if you
soak them overnight
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Transplanting
What does transplanting mean?
Transplanting means to move a plant from one spot to another
How do we transplant our vegetables without damaging them?
We do not transplant when the sun is high or hot! We
choose a cloudy day or transplant in the early morning or
towards the end of the day so that plants can settle in to
their new location before it gets to be too hot.
We turn the pot upside down and gently tap the bottom of
the pot to slide the plant out with care. Tickle the roots of
the plant and loosen up the root ball before placing the
plant in the ground
How big of a hole do we need to dig for our transplants?
We dig a hole that is twice the size of the diameter of the
root ball and just about the same depth of the root ball.
What if we are transplanting several vegetables that are
growing together in one pot?
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We gently rip them apart so we can give each of the
vegetable plants more space to grow into their new spot.
Let’s define the following
terms: Sowing: another word
for planting seeds
Transplanting: moving a plant from one location to another
Germinate: the moment when seeds break dormancy
Scarification: the process of scratching seeds to increase their
chance of germinating
FUN Facts of the week:
• Most of our food comes from seeds. Our breakfast cereal,
our tortillas, the spaghetti and pizza that we eat – all
started as seeds from different grasses
• Some seeds found in frozen soil in Canada were sown
and they germinated. Plants grew that produced flowers -
even though the seeds were thought to be more than
10,000 years old!
• Some orchid seed-pods hold 3 million seeds.
• Some seeds are poisonous and very dangerous. The
Castor Bean plant produces seeds that may look beautiful
and tasty, but should never be eaten. One Castor Bean
seed can kill an adult.
• Most oak trees don't grow acorns until they are at least 50
years old.
If you plant an acorn today and grow an oak tree from seed,
how old will you be before you can plant its acorns?
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On your own:
• Food for thought: See if you can identify seeds in your
snacks and meals this week. If you have a piece of fruit,
see if you can find its seeds. Think about what plants may
have been used to make the meals you eat.
• In your journal, draw a picture of some of these seeds and
bring it to class next week.
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WEEK 4
COMPOSTING
What we would like you to learn:
1. Learn about compost and why it’s better for the
environment
2. Learn how to build an open compost pile
3. Learn how to maintain your compost pile
4. Learn how to use your compost in the garden
Re-using our Waste
• Recycling is the process by which we take used or
waste items and reuse them. This helps the
environment by cutting down on extra waste.
• About half of our garbage is organic waste from items
such as food and paper. Organic waste is full of
nutrients that can be absorbed by the plants in our
garden when applied as compost.
• When we use compost, we keep extra trash from
entering the giant landfills that we see in the pictures
below.
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Fact: Most
Americans generate
4.6 pounds of trash
every day.
Building Your
Compost Pile: The
Green and Brown
Lasagna
Imagine a giant piece of lasagna, with green and brown layers. This is what
your compost pile will look like. Just from the colors, you know it is not the
kind you want to eat. But it is perfect for feeding your garden!
To build your compost, you will start by layering
“greens” and “browns” from the chart.
You will do this until your
compost pile is about three feet
high.
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*DO NOT add to your compost: Meat, Fat, Cooked Fruits,
Cooked Vegetables, Diseased Plants, Ashes, Human
Waste, or Manure for meat-eating animals.
Bonus Question: What do the greens and
browns in the chart above have in common?
Maintaining Your Compost Pile
Much of the maintenance work is done naturally! After a few
days, your compost pile becomes a factory where your “greens”
and “browns” are broken down by different factory workers:
worms, bugs, slugs, mushrooms, and molds.
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Within just a few days, your compost pile will begin to heat up. This is
a
sign that your factory workers are doing their job! Occasionally,
your factory workers will need a break for water, so water your
pile from time to time.
Also turn your pile regularly so that they get a breath of fresh air.
Using Your Compost
How do you know when the compost is
ready to use?
When you are no longer able to recognize what is in your
pile. This could take up to a year or as little as a month.
Tip: The smaller you chop your greens and browns, the easier it
will be for the bugs to eat your trash. Remember, bugs have
small mouths. Also, the more you turn your pile the faster your
factory workers will make compost. Turn your compost pile once
a day, and you could get compost in a month!
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Let’s define some of the following terms:
Landfill: An outdoor area designated to receive all of our waste.
Organic: Substances created from living organisms. Leftover food
from your meals would be “organic” waste.
Compost: a mixture of decaying organic substances. We reuse
these substances as food for our garden instead of adding them to
landfills.
Matching:
For each item, write a “1” for organic waste or “2” for non-
organic waste. Refer to the list of greens and browns to see
the different organic items that can be added to the compost
pile.
Banana Peel
Old T-shirt
Vegetable Oil
Apple Core
Paper Bag
Newspaper
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FUN Fact(s) of the week:
• There are hundreds of million billions of
microorganisms in just one handful of our garden soil.
That is more than the entire human population on our
planet.
On your own:
• Bring home an item from home to compost. If you need
help figuring out what to bring, refer to the list of “greens”
and “browns” Think about what items you might normally
throw away on the list. If you might throw away a banana
peel and a paper bag from lunch – that would be one
“green” and one “brown.”
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WEEK 5
RECYCLE, REDUCE, AND REUSE ORGANIC GARDENERS!
What we would like you to learn:
1. Learn about the 3 R’s: recycle, reduce, reuse
2. Learn about our Earth’s natural resources and why it is
important to recycle and reuse materials
3. Learn some techniques for reduce, reuse, recycle in the garden
4. Discuss ways to reduce, reuse, and recycle at home
Conserving our Earth’s Natural Resources
There are many types of conservation. One of the most
important is the conservation of our natural resources on
Earth –our air, water and land. The 3 R’s help keep the
resources we have already mined in production, allowing
less land to be mined or cut and putting less waste in the
ground. Reducing and reusing are important. They reduce
the need for more energy in the production of materials.
Let’s consider the life cycle of a plastic bottle:
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Before we drink water from a plastic bottle, consider the journey
that the bottle has been on.
Plastic starts out as petroleum (or crude oil), one of Earth’s natural
resources. Petroleum has to be extracted from the ground and
transported in long pipelines to chemical plants where it can be
refined. Plastic bottles are made using refined crude oil and other
chemicals.
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Why is it important to think about how many plastic bottles we
use?
Recycling saves natural resources.
Plastic bottles use energy and other natural resources to be produced.
Fact: To produce one plastic bottle requires three to seven
times its volume in water and approximately a quarter of its
volume in oil.
Recycling saves energy.
Transportation of plastic bottles uses more fuel.
Fact: Many plastic bottles are shipped to the United States on big
boats from places as far away as Latin America, Europe, and the
Pacific
Islands. Once these bottles arrive in the United States, they are
transported by trucks or trains to grocery stores. These boats,
trucks and trains use fuel – gas and oil – just like our cars. This
causes us to
dig for more oil and adds to pollution in our atmosphere.
Recycling saves our environment.
Throwing away bottles into the garbage after each use adds more
trash to our landfills.
Fact: Plastic takes many years – more than a lifetime! – to
degrade
or break down. Recycling plastics is a difficult process. A big
problem is that it is difficult to sort plastic waste and requires a
lot of people to do this, making it labor intensive.
Let’s define the following terms:
Recycle: To collect, separate, and process an item that would have
been thrown away, and reuse it or re-manufacture it into a new item.
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Reuse: To use again. To use an item a second, third, etc. time
after its original use.
Reduce: To use less. To cut down the use of an item.
Instead of throwing away a plastic water bottle after each use,
here are some other ideas:
Reuse the bottle:
• Refill your bottle with water from the tap at your home.
Tap water is clean, safe and free! It will save money
each time you refill your water bottle because you won’t
spend money on buying a new one.
• Find another use for your plastic bottle in the garden!
Exercise: How to make a deep watering can out of a two liter
empty bottle.
o Remove the cap.
o Cut off the bottom of the bottle with
scissors. (Please ask an adult to
supervise)
o Turn the bottle upside down.
o Set the spout into the
ground or pot. (About 6
inches deep)
o Fill with water.
This method will allow deep vegetable roots to get watered.
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Here are some other examples of things at home that you can
“reinvent” for use in your garden:
1. Use empty citrus rinds for the simplest seed-starting container of
all.
Just fill the rind with potting soil, place one or two
seeds in each, support it upright, and water to moisten
the mix. hin to one seedling
per rind. Transplant the whole unit into the garden. The
rind will decay into the soil, and the roots will benefit by
the fertilizer close at hand.
2. Slip half-gallon milk cartons with the tops and
bottoms cut off over celery plants to blanch them as
they grow.
3. Save your mom’s used pantyhose to hang individual
fruits and vegetables from trellises and to protect
them from birds, earwigs, snails, and other
munchers. This works well for corn, cucumbers,
grapes, melons, peaches, small pumpkins, and
squash.
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How can I practice the 3 R’s
at home?
For each of the following ways to recycle, reuse, reduce,
think of an example of how you can do this at your home
with your family.
Buy items with less packaging:
Buy less stuff:_
Share:
Look for things that are made from recycled products:
Recycle at home using your blue bin:
Buy second-hand items:
FUN Fact(s) of the week:
• The first synthetic plastic was invented in 1856.
• It’s estimated that an average family of 4 in the
United States takes home 1,000 plastic bags each
year from the store.
• Recycling one aluminum can saves enough energy to run
a TV for three hours.
• If all our newspaper was recycled, we could save about
250,000,000 trees each year!
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Test yourself:
• Which of the following are some examples of the Earth’s
natural resources? (circle all that apply)
a) Water
b)Petroleum/Crude Oil
c) Automobiles
d) Forests
• Match the following item at your home that you might
otherwise throw away into the trash with a corresponding
second use.
Item Second Use
Popsicle stick Storage for my extra toys
Plastic bag Label for my seedling
Old shirt that doesn’t fit anymore Pick up my dog’s poop
Cardboard box A rag for cleaning
On your own:
• Take a look at what your family throws away into the trash
at your home tonight. How many things can you count that
could be recycled or reused?
• Write about the things you counted in your journal
and tell us about it next week in class.
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WEEK 6
WHERE DOES WATER COME FROM?
What we would like you to learn:
1. Learn about the best time to water your vegetables.
2. Learn how to check if your vegetables need water
3. Learn about the Water Cycle.
Break-up into your groups:
Artichokes, Beets, Carrots, Daikons
Go to your plot and answer the following questions in your
journals:
What seeds sprouted and which ones did not?
Use your rulers to measure the height of the
sprouted seedlings. Draw a picture of your
sprouted seedling in your journal and
indicate the height.
How many leaves do your seedlings have?
What color are your seedlings?
Do you see any insects on your seedlings? If
so, draw them in your journal.
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Did your transplants survive? If so, are they
bigger than your seedlings? Why do you
think?
Plants drink water too!
Along with sunlight, oxygen, and minerals
from the soil, vegetable plants need
water to stay happy and healthy. Did
you know that about 90% of a vegetable
plant is water? Here are a few questions
and answers regarding your vegetables
and water:
When should I water my vegetable plants?
In the morning before the sun is high in the sky. This reduces the
amount of water lost to evaporation and also gives the vegetable
plants ample time
to dry off before the sun sets, reducing the chance of mildew, fungus,
and other diseases. Avoid watering your vegetables in the middle of
day when it is hot!
How do I know when my vegetable plants need water?
Use your forefinger (pointer finger) to do a “Feel” test. Put your
forefinger into the soil. If you feel the soil is dry, it’s time to water
your veggies. You
may also use a dry thin branch to check for moisture.
What are some signs that a vegetable plant is stressed from lack of
water? The leaves may wilt and droop. The leaves may start to turn
yellow and brown at the tips. The plant’s growth will be stunted and it
will look weak.
How much water should I give my vegetable plants?
Enough to keep the soil moist; however, the soil should not be
soaked. Overwatering your vegetable plant can cause problems too.
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When we overwater, we prevent the plant’s roots from obtaining
oxygen from the soil.
The Water Cycle
Did you know that the same water that existed on Earth millions of
years ago is still present today?
We are drinking the same water that the dinosaurs drank. The water
keeps moving around and through the earth in what we call a “Water
Cycle.” It continues to change forms.
What are some
of the forms
water takes?
• Rain (Liquid) • Snow
• Hail • Sleet
• Ice • Vapor
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What are the main parts of the water cycle?
Evaporation: When the sun heats up water in
rivers, oceans and lakes, turning the water into
steam.
Condensation: Water vapor in the air gets cold
and changes back into liquid, forming clouds.
Precipitation: When a lot of vapor has condensed and
the clouds can no longer hold the water, it falls back to
the Earth’s surface in the form of rain, sleet, hail or
snow.
Collection: When the water hits the surface of the
Earth, it flows into the Earth’s streams, rivers, lakes
and oceans or gets collected as ”ground water.”
Ground water is the water that is stored underneath
the Earth’s surface in between rocks and soil.
Did you know that much of the water we
drink comes from the ground?
Ground water is collected by our community water
systems and that gets transported to our faucet by
municipal waterways.
Why is it important to conserve and protect our water?
We’ve had our water since dinosaurs roamed the earth, and we
want to keep it safe, accessible and clean for generations to
come.
What are some ways we can protect and conserve
our water systems?
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As gardeners, we can avoid putting harsh chemicals into the soil.
We can focus on keeping our soil healthy through natural methods,
such as
encouraging worms to grow or by applying compost to the soil, and
in that way, we keep our water system clean.
As environmental stewards, we can conserve water. We can water
our plants carefully instead of leaving the hose on and letting it run-
off into the street. We can do little things at home too; for example,
we can shut the water off when we brush our teeth instead of letting
it run.
FUN facts of the week
• 97% of the water on earth is in the oceans
• Only 3% of the water on earth is freshwater
• About 2.4% of the water on earth is permanently frozen in
glaciers and at the polar ice caps
• It takes 39,090 gallons of water to make a new car, including
the tires
•
Match the question with the answer for more fun facts:
1 - How much water pipe is there throughout the US & Canada?
2 - What were the first water pipes made of in the US?
3 - How much water does one person use in a day?
4 - How much of the earth's surface is water?
5 - How much of the earth's surface water is drinkable?
6 - Water freezes at what temperature?
7 - Water boils at what temperature?
8 - How much of the human body is water?
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A - Hollowed out logs E - 32 degrees Fahrenheit
B - 80% F - About a million miles
C - 66% G - 50 gallons
D - 1% H - 212 degrees Fahrenheit, 100
On your own:
• Pour yourself a glass of water. In your journal, write a story
or
draw a map about where your water has been and how it
landed in your cup.
• Thought question: What are some of the ways that we
can save water? What are some of the ways that we
can keep our water collection systems clean?
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WEEK 7
PLANTS NEED ENERGY TOO!
What we would like
you to learn:
1. Learn what a plant needs to grow.
2. Learn about the Life Cycle of a plant.
3. Learn the parts of a flower.
4. Learn why many plants depend on bees in order to reproduce.
When people need energy, we can eat a healthy snack or a well-
rounded meal. What about plants? How do plants get the energy
they need to grow?
To obtain energy, plants undergo a process called photosynthesis.
During photosynthesis, plants use the light energy from the sun to
convert carbon dioxide and water into chemical energy that they store
in their leaves as sugar.
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What do plants need to undergo photosynthesis?
• Light energy (from the sun)
• Water (absorbed from the soil through the plants’ roots)
• Carbon dioxide (from the air)
• Chlorophyll (stored in the cells of plants, chlorophyll is
what gives plant leaves their green color)
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The Life Cycle of a Plant
In the same way that we ask the question: “what came first, the
chicken or the egg?” we can also ask, “what came first, the plant or
the seed?” A plant starts as a seed; this is its first stage of its life.
From a seed, the plant becomes a seedling. From a seedling, the
plant grows into a full grown, or mature plant.
How does a plant produce seeds?
Plants produce seeds through their flowers (the function of a flower
is to produce seeds, and in this way, continue the Life Cycle of a
plant). For a flower to produce a seed, it must be pollinated.
During pollination, pollen grains travel from the stamen of the flower
to the stigma. Once on the stigma, the pollen grains stick and grow a
long tube down the style all the way to the ovary of the flower. In the
ovary, the tiny eggs are fertilized and become seeds. The ovary of
the flower becomes the fruit that contains the seeds. This process is
called fertilization.
How do pollen grains travel from the stamen to the stigma?
Pollen grains can reach the stigma in several ways. In some
cases, an insect or a butterfly will feed on the nectar of the
flower and brush up against the stamen. Their bodies transfer
the pollen to the carpel and pollination occurs. In other cases,
the wind might cause the pollen to fly
from the stamen to the stigma. Flowers can also become pollinated
with the help of birds, bats, beetles and bees
Why Honeybees need Flowers and Flowers need
Honeybees
Honeybees are attracted to flowers because they consume the
flowers nectar as a source of energy. Honeybees also collect pollen
to bring back to their hives as food for larvae. When honeybees
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hover over a flower, drinking its nectar or collecting pollen, they help
the flower to become pollinated.
Bees are fuzzy. Their bodies are like Velcro. When they fly over a
flower, pollen grains attach to their bodies. When they fly on to the
next flower, these pollen grains may get caught on the flower’s
stigma. This is why honeybees are referred to as pollinators.
FUN Facts of the week:
• Bees carry a static electrical charge, which makes it even
easier for pollen to stick to them!
• If it weren’t for bees, thousands of plants would not get
pollinated – and the Life Cycle of plants would be broken.
The fruits that we cherish and enjoy would not be as easy
to find.
Let’s define the following terms:
Photosynthesis: the process by which plants convert light
energy into chemical energy and store it as sugar
Chlorophyll: a biomolecule that gives plants their green pigment and
helps plants to obtain energy from light.
Seedling: a young plant
Pollination: the process by which pollen grains travel from the
stamen of the flower to the stigma
Larvae: the early life stage of an insect such as a honeybee. Larvae
develop from eggs. As larvae develop, they spin a cocoon and in this
way grow into pupae that become adult bees.
Abstract (if available)
Abstract
BACKGROUND: This was an experimental study to determine whether a garden based nutrition curriculum would influence knowledge, preference, and fruit and vegetable consumption among elementary children. ❧ METHODS: The study was conducted at the afterschool program at Boys & Girls Club, City of Stanton and approved by the University of Southern California Institutional Review Board. The participants for this study were divided into an experimental group and a control group. Twenty students participated in the intervention program and completed the 12-week afterschool program. Meanwhile, twenty, fourth to sixth grade students from the Anaheim Achieve afterschool program, who were not enrolled in the intervention program, served as the control group. The Boys & Girls Club participants received weekly 75 minute, interactive classes for 12 consecutive weeks during January to April 2016. The nutrition, cooking and gardening curriculum were used from the LA Sprouts web-site with the permission of Dr. Gatto, the Director of the LA Sprouts. A questionnaire was used to determine pre-post differences. It consisted of five subscales assessing participants’ fruit, vegetable consumption per day, dietary assessment, background information, and family eating habits. ❧ RESULTS: Compared to pre-measures in the experimental group, after the intervention, the participants of the experimental group ate more fruits on average day (2.13 vs. 3.17
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Asset Metadata
Creator
Mathew, Elizabeth K.
(author)
Core Title
Childhood obesity and prevention: nutrition, cooking, and gardening learning approach for an educational intervention program to increase fruit and vegetable knowledge, preference, and consumptio...
School
School of Policy, Planning and Development
Degree
Doctor of Policy, Planning & Development
Degree Program
Urban Planning and Development
Publication Date
07/25/2018
Defense Date
06/15/2016
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
childhood obesity,OAI-PMH Harvest
Format
application/pdf
(imt)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Lewis, LaVonna B. (
committee chair
), Natoli, Deborah (
committee member
), Priester, Joseph (
committee member
)
Creator Email
emathew@marshall.usc.edu,noel998@att.net
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-c40-281945
Unique identifier
UC11281193
Identifier
etd-MathewEliz-4639.pdf (filename),usctheses-c40-281945 (legacy record id)
Legacy Identifier
etd-MathewEliz-4639.pdf
Dmrecord
281945
Document Type
Dissertation
Format
application/pdf (imt)
Rights
Mathew, Elizabeth K.
Type
texts
Source
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA
Tags
childhood obesity